Personalization in Practice: Methods and Applications

2021 ◽  
Author(s):  
Dmitri Goldenberg ◽  
Kostia Kofman ◽  
Javier Albert ◽  
Sarai Mizrachi ◽  
Adam Horowitz ◽  
...  
Keyword(s):  
Practice Methods

Development of Harmonized Outcome Measures for Use in Patient Registries and Clinical Practice: Methods and Lessons Learned

2019 ◽  
Author(s):  
Michelle B. Leavy ◽  
Claudia Schur ◽  
Ferhat Q. Kassamali ◽  
Margaret Edder Johnson ◽  
Raj Sabharwal ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Outcome Measures ◽  
Lessons Learned ◽  
Patient Registries ◽  
Practice Methods

scholarly journals Future Pharmacists’ Opinions on the Facilitation of Self-Care with Over-the-Counter Products and Whether This Should Remain a Core Role

Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 132
Author(s):  
Lezley-Anne Hanna ◽  
Alana Murphy ◽  
Maurice Hall ◽  
Rebecca Craig
Keyword(s):  
Emergency Contraception ◽  
Self Care ◽  
Pharmacy Students ◽  
Single Institution ◽  
Self Medication ◽  
Over The Counter ◽  
Otc Medicines ◽  
Practice Methods ◽  
Identifiable Data

Background: The aim was to investigate pharmacy students’ views on the role of the pharmacist in facilitating self-care with over-the-counter (OTC) medicines, particularly in light of new roles, and establish personal practice. Methods: Final year pharmacy students at Queen’s University Belfast were invited to participate. Data were collected via a pre-piloted questionnaire, distributed at a compulsory class (only non-identifiable data were requested). Descriptive statistics were performed, and non-parametric tests were employed for inferential statistical analysis (responses by gender). Results: The response rate was 87.6% (78/89); 34.6% (27/78) males and 65.4% (51/78) females. Over a third [34.6% (27/78)] reported using OTC medicines about once a month. All appreciated the importance of an evidence-based approach to optimize patient care. Most [(96.2% (75/78)] deemed OTC consultations should remain a fundamental responsibility of pharmacists and 69.2% (54/78) thought OTC consultations have the potential to be as complex as independent pharmacist prescribing. Females felt more confident recommending OTC emergency contraception than males (p = 0.002 for levonorgestrel and p = 0.011 for ulipristal acetate). Many [61.5% (48/78)] considered more medicines should not be deregulated from prescription-only status. Conclusions: Data from this single institution suggests that enabling self-medication is an important part of practice but there were confidence issues around deregulations.

scholarly journals Developing a Culturally Sensitive ICF-Based Tool to Describe Functioning of Children with Autism Spectrum Disorder: TEA-CIFunciona Version 1.0 Pilot Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3720
Author(s):  
Silvana B. Napoli ◽  
María Paula Vitale ◽  
Pablo J. Cafiero ◽  
María Belén Micheletti ◽  
Paula Pedernera Bradichansky ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Latin American ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
International Classification Of Functioning ◽  
Children With Asd ◽  
Practice Methods ◽  
Icf Core Sets ◽  
Family Centered

Background: Autism spectrum disorder (ASD) affects the daily functioning of children and their families; however, in Argentina, there are no standardized tools to guide the description, evaluation, and follow-up of functioning and disability of children with ASD. To fill this gap, the overarching purpose of this study was to create a novel tool guided by the International Classification of Functioning, Disability, and Health (ICF) Core Sets for ASD for clinical practice. Methods: A multistep methodology was used to identify the most relevant ICF categories for an Argentinian clinical setting. The content of this ICF-based shortlist was piloted and revised according to the results. Subsequently, a toolbox of measures was proposed to operationalize each ICF category. Finally, profiles of the functioning of 100 children with ASD were created. Results: An ICF-based tool called TEA-CIFunciona was created, consisting of 32 ICF categories (10 body functions, 15 activities and participation, 7 environmental factors categories). The application of TEA-CIFunciona incorporated a family-centered approach in ASD evaluations and helped identify functional needs. Conclusions: TEA-CIFunciona is the first ICF-based instrument that guides the description of functioning of children with ASD in Argentina. TEA-CIFunciona standardizes collaborative assessments in pediatric ASD populations in Latin American contexts.

scholarly journals The Role of Research in Guiding Treatment for Women’s Health: A Qualitative Study of Traditional Chinese Medicine Acupuncturists

2021 ◽  
Vol 18 (2) ◽  
pp. 834
Author(s):  
Mike Armour ◽  
Debra Betts ◽  
Kate Roberts ◽  
Susanne Armour ◽  
Caroline A. Smith
Keyword(s):  
Clinical Practice ◽  
Women’S Health ◽  
Women's Health ◽  
Clinical Decision ◽  
Health Conditions ◽  
Case Histories ◽  
Research Literacy ◽  
The Right ◽  
Practice Methods

Background: Surveys of acupuncture practitioners worldwide have shown an increase in the use of acupuncture to treat women’s health conditions over the last ten years. Published studies have explored the effectiveness of acupuncture for various conditions such as period pain, fertility, and labor induction. However, it is unclear what role, if any, peer-reviewed research plays in guiding practice. Methods: Acupuncturists with a significant women’s health caseload were interviewed online in three small groups to explore factors that contribute to acupuncturists’ clinical decision made around treatment approaches and research. Results: Eleven practitioners participated in the focus groups. The overarching theme that emerged was one of ‘Not mainstream but a stream.’ This captured two themes relating to acupuncture as a distinct practice: ‘working with what you’ve got’ as well as ‘finding the right lens’, illustrating practitioners’ perception of research needing to be more relevant to clinical practice. Conclusions: Acupuncture practitioners treating women’s health conditions reported a disconnect between their clinical practice and the design of clinical trials, predominantly due to what they perceived as a lack of individualization of treatment. Case histories were popular as a learning tool and could be used to support increasing research literacy.

scholarly journals Reasons for Tooth Extractions and Related Risk Factors in Adult Patients: A Cohort Study

2020 ◽  
Vol 17 (7) ◽  
pp. 2575
Author(s):  
Pier Carmine Passarelli ◽  
Stefano Pagnoni ◽  
Giovan Battista Piccirillo ◽  
Viviana Desantis ◽  
Michele Benegiamo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Periodontal Disease ◽  
Smoking Habit ◽  
Extraction Process ◽  
Adult Patients ◽  
Diabetic Patients ◽  
Related Risk ◽  
Potential Risk Factors ◽  
Practice Methods ◽  
Tooth Extractions

Background: The aim of this study was to evaluate oral status, the reasons for tooth extractions and related risk factors in adult patients attending a hospital dental practice. Methods: 120 consecutive patients ranging from 23 to 91 years in age (mean age of 63.3 ± 15.8) having a total of 554 teeth extracted were included. Surveys about general health status were conducted and potential risk factors such as smoking, diabetes and age were investigated. Results: a total of 1795 teeth were missing after extraction procedures and the mean number of remaining teeth after the extraction process was 16.8 ± 9.1 per patient. Caries (52.2%) was the most common reason for extraction along with periodontal disease (35.7%). Males were more prone to extractions, with 394 of the teeth extracted out of the total of 554 (71.1%). Male sex (β = 2.89; 95% CI 1.26, 4.53; p = 0.001) and smoking habit (β = 2.95; 95% CI 1.12, 4.79; p = 0.002) were related to a higher number of teeth extracted. Age (β = −0.24; 95% CI −0.31, −0.16; p < 0.001) and diabetes (β = −4.47; 95% CI −7.61, −1.33; p = 0.006) were related to a higher number of missing teeth at evaluation time. Moreover, periodontal disease was more common as a reason of extraction among diabetic patients than among non-diabetic ones (p = 0.04). Conclusions: caries and periodontal disease were the most common causes of extraction in a relatively old study population: further screening strategies might be required for the early interception of caries and periodontal disease.

scholarly journals Safer Prescribing and Care for the Elderly (SPACE): feasibility of audit and feedback plus practice mail-out to patients with high-risk prescribing

2017 ◽  
Vol 9 (2) ◽  
pp. 145 ◽  
Author(s):  
Katharine Wallis ◽  
Rebecca Tuckey
Keyword(s):  
General Practice ◽  
High Risk ◽  
The Elderly ◽  
Audit And Feedback ◽  
Structured Interviews ◽  
Medicines Information ◽  
Care For The Elderly ◽  
Increased Risk ◽  
Information Brochure ◽  
Practice Methods

ABSTRACT INTRODUCTION High-risk prescribing in general practice is common and places patients at increased risk of adverse events. AIM The Safer Prescribing and Care for the Elderly (SPACE) intervention, comprising audit and feedback plus practice mail-out to patients with high-risk prescribing, was designed to promote medicines review and support safer prescribing. This study aims to test the SPACE intervention feasibility in general practice. METHODS This feasibility study involved an Auckland Primary Health Organisation (PHO), a clinical advisory pharmacist, two purposively sampled urban general practices, and seven GPs. The acceptability and utility of the SPACE intervention were assessed by semi- structured interviews involving study participants, including 11 patients with high-risk prescribing. Interviews were audio-recorded, transcribed verbatim and analysed using a general inductive approach to identify emergent themes. RESULTS The pharmacist said the SPACE intervention facilitated communication with GPs, and provided a platform for their clinical advisory role at no extra cost to the PHO. GPs said the feedback session with the pharmacist was educational but added to time pressures. GPs selected 29 patients for the mail-out. Some GPs were concerned the mail-out might upset patients, but patients said they felt cared for. Some patients intended to take the letter to their next appointment and discuss their medicines with their GP; others said there were already many things to discuss and not enough time. Some patients were confused by the medicines information brochure. DISCUSSION The SPACE intervention is feasible in general practice. The medicines information brochure needs simplification. Further research is needed to test the effect of SPACE on high-risk prescribing.

Antifungal therapy with azoles induced the syndrome of acquired apparent mineralocorticoid excess: A literature and database analysis

2021 ◽  
Author(s):  
Huan-huan Ji ◽  
Xue-wen Tang ◽  
Ni Zhang ◽  
Ben-nian Huo ◽  
Ying Liu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Antifungal Therapy ◽  
Adverse Event Reporting System ◽  
Adverse Event Reporting ◽  
Time To Event ◽  
Database Analysis ◽  
Apparent Mineralocorticoid Excess ◽  
Itraconazole Treatment ◽  
Practice Methods ◽  
Dose Dependent

Objective. We aimed to estimate the risk of varied antifungal therapy with azoles causing the syndrome of acquired apparent mineralocorticoid excess (AME) in the real-world practice. Methods. First, we conducted a disproportionality analysis based on data from the FDA Adverse Event Reporting System (FAERS) database to characterize the signal differences of triazoles - related AME. Second, a systematic review was conducted, and to describe clinical features of AME cases reported in clinical practice. Results. In the FAERS database, we identified 27 cases of triazoles - AME, posaconazole [ROR=865.37; 95%CI (464.14; 1613.45)] and itraconazole [ROR=556.21; 95% (303.05; 1020.85)] significantly increased the risk of AME events, while fluconazole, voriconazole and isavuconazole did not affect any of the mineralocorticoid excess targets. 18 studies with 39 cases raised evidence of AME following posaconazole and itraconazole treatment, and another 27 cases were identified by analysis of the description of clinical features in FAERS database. The average age of 66 patients was 55.5 years (6∼87 years). AME mainly occurs in patients with posaconazole concentrations above 3 μg/mL (mean=4.4μg/mL, range 1.8∼9.5μg/mL), and is less likely to occur when levels are below 2 μg/mL (6%). The median time to event onset was 11.5 weeks, and 50% of the adverse events occurred within 3 months for posaconazole. Conclusion. The presented study supports very recent findings that posaconazole and itraconazole but not the other three azole antifungals investigated are associated with AME and the effects were dose-dependent, which allows for a dose de-escalation strategy and for substitution with fluconazole, isavuconazole or voriconazole to resolve the adverse effects.

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