Use of protocol-driven medication refills by pharmacists decreases rheumatologist in-basket work and improves rheumatologist satisfaction

Burn-out among US physicians has been on the rise in the past few decades. Similarly, rheumatologists in the Geisinger Health System have experienced professional dissatisfaction through significant administrative burden and in-basket work. We embedded pharmacists into our rheumatology team in 2019 with the aim of reallocating medication refills to pharmacists, trained professionals in this domain, to help reduce physician workload and burn-out and increase satisfaction. Protocol-driven medication refill parameters per the American College of Rheumatology guidelines and new refill workflows for disease-modifying antirheumatic drugs (DMARDs) and non-DMARDs were created for use by our rheumatology pharmacists. Monthly data on medication refill volume and time saved for rheumatologists were collected from 1 January 2019 to 31 March 2021. Statistical analysis was completed via Shewhart p-charts. The volume of refills by rheumatologists decreased by 73% and the time saved per month for all the rheumatologists increased to 41.5 hours within 6 months. Physicians’ feedback was obtained via anonymous electronic surveys preintervention and postintervention. The statistical difference between the presurveys and postsurveys was calculated via two-tailed unpaired t-testing. It demonstrated reduced burn-out and improved workplace satisfaction. This study showed that the integration of rheumatology pharmacists into our practice can help improve the work life of the rheumatologists. It is important for physicians’ well-being to practice at the top of their scope and achieve work–life balance.

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Current therapeutic options for the treatment of juvenile idiopathic arthritis

Current Rheumatology Reviews ◽

10.2174/1573403x16999200917151805 ◽

2020 ◽

Vol 16 ◽

Author(s):

Ioanna G. Saougou ◽

Theodora E. Markatseli ◽

Paraskevi V. Voulgari ◽

Alexandros A. Drosos

Keyword(s):

Juvenile Idiopathic Arthritis ◽

International Institutions ◽

Relevant Literature ◽

Joint Damage ◽

Chronic Inflammatory Disease ◽

Biologic Therapies ◽

Disease Modifying Antirheumatic Drugs ◽

Antirheumatic Drugs ◽

The Past ◽

American College Of Rheumatology

: Juvenile idiopathic arthritis [JIA] is a chronic inflammatory disease and an exclusion diagnosis that includes all forms of arthritis that persist more than 6 weeks under the age of 16. Although there is not yet a cure for JIA, recent advances in the therapeutic field have created a more hopeful present and future for the patients. In the past, therapies for JIA have depended on non-steroidal medication, conventional synthetic disease modifying antirheumatic drugs and corticosteroids. However, over the last decades, the advent of biologic therapies in JIA contributed to the preservation of functional activity, control of pain, avoidance of joint damage and extra-articular manifestations. Furthermore, over the last years, international institutions such as the American College of Rheumatology have released recommendations and guidelines for rheumatologists for optimal JIA management. All the above, have revolutionized the treatment of JIA with promising outcomes. To this end, we review and discuss appropriately the relevant literature.

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Forty-five good things: a prospective pilot study of the Three Good Things well-being intervention in the USA for healthcare worker emotional exhaustion, depression, work–life balance and happiness

BMJ Open ◽

10.1136/bmjopen-2018-022695 ◽

2019 ◽

Vol 9 (3) ◽

pp. e022695 ◽

Cited By ~ 18

Author(s):

J Bryan Sexton ◽

Kathryn C Adair

Keyword(s):

Pilot Study ◽

Emotional Exhaustion ◽

Well Being ◽

Work Life ◽

Effect Sizes ◽

Work Life Balance ◽

Depression Symptoms ◽

Life Balance ◽

Prospective Pilot Study ◽

Burn Out

ObjectivesHigh rates of healthcare worker (HCW) burn-out have led many to label it an ‘epidemic’ urgently requiring interventions. This prospective pilot study examined the efficacy, feasibility and evaluation of the ‘Three Good Things’ (3GT) intervention for HCWs, and added burn-out and work–life balance to the set of well-being metrics.Methods228 HCWs participated in a prospective, repeated measures study of a web-based 15-day long 3GT intervention. Assessments were collected at baseline and 1, 6 and 12-month post-intervention. The primary measure of efficacy was a derivative of the emotional exhaustion subscale of the Maslach Burnout Inventory. The secondary measures were validated instruments assessing depression symptoms, subjective happiness, and work–life balance. Paired samples t-tests and Cohen’s d effect sizes for correlated samples were used to examine the efficacy of the intervention.Results3GT participants exhibited significant improvements from baseline in emotional exhaustion, depression symptoms and happiness at 1 month, 6 months and 12 months, and in work–life balance at 1 month and 6 months (effect sizes 0.16–0.52). Exploratory subgroup analyses of participants meeting ‘concerning’ criteria at baseline revealed even larger effects at all assessment points (0.55–1.57). Attrition rates were similar to prior 3GT interventions.Conclusion3GT appears a promising low-cost and brief intervention for improving HCW well-being.Ethics and disseminationThis study is approved by the Institutional Review Board of Duke University Health System (Pro00063703). All participants are required to give their informed consent prior to any study procedure.

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Doctors don’t Do-little: a national cross-sectional study of workplace well-being of hospital doctors in Ireland

BMJ Open ◽

10.1136/bmjopen-2018-025433 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025433 ◽

Cited By ~ 7

Author(s):

Blánaid Hayes ◽

Lucia Prihodova ◽

Gillian Walsh ◽

Frank Doyle ◽

Sally Doherty

Keyword(s):

Work Ability ◽

Well Being ◽

Cross Sectional Study ◽

Work Life ◽

Work Life Balance ◽

Sectional Study ◽

Cross Sectional ◽

Life Balance ◽

Burn Out ◽

Hospital Doctors

ObjectivesTo measure levels of occupational stress, burn-out, work–life balance, presenteeism, work ability (balance between work and personal resources) and desire to practise in trainee and consultant hospital doctors in Ireland.DesignNational cross-sectional study of randomised sample of hospital doctors. Participants provided sociodemographic data (age, sex), work grade (consultant, higher/basic specialist trainee), specialty, work hours and completed workplace well-being questionnaires (Effort–Reward Imbalance (ERI) Scale, overcommitment, Maslach Burnout Inventory) and single item measures of work ability, presenteeism, work–life balance and desire to practise.SettingIrish publicly funded hospitals and residential institutions.Participants1749 doctors (response rate of 55%). All hospital specialties were represented except radiology.Results29% of respondents had insufficient work ability and there was no sex, age or grade difference. 70.6% reported strong or very strong desire to practise medicine, 22% reported good work–life balance, 82% experienced workplace stress, with effort greatly exceeding reward, exacerbated by overcommitment. Burn-out was evident in 29.7% and was significantly associated with male sex, younger age, lower years of practice, lower desire to practise, lower work ability, higher ERI ratio and greater overcommitment. Apart from the measures of work ability and overcommitment, there was no sex or age difference across any variable. However, ERI and burn-out were significantly lower in consultants than trainees.ConclusionsHospital doctors across all grades in Ireland had insufficient work ability, low levels of work–life balance, high levels of work stress and almost one-third experienced burn-out indicating suboptimal work conditions and environment. Yet, most had high desire to practise medicine. Measurement of these indices should become a quality indicator for hospitals and research should focus on the efficacy of a range of individual and organisational interventions for burn-out and occupational stress.

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EDITORIAL INTRODUCTION

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v9i2.966 ◽

2021 ◽

Vol 9 (2) ◽

Author(s):

James Appleyard ◽

Werdie Van Staden

Keyword(s):

Quality Of Life ◽

Medical Students ◽

Health System ◽

Working Conditions ◽

Well Being ◽

Work Life ◽

Positive Health ◽

Life Balance ◽

Burn Out

This issue contributes a further four international articles from the USA, Peru, Germany and Japan on wellbeing, work-life balance and burn-out, which underline the need for a person- and people-centered approach. The first paper explores, documents and discusses the concepts and procedures for positive health, particularly well-being and quality of life, within the framework of person centered medicine and health. The importance ascribed to positive health is growing internationally, with particular focus on Well-being and Quality of Life. The paper identifies some useful and encompassing instruments for assessing these concepts, which have general applicability and are substantially validated internationally. These instruments and the principles underlying them need to be incorporated into the education of medical students. Our second paper ‘on becoming a physician’ provides a qualitative analysis of medical students’ perspectives on their academic environment, well-being and mental health. Positive human connections during undergraduate years are key to dealing with adversity and helping to shape a healthier generation of practitioners Once in practice as young physicians, our third paper from Japan concludes that in order to continue their careers without burning out and excel in various fields, a health system must be created that allows for efficient learning and work–life balance for both mental and physical wellbeing. Once in established practice the maintenance of professional relationships and the nature of physicians employment within the health system become crucial as is clear from our fourth article from Germany where satisfaction with working conditions and income is high among German self-employed ambulatory doctors and psychotherapists whereas being employed by employers who are increasingly interfering with clinical practice – whether in a hospital or in an ambulatory practice – appears to decrease satisfaction with working conditions among doctors. This group is at higher risk of experiencing burn-out or have their well-being compromised, and a decreased satisfaction with working conditions among doctors.

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Work-life and safety support among construction workers: Effects on health and well-being

PsycEXTRA Dataset ◽

10.1037/e577572014-461 ◽

2013 ◽

Author(s):

Leslie Hammer ◽

Donald Truxillo ◽

Todd Bodner ◽

Mariah Kraner

Keyword(s):

Well Being ◽

Work Life ◽

Construction Workers ◽

Health And Well Being

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Quality of life of patients with Sjogren’s disease with ongoing therapy with diseasemodifying antirheumatic drugs

Medical alphabet ◽

10.33667/2078-5631-2020-15-33-38 ◽

2020 ◽

pp. 33-38

Author(s):

E. Yu. Gan ◽

L. P. Evstigneeva

Keyword(s):

Quality Of Life ◽

Short Form ◽

Life Quality ◽

Well Being ◽

Disease Modifying Antirheumatic Drugs ◽

Antirheumatic Drugs ◽

Sf 36 ◽

Disease Modifying ◽

Sjögren’S Disease

Purpose of the study. Assessing the association between the life quality of patients with Sjogren’s Disease and ongoing therapy with various disease-modifying antirheumatic drugs.Material and methods. The study was conducted on the basis of the regional rheumatology center of the consultative diagnostic clinic of the Sverdlovsk Regional Clinical Hospital No. 1. This work is based on the results of a simultaneous study of 74 patients with primary Sjogren’s Disease (SD), distributed in three comparison groups receiving various disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine. The diagnosis of SD was carried out according to European-American criteria AECGC (2002) [18]. In order to analyze the quality of life of patients with SD, the 36-Item Short Form Health Survey (SF‑36) was used. Statistical data processing was carried out using Statistica 7.0 program.Results. Assessment of the quality of life of patients with SD, which is an integrative criterion of human health and well-being, revealed the absence of statistically significant differences (p > 0.05) on eight scales and two health components of the SF‑36 questionnaire in the analyzed groups that differ in the treatment of disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine.Conclusions. The obtained data indicate an equivalent quality of life in SD patients treated with different disease-modifying antirheumatic drugs methotrexate, chlorambucil and hydroxychloroquine, and therefore hydroxychloroquine can be considered as an alternative basic therapy in patients with SD with certain limitations and contraindications methotrexate and chlorambucil.

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Enabling Community Well-being Self-Monitoring in the Context of Mining: The Naskapi Nation of Kawawachikamach

Engaged Scholar Journal Community-Engaged Research Teaching and Learning ◽

10.15402/esj.v1i2.115 ◽

2016 ◽

Vol 1 (2) ◽

Cited By ~ 1

Author(s):

Robert Klinck ◽

Ben Bradshaw ◽

Ruby Sandy ◽

Silas Nabinacaboo ◽

Mannie Mameanskum ◽

...

Keyword(s):

Indigenous Peoples ◽

Well Being ◽

Aboriginal Community ◽

Self Monitoring ◽

Community Engaged Research ◽

The Past ◽

Mineral Development ◽

Iron Deposits ◽

Term Monitoring

The Naskapi Nation of Kawawachikamach is an Aboriginal community located in northern Quebec near the Labrador Border. Given the region’s rich iron deposits, the Naskapi Nation has considerable experience with major mineral development, first in the 1950s to the 1980s, and again in the past decade as companies implement plans for further extraction. This has raised concerns regarding a range of environmental and socio-economic impacts that may be caused by renewed development. These concerns have led to an interest among the Naskapi to develop a means to track community well-being over time using indicators of their own design. Exemplifying community-engaged research, this paper describes the beginning development of such a tool in fall 2012—the creation of a baseline of community well-being against which mining-induced change can be identified. Its development owes much to the remarkable and sustained contribution of many key members of the Naskapi Nation. If on-going surveying is completed based on the chosen indicators, the Nation will be better positioned to recognize shifts in its well-being and to communicate these shifts to its partners. In addition, long-term monitoring will allow the Naskapi Nation to contribute to more universal understanding of the impacts of mining for Indigenous peoples.

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Work Life Balance and Job Satisfaction - A Structural Equation Modeling

GIS Business ◽

10.26643/gis.v14i6.11692 ◽

2019 ◽

Vol 14 (6) ◽

pp. 156-162

Author(s):

Dr. D. Shoba ◽

Dr. G. Suganthi

Keyword(s):

Job Satisfaction ◽

Structural Equation ◽

Well Being ◽

Work Life ◽

Work Life Balance ◽

Equation Modeling ◽

Subjective Well Being ◽

Life Balance ◽

Study Results

Work-Life balance has its importance from ancient days and the concept is very old, from the day the world has been created. There was a drastic change that has occurred in the market of teachers and their personal profiles. There are tremendous changes in various families which have bartered from the ‘breadwinner’ role of traditional men to single parent families and dual earning couples. This study furnishes an insight into work life balance and job satisfaction of teachers working in School of Villupuram District. The sample comprises of 75 school teachers from Government and private schools in Villupuram District. The Study results that there is increasing mediating evidence in Work-life balance as well as Job satisfaction of teachers are not affected by the type of school in which they are working. Job satisfaction or Pleasure of life will be affected as a whole by Work life balance of an individual which is the main which can be calculated by construct of subjective well being.

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