scholarly journals IMPACT OF PHARMACIST INTERVENTION IN SCREENING AND EDUCATION ON BLOOD PRESSURE IN A RURAL AREA IN SOUTHERN INDIA

2016 ◽  
Vol 9 (9) ◽  
pp. 339
Author(s):  
Shanmuga Sundaram Rajagopal ◽  
Krishnaveni Kandasamy ◽  
Agilan Natarajan ◽  
Joyal Sebastian ◽  
Manikanta Konakalla ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Health Care ◽  
Intervention Group ◽  
Pharmacist Intervention ◽  
Health Concern ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

ABSTRACTObjective: Hypertension (HTN) expends a consequential public health concern on cardiovascular health status and health-care systems in India. Theeffectuation of the pharmaceutical care program in the health care is an extremely important need to achieve the optimum therapeutic effect. Theobjective of the study was to assess the impact of pharmacist intervention on patient’s blood pressure (BP) level, quality of life (QOL), and knowledge,attitude, and practice (KAP) of hypertensive patients.Methods: A randomized controlled pilot study was carried out for 6 months. The hypertensive patients were randomized into control and interventiongroup based on age, and both the groups were interviewed using KAP and WHO QOL-BREF questionnaires, screened BP, respectively, at baseline andeach follow-up after post counseling section to the intervention group. The effect of pharmacist intervention on QOL and KAP among control andintervention was statistically analyzed by paired t-test using SPSS version 16.Results: The total sample studied was 60, of which 20 (33.33%) were males and 40 (66.67%) were females. In our study, the QOL score for eachdomain of both intervention and control groups were almost poor (p˃0.05) at baseline and for the intervention group, a highly significant improvement(p<0.001) was observed for all domains in final follow-up. KAP score of intervention group also showed a significant improvement (p<0.001) frombaseline to final follow-up. In this study, intervention group showed a significant mean reduction of systolic BP from baseline 150.13±25.670 to finalfollow-up 145.33±12.914.Conclusion: The results of the study showed a significant improvement in the patient’s KAP toward different aspects of HTN and QOL followingpharmacist mediated counseling. Involvement of pharmacy practitioners in the management of HTN significantly improves QOL and KAPs.Keywords: Hypertension, Quality of life, Knowledge, Attitude and practice, Pharmacist intervention, Patient counseling.

scholarly journals Factors related to perceived continuity of care in hospitalized cardiac patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Safstrom ◽  
T.J Jaarsma ◽  
L.N Nordgren ◽  
M.L Liljeroos ◽  
A.S Stomberg
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Continuity Of Care ◽  
Perceived Control ◽  
Care Utilization ◽  
Funding Source ◽  
Patient Reported

Abstract Background Since healthcare systems are increasingly complex and often fragmented, continuity of care after hospitalization is a priority to increase patient safety and satisfaction. Aim Describe factors related to continuity of care in patients hospitalized due to cardiac conditions. Methods This cross-sectional multicenter study enrolled patients 6 weeks after hospitalization due to cardiac conditions. A total of 993 patients were included (mean age 72.2 (SD 10.4), males 66%) with AMI (35%), AF (25%), angina (21%) and HF (17.3%). Patients completed the Patient Continuity of Care Questionnaire, a questionnaire based on the definition that continuity of care is “the extent to which a series of health care services is experienced as connected and coherent and is consistent with a patient's health needs and personal circumstances”. The total score of the questionnaire ranges from 6 to 30, higher score indicating higher continuity and a score &lt;24 indicating insufficient continuity. Cronbach's alpha on the total PCCQ was 0.94. Correlations between PCCQ and quality of life, depression, anxiety, perceived control and health care utilization were estimated using spearman rang correlation. Results Insufficient continuity of care ranged between 47% to 59% in the different diagnosis groups, which the highest continuity in the AMI group and lowest in patients with atrial fibrillation. In patients hospitalized due to AMI (n=355, mean age 71 (± 11), 70% men), continuity of care was related to higher perceived control, higher quality of life, a good financial situation, being a man, no symptoms of anxiety or depression (ᚹ range 0.17–0.26 p≤0.002). A low score on the PCCQ were associated with follow-up visit to a nurse in primary care after hospitalization (ᚹ −0.12 p=0.033). In patients hospitalized due to angina (n=210, mean age 73 (± 9), 74% men), continuity of care was related to higher perceived control, higher quality of life and no depressive symptoms (ᚹ range between 0.20 and 0.26 p=0.005). In patients with AF, (n=255, mean age 71 (± 10.), 58% men), continuity of care was related to having had contact by telephone with a nurse-led AF clinic, higher perceived control, higher quality of life and not being depressed (ᚹ range between 0.14–0.25 p=0.03). In patients with HF, (n=173, mean age 77 (±8) 59% men), continuity was related to male ender, younger age, follow-up in a nurse-led HF clinic and not being anxious (ᚹ range between 0.16 and 0.22 p=0.004–0.047). Low total score on PCCQ correlated to having had telephone contact with nurse in primary care (ᚹ −0.24 p=0.002). Conclusion Almost half of all patient reported insufficient continuity of care. Perceived control, quality of life, and symptoms of depression were related to higher continuity of care in all diagnose groups except heart failure. Further, there was a correlation between continuity and follow-up visits or contact by telephone with nurse-led clinics in all diagnose groups except angina. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Medical Research Council of Southeast Sweden, Centre for Clinical Research Sörmland

scholarly journals Integrated multidisciplinary diagnostic approach for dementia care: Randomised controlled trial

2008 ◽  
Vol 192 (4) ◽  
pp. 300-305 ◽  
Author(s):  
Claire A. G. Wolfs ◽  
Alfons Kessels ◽  
Carmen D. Dirksen ◽  
Johan L. Severens ◽  
F. R. J. Verhey
Keyword(s):  
Quality Of Life ◽  
Multidisciplinary Approach ◽  
Intervention Group ◽  
Dementia Care ◽  
Clinical Effects ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

BackgroundAn integrated multidisciplinary approach to dementia is often recommended but has rarely been evaluated.AimsTo evaluate the clinical effects of an integrated multidisciplinary diagnostic facility for psychogeriatric patients.MethodPatients suspected of having complex psychogeriatric problems were randomly allocated to the intervention (n=137) or to treatment as usual (n=93). They were assessed at baseline, and at 6 months and 12 months follow-up by means of personal interviews with the patient's proxy. The primary outcome was health-related quality of life, assessed using the visual analogue scale (VAS) of the EuroQd measure, EQ-5D.ResultsHealth-related quality of life had improved at 6 months in the intervention group, whereas that of the control group had decreased. Furthermore, more patients in the intervention group experienced a clinically relevant improvement of 10 points or more on the VAS at both follow-up measurements.ConclusionsAn integrated multidisciplinary approach improves dementia care.

scholarly journals Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Shima Ghannadi ◽  
Atieh Amouzegar ◽  
Parisa Amiri ◽  
Ronak Karbalaeifar ◽  
Zhale Tahmasebinejad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Microvascular Complications ◽  
Glycosylated Hemoglobin ◽  
Self Care ◽  
Self Management ◽  
Diabetic Patients ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Background.Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP) toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it.Methods.This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life.Result.117 diabetic patients on hemodialysis (42 females) with mean (SD) age of68.70±9.26years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were59.90±11.23,44.27±8.35,45.06±12.87,46.21±10.23, and26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities.Conclusion.The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.

Using Telemedicine to Improve the Quality of Life of Parents of Infants With CHD Surgery After Discharge

2021 ◽  
Author(s):  
Qi-Liang Zhang ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Hua Cao ◽  
Qiang Chen
Keyword(s):  
Quality Of Life ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Intervention Group ◽  
Control Group ◽  
Educational Levels ◽  
Education Levels

Abstract Background The purpose of this study was to investigate the effect of using telemedicine to improve the quality of life of parents of infants with congenital heart disease surgery after discharge. Methods A prospective randomized controlled study was conducted in a provincial hospital in China from November 2020 to April 2021 to compare the quality of life of parents of infants with congenital heart disease surgery after discharge between the WeChat follow-up group and the outpatient follow-up group. A total of 84 patients (42 in each group) and 168 parents (84 in each group) participated in this study. Results One month after discharge, the SAS and SDS scores of parents in the intervention group were significantly lower than those in the control group (P&lt;0.05). Compared with the SAS and SDS scores at discharge, the scores of parents in the intervention group were significantly lower at one month after discharge (P&lt;0.05), while the scores of parents in the control group were similar at one month after discharge (P&gt;0.05). At discharge, in both the intervention group and the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P&lt;0.05). One month after discharge, in the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P&lt;0.05). One month after discharge, in the intervention group, the SAS and SDS scores of the mothers were similar to those of the fathers (P&gt;0.05). The comparison of the SAS and SDS scores of parents with different education levels showed that in both the intervention group and control group, the lower the parents’ educational levels were, the higher their SAS and SDS scores were (P&lt;0.05). One month after discharge, in the control group, the lower the parents’ education levels were, the higher their SAS and SDS scores (P&lt;0.05). One month after discharge, in the intervention group, the SAS and SDS scores were similar among parents with different educational levels. The results of the WHOQOL-BREF scale showed that the scores of the physiological, psychological, social and environmental fields at one month after discharge in the intervention group were significantly higher than those in the control group (P&lt;0.05). Conclusion Providing health education and medical support to the parents of infants with congenital heart disease surgery after discharge via telemedicine can effectively relieve the parents’ anxiety and depression and improve their quality of life.

Cost-Effectiveness of Interim PET Response Adapted Therapy In ABVD-Treated, Advanced-Stage Hodgkin Lymphoma

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1563-1563 ◽  
Author(s):  
Andrea Gallamini ◽  
Monia Marchetti ◽  
Anna Borra ◽  
Roberto Sorasio ◽  
Francesca Fiore
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Sensitivity Analysis ◽  
Cost Saving ◽  
Disease Control ◽  
Hodgkin Lymphoma ◽  
Advanced Stage ◽  
Interim Pet

Abstract Abstract 1563 Background: ABVD chemotherapy (AT) is the standard treatment for patients with advanced-stage Hodgkin lymphoma (HL). However, BEACOPP achieves a higher disease control at a cost of a definitely higher toxicity. Positron emission tomography (PET) after two chemotherapy cycles (PET2) is the most reliable predictor of treatment outcome in ABVD-treated patients. A PET-2 response-adapted strategy with a therapy shift from ABVD to BEACOPP in PET2 positive patients (A/B-T) was shown to increase the 2-y Failure Free Survival (FFS) in the latter from 12% to 62% by indirect retrospective comparison, and to improve the disease control in the overall patient population (Gallamini Br. J. Haematol 2011). However, PET is an expensive test which deserves a careful economic assessment before widespread adoption and reimbursement. Methods: We built a Markov decision model comparing A/B-T with AT strategies for advanced HL. The model was calibrated on the reported retrospective cohort of 154 ABVD-treated HL patients in which treatment intensification with BEACOPP was given in PET-2 positive patients. Briefly, patients were treated with standard ABVD × 2 courses and an interim-PET performed afterwards: PET-2 negative patients continued with ABVD × 4 and consolidation RxT in presence of bulky disease; PET-2 positive patients shifted to BEACOPP escalated × 4 + BEACOPP baseline × 4. Patients failing either AT or A/B-T underwent rescue treatment with IGEV × 4, followed by Autologous Stem Cell Transplantation (ASCT). In patients failing ASCT, DHAP reinduction therapy was given and allogeneic SCT (alloSCT) was performed whenever possible. The model included 12 health-states: ABVD cycles 1–2, ABVD cycles 3–6, BEACOPP escalated (4 cycles), BEACOPP baseline (4 cycles), IGEV (4 cycles), ASCT, DHAP + allogeneic SCT, follow-up (FFS patients PET2 negative), follow-up (FFS patients PET2 positive), follow-up (FFS after ASCT/CST), relapse, death. Each health state last 1 month and the overall time horizon at baseline was 5 years. We considered severe toxicity needing inpatient care and transplant-related mortality. Quality of life was reduced by 20% for chemotherapy-treated patients, 30% for transplanted ones and 40% in relapsed ones. The model assessed the following endpoints: survival, quality of life – adjusted survival (QALY) and costs (in the perspective of the health-care system) as the principal end-points. TreeAge SW (2008) was run. National charges were used as estimators of unitary costs. First and second-order sensitivity analysis was performed. Results: A/B-T reduced the overall percentage of patients failing treatment (refractory and relapsing) from 27% to 14%. This clinical advantage induced a prolongation of quality-adjusted survival from 53.20 to 55.63 quality-adjusted months, that is a gain of 0.18 QALYs (90% CI: −0.1;+1.4). The number of interim PET needed to avoid one ASCT was 8.3. The cost of universal interim PET (€1,546) was offset by the reduced number of ASCT procedures (€36,575). Consequently, health-care costs were €27,861 for A/BT versus €29,050 for AT strategy which is a €1189 (90%CI: −41,208; +13,240) saving. At sensitivity analysis we verified that the results were mildly sensitive to the costs of PET and ASCT: A/B-T was not cost saving if PET would cost more than €3,031 and ASCT less than €20,200. A/B-T would cost more than €40,000/QALY only at a PET cost higher than €16,300. The results were also sensitive to the portion of PET2 positive patients: A/B-T wouldn't turn out cost saving if the portion was higher than 22%. The results were not sensitive to the rate of severe adverse events during chemotherapy. The results were overall robust, since A/B-T cost less than €30,000/QALY in more than 80% out of 100,000 simulations (MonteCarlo analysis). Conclusions: A/B-T is more efficacious and less expensive than standard AT treatment for advanced-stage HL patients, therefore the routine use of interim-PET is warranted in treatment planning and chemosensitivity adapting in these patients. Disclosures: Off Label Use: The study includes use of Rituximab as maintenance in responding patients after first line chemoimmunotherapy.

LuCaS (Lung Cancer Surveillance) study: Surveillance models for advanced lung cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20546-e20546
Author(s):  
Sarah Anne Fraser
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Health Care ◽  
Cancer Patients ◽  
Small Cell ◽  
Advanced Lung Cancer ◽  
Small Cell Lung ◽  
Lung Cancer Patients

e20546 I hope to present the trial protocol as a poster at ASCO with co design work commencing 2017. Background: Lung cancer is the leading cause of cancer death in NZ.1 85% of registrations annually are stage four at diagnosis, presenting a significant burden on resources. Despite novel therapies, survival is poor and quality of life is a key consideration in patient management .2,3 Currently the aim of surveillance is to detect for disease progression and follows a three monthly pattern. There is little literature around benefits of surveillance on survival, and quality of life in these patients. 4-6 Alternative approaches to surveillance should be evaluated to ensure safe, convenient, economical care. Lung cancer outcomes for Maori patients sit significantly lower than those for New Zealand Europeans. Maori patients are twice as likely to present with locally advanced disease and four times less likely to receive curative treatment (multivariate analysis). There are significant barriers for Maori patients to attending health care including time off work, health literacy, costs, child care, language barriers, and transport. 19 Ministry of Health data describes poor outcomes for Maori lung cancer patients with rate of death sitting at 3.4 times that of non-Maori. Co-Primary End Points To determine if there is a reduction in health services utilisation (ED visits, hospital visits, unplanned clinic visits, GP visits, and Nurse Specialist contact) with the end point identified at progression, lost to follow up, or death. To compare the impact of a novel virtual surveillance model (VSM) versus usual follow-up care on patient anxiety measured using the HADS-A tool. Methods: LuCaS is a Randomised Controlled trial in patients with advanced lung cancer randomised to virtual model or standard care. Results: recruitment begins this year. Conclusions: Hypothesis:A virtual follow up model for advanced stage non-small cell lung cancer patients, extensive stage small cell lung cancer patients, and mesothelioma patients will reduce health care utilisation and patient experienced anxiety defined by reduction in Hospital Anxiety and Depression Scale (HADS-A) score, while maintaining effectiveness detecting recurrence and survival.

scholarly journals A Children’s Asthma Education Program: Roaring Adventures of Puff (RAP), Improves Quality of Life

2010 ◽  
Vol 17 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Shawna L McGhan ◽  
Eric Wong ◽  
Heather M Sharpe ◽  
Patrick A Hessel ◽  
Puish Mandhane ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Education Program ◽  
Intervention Group ◽  
Asthma Management ◽  
Control Group ◽  
Asthma Education ◽  
Children With Asthma

BACKGROUND: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.OBJECTIVE: To assess the feasibility and impact of ‘Roaring Adventures of Puff’ (RAP), a six-week childhood asthma education program administered by health professionals in schools.METHODS: Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group). Baseline measurements from parent and child were taken before the intervention, and at six and 12 months.RESULTS: The intervention group had more smoke exposure at baseline. Participants lost to follow-up had more asthma symptoms. Improvements were significantly greater in the RAP intervention group from baseline to six months than in the control group in terms of parent’s perceived understanding and ability to cope with and control asthma, and overall quality of life (P<0.05). On follow-up, doctor visits were reduced in the control group.CONCLUSION: A multilevel, comprehensive, school-based asthma program is feasible, and modestly improved asthma management and quality of life outcomes. An interactive group education program offered to children with asthma at their school has merit as a practical, cost-effective, peer-supportive approach to improve health outcomes.

scholarly journals Influence of Craniosacral Therapy on Anxiety, Depression and Quality of Life in Patients with Fibromyalgia

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Guillermo A. Matarán-Peñarrocha ◽  
Adelaida María Castro-Sánchez ◽  
Gloria Carballo García ◽  
Carmen Moreno-Lorenzo ◽  
Tesifón Parrón Carreño ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Placebo Group ◽  
Sleep Quality ◽  
Treatment Period ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Intervention Group ◽  
Craniosacral Therapy

Fibromyalgia is considered as a combination of physical, psychological and social disabilities. The causes of pathologic mechanism underlying fibromyalgia are unknown, but fibromyalgia may lead to reduced quality of life. The objective of this study was to analyze the repercussions of craniosacral therapy on depression, anxiety and quality of life in fibromyalgia patients with painful symptoms. An experimental, double-blind longitudinal clinical trial design was undertaken. Eighty-four patients diagnosed with fibromyalgia were randomly assigned to an intervention group (craniosacral therapy) or placebo group (simulated treatment with disconnected ultrasound). The treatment period was 25 weeks. Anxiety, pain, sleep quality, depression and quality of life were determined at baseline and at 10 minutes, 6 months and 1-year post-treatment. State anxiety and trait anxiety, pain, quality of life and Pittsburgh sleep quality index were significantly higher in the intervention versus placebo group after the treatment period and at the 6-month follow-up. However, at the 1-year follow-up, the groups only differed in the Pittsburgh sleep quality index. Approaching fibromyalgia by means of craniosacral therapy contributes to improving anxiety and quality of life levels in these patients.

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