scholarly journals The effect of  clinical pharmacist-led educational tool on adherence to antiepileptic drugs in pediatrics: an interventional study        

Author(s):  
Suha Jarad ◽  
Amal Akour ◽  
Wael Khreisat ◽  
Afrah El-Shammari

Background: Rate of non-adherence to antiepileptic drugs (AEDs) in children is about 33%. Engaging clinical pharmacists in the management of patients has proved to increase adherence to medications which will improve the outcomes of treatment. Objectives: To investigate the effect of a clinical pharmacist-led educational tool on the adherence to AEDs in pediatric patients with epilepsy. Secondary outcomes include effectiveness and safety of AEDs, satisfaction with information about AEDs provided to the caregivers, and patients quality of life (QoL). Methods: This was an interventional study where pediatric patients were randomly assigned to the intervention (n=41) or the control (n=40) group. A 30-minute clinical pharmacist-led educational interview to the parent/caregiver was provided to the intervention group as add-on to standard medical care received by the control group. Outcomes were measured at baseline and after eight-week follow-up. Results: The intervention group had an increase in mean adherence score from 6 ± 1.09 at baseline to 7.6 ± 0.9 at follow up (P-value < 0.001), while the control group had no significant change (P-value > 0.05), the difference between the two groups at follow-up was significant (P-value <0.0001). No significant difference was observed between groups at follow up with regard to effectiveness (P- value > 0.05), and safety (P-value=0.08). While higher satisfaction with information (P-value <0.0001), and higher QoL (P-value <0.05) was observed in the intervention group. There was a significant positive correlation between satisfaction and adherence (r=0.682, P-value < 0.0001), adherence and QoL (r=0.323, P-value < 0.01), satisfaction and QoL (r=0.298, P-value < 0.05). While, satisfaction and safety, safety and QoL correlated significantly and negatively (r=-0.263, P-value < 0.05 and r=-0.782, P-value < 0.0001, respectively) Conclusion: Clinical pharmacist-led educational tool had a positive outcome on pediatric patients with epilepsy with regard to adherence, effectiveness, safety, satisfaction with information about AEDs, and QoL.

Author(s):  
Suha Jarad ◽  
Amal Akour ◽  
Wael Khreisat ◽  
Afrah El-Shammari

Aim: To investigate the effect of a clinical pharmacist-led educational tool on pediatric patients with epilepsy in Jordan. Specifically on the efficacy, safety, adherence to antiepileptic drugs (AEDs), satisfaction with information about AEDs provided to the caregivers, and quality of life (QoL). Methods: This was a randomized controlled trial where pediatric patients were randomly assigned to the intervention (n=41) or the control (n=40) group. 30-minute clinical pharmacist-led educational interview to the parent/caregiver was provided to the intervention group as add-on to standard medical care received by the control group. Efficacy was measured by number of seizure-free patients, while epilepsy specific questionnaires were used to evaluate safety, adherence, satisfaction with information about AEDs and QoL; measured at baseline and after 8-week follow-up. Results: The intervention group had 63.9% seizure free patients at follow up vs. 31.7% at baseline (P-value <0.001), and the control group had 48.6% at follow up vs. 27.5% at baseline (P-value <0.05); with no significant difference between groups (P- value > 0.05). At follow-up, mean pediatric epilepsy side effects questionnaire (PESQ) score was reduced in the intervention group (P-value <0.001), and increased in the control group (P-value <0.001); with no significant difference between groups (P-value=0.08). While the intervention group had a significant higher mean score of adherence (P-value <0.0001), and higher satisfaction with information (P-value <0.0001), and a higher QoL (P-value <0.05). There was a significant positive correlation between satisfaction and adherence (r=0.682, P-value < 0.0001), satisfaction and QoL (r=0.298, P-value < 0.05), adherence and QoL (r=0.323, P-value < 0.01). While, satisfaction and safety, safety and QoL correlated significantly and negatively (r=-0.263, P-value < 0.05 and r=-0.782, P-value < 0.0001, respectively) Conclusion: Clinical pharmacist-led educational tool had a positive outcome on pediatric patients with epilepsy with regard to efficacy, safety, adherence, satisfaction with information about AEDs and QoL.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Younes Lotfi ◽  
Mahdieh Hasanalifard ◽  
Abdollah Moossavi ◽  
Enayatollah Bakhshi ◽  
Mohammad Ajalloueyan

Abstract Background The objective of this study was to evaluate the effect of “Spatially separated speech in noise” auditory training on the ability of speech perception in noise among bimodal fitting users. The assumption was that the rehabilitation can enhance spatial hearing and hence speech in noise perception. This study was an interventional study, with a pre/post-design. Speech recognition ability was assessed with the specific tests. After performing the rehabilitation stages in the intervention group, the speech tests were again implemented, and by comparing the pre- and post-intervention data, the effect of auditory training on the speech abilities was assessed. Twenty-four children of 8–12 years who had undergone cochlear implantation and continuously used bimodal fitting were investigated in two groups of control and intervention. Results The results showed a significant difference between the groups in different speech tests after the intervention, which indicated that the intervention group have improved more than the control group. Conclusion It can be concluded that “Spatially separated speech in noise” auditory training can improve the speech perception in noise in bimodal fitting users. In general, this rehabilitation method is useful for enhancing the speech in noise perception ability.


2020 ◽  
Vol 54 ◽  
pp. 103
Author(s):  
Marco Antonio Vieira da Silva ◽  
Thaís Moreira São-João ◽  
Marilia Estevam Cornelio ◽  
Fábio Luiz Mialhe

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.


2013 ◽  
Vol 25 (2) ◽  
pp. 300-307 ◽  
Author(s):  
Elaine Murtagh ◽  
Maureen Mulvihill ◽  
Oonagh Markey

The school has been identified as a key setting to promote physical activity. The purpose of this study was to evaluate the effect of a classroom-based activity break on in-school step counts of primary school children. Data for 90 children (49 boys, 41 girls, 9.3 ± 1.4 years) from three Irish primary schools is presented. In each school one class was randomly assigned as the intervention group and another as controls. Children’s step counts were measured for five consecutive days during school hours at baseline and follow-up. Teachers of the intervention classes led a 10 min activity break in the classroom each day (Bizzy Break!). Mean daily in-school steps for the intervention at baseline and follow-up were 5351 and 5054. Corresponding values for the control group were 5469 and 4246. There was a significant difference in the change in daily steps from baseline to follow-up between groups (p < .05). There was no evidence that girls and boys responded differently to the intervention (p > .05). Children participating in a daily 10 min classroom-based activity break undertake more physical activity during school hours than controls.


Author(s):  
Luciana Regina Ferreira da Mata ◽  
Cissa Azevedo ◽  
Mariana Ferreira Vaz Gontijo Bernardes ◽  
Tânia Couto Machado Chianca ◽  
Maria da Graça Pereira ◽  
...  

ABSTRACT Objective: To evaluate the effectiveness of a teaching program for hospital discharge of patients submitted to radical prostatectomy based on the self-efficacy construct of the Cognitive Social Theory. Method: A controlled clinical trial carried out on a 2-month follow-up of 68 prostatectomized men randomized into intervention group (n = 34) and control (n = 34). The intervention group received routine guidance from the service plus the teaching program. The control group only received routine guidance from the service. The data collection instruments were: sociodemographic and clinical questionnaire, self-efficacy scale, hospital depression and anxiety scale, household care knowledge questionnaire, and an item on satisfaction with a score of 1 to 5. Results: There was a significant difference between the intragroups for satisfaction (p<0.001) and knowledge (p<0.001) of the pre-test to the post-test. In the intervention group, there were significant changes between the times for anxiety (p=0.011) and knowledge (p<0.001). Conclusion: The teaching program with a combination of oral guidance, written instruction and telephone follow-up was effective in improving knowledge about home care and personal satisfaction. Brazilian Registry of Clinical Trials: RBR-5n95rm.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Alicia Sneij Perez ◽  
Adriana Campa ◽  
Leslie Seminario ◽  
Sabrina Martinez ◽  
Fatma Huffman ◽  
...  

Abstract Objectives The objective of this study is to assess the effectiveness of a 6-month nutrition intervention to improve glycemic parameters and inflammation in prediabetic PLWH on stable ART with undetectable HIV viral load. Methods A 6-month randomized, controlled nutrition intervention was conducted in prediabetic PLWH. The study participants for the intervention were recruited from the Miami Adult Studies for HIV (MASH) cohort at the FIU-Borinquen Research Clinic. Upon their consent, the participants were randomized into the intervention group or the control group. Participants randomized in the intervention group met once a month for approximately 1 hour where they received medical nutrition therapy, nutrition counseling and nutrition education; participants randomized into the control group received educational material at baseline. Blood was drawn at baseline and at 6-month to measure fasting blood glucose (FBG) and high sensitivity C-reactive protein (hs-CRP). Results A total of 38 participants were recruited and randomized into either the intervention group (n = 20) or the control group (n = 18). We found that the FBG for the 6-month follow-up for the intervention group was significantly lower than the baseline FBG values of the same study group (paired t-test; P = 0.031). No significant difference was found in the control group between the baseline and 6-month fasting blood glucose values (P = 0.068). Moreover, no significant difference was found in pre/post C-reactive protein (CRP) levels in the intervention or control group (paired t-test; P = 0.404 and P = 0.117 respectively). There was a significant difference in CRP levels at baseline (P = 0.028) between the study groups but no difference at the 6-month follow up (Mann Whitney U test: P = 0.430). Conclusions The results from this intervention support the notion that a nutrition intervention is effective in prediabetic PLWH to lower diabetes risk by significantly lowering fasting blood glucose and may be implemented into larger scale interventions; however, no significant changes was seen in hs-CRP values between the 2 groups. Funding Sources National Institute of General Medical Sciences (NIGMS): Research Initiative for Scientific Enhancement (RISE), Biomedical Research Initiative (BRI) Grant, National Institute on Drug Abuse 5U01DA040381-03 and FIU-Dissertation Funding.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Cui-na Yan ◽  
Wei-guo Yao ◽  
Yi-jie Bao ◽  
Xiao-jing Shi ◽  
Hui Yu ◽  
...  

Background. Uremic pruritus (UP) is a common symptom in patients undergoing maintenance hemodialysis for end-stage renal disease (ESRD).Objective. To determine the clinical efficacy of auricular acupressure therapy on pruritus in hemodialysis patients and to explore possible underlying mechanisms.Methods. Patients receiving maintenance hemodialysis at a referral medical center were recruited and assigned to intervention (n=32) and control (n=30) groups. The intervention group underwent auricular acupressure treatment three times a week for six weeks. Auricular acupressure was not applied to patients in the control group. However, tape withoutVaccariaseeds was applied to the same six auricular acupoints as the intervention group. Pruritus scores were assessed using VAS scores, and enzyme-linked immunosorbent assays (ELISA) were used to measure levels of other possible contributory biochemical factors.Results. There was a significant difference in mean VAS scores between the postintervention and control groups during follow-up (3.844 ± 1.687 versus 5.567 ± 2.285,F=22.32,P<0.0001). Compared to the control group, serum histamine levels in the postintervention group at the six-week follow-up had decreased significantly (F=5.01,P=0.0290).Conclusion. Our findings suggest that auricular acupressure may be a useful treatment in the multidisciplinary management of UP in ESRD patients.


2021 ◽  
Author(s):  
Pegah Mohammadzadeh ◽  
Elnaz Shaseb ◽  
Zohreh Sanaat ◽  
Parvin Sarbakhsh ◽  
Nasrin Gholami ◽  
...  

Abstract Purpose Peripheral neuropathy is a complication of taxane that in severe cases can limit the optimal treatment. The aim of this study was to evaluate the efficacy of memantine in prevention of docetaxel induced peripheral neuropathy in patients with breast cancer. Methods In this randomized clinical trial, 40 women between the ages of 18 and 64 years with non-metastatic breast cancer (stages I to III) were included (registry number: IRCT20160310026998N9 and registry date: 26 March 2019). All patients were treated with the AC-T regimen (with docetaxel). Patients in intervention group received memantine at a dose of 20 mg for 8 weeks at the beginning of the first cycle of docetaxel. Patients in control group did not take any medication for neuropathy prevention. To assess the neuropathy, DN4 and CTCAE questionnaires were used at baseline, one months, three months and six months after the intervention. Results The DN4 questionnaire score was remarkably less in memantine group in follow up one (p-value: 0.033) and three (p < 00.1). The CTCAE follow up score did not change during study. The Neuropathy duration and Neuropathy onset, were shown significant difference between the intervention and control groups, p = 0.050 and p = 0.001, respectively. From 40 patients, 8 (40%) in memantine group and 2 (10%) in control group, did not experience any kind of neuropathy. Conclusion Data showed that prophylactic administration of memantine 20 mg/day has been effective in prevention of severity and incidence of docetaxel induced neuropathy in patients with breast cancer.


2019 ◽  
pp. 29-36

Background: Marital conflict is a type of lack of ongoing meaningful agreement between spouses. The present study aimed to investigate the effectiveness of mindfulness-based cognitive therapy on sexual self-efficacy and marital satisfaction in couples with marital conflicts. Materials and Methods: This quasi-experimental study was carried out on the intervention and control groups with a pretest/posttest design and follow-up. The study population consisted of 30 females who referred to counseling centers in district 1 of Tehran, Iran, in 2018 through simple random sampling. The participants were randomly divided into two groups, each with 15 members. The intervention group received mindfulness-based cognitive therapy, and the control group received no intervention. Data collection tools were the questionnaires of sexual self-efficacy, marital satisfaction, and marital conflicts. The questionnaires were filled out by the participants before and after the intervention and 3 months later. The collected data were analyzed using repeated measurement analysis and analysis of covariance by SPSS software (version 22). Results: The results of the study showed that mindfulness-based cognitive therapy led to increased sexual self-efficacy (P<0.033) and marital satisfaction (P<0.003) in the intervention group; however, in the control group, there was no significant difference in pretest, posttest and follow-up scores. Conclusion: Based on the results, it can be concluded that mindfulness-based cognitive therapy can improve sexual self-efficacy and marital satisfaction in couples with marital conflicts.


Author(s):  
Sandeep Kumar Kanugula ◽  
Mallesh Rathod ◽  
Venugopal S. M.

<p class="abstract"><strong>Background:</strong> Anterior knee pain (AKP) following total knee arthroplasty (TKA) ­­­­­­is one of the complication which cause dissatisfaction in patients. Incidence estimated to be 4-49%. The aim of our study is to know the efficacy of patelloplasty with circumpatellar denervation with diathermy in reducing AKP in primary TKA.</p><p class="abstract"><strong>Methods:</strong> A total of 130 unilateral TKAs’ are divided into 2 groups. Group I (control) includes 65 patients in which only patelloplasty was done. Group II (intervention) includes 65 patients in which both patelloplasty and circumpatellar denervation with diathermy was done and analysed. Mean follow up period was 18 months. Patients were assessed both preoperatively and postoperatively at final follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> The overall incidence of AKP at follow up (18 months) was 16.9%, with 7.7% in the intervention group and 26.1% in the control group (p&lt;0.05).  Western Ontario and McMaster Universities osteoarthritis index scores were significantly  better in intervention group when compared to control group (28.71±3.948 vs 31.40±3.860). Better results were also found in knee society scores for intervention group compared to control group (166.57±7.941 vs 161.23±11.219); Feller patellar score of  intervention group was significantly better when compared to control group (23.28±2.546 vs 20.69±3.729); the range of knee flexion was similar in both the groups (94.62±12.6 vs 93.54±10.7). In terms of pain referred by the patient at 72 hrs postoperatively, there was statistically significant difference observed according to visual analogue scale.</p><p class="abstract"><strong>Conclusions:</strong> There is statistically significant difference with respect to AKP in patients who have undergone patelloplasty with circumpatellar denervation using diathermy compared with patelloplasty alone.</p><p> </p>


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