Differentiating Behavioral Disturbances of Dementia From Drug Side Effects

1997 ◽  
Vol 8 (S3) ◽  
pp. 429-434 ◽  
Author(s):  
John H. Eastham ◽  
Dilip V. Jeste
Keyword(s):  
Side Effects ◽  
Behavioral Problems ◽  
Patient Management ◽  
Cost Of Care ◽  
New Drugs ◽  
Behavioral Disturbance ◽  
Drug Side Effects ◽  
Comorbid Conditions ◽  
Behavioral Disturbances

Patients with dementia may be treated with several drugs because of comorbid conditions or symptoms related to the dementia itself. Such drug treatment can complicate patient management because many drugs may cause side effects, such as depression and Parkinsonism, that also are considered behavioral disturbances of dementia. Distinguishing between drug side effects and behavioral problems is difficult but necessary for several reasons. Attributing the behavioral disturbance to an incorrect cause can affect the type of treatment selected and the patient's response to it. It also can increase the overall cost of care and adversely affect the patient's quality of life. Making this distinction has theoretical importance as well, including the development of new drugs that have fewer behavioral side effects.

P026 TOP GOALS AND CONCERNS REPORTED BY INDIVIDUALS WITH INFLAMMATORY BOWEL DISEASE AT OUTPATIENT GASTROENTEROLOGY CLINIC VISITS

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S57-S57
Author(s):  
Chung Sang Tse ◽  
Samir Shah ◽  
Damara Crate ◽  
Ridhima Oberai ◽  
Caroline Hwang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Side Effects ◽  
Bowel Disease ◽  
Clinical Course ◽  
Cost Of Care ◽  
Psychosocial Effects ◽  
Inflammatory Bowel ◽  
Clinic Visits

Abstract Background The goals of managing inflammatory bowel disease (IBD) include eliminating disease symptoms, improving quality of life, and preventing disease progression/complications. In patients with chronic illnesses, their perception of the illness, emotional reactions, and concerns about the disease/treatment can influence self-management behaviors and their quality of life.[1] Studies of IBD patients’ self-reported disease concerns and subjective perceptions of quality of life are lacking. Here, we aim to understand IBD patients’ top concerns and goals using survey data collected within IBD Qorus, a nationwide Learning Health System for IBD with approximately 40 participating sites. Methods We conducted a qualitative content analysis on an open-ended question that was sent to IBD patients prior to their clinic visits with an IBD Qorus provider: “Currently, what is your number ONE concern or goal related to your IBD? This could be related to a specific symptom (e.g., diarrhea), worry for the future (e.g., need for surgery, cost of care) or how IBD might impact an upcoming life event (e.g., wedding, travel). Or you can report that you have no current concerns or goals.” Using the inductive approach, two independent researchers (who are not involved with direct clinical care of IBD Qorus patients) coded the responses into major and minor themes, which were then discussed with a third independent coder (an IBD Qorus provider). Each response received one or more codes (if multiple themes were mentioned). Results In the first 100 responses from a purposeful sample of six IBD Qorus sites (3 academic and 3 community sites in diverse rural and urban geographic locations), four domains of goals/concerns were identified: symptoms and goals for the symptoms (28/100), medication and their efficacy/side effects (28/100), IBD clinical course and management (29/100), and psychosocial effects of IBD (29/100) (Figure 1). The most common themes in each domain were: abdominal pain and fecal urgency (symptoms), biologics and side effects (medications), surgery and nutrition (IBD clinical course and management), and fear/worry and traveling (psychosocial effects) (Figure 1). Fives responses contained no concerns/goals and three were uncodeable. Conclusion IBD patients’ disease-related concerns and goals are broad and diverse, and our study suggests that they are evenly distributed between symptoms, medications, disease course, and psychosocial effects. Understanding patients’ perceptions about the disease and the types of information they desire can aid providers to create and achieve shared treatment goals. Reference

Perspectives of an Institution-Based Research Nurse

1997 ◽  
Vol 8 (S3) ◽  
pp. 459-463 ◽  
Author(s):  
Astrid Norberg
Keyword(s):  
Quality Of Care ◽  
Rating Scales ◽  
Behavioral Disturbance ◽  
Behavioral Disturbances ◽  
Premorbid Personality ◽  
Care Plans ◽  
Dysfunctional Behavior ◽  
Effective Care ◽  
Institutionalized Patients

Behavioral disturbance of dementia are described in the literature as related to brain damage and premorbid personality. This perspective, however, does not consider that a patient with dementia is a human being who feels, thinks, wishes, and behaves. It also does not consider that the dysfunctional behavior may be related to the patient's other behaviors or to the behaviors of the patient's caregivers. Although rating scales are commonly used to assess behavioral disturbances, an assessment that a patient shouts, for example, is meaningless unless the situation in which the patient shouts is considered. What provoked the patient to shout? How does the caregiver react when the patient shouts? Understanding the context in which the behavioral disturbance occurs is important for developing effective care plans. Effective treatment is necessary because behavioral disturbances can negatively affect the quality of care received by institutionalized patients with dementia.

Depression, Anxiety, and Sleep Disturbances

1997 ◽  
Vol 8 (S3) ◽  
pp. 415-418 ◽  
Author(s):  
Burton V. Reifler
Keyword(s):  
Quality Of Life ◽  
Family Member ◽  
Behavioral Problems ◽  
Sleep Disturbances ◽  
Current Knowledge ◽  
Behavioral Disturbances ◽  
Appropriate Treatment ◽  
Considerable Impact

Of the numerous behavioral disturbances identified in patients with dementia, depression, anxiety, and sleep disturbances can have a considerable impact on the quality of life of both the patient and the caregiver, particularly if the caregiver is a family member. Our task as clinicians is to identify the most appropriate treatment based on current knowledge of these behavioral problems.

Research Methodologic Issues in Evaluating Behavioral Disturbances of Dementia

1996 ◽  
Vol 8 (S2) ◽  
pp. 149-150 ◽  
Author(s):  
Sanford I. Finkel
Keyword(s):  
Quality Of Life ◽  
Behavioral Problems ◽  
Neuropsychiatric Symptoms ◽  
Healthcare Providers ◽  
Case Description ◽  
Behavioral Disturbances ◽  
Policy Makers ◽  
Societal Costs ◽  
Intrinsic Component

Behavioral disturbances of dementia have been noted by early researchers in the field, including Esquirol (1838) and Alzheimer in his seminal case description (1907). Increasingly, family members, healthcare providers, and policy makers are realizing that neuropsychiatric symptoms and behavioral problems are an intrinsic component of Alzheimer's disease and result in caregiver psychopathology, early institutionalization, substantial societal costs, and detriment in the quality of life for the patient and caregivers.

scholarly journals Evaluation of Drug Side Effects Chemotherapy on Quality of Life (QOL) Breast Cancer Patients at Hospital X in Jakarta

2019 ◽  
Vol 17 (1) ◽  
pp. 9
Author(s):  
Sondang Khairani ◽  
Sesilia A Keban ◽  
Meyke Afrianty
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Sampling Technique ◽  
Cancer Type ◽  
Drug Side Effects ◽  
Breast Cancer Patients ◽  
Chemotherapy Drugs

Breast cancer is the number one cancer type discovered at women in the world. Most causes are genetic factors and hormonal factors. One cancer treatments with chemotherapy. Chemotherapy drugs active in cells dividing and reproducing, but cells normally to be affected by chemotherapy and side effects from chemotherapy drugs affect quality of life. The aim of the study to evaluate side effects of chemotherapy drugs on the quality of life of breast cancer patients. Sampling technique observational prospective breast cancer patients with completed the chemotherapy cycle from September 2017 to April 2018 with descriptive analysis and statistics by looking correlation between drug side effects and Quality of Life (QoL). Results of the study were side effects of fatigue 100%, nausea 67,5%, vomiting 60%, no appetite 63,75%, fever 42,5%, joint pain 43,75%, diarrhea 16,25%, difficulty swallowing 16,25%, allergies 5%, itching 1,25%, mouth sores 3,75%, swollen right hand 1,25%, constipation 3,75%. QoL results are physical 6,2%; psychology 5,3%; social 4,9%; spiritual 6,8%. Results of Sperman test showed no correlation between the side effects of chemotherapy and QoL P> 0,05. This study shows that there is no relationship between the side effects drug chemotherapy and QoL in breast cancer patients.

Nursing Home Research From Investigators' Perspective

1997 ◽  
Vol 8 (S3) ◽  
pp. 371-373
Author(s):  
Sanford I. Finkel ◽  
John Lyons
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Family Caregivers ◽  
Behavioral Problems ◽  
Negative Effects ◽  
Behavioral Disturbances ◽  
Behaviorally Disturbed

The negative effects of behavioral disturbances of dementia on the quality of life of both the patient and caregiver have been recognized for some time. For family caregivers, behavioral problems increase stress and may lead to institutionalization of the patient. In nursing homes, professional caregivers may have difficulty managing behaviorally disturbed patients and avoid interactions with them.

Perspectives of a Clinical Trials Research Nurse

1997 ◽  
Vol 8 (S3) ◽  
pp. 465-468 ◽  
Author(s):  
Carolyn York Cooler
Keyword(s):  
Behavioral Problems ◽  
Adult Child ◽  
Well Being ◽  
Community Settings ◽  
Behavioral Disturbances ◽  
Term Care ◽  
Care Facilities ◽  
Considerable Impact

In both the nursing home and community settings, behavioral disturbances of dementia have a considerable impact on caregivers. In long-term care facilities, behavioral problems impede the ability of nursing staff to perform their duties and affect their sense of job satisfaction. In the community, where persons with dementia typically are cared for by a spouse or adult child, behavioral problems affect the quality of life and sense of well-being of the caregiver. The overwhelming stress and feelings of burden engendered by behavioral disturbances often lead family caregivers to place patients in nursing homes.

Investigating side effect modules in the interactome and their use in drug adverse effect discovery

2016 ◽  
Author(s):  
Emre Guney
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Drug Targets ◽  
Large Scale ◽  
New Drugs ◽  
Drug Side Effects ◽  
Data Set ◽  
Drug Adverse Effect ◽  
Phase Ii And Iii

One of the biggest challenges in drug development is increasing costs of bringing new drugs to the market. Many candidate drugs fail during phase II and III trials due to unexpected side effects and experimental methods remain cost ineffective for large scale discovery of adverse effects. Alternatively, computational methods are used to characterize drug side effects, but they often rely on training predictors based on drug and side effect similarity. Moreover, these methods are typically tailored to the underlying data set and provide little mechanistic insights on the predicted associations. In this study, we investigate the role of network topology in explaining observed side effects of drugs. We find that drug targets are closer in the interactome to the proteins inducing the known side effects of the drug compared to the proteins associated with the rest of the side effects. We show that the interactome based proximity can be used to identify side effects and we highlight a use case in which interactome-based side effect prediction can give insights on drug side effects observed in the clinic.

scholarly journals FACTORS RELATED TO THE SUCCESS OF THE TREATMENT PROGRAM OF MULTIDRUG-RESISTANT TUBERCULOSIS IN POLYCLINIC OF MDR-TB OF THE GENERAL HOSPITAL OF UNDATA PALU, INDONESIA

2017 ◽  
Vol 3 (4) ◽  
pp. 162-166
Author(s):  
Muhammad Ryman Napirah ◽  
Bertin Ayu Wandira ◽  
Ana Aulia
Keyword(s):  
Side Effects ◽  
General Hospital ◽  
Multidrug Resistant ◽  
Drug Control ◽  
Drug Side Effects ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
The Government

Background: Incidence of Multi Drug Resistant Tuberculosis remains high in Indonesia. Thus, understanding the factors related to the success of the Government Program on the treatment of Multidrug-resistant is necessity. Objective: This study aims to determine the factors related to the success of government programs on the treatment of MDR-TB patients in Polyclinic of MDR-TB of Undata Palu Hospital.Methods: This was a correlational study with cross-sectional design conducted in the polyclinic of MDR-TB of the General Hospital of Undata Palu from October 2016 to November 2016. There were 46 patients recruited by total sampling. Chi-square was used for data analysis.Results: Findings showed that there were statistically significant correlations between knowledge (p = 0.002), the regularity of treatment (p = 0.000), the role of drug control (p = 0.010), drug side effects (p = 0.000) and quality of service of health workers (p = 0.001) with the success of multidrug-resistant tuberculosis program. There was no correlation between distance to health facilities (p = 0.315) and the success of the treatment.Conclusion: There were significant relationships between knowledge, regularity of treatment, drug control, drug side effects, quality of health staffs and the success of multidrug-resistant tuberculosis program. These factors could be considered important for the government to the success of multidrug-resistant tuberculosis program, especially in the polyclinic of MDR-TB of the General Hospital of Undata Palu.

Effect of megestrol acetate on quality of life in a dose-response trial in women with advanced breast cancer. The Cancer and Leukemia Group B.

1993 ◽  
Vol 11 (11) ◽  
pp. 2081-2089 ◽  
Author(s):  
A B Kornblith ◽  
D R Hollis ◽  
E Zuckerman ◽  
A P Lyss ◽  
G P Canellos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Megestrol Acetate ◽  
Drug Side Effects ◽  
Psychologic Distress ◽  
Group B ◽  
Higher Doses ◽  
Leukemia Group

PURPOSE The impact of the side effects of megestrol acetate on the quality of life of noncachectic women with advanced breast cancer was studied in a dose-response clinical trial of the Cancer and Leukemia Group B (CALGB 8741). Side effects of appetite increase and weight gain at higher doses were predicted to have a negative effect on quality of life. PATIENTS AND METHODS Stage IV breast cancer patients were randomized to receive either 160, 800, or 1,600 mg/d of megestrol acetate. Quality of life was assessed in 131 patients at trial entry and at 1 and 3 months while on treatment, by telephone interview, using the following measures: the Functional Living Index-Cancer (FLIC), Rand Functional Limitations Scale, Rand Mental Health Inventory (MHI), the Body Image Subscale, and linear analog scales of drug side effects. RESULTS At 3 months, women treated with 160 mg/d reported less severe side effects (P < .0005), better physical functioning (FLS, P < .0005), less psychologic distress (MHI, P = .008), and an improvement in overall quality of life (FLIC, P = .003) from the time of study entry as compared with those treated with 1,600 mg/d. Patients who received the 800-mg/d dose fell between the low- and high-dose arms in reported intensity of drug side effects, but responded similarly to those in the 160-mg/d group in terms of physical functioning, psychologic distress, and overall quality of life. CONCLUSION Unless additional follow-up data demonstrate a survival advantage at higher doses, the 160-mg/d dose is optimal, achieving maximal treatment effect with the fewest side effects and better quality of life.

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