P.0777 Treatment journey of patients with schizophrenia from diagnosis to the successful implementation of treatment with a long-acting injectable antipsychotic agent

2021 ◽  
Vol 53 ◽  
pp. S567
Author(s):  
J.M. Kane ◽  
M.A. Mychaskiw ◽  
S. Lim ◽  
M. Suett ◽  
M. Tian ◽  
...  
Keyword(s):  
Antipsychotic Agent ◽  
Successful Implementation ◽  
Long Acting

scholarly journals Aripiprazole Lauroxil, a Novel Injectable Long-Acting Antipsychotic Treatment for Adults with Schizophrenia: A Comprehensive Review

2021 ◽  
Vol 13 (3) ◽  
pp. 279-296
Author(s):  
Kunal Maini ◽  
Haley Gould ◽  
Jessica Hicks ◽  
Fatima Iqbal ◽  
James Patterson ◽  
...  
Keyword(s):  
Partial Agonist ◽  
Antipsychotic Agent ◽  
The United States ◽  
Mental Health Disorder ◽  
Oral Dosage ◽  
Antipsychotic Treatment ◽  
Comprehensive Review ◽  
Social Commitment ◽  
Hearing Voices ◽  
Long Acting

Purpose of Review. This is a comprehensive review of the literature regarding the use of Aripiprazole lauroxil for schizophrenia. This review presents the background, evidence, and indications for using aripiprazole lauroxil to treat schizophrenia in the context of current theories on the development of schizophrenia. Recent Findings. Schizophrenia is a chronic mental health disorder that currently affects approximately 3.3 million people in the United States. Its symptoms, which must be present for more than six months, are comprised of disorganized behavior and speech, a diminished capacity to comprehend reality, hearing voices unheard by others, seeing things unseen by others, delusions, decreased social commitment, and decreased motivation. The majority of these symptoms can be managed with antipsychotic medication. Aripiprazole lauroxil is a long-acting intramuscular injection that works as a combination of partial agonist activity at D2 and 5-HT1A receptors combined with antagonist activity at 5-HT2A receptors. It can be dosed as a 4-, 6-, or 8-week injection, depending on oral dosage. Aripiprazole lauroxil was FDA approved in October of 2015. Summary. Schizophrenia is a severe psychiatric disorder if left untreated. There are multiple medications to help treat schizophrenia. One antipsychotic agent, aripiprazole lauroxil, offers long duration injections that optimize and improve compliance. Known side effects include weight gain, akathisia, neuroleptic malignant syndrome, tardive dyskinesia, and orthostatic hypotension. Aripiprazole lauroxil is an FDA-approved drug that can be administered monthly, every six weeks, or every two months and has been shown to be both safe and effective.

Framework Development for an Immediate Postpartum Long-Acting Reversible Contraception Program

2020 ◽  
Vol 13 (1) ◽  
pp. 25-30
Author(s):  
Jessica Poulsen ◽  
Kylea Liese
Keyword(s):  
Critical Time ◽  
The United States ◽  
Perceived Barriers ◽  
Successful Implementation ◽  
Time Period ◽  
Complex Process ◽  
Maternal Morbidity And Mortality ◽  
Long Acting ◽  
Framework Development ◽  
E Mail

BackgroundWith the high rates of unintended pregnancy and associated maternal morbidity and mortality in the United States, particularly among poor and minority women, it is imperative that all individuals have information about and access to long-acting reversible contraception (LARC) methods in the immediate postpartum period.ObjectiveThe creation of a framework to provide guidance, address barriers, and dispel myths associated with the implementation of an immediate postpartum LARC program.MethodsA multistep approach to develop a framework to guide planning and implementation of an immediate postpartum LARC program. A literature review, telephone and e-mail interviews with clinical experts involved with successful implementation of immediate postpartum LARC programs, development of a list of interdisciplinary specialists, and steps required to initiate a change in current practice.ResultsThe provision of a framework to guide the planning and implementation of an immediate postpartum LARC program to streamline the process while addressing perceived barriers and myths.ConclusionsAddressing the lack of knowledge about LARCs, financial concerns, and absence of a standardized framework related to planning and implementation of this complex process will hopefully begin the process of making effective and reliable contraception available.Implications for NursingThe use of a standardized framework to guide the implementation of an immediate postpartum LARC program provides the potential for easier access to LARC methods in this critical time period.

scholarly journals Pharmacist Intentions to Prescribe Hormonal Contraception Following New Legislative Authority in California

2017 ◽  
Vol 32 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Kevin Vu ◽  
Sally Rafie ◽  
Kate Grindlay ◽  
Hialy Gutierrez ◽  
Daniel Grossman
Keyword(s):  
Online Survey ◽  
Hormonal Contraception ◽  
Cross Sectional Study ◽  
Training Needs ◽  
Successful Implementation ◽  
Cross Sectional ◽  
Legislative Authority ◽  
Protocol Development ◽  
Long Acting ◽  
Access To Contraception

Objective: Following a California law expanding pharmacists’ scope of practice to include directly providing self-administered hormonal contraception to patients pursuant to a statewide protocol, this study aimed to assess California pharmacists’ intentions to provide this new service prior to the protocol development and implementation. Design: Descriptive, nonexperimental, cross-sectional study. Setting: California between August and September 2014. Participants: California pharmacists working in community pharmacies. Intervention: Invitations to participate in the online survey were sent to 1774 pharmacists. Main Outcome Measures: Main outcomes included pharmacists’ current practices, intentions to prescribe hormonal contraception, comfort performing various activities, knowledge about contraceptive methods, training needs, and barriers to prescribing. Results: A total of 257 responses (14.5% response rate) were received. Of those, 121 respondents met inclusion criteria and were included in the analysis. About half of the respondents (49.6%) reported working in a community chain pharmacy, 46.3% in an independent pharmacy, and 4.1% in other community pharmacy settings. The majority (72.7%) of pharmacists reported that they would likely provide this new service. Respondents reported being comfortable educating patients on short-acting (94.2%) and long-acting reversible contraception (81.7%), as well as identifying drug interactions with hormonal contraception (96.7%). Respondents indicated time constraints (74.4%), lack of reimbursement (63.6%), and liability concerns (62.0%) as barriers to prescribing hormonal contraception. Conclusions: California pharmacists expressed strong intentions and comfort in prescribing hormonal contraception. Pharmacists’ additional training needs and barriers should be addressed for successful implementation. This new service has great potential to increase access to contraception, potentially fostering increased use and adherence.

scholarly journals Pharmacokinetics of Injectable, Long-Acting Nevirapine for HIV Prophylaxis in Breastfeeding Infants

2014 ◽  
Vol 59 (1) ◽  
pp. 59-66 ◽  
Author(s):  
John M. Cortez ◽  
Rafaela Quintero ◽  
John A. Moss ◽  
Martin Beliveau ◽  
Thomas J. Smith ◽  
...  
Keyword(s):  
Sustained Release ◽  
Release Kinetics ◽  
Subcutaneous Administration ◽  
Rat Plasma ◽  
World Health ◽  
Pharmacokinetic Analysis ◽  
Successful Implementation ◽  
Time Data ◽  
Prophylactic Regimen ◽  
Long Acting

ABSTRACTMother-to-child transmission (MTCT) of HIV-1 remains a global health problem. The World Health Organization (WHO) recommendations advise the administration of a once-daily, oral, prophylactic regimen of the nonnucleoside reverse transcriptase inhibitor nevirapine (NVP) from birth until 4 to 6 weeks of age for infants born to HIV-infected mothers in regions without access to safe and nutritionally adequate alternatives to breast milk. A critical factor driving the successful implementation of the WHO guidelines involves sustaining high adherence to the frequent dosing. With these challenges in mind, we have developed the first injectable, sustained-release NVP formulations with the goal of providing, for 6 weeks or longer, preventative plasma drug levels from a single subcutaneous administration at birth. The long-acting NVP consists of large (>50 μm), monodisperse NVP particles coated with biocompatible polymers that control the drug release kinetics. Two lead formulations exhibiting burst-free, sustained-release kinetics for up to 75 daysin vitrowere developed. Subsequentin vivostudies in rats demonstrated no toxicity related to the formulations. Rat plasma NVP concentrations were above the analytical assay's limit of quantification for up to 28 days. Pharmacokinetic analysis of the rat plasma NVP concentration-time data allowed absorption rate constants to be calculated. These data then were used to simulate infant NVP exposure from a single injected dose (<200 mg) of our long-acting formulations, demonstrating preliminary feasibility of the technology to maintain safe, preventative NVP plasma levels (0.2 to 3.0 μg ml−1) for 6 weeks or longer.

Long-acting injectable aripiprazole. Clinical experience in a case series

2016 ◽  
Vol 33 (S1) ◽  
pp. S614-S614
Author(s):  
J.M. Hernández Sánchez ◽  
M.C. Cancino Botello ◽  
M.F. Molina López ◽  
D. Peña Serrano ◽  
M. Machado Vera
Keyword(s):  
Mental Health ◽  
Health Center ◽  
Mental Health Center ◽  
Case Series ◽  
Antipsychotic Agent ◽  
Clinical History ◽  
Concomitant Treatment ◽  
Patient Profile ◽  
Competing Interest ◽  
Long Acting

IntroductionThe use of long-acting injectable antipsychotics is useful in patients with low therapeutic compliance.ObjectiveTo present the demographic and clinical data of a case series in which long-acting injectable aripiprazole has been prescribed in an ambulatory Mental Health Center.MethodsSystematic review of the related literature and clinical history of patients in which long-acting injectable aripiprazole had been prescribed from January to March 2015 in a Mental Health Center.ResultsWe found 10 patients, whose diagnosis were schizophrenia (4), non-specified psychosis (2), personality disorder (1), bipolar disorder (1), schizoaffective disorder (2), of whom 7 were men and 3 women, with a mean age of 43.8 years old. The mean of years since diagnosis was 15.1 years. In 7 patients, we found concomitant treatment with another antipsychotic agent (low dose quetiapine in all of them); antidepressants in 1 patient, benzodiazepines in 6; mood stabiliser in 5 and biperidene in 1. In relation to previous antipsychotic drugs, we found: aripiprazole 15 mg/day oral (4); long-acting injectable paliperdidone 150 mg/28 days (2) paliperdone 6 mg/day oral (1); combination of paliperidone 6 mg/day oral plus olanzapine 5 mg/day oral (1). Only 4 patients had used long-acting injectable drugs previously in their lifetime. The reason of having initiated treatment with long-acting injectable aripiprazole was sexual disturbance (3); lack of compliance (4); clinical inestability (2) and motor side effects (1).ConclusionsIn our series, we can observe a chronic patient profile, predominantly men with diagnosis of psychotic spectrum.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Clinical outcomes of paliperidone long-acting injection in patients with schizophrenia: a 1-year retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hsue-Wei Chan ◽  
Chin-Yu Huang ◽  
Yung-Chieh Yen
Keyword(s):  
Cohort Study ◽  
Emergency Room ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Beta Blockers ◽  
Antipsychotic Agent ◽  
Medical Adherence ◽  
Emergency Room Visits ◽  
One Year ◽  
Long Acting

Abstract Background Schizophrenia is a severe psychiatric disorder. Poor medical adherence increases relapse rate. Long-acting injection of antipsychotic agent is developed for improving medical adherence. In this study, we examined the effect of paliperidone long-acting injection (PLAI) treatment in patients with schizophrenia in a real-world setting. Methods In this retrospective cohort study, 467 patients with schizophrenia were enrolled, treated with risperidone PLAI or oral antipsychotics, and followed for 1 year. Concomitant medication, namely anticonvulsants, antidepressants, anxiolytics, sedatives or hypnotics, anticholinergics, and beta-blockers, were administered. Patients were classified into 2 groups: the LAI group (patients received LAI for treatment) and the NLAI group (patients taking only oral antipsychotics). The incidence of hospitalization, the length of hospitalization, and the incidence of emergency room visits were assessed. Results The LAI group had a higher incidence of psychiatric acute ward admission (NLAI group = 4.8%; LAI = 30.3%) and emergency room visits (NLAI group = 7.3%; LAI group = 36.0%) before enrolment. During the one-year follow-up, the incidence of acute ward admission and emergency room visit did not differ in the NLAI group (P = .586 and .241) compared with before enrolment, whereas both incidences were significantly decreased in the LAI group (P < .0001 in both of them). Conclusions PLAI reduces the incidence of admission and emergency room visits.

Some applications of electron beam microanalysis techniques in VLSI process evaluation

1983 ◽  
Vol 41 ◽  
pp. 160-161
Author(s):  
Simon Thomas
Keyword(s):  
Integrated Circuits ◽  
Process Evaluation ◽  
Large Scale ◽  
Technology Development ◽  
Analytical Techniques ◽  
Successful Implementation ◽  
Analysis Of Failures ◽  
Characterization Of Materials ◽  
Circuits Vlsi

Trends in the technology development of very large scale integrated circuits (VLSI) have been in the direction of higher density of components with smaller dimensions. The scaling down of device dimensions has been not only laterally but also in depth. Such efforts in miniaturization bring with them new developments in materials and processing. Successful implementation of these efforts is, to a large extent, dependent on the proper understanding of the material properties, process technologies and reliability issues, through adequate analytical studies. The analytical instrumentation technology has, fortunately, kept pace with the basic requirements of devices with lateral dimensions in the micron/ submicron range and depths of the order of nonometers. Often, newer analytical techniques have emerged or the more conventional techniques have been adapted to meet the more stringent requirements. As such, a variety of analytical techniques are available today to aid an analyst in the efforts of VLSI process evaluation. Generally such analytical efforts are divided into the characterization of materials, evaluation of processing steps and the analysis of failures.

Moving From Interprofessional Education Toward Interprofessional Practice: Bridging the Translation Gap

2019 ◽  
Vol 4 (5) ◽  
pp. 971-976
Author(s):  
Imran Musaji ◽  
Trisha Self ◽  
Karissa Marble-Flint ◽  
Ashwini Kanade
Keyword(s):  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Evaluation Model ◽  
Implementation Strategies ◽  
Future Research ◽  
Successful Implementation ◽  
Interprofessional Practice ◽  
Translational Model ◽  
Key Stakeholders ◽  
Clear Identification

Purpose The purpose of this article was to propose the use of a translational model as a tool for identifying limitations of current interprofessional education (IPE) research. Translational models allow researchers to clearly define next-step research needed to translate IPE to interprofessional practice (IPP). Method Key principles, goals, and limitations of current IPE research are reviewed. A popular IPE evaluation model is examined through the lens of implementation research. The authors propose a new translational model that more clearly illustrates translational gaps that can be used to direct future research. Next steps for translating IPE to IPP are discussed. Conclusion Comprehensive reviews of the literature show that the implementation strategies adopted to date have fostered improved buy-in from key stakeholders, as evidenced by improved attitudes and perceptions toward interprofessional collaboration/practice. However, there is little evidence regarding successful implementation outcomes, such as changed clinician behaviors, changed organizational practices, or improved patient outcomes. The authors propose the use of an IPE to IPP translational model to facilitate clear identification of research gaps and to better identify future research targets.

A Qualitative Examination of User Perceptions of User-Driven and App-Controlled Hearing Technologies

2019 ◽  
Vol 28 (4) ◽  
pp. 993-1005 ◽  
Author(s):  
Gitte Keidser ◽  
Nicole Matthews ◽  
Elizabeth Convery
Keyword(s):  
Hearing Aids ◽  
Care Delivery ◽  
Hearing Aid ◽  
New Technology ◽  
Successful Implementation ◽  
Semistructured Interview ◽  
User Perceptions ◽  
Template Analysis ◽  
Training And Support ◽  
And Training

Purpose The aim of this study was to examine how hearing aid candidates perceive user-driven and app-controlled hearing aids and the effect these concepts have on traditional hearing health care delivery. Method Eleven adults (3 women, 8 men), recruited among 60 participants who had completed a research study evaluating an app-controlled, self-fitting hearing aid for 12 weeks, participated in a semistructured interview. Participants were over 55 years of age and had varied experience with hearing aids and smartphones. A template analysis was applied to data. Results Five themes emerged from the interviews: (a) prerequisites to the successful implementation of user-driven and app-controlled technologies, (b) benefits and advantages of user-driven and app-controlled technologies, (c) barriers to the acceptance and use of user-driven and app-controlled technologies, (d) beliefs that age is a significant factor in how well people will adopt new technology, and (e) consequences that flow from the adoption of user-driven and app-controlled technologies. Specifically, suggested benefits of the technology included fostering empowerment and providing cheaper and more discrete options, while challenges included lack of technological self-efficacy among older adults. Training and support were emphasized as necessary for successful adaptation and were suggested to be a focus of audiologic services in the future. Conclusion User perceptions of user-driven and app-controlled hearing technologies challenge the audiologic profession to provide adequate support and training for use of the technology and manufacturers to make the technology more accessible to older people.

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