The annual adult asthma review

2021 ◽  
pp. 175573802110611
Author(s):  
Shilen Shanghavi
Keyword(s):  
Respiratory Symptoms ◽  
Hospital Admissions ◽  
Airflow Limitation ◽  
Improve Quality ◽  
Shortness Of Breath ◽  
Chest Tightness ◽  
Lung Condition ◽  
The Uk ◽  
The Cost

Asthma is a chronic inflammatory lung condition characterised by variable respiratory symptoms (wheeze, shortness of breath, cough, and chest tightness) and variable expiratory airflow limitation, usually associated with airway inflammation. It affects 1-in-11 people in the UK and is the cause of over 75 000 hospital admissions per year. Given its prevalence, and the fact that patients are mainly cared for in the community, this article aims to highlight the need for a thorough annual asthma review and what that review entails. When carried out effectively, an asthma review will improve quality of life for those living with the condition, reduce their likelihood of hospital admission and reduce the cost to the NHS as a whole.

scholarly journals Spirometry and mannitol bronchial challenge test among firefighters in Bhuj district: a questionnaire based study

2017 ◽  
Vol 4 (5) ◽  
pp. 1434
Author(s):  
Kashyap Buch ◽  
Vinayak Chauhan
Keyword(s):  
Nitric Oxide ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Respiratory Symptoms ◽  
Challenge Test ◽  
Shortness Of Breath ◽  
Chest Tightness ◽  
Bronchial Challenge ◽  
Challenge Tests ◽  
Skin Prick Tests

Background: Asthma is a common chronic lung disease that inflames and narrows the airways. It causes recurring period of wheezing, chest tightness, shortness of breath and coughing.Methods: A questionnaire, spirometry, direct and indirect airway challenge tests, exhaled nitric oxide, and skin-prick tests were administered prospectively to 100 out of 120 firefighters employed in Bhuj district, Gujarat, India. Asthma was defined as the combination of respiratory symptoms with airway hyper responsiveness.Results: Twenty out of 100 firefighters (12%) had physician-diagnosed asthma, which could be confirmed in 8 firefighters. In contrast, asthma was diagnosed in 28% (28 of 100 firefighters). Wheezing was the most sensitive symptom for the diagnosis of asthma (sensitivity, 88%; specificity, 90%).Conclusions: Asthma was considerably under diagnosed in firefighters. The combination of a structured symptom questionnaire with a bronchial challenge test allows identifying patients with asthma and should routinely be used in the assessment of active firefighters and may be of help when evaluating candidates for this profession.

Deprescribing in mental health: pragmatic steps for a better quality of life

2021 ◽  
Vol 3 (2) ◽  
pp. 60-66
Author(s):  
Nana Tomova ◽  
Ami Hale ◽  
Michelle Kruschandl
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Adverse Effects ◽  
Chronic Conditions ◽  
Adverse Reactions ◽  
Hospital Admissions ◽  
Medication Reviews ◽  
The Uk ◽  
Specialist Pharmacist

Half of the UK population take at least one prescribed medicine, while a quarter take three or more. Polypharmacy has become increasingly common, with the average number of items prescribed per person per year in England having increased by 53.8% in the last decade. Patients are prescribed, and may continue taking, medicines that cause adverse effects and where the harm of the medicine outweighs the benefit. Adverse reactions to medicines are connected to 6.5% of hospital admissions. Patients admitted with one drug side effect are more than twice as likely to be admitted with another. Deprescribing is the optimisation of medication and is a vital part of improving outcomes, managing chronic conditions, and avoiding adverse effects. The goal of deprescribing is to lessen medication burden and enhance quality of life. This article presents case studies from clinical practice in a mental health service, and highlights the merits of specialist pharmacist-led interventions with respects to medication reviews and deprescribing.

scholarly journals Are the Triptans for Migraine Therapy Worth the Cost?

2000 ◽  
Vol 27 (2) ◽  
pp. 111-115 ◽  
Author(s):  
W.J. Becker
Keyword(s):  
Quality Of Life ◽  
Significant Proportion ◽  
Cost Benefit ◽  
New Drugs ◽  
Major Advance ◽  
Improve Quality ◽  
Migraine Therapy ◽  
The Cost ◽  
Severe Migraine

ABSTRACT:The triptans represent a major advance in migraine therapy but their cost per dose greatly exceeds that of many older treatments. There is evidence that for a significant proportion of migraine patients these new drugs can show a positive cost benefit and also improve quality of life. Cost benefit would be expected to be greatest in patients with more severe migraine attacks.

scholarly journals (P2-81) A Survey of the Health Effects of Bushfire Smoke on Patients Attending Two Sydney Emergency Departments

2011 ◽  
Vol 26 (S1) ◽  
pp. s162-s163
Author(s):  
G.O. Watkins
Keyword(s):  
Emergency Departments ◽  
Respiratory Symptoms ◽  
Medication Use ◽  
Control Group ◽  
Study Group ◽  
Shortness Of Breath ◽  
Chest Tightness ◽  
Respiratory Pathology ◽  
The Subject ◽  
Emergency Department Patients

The objective of this survey was to investigate the incidence of respiratory symptoms reported by emergency department patients during the Christmas 2001–2002 Sydney bushfire disaster. Two hundred and thirty patients attending two Sydney emergency departments for any reason completed questionnaires regarding respiratory symptoms. The symptoms investigated were cough, shortness of breath, chest tightness and wheeze. The same questionnaire was subsequently administered to a similar control group who were not exposed to bushfire smoke. 51% of those surveyed during the bushfires reported one or more of the respiratory symptoms investigated compared to 31% of the control group. This difference was statistically significant (p < 0.01). A significantly higher proportion of respiratory patients in the study group reported an exacerbation of their condition and increased medication use during the bushfires (p < 0.01). The results are consistent with other research on the subject and suggest that exposure to bushfire smoke causes an increased incidence of respiratory pathology.

scholarly journals Current Issues in the Management of Genital Herpes

1995 ◽  
Vol 6 (6_suppl) ◽  
pp. 3-6 ◽  
Author(s):  
S. E. Barton
Keyword(s):  
General Practitioners ◽  
New Technologies ◽  
Clinical Manifestations ◽  
Best Interest ◽  
First Results ◽  
The Uk ◽  
Simplex Virus ◽  
The Cost ◽  
Antibody Tests

Genital infection by herpes simplex virus (HSV) produces a variety of clinical manifestations, patient presentations and management problems which differ in their severity and complexity. In the UK the currently available data for the incidence of genital HSV have been provided predominantly by the KC60 returns from diagnoses made in genitourinary (GU) medicine clinics. The increasing availability and recent publication of the first results, using HSV type-specific antibody tests within GU and non-GU patient populations, provide a tool to monitor trends in the epidemiology of HSV. It is, however, important to understand that the sexual behaviour which leads to this infection is variable and not necessarily general. The clinical availability of type-specific HSV antibody tests also gives rise to the possibility of screening individuals and informing those who test positive of their, previously undiagnosed, condition. The practicalities and problems of this approach need to be fully assessed. The possibility of uncovering previously undiagnosed cases through general practitioners is being considered, first, in terms of surveys of the general practitioners' management of genital HSV and, secondly, because the funding of health care in the UK has put the cost-effectiveness in GU medicine clinics under the spotlight. This paper will explore the new developments in the management of genital HSV and suggests adherence to the clear principles of diagnosis and treatment that is in the patient's best interest. This has the clear aim of improving the patient's quality of life, a factor which must remain paramount as new technologies, healthcare strategies and therapies become available.

scholarly journals IMPACT OF THE TREATMENT WITH COMBINATION OF TIOTROPIUM/OLODATEROL ON THE QUALITY OF LIFE IN PATIENTS WITH COPD

2021 ◽  
Vol 2021 (3) ◽  
pp. 36-42
Author(s):  
K. D. Dmytriiev
Keyword(s):  
Quality Of Life ◽  
Hospital Admissions ◽  
Clinical Course ◽  
Improve Quality ◽  
Sf 36 ◽  
Emotional Role ◽  
University Department ◽  
Medical University ◽  
E Mail

IMPACT OF THE TREATMENT WITH COMBINATION OF TIOTROPIUM/OLODATEROL ON THE QUALITY OF LIFE IN PATIENTS WITH COPD K. D. Dmytriiev Vinnytsia National Pirogov Memorial Medical University Vinnytsia, Ukraine Abstract. Materials and methods. 100 patients with the diagnosis of COPD were included into the study, their average age was (64.09 ± 1.94) years, there were 66 men (66 %) and 34 women (34 %). The average duration of COPD was (9.35 ± 2.42) years. Clinical course of COPD was assessed based on the clinical documentation of the patients. All patients filled out questionnaires for the assessment of the COPD severity — mMRC and CAT; and quality of life — SF-36, SGRQ at visit 1, visit 2 (4-6 weeks) and visit 3 (1 year). Results. Treatment with combination of tiotropium/olodaterol reliably improve COPD course, by decrease in the amount of exacerbations from (2.63 ± 0.29) to (1.63 ± 0.21) and hospital admissions from (1.2 ± 0.2) to (0.37 ± 0.11); dyspnea severity according to mMRC questionnaire from (2.3 ± 0.14) to (1.87 ± 0.15); САТfrom (23.28 ± 1.71) to (15.77 ± 1.58). Treatment with combination of tiotropium/olodaterol reliably improve quality of life according to SF-36 questionnaire, specifically physical and emotional role functioning from (16 ± 5.57) % to (35.10 ± 7.15) % and from (27.35 ± 7.83) % to (50.29 ± 7.99) %, exerted vitality from (38.26 ± 3.86) % to (49.49 ± 3.7) %, mental health from (51.56 ± 3.76) % to (61.49 ± 3.59) %, social functioning from (57.61 ± 5.93) % to (69.22 ± 5.08) % and pain intensity from (66.92 ± 5.99) % tо (81.00 ± 4.17) %. Treatment with combination of tiotropium/olodaterol reliably improve quality of life according to SGRQ questionnaire, specifically «Symptoms» scale from (76.72 ± 3.85) tо (61.37 ± 4.59), «Activity» from (65.26 ± 4.18) to (51.97 ± 3.86), «Impact» from (52.36 ± 4.65) to (35.19 ± 4.25) and Total score from(60.31 ± 3.95) tо (44.62 ± 3.89). Conclusions. Combination of tiotropium/olodaterol showed its efficacy in real clinical practice. This combination is effective in the improvement of the clinical course of COPD and decrease of symptoms intensity, which is also accompanied by the improvement of the quality of life. Key words: COPD, quality of life, tiotropium/olodaterol. K. D. Dmytriiev Vinnytsia National Pirogov Memorial University Department of the Propedeutics of Internal Medicine PhD student str. Khmelnytske highway 96, 20129, Vinnytsia, Ukraine e-mail: [email protected] Аsthma and Allergy, 2021, 3, P. 36–42.

scholarly journals Enforcing Quality Metrics over Equipment Utilization Rates as Means to Reduce Centers for Medicare and Medicaid Services Imaging Costs and Improve Quality of Care

2011 ◽  
Vol 1 ◽  
pp. 28 ◽  
Author(s):  
Amit Sura ◽  
Alexander Ho
Keyword(s):  
Quality Of Care ◽  
Quality Metrics ◽  
Utilization Rate ◽  
Improve Quality ◽  
Appropriateness Criteria ◽  
Cost Cutting ◽  
Equipment Utilization ◽  
The Cost ◽  
Fee Schedule

Radiology has been the focus of efforts to reduce inefficiencies while attempting to lower medical costs. The 2010 Medicare Physician Fee Schedule has reduced Centers for Medicare and Medicaid Services’ (CMS) reimbursements related to the technical component of imaging services. By increasing the utilization rate, the cost of equipment spreads over more studies, thus lowering the payments per procedure. Is it beneficial for CMS to focus on equipment utilization as a cost-cutting measure? Can greater financial and quality of care rewards be made by improving metrics like appropriateness criteria and pre-authorization? On examining quality metrics, such as appropriateness criteria and pre-authorization, promising results have ensued. The development and enforcement of appropriateness criteria lowers overutilization of studies without requiring unattainable fixed rates. Pre-authorization educates ordering physicians as to when imaging is indicated.

scholarly journals An exploration of the role of advanced clinical practitioners in the East of England

2020 ◽  
Vol 29 (15) ◽  
pp. 864-869
Author(s):  
Claire Hooks ◽  
Susan Walker
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Self Awareness ◽  
The Uk ◽  
The Cost ◽  
High Degree ◽  
Individual Accountability

Medical staff shortages in the UK have provided impetus for the introduction of advanced clinical practitioners (ACPs). This case study explored the views of 22 ACPs, managers and doctors in primary and acute settings in a region of England, to understand how the role is used, and barriers and facilitators to its success. ACP roles improved the quality of service provision, provided clinical career development and enhanced job satisfaction for staff and required autonomous clinical decision-making, with a high degree of self-awareness and individual accountability. Barriers included disparate pay-scales and funding, difficulty accessing continuing education and research, and lack of agreed role definition and title, due to a lack of standardised regulation and governance, and organisational barriers, including limited access to referral systems. Facilitators were supportive colleagues and opportunities for peer networking. Regulation of ACP roles is urgently needed, along with evaluation of the cost-effectiveness and patient experience of such roles.

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