Patient and provider perspectives on home telecare: Preliminary results from a randomized controlled trial

2005 ◽  
Vol 11 (1_suppl) ◽  
pp. 95-97 ◽  
Author(s):  
F S Mair ◽  
P Goldstein ◽  
C May ◽  
R Angus ◽  
C Shiels ◽  
...  
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Chronic Obstructive ◽  
Care Providers ◽  
North West ◽  
Randomized Controlled ◽  
The North ◽  
Provider Perspectives

A randomized controlled trial of home telecare for the management of acute exacerbations of chronic obstructive pulmonary disease has been undertaken in the north-west of England. A videophone was used that communicates via the ordinary telephone network. The intervention period for each participant was two weeks. Participants in the telecare arm of the trial were asked to complete logbooks to record their experiences of each telecare encounter. A simple, self-completed, 10–item questionnaire was used that consisted of a Likert scale, ranging from 1 (totally disagree) to 5 (totally agree). Fourteen nurses completed 150 logbooks and 22 patients completed 145 logbooks. These results demonstrate significant differences in perception between patients and their health-care providers with regard to telecare encounters across all the domains addressed. Participating patients consistently demonstrated more positive views of the telecare encounters than their health-care providers.

scholarly journals Does mhGAP training of primary health care providers improve the identification of child- and adolescent mental, neurological or substance use disorders? Results from a randomized controlled trial in Uganda

2018 ◽  
Vol 5 ◽  
Author(s):  
A. Akol ◽  
F. Makumbi ◽  
J. N. Babirye ◽  
J. S. Nalugya ◽  
S. Nshemereirwe ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Randomized Controlled Trial ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Child And Adolescent ◽  
Care Providers ◽  
Randomized Controlled ◽  
Primary Health

Background.Integrating child and adolescent mental health (CAMH) into primary health care (PHC) using the WHO mental health gap action program (mhGAP) is recommended for closing a mental health treatment gap in low- and middle-income countries, but PHC providers have limited ability to detect CAMH disorders. We aimed to evaluate the effect of PHC provider mhGAP training on CAMH disorder identification in Eastern Uganda.Methods.Thirty-six PHC clinics participated in a randomized controlled trial which compared the proportion of intervention (n= 18) to control (n= 18) clinics with a non-epilepsy CAMH diagnosis over 3 consecutive months following mhGAP-oriented CAMH training. Fisher's exact test and logistic regression based on intention to treat principles were applied. (clinicaltrials.gov registration NCT02552056).Results.Nearly two thirds (63.8%, 23/36) of all clinics identified and recorded at least one non-epilepsy CAMH diagnosis from 40 692 clinic visits of patients aged 1–18 recorded over 4 months. The proportion of clinics with a non-epilepsy CAMH diagnosis prior to training was 27.7% (10/36, similar between study arms). Training did not significantly improve intervention clinics’ non-epilepsy CAMH diagnosis (13/18, 72.2%) relative to the control (7/18, 38.9%) arm,p= 0.092. The odds of identifying and recording a non-epilepsy CAMH diagnosis were 2.5 times higher in the intervention than control arms at the end of 3 months of follow-up [adj.OR 2.48; 95% CI (1.31–4.68);p= 0.005].Conclusion.In this setting, mhGAP CAMH training of PHC providers increases PHC clinics’ identification and reporting of non-epilepsy CAMH cases but this increase did not reach statistical significance.

The impact of training informal health care providers in India: A randomized controlled trial

Science ◽  
2016 ◽  
Vol 354 (6308) ◽  
pp. aaf7384-aaf7384 ◽  
Author(s):  
J. Das ◽  
A. Chowdhury ◽  
R. Hussam ◽  
A. V. Banerjee
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Care Providers ◽  
Randomized Controlled ◽  
The Impact

scholarly journals Comparative maternal outcomes of oral nifedipine and intravenous labetalol for severe hypertension during pregnancy: an open label randomized controlled trial

2020 ◽  
Vol 9 (7) ◽  
pp. 2847
Author(s):  
Monika Sharma ◽  
Sita Thakur ◽  
Kamal Singh ◽  
Shashank Shekhar
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trial ◽  
Health Care Providers ◽  
Severe Hypertension ◽  
Controlled Trial ◽  
Care Providers ◽  
Open Label ◽  
Serious Adverse Events ◽  
Randomized Controlled ◽  
Hypertensive Diseases

Background: Hypertensive diseases are commonly seen during pregnancy and remain one of the leading causes of maternal morbidity and mortality. Mostly commonly preferred drugs by health care providers for treatment of severe hypertension during pregnancy are labetalol and hydralazine. However, they require proper storage, intravenous access, and adequately trained staff for usage. Oral nifedipine in contrast is easier to use and widely available.  Objective of this study was to report the efficacy and safety of oral nifedipine as compared to intravenous labetalol for treatment of severe hypertension during pregnancy.Methods: It was an open label randomized controlled trial in which 100 women with severe hypertension during pregnancy were enrolled. They were randomized to receive either incremental doses of intravenous labetalol every 20 minutes (total 300 mg) or 10 mg oral nifedipine every 20 minutes (up to 50 mg) to lower the blood pressure to safer levels.Results: Women receiving oral nifedipine took significantly less time to achieve target blood pressure [(37.6±23.3) minutes (SD) as compared to those receiving intravenous labetalol (52.0 minutes±27.95 (SD)]. Women receiving nifedipine for treatment also required significantly lesser doses to control the blood pressure [mean dose 1.8±1.1 (SD) versus 2.6±1.2 (SD) p=0.006]. There were two failures in labetalol group and one failure in nifedipine group. No serious adverse events were reported in either group.Conclusions: Oral nifedipine is equally efficacious to I.V. labetalol for treatment of severe hypertension during pregnancy and is easier to use in low resource settings.

The Role of Docusate for Constipation in Older People

2021 ◽  
Vol 36 (10) ◽  
pp. 501-507
Author(s):  
Timothy Nguyen
Keyword(s):  
Randomized Controlled Trial ◽  
Older People ◽  
Older Adult ◽  
Health Care Providers ◽  
Chronic Constipation ◽  
Data Extraction ◽  
Controlled Trial ◽  
Adult Population ◽  
Care Providers ◽  
Randomized Controlled

Objective: To provide brief information on the effectiveness of docusate use for constipation in older people. Data Sources: PubMed search using the following terms (“docusate and chronic constipation,” “docusate, chronic constipation and geriatric,” “docusate, chronic constipation and older adult,” “docusate and randomized controlled trial” and included relevant information related to docusate and chronic constipation in the population described. Study Selection: Studies that fit the criteria for “chronic/general constipation,” “geriatric/older adults,” and/or “randomized controlled trials” were included. Four studies described docusate for chronic/general constipation and older people. Not included were other studies not related to chronic/general constipation and older people (eg, surgery-related). Data Extraction: Data extraction from each study included primary outcomes related to chronic constipation and efficacy of docusate. Data also included relevant reports from other relevant trials and discussions. Data Synthesis: Docusate when compared with placebo or psyllium or sennosides in these trials did not show any benefits for constipation. Psyllium and sennosides showed to be more effective compared with docusate. No differences found between docusate versus placebo. In summary, there is a lack of data to support the use of docusate for constipation and the data presented that docusate is not effective for use in constipation. Conclusion: Docusate is commonly used for constipation despite little evidence supporting its efficacy. There is not enough randomized controlled trial and data to support the use of docusate for constipation. Pharmacists along with health care providers should reassess and reconsider whether to use it and add extra layers to an already complex medication regimen in the older adult population.

Improving the Doctor/Patient Relationship: A Feminist Perspective

1989 ◽  
Vol 18 (3) ◽  
pp. 337-361 ◽  
Author(s):  
Peggy Foster
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Delivery ◽  
Patient Relationship ◽  
Care Providers ◽  
Doctor Patient Relationship ◽  
North West ◽  
Care Services ◽  
The North

ABSTRACTSince the early 1970s British and American feminists have developed a comprehensive critique of the dominant doctor/patient relationship within mainstream health care services. In Britain, activists in the women's health movement have struggled to put into practice a model of health care delivery based on feminist principles, within which the doctor/patient relationship is radically redesigned. This paper will explore the principles and practice of this feminist health care model. It will then attempt to evaluate alternative strategies for strengthening and expanding feminist health care within the NHS. The paper will draw on data gathered by the author in 1987 through a series of unstructured interviews with feminist health care providers who were working within a variety of NHS settings in the North West of England.

Efficacy of Motivational Interviewing to Enhance Advance Directive Completion in Latinos With Chronic Illness: A Randomized Controlled Trial

2019 ◽  
Vol 36 (11) ◽  
pp. 980-992 ◽  
Author(s):  
Frances R. Nedjat-Haiem ◽  
Tamara J. Cadet ◽  
Anup Amatya ◽  
Beti Thompson ◽  
Shiraz I. Mishra
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Chronic Illness ◽  
Motivational Interviewing ◽  
Advance Directive ◽  
Controlled Trial ◽  
Family Members ◽  
Care Providers ◽  
Randomized Controlled ◽  
Eol Care

Background: End-of-life (EOL) care for Latinos with chronic illness is a critically important problem. Latinos with chronic illness suffer worse health outcomes and poorer quality of care due to various issues occurring in care delivery systems. Latinos are less likely than non-Hispanic whites to prepare an advance directive (AD) for health-care decision-making that impacts treatment decisions for when EOL is near. Advance care planning (ACP) interventions tailored specifically for Latinos have rarely been implemented. Objective: The primary aim examines whether a motivational interviewing (MI) intervention increased rates of AD documentation among older Latinos. The secondary aim was to examine whether MI improved communication with providers and family members. Methods: We pilot tested a randomized controlled trial with older Latinos >50 years with one or more chronic illnesses, including cancer. Participants were randomly assigned to usual care (UC) receiving ACP education alone versus treatment (TX), which received ACP education, plus MI counseling including interactive decisional support, emotional support, and barrier navigation. Results: Results of logistic regression indicate TX group participants were significantly more likely to document an AD than UC, however were less ready to talk with health-care providers or family members. Those reporting navigational barriers for talking about dying is difficult showed a significant negative relationship for AD completion even with significant intervention effects. Conclusion: When using MI to motivate individuals toward ACP EOL conversations other factors are important to consider. Further research is needed, especially among Latinos to understand best practices for ACP education and counseling for EOL care.

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