scholarly journals Expectations and educational needs of rheumatologists, rheumatology fellows and patients in the field of precision medicine in Canada, a quantitative cross-sectional and descriptive study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Sophie Ruel-Gagné ◽  
David Simonyan ◽  
Jean Légaré ◽  
Louis Bessette ◽  
Paul R. Fortin ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Patient Adherence ◽  
Educational Needs ◽  
Cross Sectional ◽  
Potential Benefits ◽  
Improve Patient Adherence ◽  
Negative Impacts ◽  
To Receive ◽  
Improve Patient ◽  
Medicine Education

Abstract Background Precision medicine, as a personalized medicine approach based on biomarkers, is a booming field. In general, physicians and patients have a positive attitude toward precision medicine, but their knowledge and experience are limited. In this study, we aimed at assessing the expectations and educational needs for precision medicine among rheumatologists, rheumatology fellows and patients with rheumatic diseases in Canada. Methods We conducted two anonymous online surveys between June and August 2018, one with rheumatologists and fellows and one with patients assessing precision medicine expectations and educational needs. Descriptive statistics were performed. Results 45 rheumatologists, 6 fellows and 277 patients answered the survey. 78% of rheumatologists and fellows and 97.1% of patients would like to receive training on precision medicine. Most rheumatologists and fellows agreed that precision medicine tests are relevant to medical practice (73.5%) with benefits such as helping to determine prognosis (58.9%), diagnosis (79.4%) and avoid treatment toxicity (61.8%). They are less convinced of their usefulness in helping to choose the most effective treatment and to improve patient adherence (23.5%). Most patients were eager to take precision medicine tests that could predict disease prognosis (92.4%), treatment response (98.1%) or drug toxicity (93.4%), but they feared potential negative impacts like loss of insurability (62.2%) and high cost of the test (57.5%). Conclusions Our study showed that rheumatologists and patients in Canada are overall interested in getting additional precision medicine education. Indeed, while convinced of the potential benefits of precision medicine tests, most physicians don’t feel confident in their abilities and consider their training insufficient to incorporate them into clinical practice.

Barriers to Deprescribing

2019 ◽  
pp. 47-68
Author(s):  
Swapnil Gupta ◽  
Rebecca Miller ◽  
John D. Cahill
Keyword(s):  
Side Effects ◽  
Patient Adherence ◽  
Medical Institution ◽  
Sociocultural Factors ◽  
Related Factors ◽  
Potential Patient ◽  
Improve Patient Adherence ◽  
The Relationship ◽  
Improve Patient

This chapter identifies the possible barriers to deprescribing, and presents suggestions for strategies to overcome them. Although deprescribing has the potential to streamline medication regimens, minimize side effects, cut costs, improve patient adherence, and strengthen the relationship between the patient and the prescribing professional, barriers may originate from the patient, physician, and/or the institution, both local and the larger medical institution. Barriers related to prescriber-related factors such as the physician’s illusion and fear of litigation, are discussed. Potential patient- and environment-related barriers are also discussed, including sociocultural factors which may emerge in the process of initiating a course of deprescribing. Included in this chapter is a discussion of the possibility of relapse, colloquially defined, and the patient’s and provider’s fears for rehospitalization. Possible strategies for overcoming each of these barriers are discussed.

Management of HIV-1 Infection in Adults and Adolescents

2000 ◽  
Vol 13 (6) ◽  
pp. 426-441 ◽  
Author(s):  
Kenneth R. Eugenio ◽  
Caroline S. Zeind
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Patient Adherence ◽  
Social Barriers ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Improve Patient Adherence ◽  
Substantial Decline ◽  
Improve Patient ◽  
Hiv 1 ◽  
New Strategies

The management of Human Immunodeficiency Virus-1 (HIV-1) infection has undergone dramatic change since its initial identification. Advances have occurred in drug development, viral pathology understanding, laboratory monitoring and genetic analysis. With the advent of highly active antiretroviral therapy (HAART), there has been a substantial decline in HIV-1-related morbidity and mortality. Today, HIV-1 infection is treated as a chronic disease that requires strict patient adherence to HAART. Pharmacists provide pharmaceutical care to patients with HIV disease in a variety of ways, and they can improve patient adherence rates. Current therapeutic strategies have not resulted in eradication of HIV-1 infection. Present and future therapeutic challenges include viral resistance, reservoirs of virus and drug toxicities. Globally, the spread of HIV-1 infection continues at an alarming rate, and economic and social barriers may limit access and success of HAART. New strategies and novel approaches in managing HIV-1 infection continue to be developed in an effort to cure and eradicate this disease.

Adherence measurement and patient recruitment methods are poor in intervention trials to improve patient adherence

2014 ◽  
Vol 67 (10) ◽  
pp. 1076-1082 ◽  
Author(s):  
Rebecca A. Jeffery ◽  
Tamara Navarro ◽  
Nancy L. Wilczynski ◽  
Emma C. Iserman ◽  
Arun Keepanasseril ◽  
...  
Keyword(s):  
Patient Adherence ◽  
Patient Recruitment ◽  
Recruitment Methods ◽  
Adherence Measurement ◽  
Improve Patient Adherence ◽  
Intervention Trials ◽  
Improve Patient

Health care practitioner prescribing patterns and perspectives on oral chemotherapy management: A survey of cancer centers in Toronto, Canada.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 48-48
Author(s):  
Mark Pasetka ◽  
Larissa Day ◽  
Maggie Ford ◽  
Angela Boudreau ◽  
Angie Giotis ◽  
...  
Keyword(s):  
Side Effects ◽  
Patient Education ◽  
Oral Cancer ◽  
Patient Adherence ◽  
Oral Chemotherapy ◽  
Cancer Therapies ◽  
Prescription Practices ◽  
Toxicity Monitoring ◽  
Improve Patient Adherence ◽  
Improve Patient

48 Background: With an increasing number of patients receiving oral cancer therapies, evaluation of safe prescription practices, effective patient education, and toxicity monitoring of these agents is imperative. Methods: Multi-disciplinary oncology practitioners at several cancer centres in Toronto, Canada were surveyed using a web-based platform, to evaluate their prescription practices, use of patient education and symptom management tools, as well as their views on patient adherence and toxicity reporting. Results: Of 170 respondents, 43% were nurses, 34% were pharmacists, and 23% were physicians. Seventy nine percent considered patient education, medication adherence (76%), and toxicity management (78%) as “very important” components of oral chemotherapy management. Prescription methods varied: 59% of respondents used written prescriptions, 39% computerized physician order entry (CPOE), and 0% pre-printed orders, ≥50% of the time. Clinicians felt that patients report side effects from oral agents only “some of the time” (53%), and the most problematic toxicities were nausea (61%) and diarrhea (61%). Practitioners perceived the most common reasons for patient underreporting of side effects to be “fear of treatment interruption” (62%), and that “toxicities are part of the treatment” (66%). Seventy three percent of those surveyed felt individual counseling, follow-up calls (69%), and updated medication information (57%) would improve patient adherence and safety. Conclusions: A diverse group of surveyed oncology professionals expressed the importance of utilizing educational and toxicity monitoring tools for patients on oral cancer therapies, particularly as patients are thought to under-report symptoms. Prescription practices are variable, and CPOE use should be improved. The results of this survey will also be compared to a patient survey, to help develop better tools and policies to standardize practice, and improve patient adherence and toxicity management on oral cancer agents.

To Improve Patient Adherence to Drug Regimens: An Interdisciplinary Approach

1978 ◽  
Vol 78 (7) ◽  
pp. 1216 ◽  
Author(s):  
John A. Romankiewicz ◽  
Vincent Gotz ◽  
Ann Capelli ◽  
Herbert S. Carlin
Keyword(s):  
Patient Adherence ◽  
Interdisciplinary Approach ◽  
Drug Regimens ◽  
Improve Patient Adherence ◽  
Improve Patient
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