Use of pharmacist integration in oncology clinics to identify and resolve moderate to major drug-drug interactions.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 71-71
Author(s):  
Jack Toshimine Seki ◽  
Matthew Hughsam ◽  
Monika Krzyzanowska ◽  
Aaron Lo ◽  
Pamela Ng ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Drug Effects ◽  
Medical Problem ◽  
Care Providers ◽  
Level Of Evidence ◽  
Wrong Drug ◽  
Survey Results ◽  
Major Drug

71 Background: Medication reconciliation (MR) in outpatient clinics has been under-evaluated. We postulated that cancer patients would benefit from MR done by a pharmacist as these patients have many care providers, many medications, and are at high risk of drug-drug interactions (DDIs). Hence, we conducted a quality initiative evaluating the role of a pharmacist in the ambulatory clinics. Methods: One pharmacist prospectively rotated amongst four oncology clinics four days a week from June 3 to September 18, 2008. The pharmacist performed MR, and as a consultant developed therapeutic plans related to drug therapeutic problems (DTPs) including adverse reactions and DDIs. Patient medication lists were retrospectively analyzed using Micromedex and DDIs were categorized by frequency, severity and evidence level. A monthly survey (Likert scale) evaluating pharmacist contributions to each clinic team was completed by physicians and nurses. Results: A total of 158 patients were seen in 227 patient visits. The pharmacist identified 141 DTPs in 60 patients across 74 visits. The most frequently observed were no drug for a medical problem (51.1%), dose too low (12.8%), wrong drug (9.9%), and adverse drug reactions (9.2%). In response, 174 therapeutic plans were made. The most frequently recommended actions were drug added (40.8%), dose changed (13.2%), drug discontinued (9.2%), and interval/duration changed (7.5%). A total of 414 DDIs were identified in 110 patients, across 149 patient visits. On average, 2.62 DDIs were reported per patient, and 1.82 DDIs per visit. By severity, 139 (33.6%) major, 258 (62.3%) moderate, 16 (3.9%) minor and 1 (0.2%) contraindicated DDIs were documented. By level of evidence, 46 (11.1%) DDIs were excellent, and 236 (57%) were good. Survey results showed that doctors and nurses agreed/strongly agreed that pharmacist presence was valuable. The most useful contributions identified were consultation regarding DDIs, adverse drug effects, and medication efficacy decisions. Conclusions: DDI rates are high and most are moderate or major in severity. There is a clear benefit from the integration of a pharmacist to the clinics with an improvement in patient safety and quality of care.

scholarly journals Increasing the public health potential of basic research and the scientist satisfaction. An international survey of bioscientists

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 56 ◽  
Author(s):  
Giorgio Scita ◽  
Carmen Sorrentino ◽  
Andrea Boggio ◽  
David Hemenway ◽  
Andrea Ballabeni
Keyword(s):  
Public Health ◽  
Diagnostic Method ◽  
Intrinsic Value ◽  
Basic Research ◽  
Previous Survey ◽  
The Public ◽  
Quality Of Work ◽  
Survey Results

Basic scientific research generates knowledge that has intrinsic value which is independent of future applications. Basic research may also lead to practical benefits, such as a new drug or diagnostic method.  Building on our previous study of basic biomedical and biological researchers at Harvard, we present findings from a new survey of similar scientists from three countries.  This survey asked about the scientists’ motivations, goals and perspectives along with their attitudes concerning  policies designed to increase both the practical (i.e. public health) benefits of basic research as well as their own personal satisfaction. Close to 900 basic investigators responded to the survey; results corroborate the main findings from the previous survey of Harvard scientists.  In addition, we find that most bioscientists disfavor present policies that require a discussion of the public health potential of their proposals in grants but generally favor softer policies aimed at increasing the quality of work and the potential practical benefits of basic research. In particular, bioscientists are generally supportive of those policies entailing the organization of more meetings between scientists and the general public, the organization of more academic discussion about the role of scientists in the society, and the implementation of a “basic bibliography” for each new approved drug.

Nursing in Integrative Medicine and Nurses’ Engagement in Caring-Healing

2012 ◽  
pp. 235-239
Author(s):  
Chiyoko Inomata ◽  
Shin’ichi Nitta
Keyword(s):  
Music Therapy ◽  
Neurodegenerative Diseases ◽  
Integrative Medicine ◽  
Collaborative Work ◽  
Care Providers ◽  
Team Members ◽  
Healing Environment ◽  
Therapy Sessions

In 2008, the authors’ team started an ongoing project to administer music therapy sessions for patients with neurodegenerative diseases. Studies were made conducted from the “caring” perspective to evaluate the effects of music therapy on the mental health of the patients (Inomata, 2008a, Inomata 2008b) and on the role of nurses in integrative medicine (Inomata, 2008c). On the basis of the findings from these studies, music therapy programs were designed and conducted to meet the different needs of various neurodegenerative diseases. This project was the first ever reported music therapy initiative undertaken as a multi-disciplinary collaborative work and in partnership with a patients’ group (Saji, 2010). The findings from four years of running the project are summarized as follows: (1) Music therapy helped maintain/improve the QOL(Quality of Life) level of neurodegenerative disease patients, which would otherwise deteriorate with the progress of symptoms; (2) There was an improvement in the patients’ psychological and spiritual health as exemplified by the expansion of consciousness and rebuilding of relationships; (3) The project increased the feeling of partnership among the multi-disciplinary team members; (4) Care providers shared values such as self-belief and respect for both the self and others; (5) Caring for patients’ emotional side by being compassionate and staying with them and/or listening to them resulted in a stronger care provider-patient bond; (6) Nurses were engaged in the building a healing environment as “healers,” and the patients found more hope in everyday life.

scholarly journals Palliative Care and Advance Care Planning in Pulmonary Hypertension

2018 ◽  
Vol 17 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Charles L. Rhee ◽  
Michael Cuttica
Keyword(s):  
Palliative Care ◽  
Pulmonary Hypertension ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Progressive Disease ◽  
Care Planning ◽  
Care Providers ◽  
Advance Care

Pulmonary hypertension (PH) is a progressive disease with high associated morbidity and mortality despite the development of novel therapies. Palliative care is a multidisciplinary field focused on optimization of quality of life and overall supportive care for patients and their families in the setting of life-limiting illness. Although the benefits of palliative care in oncology are well described, there are few studies regarding the timing and involvement of palliative care in PH patients. In this paper, we describe the importance of longitudinal advance care planning, including suggestions for addressing difficult topics such as end-of-life care, and the role of palliative care providers in helping guide these discussions throughout the course of the illness.

Empowerment of Patients in the Process of Rehabilitation

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 32-34
Author(s):  
Lan Wang ◽  
Jie Dong ◽  
Hong-Bin Gan ◽  
Tao Wang
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Empowerment ◽  
Self Management ◽  
Self Awareness ◽  
Care Providers ◽  
Current Health ◽  
Appropriate Treatment

The management and appropriate treatment of peritoneal dialysis (PD) patients is an ongoing challenge in current health care. We believe that health education—consisting of knowledge, skills, and self-awareness—is a useful mechanism for patient empowerment. Patients should have an awareness of their disease, and as health care providers, PD nurses have the role of focusing their patients on preventive care, rather than of simply training patients. An empowerment program is a valuable intervention for improving the self-management of patients. It can both improve quality of life and assist in rehabilitation.

scholarly journals THE PREVALENCE OF DRUG–DRUG INTERACTIONS OF PRESCRIPTIONS DISPENSED IN COMMUNITY PHARMACIES IN NAJAF CITY-IRAQ

2019 ◽  
pp. 202-204
Author(s):  
SAMER NOORI HASHIM ◽  
MOHAMMED JAWAD SALIH AL-HAIDAREY
Keyword(s):  
Internal Medicine ◽  
Drug Interactions ◽  
General Practitioners ◽  
Screening Program ◽  
General Surgeon ◽  
Community Pharmacies ◽  
Vital Function ◽  
Computerized Screening ◽  
Major Drug

Objectives: The main objectives of this work were to estimate the frequency, type, and nature of possible drug–drug interactions in prescriptions dispensed from community pharmacies in Al-Najaf city, secondary objectives were the study of the association between specialty of physicians and the rate of recurrence of drug–drug interactions and to determine medication classes, which were involved in possible drug–drug interactions. Methods: To investigate this study, 211 prescriptions dispensed in three community pharmacies in Al-Najaf city were collected and by the computerized screening program to identify drug–drug interactions. Results: The results showed that the total number of interactions was recognized to be 41% of all prescriptions with the prevalence of major drug– drug interactions was 14%, minor was 16%, and moderate was 70%. Conclusions: This study concluded that most identified drug–drug interactions were recognized in prescriptions written by an internal medicine specialist, orthopedics, general practitioners, an ear-nose-throat specialist, and general surgeon. The ratio of drug–drug interactions/number of prescriptions increased with increasing the number of drugs prescribed per patient (r=0.93, regression p<0.05). This study suggested that the role of the pharmacist should be moved from medication-oriented to patient-oriented, and the clinical pharmacists should have a vital function in recognizing and avoiding drug–drug interactions in prescriptions dispensed to patients.

Pharmacotherapy in Lifestyle Medicine and the Role of the Pharmacist

2012 ◽  
Vol 6 (6) ◽  
pp. 479-488
Author(s):  
Catherine Murphy ◽  
Ronald J DeBellis
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Status ◽  
Health Care Providers ◽  
Smoking Status ◽  
Care Providers ◽  
Lifestyle Medicine ◽  
Positive Effect

Pharmacotherapy can have a significant impact on a patient’s quality of life and health status, potentially affecting multiple lifestyle areas, including weight, smoking status, sleep, and mood. Although pharmacotherapy can have a positive effect on such areas, its effects can also be detrimental. Pharmacists may be the most accessible health care providers to the general public, and their role in advising patients and other health care providers in making appropriate pharmacotherapy choices to positively affect one’s health and lifestyle areas is essential. This review will examine the effects of pharmacotherapy on different areas of lifestyle medicine and the role of the pharmacist as the medication expert in advising and informing patients and providers.

scholarly journals Reverse logistics policy – differences between conservative and innovative reverse logistics management

2013 ◽  
Vol 61 (7) ◽  
pp. 2285-2294
Author(s):  
Alena Klapalová
Keyword(s):  
Reverse Logistics ◽  
Product Innovation ◽  
Logistics Management ◽  
Corporate Management ◽  
Body Of Knowledge ◽  
Efficient Management ◽  
Survey Results ◽  
Reverse Logistics Management

One of the of the key barriers that hampers effective and efficient management of reverse flows detected within a number of empirical surveys and case studies focused on reverse logistics and/or return management is business (organisational) policy, specifically lack of policy, deficiency in existing policy or inferior policy. Despite this fact, there is a gap in literature which would show some evidence from practice that innovative reverse logistics policy both can pay off and is associated with certain aspects of reverse logistics management. Such proof can have several implications. It can support the call for better understanding and more research of the linkages of reverse logistics with other corporate functions, promote the acceptation of strategic character of reverse logistics and stress the role of RL policy within the rest of overall corporate management.The aim of this paper is to contribute and to enrich the existing body of knowledge concerning the above-mentioned gap through presentation of survey results that was realized in 2012 among managers of 244 Czech firms. The results demonstrate the statistically significant association between the innovativeness of RL policy and profitability of firms, quality of RL planning, perception of RL importance, level of RL knowledge and perception of product innovation importance for firms’ competitiveness and frequency of product innovation. They also reveal statistically significant differences between firms with conservative and innovative RL policy and the perceived existence of some barriers to manage RL.

scholarly journals Role of the speech therapist in the treatment of dysphagia in users with clinical discharge for COVID-19: A literature review

2020 ◽  
pp. 1-10
Author(s):  
Andrés Sanzana Leiva ◽  
David David Parra Reyes
Keyword(s):  
Experimental Studies ◽  
Level Of Evidence ◽  
Prolonged Intubation ◽  
Speech Pathologist ◽  
Quasi Experimental ◽  
Progressive Respiratory Failure ◽  
Speech Therapist ◽  
The One

The disease known as Covid-19 was declared a pandemic at the beginning of 2020, substantially attacking the respiratory system of those infected. The progressive respiratory failure generated by the disease even leads to death in severe stages of the disease. Due to this alteration some users may require mechanical ventilation. Much research links intubation to dysphagia. The Speech Therapist is the one who helps in the rehabilitation of swallowing disorders, the objective of this research was to review specialized literature to gather information on the Role of the Speech Pathologist in the Treatment of Dysphagia in High Clinic Users due to (Covid-19). A specific search was carried out in the databases PubMed, Science direct and in the Virtual Health Library (BSV). The key term Mesh “Covid-19” was used then the intersection boolean “AND” and the key term Mesh “Dysphagia” then the intersection boolean “OR” and the key term Mesh “Swallowing Disorder”. A total of 42 articles in distributed as follows: PubMed (14), ScienceDirect (7), BSV (21). In the present investigation only articles corresponding to experimental studies, quasi-experimental studies, case studies, bibliographic reviews were included, clinical trials, where the role of the speech therapist in the work of dysphagia in patients with clinical discharge after having had Covid-19 is observed. The results obtained relate prolonged intubation to dysphagia, although the articles found are not enough to make a generalization, added to the fact that the quality of the articles found does not have the expected level of evidence, despite that, the results found confirm the speech pathologist specializing in orofacial motor skills as a relevant actor both in the evaluation and in the intervention of users who have dysphagia due to prolonged intubation by Covid-19.

scholarly journals The Impact of Ideological Diversity on Educational Performance: A Pilot Study

2020 ◽  
Author(s):  
Cecilia Elena Rouse ◽  
Elizabeth Levy Paluck ◽  
Jason C. Chin ◽  
Amy Wickett ◽  
John-Henry Pezzuto
Keyword(s):  
Group Dynamics ◽  
Discussion Groups ◽  
Future Research ◽  
Student Identity ◽  
Education Outcomes ◽  
Higher Education Outcomes ◽  
Survey Results ◽  
The Impact

What is known about the real-world educational effects of ideological diversity in the classroom? Surprisingly, given the amount of attention paid to the role of ideological diversity on higher education outcomes such as critical thinking and academic performance, scant causal evidence exists. We use a lab-in-the-field experiment to test whether the presence of ideologically more conservative students in academic discussion groups, as compared to groups of students who all slanted ideologically liberal, would improve academic outcomes in terms of the quality of each student’s individual academic work. The complete population of an incoming cohort of policy graduate students (N = 78) took part in the experiment. Results demonstrate that students assigned to the ideologically heterogeneous discussion groups subsequently wrote individual assignments that received significantly more negative grades by a professional grader blind to experimental condition and to student identity. Survey results from participating students also suggest that students in the ideologically heterogeneous discussion groups were also significantly more likely to perceive interpersonal conflict and to dislike their group dynamics—a result that was not driven by students of a particular ideological slant. As a small pilot, this study provides questions to resolve with future research, including the role of pedagogy in managing ideological diversity, and provides a template for future experimental designs.

The Role of Tourist Networks in the Improvement of the Destination Product’s Quality – Results of Research

2016 ◽  
Vol 38 (0) ◽  
pp. 0-0
Author(s):  
Justyna Maciąg
Keyword(s):  
Tourist Destination ◽  
Self Evaluation ◽  
Tourism Product ◽  
Product Method ◽  
Network Organizations ◽  
Survey Results ◽  
Practical Implications ◽  
Network Organisations

Purpose. The aim of paper is to present the survey results to determine and assess the role of tourism networks in improving the quality of a tourism destination product. Method. The study was based on: the literature analysis method and other sources of data and interview technique. Findings. The study indicates that network organisations influence the quality of tourist destination in main dimensions of: Reliability, Assurance and Responsiveness. Less activity can be observed in the dimensions: Tangibles and Empathy. Direct effects in terms of improving the quality of tourism infrastructure are indicated by these organizations, which represent the majority share of local government units. Research indicates a low level of development of ethical attitudes. However, it should be noted that activities of network organizations are often distracted. Research and conclusion limitations . Investigated network organizations do not have clearly defined strategies, evaluation was based on self–evaluation made by organization leaders, restrictions on access to information of the network organizations. Practical implications. The study highlighted further directions of improving the tourism product of destination in terms of both organizational and individual dimensions of quality. Originality. The originality of the study is an attempt of influence evaluation of network organisations on quality of tourist destination. The novelty is also empirical verification of theoretical postulates regarding the role of network organizations in improving the quality of tourist products of a destination which have been formulated in the literature. Type of paper. Research paper.

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