scholarly journals Evaluation of a Community Pharmacist Managed Asthma Consultation Service

2021 ◽  
Author(s):  
John Odame
Keyword(s):  
Diurnal Variation ◽  
Positive Impact ◽  
Critical Role ◽  
Intervention Group ◽  
Asthma Management ◽  
Controlled Study ◽  
Asthma Knowledge ◽  
Adherence To Medication ◽  
Asthma Patients ◽  
Medication Reviews

Background: Asthma is one of the most common chronic health conditions, affecting 900,000 Ontarians and 2.4 million Canadians. Research evidence indicates that pharmacists can play a critical role in the management of asthma yet there is a paucity of studies which focus on community-based pharmacist asthma interventions on adults in Ontario, Canada. Purpose: The aim of this study is to evaluate an asthma-specific pharmacist-led intervention over a 12-month period in relation to patient health outcomes and patient satisfaction. Methods: This prospective cluster randomized controlled study required trained intervention pharmacists to identify asthma patients, deliver medication reviews and educate patients in order to improve asthma measures. The validated measures selected for the study were adherence to medication, asthma knowledge and peak expiratory flow rate. 12 pharmacies in and around Toronto, Ontario were recruited. Results: A total of 81 patients were identified by pharmacists as potential participants over the course of the program. Of these, 19 consented to participate and 14 completed the program. The intervention group saw a statistically significant improvement of asthma knowledge scores (p=0.02). In both groups, all patients had improved medical adherence scores after completion of the program. Diurnal variation between control and intervention groups was found to be significantly different. Control patients had significantly more days of high variability than the intervention group. Conclusion: The implementation of a pharmacist-provided comprehensive education program in a community pharmacy setting had a positive impact on patients’ diurnal variation, asthma related knowledge and adherence to medication. While the target sample size was not achieved and results cannot be generalized, this study is an important step towards understanding the benefits of a pharmacist-delivered intervention in asthma management.

scholarly journals Evaluation of a Community Pharmacist Managed Asthma Consultation Service

2021 ◽  
Author(s):  
John Odame
Keyword(s):  
Diurnal Variation ◽  
Positive Impact ◽  
Critical Role ◽  
Intervention Group ◽  
Asthma Management ◽  
Controlled Study ◽  
Asthma Knowledge ◽  
Adherence To Medication ◽  
Asthma Patients ◽  
Medication Reviews

Background: Asthma is one of the most common chronic health conditions, affecting 900,000 Ontarians and 2.4 million Canadians. Research evidence indicates that pharmacists can play a critical role in the management of asthma yet there is a paucity of studies which focus on community-based pharmacist asthma interventions on adults in Ontario, Canada. Purpose: The aim of this study is to evaluate an asthma-specific pharmacist-led intervention over a 12-month period in relation to patient health outcomes and patient satisfaction. Methods: This prospective cluster randomized controlled study required trained intervention pharmacists to identify asthma patients, deliver medication reviews and educate patients in order to improve asthma measures. The validated measures selected for the study were adherence to medication, asthma knowledge and peak expiratory flow rate. 12 pharmacies in and around Toronto, Ontario were recruited. Results: A total of 81 patients were identified by pharmacists as potential participants over the course of the program. Of these, 19 consented to participate and 14 completed the program. The intervention group saw a statistically significant improvement of asthma knowledge scores (p=0.02). In both groups, all patients had improved medical adherence scores after completion of the program. Diurnal variation between control and intervention groups was found to be significantly different. Control patients had significantly more days of high variability than the intervention group. Conclusion: The implementation of a pharmacist-provided comprehensive education program in a community pharmacy setting had a positive impact on patients’ diurnal variation, asthma related knowledge and adherence to medication. While the target sample size was not achieved and results cannot be generalized, this study is an important step towards understanding the benefits of a pharmacist-delivered intervention in asthma management.

scholarly journals The impact of using a mobile application to improve asthma patients’ adherence to medication in Jordan

2021 ◽  
Vol 27 (3) ◽  
pp. 146045822110429
Author(s):  
Mohammad K Al-Nawayseh ◽  
Montaha AL-Iede ◽  
Eman Elayeh ◽  
Rima Hijazeen ◽  
Khaled Al Oweidat ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Asthma Control ◽  
Mobile Application ◽  
Intervention Group ◽  
P Value ◽  
Asthma Control Test ◽  
Adherence To Medication ◽  
Asthma Patients ◽  
Act Score ◽  
The Impact

The main aim of this study is to assess the effectiveness of using a developed asthma mobile application to enhance medication adherence in Jordan. Asthma patients visiting outpatient respiratory clinics and using inhalers were recruited. Patients were assigned into two groups: intervention and control. The intervention group was instructed to download and use the application. Asthma control was assessed using Asthma Control Test (ACT) at baseline and at follow-up of 3 months for both groups. A total of 171 patients (control, n = 83, and intervention, n = 88) participated in the study. After 3 months of usage, patients in the intervention group achieved a significant improvement in ACT score compared to control ( p-value <0.05), and reported a significant satisfaction of the application use. Therefore, the asthma mobile application is found as an effective tool to enhance medication adherence in asthma patients.

A Randomized Controlled Study of the Effectiveness of Electrophysiological Monitoring of Dexmedetomidine in Patients with Brain Damage of Various Origins

2020 ◽  
Vol 75 (5) ◽  
pp. 490-499
Author(s):  
Yuri Y. Kiryachkov ◽  
Marina V. Petrova ◽  
Bagautdin G. Muslimov ◽  
Sergey A. Bosenko ◽  
Mikhail M. Gorlachev
Keyword(s):  
Intervention Group ◽  
Clinical Effectiveness ◽  
Protective Role ◽  
Digital Data ◽  
Controlled Study ◽  
Control Group ◽  
Average Dose ◽  
Autonomic Nervous System Dysfunction ◽  
Sympathetic Hyperactivity ◽  
Starting Dose

Background.At the same time, the main effect of the use of this drug is the elimination of the autonomic nervous system dysfunction and sympatholysis. It seems important to search for a method of indications and selection of a dose of dexmedetomidine in intensive care.Aims to improve the clinical effectiveness of the electrophysiological navigation of the prolonged use of dexmedetomidine in patients with brain pathology of various origins.Methods.The study included 83 patients 2050 days after the traumatic brain injury, anoxic damage; consequences of acute disorders of cerebral. 37 patients comprised the 1st intervention group with a clinical course of dexmedetomidine (male 28; female 9; average age 49.62.3 years) and 46 patients comprised the 2nd control group without pharmacological correction with dexmedetomidine (male 23; female 23, average age 512.5 years). Criteria for the inclusion of prolonged infusion of the drug dexmedetomidine (Orion Pharma, Finland) are based on heart rate variability (HRV) indicators characteristic of sympathetic hyperactivity, the target task of titration of doses of dexmedetomidine served as the parameters for achieving normal HRV indicators, the appearance of parasympathetic hyperactivity served as the basis for reducing the dosage of the drug or stopping it of application. HRV parameters were recorded before dexmetomedine infusion-initially, on 13; 45; 910; 1520 days of drug administration.Results.The starting dose of dexmedetomidine with sympathetic hyperactivity in patients was 0.12 to 0.24 g.kg1.hr1(average dose 0.160.01; total 200 mg/day). According to digital data from HRV, the effective dose of dexmedetomidine ED50 was 0.260.03 g.kg1.hr1(total daily 353.835.1 g) and was achieved on day 910 using dexmedetomidine.Conclusions.The protective role of dexmedetomidine with correction of sympathetic hyperactivity based on electrophysiological navigation according to the HRV is reliable in the following indicators: The improvement of consciousness; a significant decrease in the incidence of distress lung syndrome; septic shock; mortality.

Effectiveness of Medication Review Services on Diabetes Self-Care in Primary Care Patients (Preprint)

2020 ◽  
Author(s):  
Tay Siew Cheng Sarah ◽  
Lim Jit Fan Christina ◽  
Tan Soo Chieng Daphne ◽  
Tan Seok Yee Maureen ◽  
Chen Jieying Cordelia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Healthcare ◽  
Medication Review ◽  
Intervention Group ◽  
Self Care ◽  
Effective Intervention ◽  
Controlled Study ◽  
Control Group ◽  
Dietary Control ◽  
Glucose Management

BACKGROUND Diabetes is one of the most common medical conditions referred to medication review service run by pharmacists, OBJECTIVE This study aims to determine whether pharmacist-run MRS can be an effective intervention tool to improve patients’ participation in self-care of diabetes. METHODS This randomised controlled study was conducted in five public primary healthcare centres from December 2014 to October 2016. Participants were 40 to 80 years of age and had been diagnosed with type 2 diabetes. These participants were prescribed with five or more chronic medications, of which at least one was an antidiabetic medication, by the primary healthcare centres’ doctors. The participants were randomly recruited into the intervention or control arm. A self-developed questionnaire which incorporated the validated Diabetes Self-Management Questionnaire (DSMQ) was administered face-to-face by the study team to the participants prior to and after MRS. MRS was not administered to participants in the control group. RESULTS A total of 221 participants completed the follow up. There were 105 participants in the control arm and 116 in the intervention arm. The DSMQ Sum Scale score of the control group improved by 0.16 ± 1.11 (p= 0.136) while the intervention group improved by 0.40 ± 0.99 (p=0.000). Participants in the intervention group reported a better improvement in their self-care of diabetes, specifically in glucose management (0.38± 1.35, p=0.003), dietary control (0.26±1.66, p=0.096) and physical activity (0.67±2.36, p=0.003). CONCLUSIONS Pharmacist-run MRS is an effective intervention tool to improve participants’ self-care of diabetes, particularly in glucose management, dietary control and physical activity.

scholarly journals A Combination of Lactoplantibacillus plantarum Strains CECT7527, CECT7528 and CECT7529 Plus Monacolin K Reduces Blood Cholesterol: Results from a Randomized, Double-Blind, Placebo-Controlled Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1206
Author(s):  
Rafael Guerrero-Bonmatty ◽  
Guadalupe Gil-Fernández ◽  
Francisco José Rodríguez-Velasco ◽  
Jordi Espadaler-Mazo
Keyword(s):  
Intervention Group ◽  
Study Groups ◽  
Statin Treatment ◽  
Blood Cholesterol ◽  
Controlled Study ◽  
Controlled Clinical Trial ◽  
Red Yeast Rice ◽  
Monacolin K ◽  
Double Blind ◽  
History Of

Background: Dietary supplements have been proposed to help manage blood cholesterol, including red yeast rice (RYR) extracts, plant sterols and stanols, beta-glucans, and some probiotics. This study was conducted to evaluate the efficacy of RYR (containing 10 mg of monacolin K) combined with 109 CFU of three Lactoplantibacillus plantarum strains (CECT7527, CECT7528, and CECT7529). Methods: A 12-week randomized, double-blinded, placebo-controlled clinical trial was conducted. In total, 39 adult patients were enrolled, having total cholesterol (TC) ≥200 mg/dL, and being statin-naïve or having recently stopped statin treatment because of intolerance. Active product or placebo were taken once daily, and subjects were evaluated at baseline, 6, and 12 weeks. Results: Study groups were comparable at baseline, except for history of recent hypercholesterolemia treatment (81% in active vs. 22% in placebo). Changes in LDL cholesterol and TC became significant compared to placebo (mean difference between groups and standard error of the mean = 23.6 ± 1.5 mg/dL, p = 0.023 and 31.4 ± 1.9 mg/dL, p = 0.011, respectively) upon adjusting for the baseline imbalance in hypercholesterolemia treatment. No adverse effects were noted during the study. Conclusion: This combination of 10 mg of monacolin K and L. plantarum strains was well tolerated and achieved a statistically significant greater reduction in LDL-C and TC in the intervention group compared to the placebo, once adjusting for recent history of hypercholesterolemia treatment.

scholarly journals Disclosure and health-related outcomes among children living with HIV and their caregivers

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Margaret Amankwah-Poku ◽  
Delight Abla Klutsey ◽  
Kwaku Oppong Asante
Keyword(s):  
Medication Adherence ◽  
Psychological Health ◽  
Positive Impact ◽  
Well Being ◽  
Demographic Variables ◽  
Hiv Status ◽  
African Countries ◽  
Psychological Well Being ◽  
Adherence To Medication ◽  
Living With Hiv

Abstract Background The prevalence of disclosure of status to children living with the Human Immunodeficiency Virus (HIV) is low in most sub-Saharan African countries, leading to poor compliance and adverse psychological outcomes in these children. This study examined the influence of disclosure on health outcomes in children living with HIV and their caregivers. Methods Using a cross-sectional design, 155 HIV-positive children between age 6–15 years and their caregivers were administered standardized questionnaires measuring adherence to medication, children's psychological well-being, caregiver burden, and caregivers’ psychological health. Results Results indicated that only 33.5% of the children sampled knew their status. Disclosure of HIV status was significantly related to medication adherence, psychological wellbeing, the burden of caregiving, and the length of the disclosure. A child’s age and level of education were the only demographic variables that significantly predicted disclosure of HIV status. In a hierarchical analysis, after controlling for all demographic variables medication adherence, psychological well-being and burden of caregiving were found to be significant predictors of disclosure of status in children living with HIV. Conclusions Findings suggest the need for disclosure of status among children living with HIV for a positive impact on their medication adherence and psychological health. These findings underscore the need for the development of context-specific interventions that will guide and encourage disclosure of status by caregivers to children living with HIV.

scholarly journals 179 Evaluating a Clinical Pharmacist Service in a Residential Care Unit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Claire Kavanagh ◽  
Eimear O'Dwyer ◽  
Róisín Purcell ◽  
Niamh McMahon ◽  
Morgan Crowe ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Patient Outcomes ◽  
Residential Care ◽  
Clinical Pharmacist ◽  
Comparative Evaluation ◽  
Positive Impact ◽  
Standard Of Care ◽  
Pharmacist Interventions ◽  
Medication Reviews

Abstract Background This study assessed the pharmacist role in an 80 bed residential care unit by: Quantifying the number and type of pharmacist interventions made and their acceptance rate.Assessing impact of pharmacist interventions on patient care.Assessing staff attitudes towards the clinical pharmacist service. Methods This was a non-blinded, non-comparative evaluation of the existing clinical pharmacist service in the unit. All residents were included. All pharmacist interventions over a 10-week period were recorded, then graded according to the Eadon scale1 by a consultant gerontologist and an experienced pharmacist to assess their impact on patient care. Results There were 615 pharmacist interventions. The most common interventions were: Drug Therapy Review, 34% (n=209) Technical Prescription, 26.5% (n=163) Administration, 15.3% (n=94) Drug Interaction, 10.4% (n=64) Medication Reconciliation, 8.5% (n=52) 98% (n=596) of interventions were rated as having significance to patient care, of which: 48.4% (n=298) and 41.8% (n=257) of the interventions rated as ‘significant and resulting in an improvement in the standard of care’1% (n=6) and 0.5% (n=3) rated as ‘very significant and preventing harm’. There was a statistically significant agreement between the evaluators, κw = 0.231 (95% CI, 0.156 to 0.307), p < .0005. The strength of agreement was fair. Of interventions requiring acceptance by medical team (n=335), 89.9% (n=301) were accepted. 95% (n=36) of staff who responded agreed or strongly agreed that improved patient safety resulted from the pharmacist’s involvement in multidisciplinary medication reviews. Over 92% (n=35) agreed or strongly agreed that their experience of the pharmacist was positive. Conclusion The pharmacist has an important role in our residential care unit. Their involvement in the medicines optimisation process positively impacts patient outcomes and prevents harm. Staff perceived a positive impact of the clinical pharmacist service provided on patient care and patient safety.

scholarly journals Effect of exergaming on wellbeing of residents in a nursing home: a single blinded intervention study

2021 ◽  
Author(s):  
Marlies Gunst ◽  
Isabelle De Meyere ◽  
Hannah Willems ◽  
Birgitte Schoenmakers
Keyword(s):  
Intervention Study ◽  
Positive Impact ◽  
Objective Assessment ◽  
Intervention Group ◽  
Social Contact ◽  
Mental Wellbeing ◽  
Vulnerable Groups ◽  
Future Research ◽  
Control Group ◽  
Average Intensity

Abstract Introduction To improve the quality of life in nursing homes, meaningful activities and social contact are indispensable. Exergames can play a role addressing these needs. Methods In a randomized single blinded controlled intervention study, we investigated the effect of playing exergames on general wellbeing, fun and on social interaction. Results Thirty-five residents participated: 18 residents took part in the intervention group and 17 in the control group. The median mental wellbeing score of the intervention group increased from 42/50 to 45. The median sleep score of the intervention increased from 23/30 to 28. The median pain score of the intervention group improved from 18/20 to 20. The median score on subjective cognition increased from 24/30 to 26 while the mean scores on the objective assessment decreased from 1.8/2 to 1.7. Coaches gave an average fun score of 8.9/10 and an average intensity of exercise score of 11.6/20. Residents and coaches appreciated the social contact. Coaches reported a high feasibility (average of 4.1/5) but a low accessibility and a high intensity of supervision. Conclusions Exergaming is a feasible and pleasant complement to the usual activities with a positive impact on wellbeing, sleep, pain, and perceived cognition. Future research should focus on vulnerable groups and aim to develop a study in an implementation design.

scholarly journals Classification of non-acute bronchial asthma according to allergy and eosinophil characteristics: a retrospective study

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yi Jiang ◽  
Ruoli An ◽  
Li Cheng ◽  
Qianru Yue ◽  
Hanwei Zhang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Lung Function ◽  
Allergic Asthma ◽  
Asthma Management ◽  
Effective Management ◽  
Sputum Cytology ◽  
Eosinophilic Asthma ◽  
Asthma Patients ◽  
Medical University

Abstract Background Investigating the endotypes of the different asthma phenotypes would help disease monitoring, prognosis determination, and improving asthma management standardization. This study aimed to classify asthma into four endotypes according to the allergic and eosinophilic characteristics and explore the phenotypes (clinical characteristics, pulmonary functions, and fractional expired nitric oxide (FeNO)) of each endotype. Methods This retrospective study included non-acute asthma patients treated at the First Hospital of Shanxi Medical University (05/2016–01/2018). The patients were classified into the eosinophilic allergic, eosinophilic non-allergic, non-eosinophilic allergic, and non-eosinophilic non-allergic asthma endotypes. Serum sIgE, lung function, FeNO, and induced sputum cytology were tested and compared among groups. Results Of the 171 included patients, 22 had eosinophilic allergic asthma, 17 had eosinophilic non-allergic asthma, 66 had non-eosinophilic allergic asthma, and 66 had non-eosinophilic non-allergic asthma. Lung function measurements (FEV1%, FEF25%, FEF50%, FEF75%, and FEF25–75%) showed that airway dysfunction was worse in eosinophilic non-allergic asthma than in the other three endotypes (all P < 0.001). In allergic asthma patients, eosinophilic asthma had worse airway dysfunction than non-eosinophilic asthma (all P < 0.05). Similar results were found in non-allergic asthma (all P < 0.01). The FeNO levels in eosinophilic allergic asthma were higher than in eosinophilic non-allergic and non-eosinophilic non-allergic asthma (both P = 0.001). Conclusions FeNO can objectively reflect eosinophilic airway inflammation in asthma. Endotypic classification of asthma patients regarding the allergic and eosinophilic characteristics is conducive to the effective management of patients with asthma.

Effect of breast milk oral care in infants who underwent surgical correction of ventricular septal defect

2021 ◽  
pp. 1-4
Author(s):  
Xian-Rong Yu ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Zeng-Chun Wang ◽  
Hua Cao ◽  
...  
Keyword(s):  
Breast Milk ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Oral Care ◽  
Intervention Group ◽  
Physiological Saline ◽  
Surgical Correction ◽  
Controlled Study ◽  
Care Group ◽  
Control Group

Abstract Objective: This study explored the clinical effect of employing breast milk oral care for infants who underwent surgical correction of ventricular septal defect. Methods: A prospective randomised controlled study was conducted in a provincial hospital between January, 2020 and July, 2020 in China. Patients were randomly divided into an intervention group (breast milk oral care, n = 28) and a control group (physiological saline oral care, n = 28). The intervention group was given oral nursing using breast milk for infants in the early post-operative period, and the control group was given oral nursing using physiological saline. Related clinical data were recorded and analysed. Results: There were no significant differences in age, gender, weight, operation time, cardiopulmonary bypass time, or aortic cross-clamping time between the two groups. Compared with the physiological saline oral care group, the mechanical ventilation duration, the length of ICU stay in the breast milk oral care group were significantly shorter. The time of start feeding and total enteral nutrition were significantly earlier in the intervention group than those in the control group. The incidence of post-operative pneumonia in the breast milk oral care group was 3.6%, which was significantly lower than that of the physiological saline oral care group. Conclusion: The use of breast milk for oral care in infants who underwent surgical correction of VSD can reduce the incidence of post-operative pneumonia and promote the recovery of gastrointestinal function.

Sign in / Sign up

Export Citation Format

Share Document