scholarly journals Non-dispensing pharmacist integrated in the primary care team: effect on the quality of physician’s prescribing, a non-randomised comparative study

2020 ◽  
Vol 42 (5) ◽  
pp. 1293-1303
Author(s):  
Vivianne M. Sloeserwij ◽  
Dorien L. M. Zwart ◽  
Ankie C. M. Hazen ◽  
Judith M. Poldervaart ◽  
Anne J. Leendertse ◽  
...  
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Intervention Group ◽  
P Value ◽  
Control Groups ◽  
Clinical Pharmacists ◽  
Prescribing Quality ◽  
Primary Care Teams ◽  
Quality Of Prescribing

Abstract Background Especially in elderly with polypharmacy, medication can do harm. Clinical pharmacists integrated in primary care teams might improve quality of pharmaceutical care. Objective To assess the effect of non-dispensing clinical pharmacists integrated in primary care teams on general practitioners’ prescribing quality. Setting This study was conducted in 25 primary care practices in the Netherlands. Methods Non-randomised, controlled, multi-centre, complex intervention study with pre-post comparison. First, we identified potential prescribing quality indicators from the literature and assessed their feasibility, validity, acceptability, reliability and sensitivity to change. Also, an expert panel assessed the indicators’ health impact. Next, using the final set of indicators, we measured the quality of prescribing in practices where non-dispensing pharmacists were integrated in the team (intervention group) compared to usual care (two control groups). Data were extracted anonymously from the healthcare records. Comparisons were made using mixed models correcting for potential confounders. Main outcome measure Quality of prescribing, measured with prescribing quality indicators. Results Of 388 eligible indicators reported in the literature we selected 8. In addition, two more indicators relevant for Dutch general practice were formulated by an expert panel. Scores on all 10 indicators improved in the intervention group after introduction of the non-dispensing pharmacist. However, when compared to control groups, prescribing quality improved solely on the indicator measuring monitoring of the renal function in patients using antihypertensive medication: relative risk of a monitored renal function in the intervention group compared to usual care: 1.03 (95% CI 1.01–1.05, p-value 0.010) and compared to usual care plus: 1.04 (1.01–1.06, p-value 0.004). Conclusion This study did not demonstrate a consistent effect of the introduction of non-dispensing clinical pharmacists in the primary care team on the quality of physician’s prescribing. This study is part of the POINT-study, which was registered at The Netherlands National Trial Register with trial registration number NTR‐4389.

scholarly journals Android-Based Education toward the Role of Postpartum Primipara Mothers in Fulfilling the Independent Perinium Care

2021 ◽  
Vol 1 (2) ◽  
pp. 55-67
Author(s):  
Werna Nontji ◽  
Dwi Kartika Sari ◽  
Sitti Maria Ulfa ◽  
Syafruddin Syarif ◽  
Inez Vravty Lestari ◽  
...  
Keyword(s):  
Treatment Group ◽  
Intervention Group ◽  
Wilcoxon Test ◽  
Control Group ◽  
P Value ◽  
Control Groups ◽  
Post Test ◽  
Android App ◽  
And Control ◽  
Perineal Care

Background: Educating mothers during their postpartum period could potentially help them to overcome some important phases after giving birth. The process of education is evaluated based on the mothers’ knowledge about their independent self-care. Independency is an activity that is started individually and is done based on self-capability. The independency in the postpartum care is not only important to decrease the mother’s mortality and morbidity rate, but it is also crucial to strengthen and improve the post-partum mother’s healthy behavior during the perineal care. Providing education using Android-based application called BUBI Care could be potential to facilitate a more dynamic transfer of knowledge to the postpartum mothers.Aims: To analyze the knowledge, skills, and independence of primipara postpartum mothers in independent perineal care before and after accessing BUBI Care app. Research Method: employing quasi experimental research with pre-test and post-test design with control group design. The sample for this research were 19 pregnant mothers TM III (pregnancy age of ? 38 weeks) on each group. The treatment group was educated using BUBI Care Android app that was conducted at one of Public Health Center. The control group was educated without BUBI Care that was conducted at a Midwife Practice Clinic. The research was conducted on September to October 2020. Study Result: According to the Wilcoxon test, there was a difference in the pre-test knowledge of the treatment and control groups with the similar median of 53 and p-value of 0.666, the treatment group showed their scores improved to 80 on the post-test while the control group stayed at 53 with the p-value of 0.000. It means that BUBI Care app education influences the post-test. On the other hand, the perineal care skill saw a difference between the intervention and control groups. The intervention group had a mean of 70.05 and 56.68 for the control group with the p-value of 0.002 which means that there was an influence from the BUBI Care app education. Additionally, Mann Whitney test showed that the intervention group had a mean score of 78.95, but the control group only had 49.26, the total difference between the two are 29.69 with the p-value of 0.000. It can be concluded that there is a significance in difference in the independency rate from the provision of BUBI Care Android app education.Conclusion:  there is a significance effect on the intervention group in terms of Android based usage.

scholarly journals PENGARUH PENERAPAN TEKNIK KONSERVASI ENERGI DENGAN PEMBERDAYAAN DIRI TERHADAP KUALITAS HIDUP PASIEN GAGAL GINJAL KRONIK

2019 ◽  
Vol 9 (3) ◽  
pp. 219-224
Author(s):  
Nieniek Ritianingsih
Keyword(s):  
Quality Of Life ◽  
Energy Conservation ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Group Design ◽  
Post Test ◽  
Test Control

Penyakit gagal ginjal kronis atau disingkat GGK, saat ini diakui sebagai prioritas kesehatan masyarakat di seluruh dunia. Pasien GGK akan mengalami  gangguan fisik dan psikologis sehingga mempengaruhi kualitas hidupnya. Teknik konservasi energi dengan pemberdayaan diri dapat diberikan pada pasien GGK dengan tujuan dapat meningkatkan energi, mengurangi fatigue dan kualitas hidup dapat meningkat. Penelitian ini bertujuan untuk mengetahui pengaruh penerapan teknik konservasi energi dengan pemberdayaan diri terhadap kualitas hidup pasien gagal ginjal kronik.Hipotesis penelitian ini adalah teknik konservasi energydengan pemberdayaan diridapat meningkatkan kualitas hidup pasien GGK.   Responden penelitian ini berjumlah 47 orang untuk kelompok intervensi dan untuk kelompok kontrol 47 orang responden. Penelitian ini merupakan penelitian kuantitatif menggunakan metoda kuasi eksperimental dengan pendekatan pre test – post test control group design. Hasil uji statistik didapatkan nilai p value 0,000 maka dapat disimpulkan ada perbedaan yang signifikan antara  kualitas hidup  kelompok kontrol dengankualitas hidup kelompok intervensi setelah dilakukan penerapan teknik konservasi energy. Perawat agar menerapkan tehnik konservasi energy sebagai suatu program terstruktur dari intervensi keperawatan bagi pasien GGK   Kata kunci : teknik konservasi energi, kualitas hidup, GGK   THE EFFECT OF THE APPLICATION OF ENERGY CONSERVATION TECHNIQUES WITH SELF-EMPOWERMENT TO THE QUALITY OF LIFE OF PATIENTS WITH CHRONIC RENAL FAILURE   ABSTRACT Chronic kidney failure or abbreviated CRF, is currently recognized as a public health priority throughout the world. GGK patients will experience physical and psychological disorders that affect their quality of life. Energy conservation techniques with self-empowerment can be given to CRF patients with the aim of increasing energy, reducing fatigue and quality of life can be increased. This study aims to determine the effect of the application of energy conservation techniques with self-empowerment to the quality of life of patients with chronic renal failure. The hypothesis of this study is conservation techniques of energy with empowerment can improve the quality of life of patients with CRF. The respondents of this study were 47 people for the intervention group and for the control group 47 respondents. This research is a quantitative research using a quasi-experimental method with a pre test - post test control group design approach. The statistical test results obtained p value 0,000, it can be concluded that there is a significant difference between the quality of life of the control group and the quality of life of the intervention group after the application of energy conservation techniques. The nurse is to apply energy conservation techniques as a structured program of nursing interventions for CRF patients   Keywords: energy conservation techniques, quality of life, CRF

scholarly journals Expanding the role of clinical pharmacists on interdisciplinary primary care teams for chronic pain and opioid management

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Karleen F. Giannitrapani ◽  
Peter A. Glassman ◽  
Derek Vang ◽  
Jeremiah C. McKelvey ◽  
R. Thomas Day ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Clinical Pharmacists ◽  
Primary Care Teams

scholarly journals Assessing system-based trainings for primary care teams and quality-of-life of patients with multimorbidity in Thailand: patient and provider surveys

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Paibul Suriyawongpaisal ◽  
Wichai Aekplakorn ◽  
Borwornsom Leerapan ◽  
Fatim Lakha ◽  
Samrit Srithamrongsawat ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Primary Care Teams ◽  
Provider Surveys

scholarly journals What Role Can Trained Volunteers Add to Chronic Disease Care of Immigrants?

2020 ◽  
Vol 22 (6) ◽  
pp. 1281-1286
Author(s):  
Ellen Rosenberg ◽  
Tamara Carver ◽  
Nina Mamishi ◽  
Gillian Bartlett
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Disease ◽  
Well Being ◽  
Life Goals ◽  
Financial Situation ◽  
Health Goals ◽  
Primary Care Teams ◽  
Community Volunteers

AbstractTo help primary care teams improve patient-centered care, we elicited health and life goals of immigrants with a chronic disease. We conducted an exploratory study of the (1) acceptability of home visits by volunteers to collect health information and (2) content of health and life goals within a primary care program for immigrants with chronic disease. Pairs of trained community volunteers visited 23 patients in their homes and asked them to identify three life goals and three health goals. We conducted content analyses of written notes. Health goals were related to disease prevention and symptom control, family well-being, own quality of life, own or family members’ work and/or financial situation. Life goals concerned family well-being, their own quality of life, work/financial situation and health. Given the limited time health professionals have with their patients, trained community volunteers could be important members of primary care teams caring for immigrants.

scholarly journals Effects of the “Living well with COPD” intervention in primary care: a comparative study

2018 ◽  
Vol 51 (1) ◽  
pp. 1701375 ◽  
Author(s):  
Claudia Steurer-Stey ◽  
Kaba Dalla Lana ◽  
Julia Braun ◽  
Gerben ter Riet ◽  
Milo A. Puhan
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Usual Care ◽  
Self Management ◽  
Health Related Quality ◽  
Management Intervention ◽  
Living Well ◽  
Related Quality ◽  
Health Related

The pivotal objective of chronic obstructive pulmonary disease (COPD) self-management programmes is behaviour change to avoid moderate and severe exacerbations and improve health related quality of life.In a prospectively planned, controlled study, COPD patients who participated in the “Living well with COPD” (LWWCOPD) self-management intervention were compared with usual care patients from the primary care COPD Cohort ICE COLD ERIC, who did not receive self-management intervention (NCT00706602) The primary outcome was behaviour change and disease-specific health related quality of life after 1 year. Secondary end-points included exacerbation rates. We calculated mixed linear, zero-inflated negative binomial and logistic regression models and used propensity scores to counteract confounding.467 patients, 71 from the LWWCOPD and 396 from the usual care cohort, were included. The differences between intervention and control were 0.54 (95% CI 0.13−0.94) on the Chronic Respiratory Questionnaire domain “mastery”, 0.55 (95% CI 0.11−0.99) on “fatigue”, 0.54 (0.14−0.93) on “emotional function” and 0.64 (95% CI 0.14−1.14) on “dyspnoea”. The intervention considerably reduced the risk of moderate and severe exacerbations (incidence rate ratio 0.36, 95% CI 0.25−0.52).Self-management coaching in primary care improves health-related quality of life and lowers exacerbation rates and health care use.

scholarly journals A Children’s Asthma Education Program: Roaring Adventures of Puff (RAP), Improves Quality of Life

2010 ◽  
Vol 17 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Shawna L McGhan ◽  
Eric Wong ◽  
Heather M Sharpe ◽  
Patrick A Hessel ◽  
Puish Mandhane ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Education Program ◽  
Intervention Group ◽  
Asthma Management ◽  
Control Group ◽  
Asthma Education ◽  
Children With Asthma

BACKGROUND: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.OBJECTIVE: To assess the feasibility and impact of ‘Roaring Adventures of Puff’ (RAP), a six-week childhood asthma education program administered by health professionals in schools.METHODS: Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group). Baseline measurements from parent and child were taken before the intervention, and at six and 12 months.RESULTS: The intervention group had more smoke exposure at baseline. Participants lost to follow-up had more asthma symptoms. Improvements were significantly greater in the RAP intervention group from baseline to six months than in the control group in terms of parent’s perceived understanding and ability to cope with and control asthma, and overall quality of life (P<0.05). On follow-up, doctor visits were reduced in the control group.CONCLUSION: A multilevel, comprehensive, school-based asthma program is feasible, and modestly improved asthma management and quality of life outcomes. An interactive group education program offered to children with asthma at their school has merit as a practical, cost-effective, peer-supportive approach to improve health outcomes.

scholarly journals 571Effect of a computer network-based feedback program on antibiotic prescription rates of primary care physicians

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Yue Chang
Keyword(s):  
Primary Care ◽  
Antibiotic Resistance ◽  
Computer Network ◽  
Antibiotic Prescription ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Prescription Rate ◽  
Feedback Intervention ◽  
Prescription Rates

Abstract Background Antibiotic overuse is one of the major prescription problems in rural China and a major risk factor for antibiotic resistance. Low antibiotic prescription rates can effectively reduce the risk of antibiotic resistance. Methods A cluster randomized crossover open controlled trial was conducted in 31 hospitals. These hospitals were randomly allocated to two groups to receive the intervention for three months followed by no intervention for three months in a random sequence. The feedback intervention information, which displayed the physicians’ antibiotic prescription rates and ranking, was updated every 10 days. The primary outcome was the 10-day antibiotic prescription rate of the physicians. Results There were 82 physicians in group 1 (intervention first followed by control) and 81 in group 2 (control first followed by intervention). Baseline comparison showed no significant difference in antibiotic prescription rate between the two groups (30.8% vs 35.2%, P-value = 0.07). At the crossover point, the relative reduction in antibiotic prescription rate was significantly higher among physicians in the intervention group than in the control group (33.1% vs 20.3%, P-value &lt; 0.001). After a further 3 months, the rate of decline in antibiotic prescriptions was also significantly greater in the intervention group compared to the control group (14.2% vs 4.6%, P-value &lt; 0.001). Conclusions A computer network-based feedback intervention can significantly reduce the antibiotic prescription rates of primary care outpatient physicians. Key messages The feedback intervention continuously affected their prescription behavior for up to six months.

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