scholarly journals Medication adherence and its relationship to the therapeutic alliance: Results from an innovative pilot study within a community pharmacy MTM practice

2011 ◽  
Vol 2 (1) ◽  
Author(s):  
Janice Pringle ◽  
Michael Melczak ◽  
Arnie Aldridge ◽  
Margie Snyder ◽  
Randall Smith
Keyword(s):  
Medication Adherence ◽  
Therapeutic Alliance ◽  
Community Pharmacy ◽  
Comparison Group ◽  
Intervention Group ◽  
Community Pharmacists ◽  
Original Research ◽  
Percentage Point Increase ◽  
Medication Therapy ◽  
Quasi Experimental

Objectives: To determine whether patients who received Medication Therapy Management (MTM) from community pharmacists using a brief scale to measure Therapeutic Alliance (i.e., MTM + TA) would show better medication adherence than patients who received MTM without use of the TA scale (MTM only). Design: Quasi-experimental, using a direct intervention group (MTM + TA) and a comparison group of randomly selected claims records from patients who received only the MTM service (MTM only). We used a doubly robust propensity score approach to estimate the average effect of therapeutic alliance on medication adherence. The analysis was limited to the following broad medication categories: antihypertensives, antidiabetic agents, and antihyperlipidemics. Setting: The direct intervention group included patients receiving MTM services from pharmacists in a community pharmacy chain setting. Participants: After matching with claims data, the direct intervention group was n=117, with an average age of 76.4. The comparison group was n=146, with an average age of 76.2. Intervention: Administration of two brief scales designed to measure general health outcomes and TA within the context of MTM (with focus on TA scale administration). Main Outcome Measures Proportion of Days Covered (PDC) and PDC80. Results: Using the therapeutic alliance scales in the context of community pharmacist-provided MTM was associated with a 3.1 percentage point increase in patients' overall PDC (p<.001) and an increase of 4.6 percentage points in PDC80 (p=.02) as compared to patients receiving MTM without use of the therapeutic alliance scales. Conclusion: Measuring therapeutic alliance in the context of MTM is associated with improved medication adherence and represents one strategy for enhancing the effectiveness of MTM encounters. Furthermore, administration of the therapeutic alliance scales used very little time; therefore it is likely feasible for pharmacists to routinely use the scales in their practice. Type: Original Research

scholarly journals "Until they know how much you care": A qualitative analysis of an innovative practice in community pharmacy

2011 ◽  
Vol 2 (2) ◽  
Author(s):  
Michael Melczak ◽  
Janice Pringle
Keyword(s):  
Medication Adherence ◽  
Therapeutic Alliance ◽  
Community Pharmacy ◽  
Patient Outcomes ◽  
Qualitative Content Analysis ◽  
Original Research ◽  
Routine Practice ◽  
Medication Therapy ◽  
Advantages And Disadvantages ◽  
Innovative Practice

Purpose: This qualitative study was concerned with investigating community pharmacists' thoughts on the use of two brief scales to measure patient outcomes and therapeutic alliance in the context of their Medication Therapy Management (MTM) services. The scales were originally developed for use in behavioral healthcare, but were used in a novel (community pharmacy) setting as part of a previous parent study. We describe this practice (using these scales in a novel setting) as an innovative practice, report on the pharmacists' experiences with the practice, and discuss relative advantages and disadvantages for integrating the use of the scales as part of routine practice. Methods: Six community pharmacy practitioners participated in a semi-structured interview pertaining to the use of the scales in their MTM services. Pharmacist interviews were transcribed, analyzed according to qualitative content analysis methodology, and presented in relation to the guiding interview questions. Results: Pharmacists had varying opinions on the use of the scales as part of their practice. Initial concerns included patient (mis)understanding about the purpose and proper completion of the scales, as well as apprehension about the use of the information. These concerns were largely resolved through education, repeated use, and routinization. Pharmacists, in general, saw a value to using these scales in clinical practice, for clinical and professional reasons, although there was variability on the degree to which pharmacists integrated the scales into practice after the study completion. Pharmacists had varied opinions as well as on the degree to which the use of the scales would impact medication adherence. Pharmacists were most surprised by how much participation in this study prompted them to reflect on their interactions with patients. Conclusions: Pharmacists, in general, were receptive to participating in the parent study and using two brief scales to measure patient outcomes and therapeutic alliance. Pharmacists had varying opinions on the degree to which the use of these scales could impact patient medication adherence, although they perceived other value and benefits secondary to the interactions. While most pharmacists did not maintain formal use of the scales after study end, they took away general principles of patient-centered care and individualized feedback.   Type: Original Research

scholarly journals Development and implementation of a community pharmacy medication therapy management-based transition of care program in the managed Medicaid population

2013 ◽  
Vol 4 (4) ◽  
Author(s):  
Sarah E. Kelling ◽  
David R. Bright ◽  
Timothy R. Ulbrich ◽  
Donald L. Sullivan ◽  
James Gartner ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Care Service ◽  
Care Program ◽  
Medication Therapy Management ◽  
Original Research ◽  
Transition Of Care ◽  
Therapy Management ◽  
Medication Therapy ◽  
Medicaid Population ◽  
Managed Medicaid

Objective: To describe successes and barriers with the development and implementation of a community pharmacy medication therapy management-based transition of care program in the managed Medicaid population. Setting: A single supermarket chain pharmacy Practice description: Community pharmacists provide dispensing and non-dispensing pharmacy services including medication therapy management, biometric wellness screenings, and immunizations. Practice innovation: Developed and implemented a community pharmacy medication therapy management-based transition of care program for patients with managed Medicaid Main outcome measures: Feasibility of developing and implementing a transition of care service in a community pharmacy Results: During the first six months, a total of 17 patients were seen as part of the program. Study pharmacists identified successes and potential strategies for overcoming barriers. Conclusion: Developing and implementing a community pharmacy transition of care program for patients with managed Medicaid was logistically feasible.   Type: Original Research

scholarly journals Self-Care Options for Resilient Educators (SCORE) Teaches Aspiring Teachers How to Manage Stress in Light of COVID-Related Disruptions

2021 ◽  
Vol 06 (04) ◽  
pp. 1-1
Author(s):  
Brandis M. Ansley ◽  
◽  
Meagan A. Wander ◽  
Keyword(s):  
Stress Management ◽  
Comparison Group ◽  
Secondary Trauma ◽  
Intervention Group ◽  
Self Care ◽  
Management Training ◽  
Medium Effects ◽  
Post Intervention ◽  
Stress Management Training ◽  
Quasi Experimental

Self-Care Options for Resilient Educators (SCORE) is an 8-week, asynchronous virtual training program that teaches stress management skills relevant to educators’ job-related responsibilities and interpersonal interactions. From January-April 2020, 28 pre-service teachers participated in a quasi-experimental study of SCORE’s feasibility and preliminary efficacy. Volunteers chose to either complete SCORE concurrent with their teaching internship or to complete the same assessments for comparison purposes. Recruitment and implementation took place prior to COVID-19 disruptions. Then, six weeks into SCORE, the participants encountered unanticipated school closures and uncertainties associated with their internships (e.g., Would they be able to complete their internships and degree programs? Would they be eligible to teach the next school year?). Despite disruptions to their teaching internships, the remote format of SCORE allowed the study to continue and for participants to complete the full training. Pre-intervention to post-intervention changes in outcomes for the intervention group reflected large effect sizes for decreases in burnout and increases in teacher efficacy. There were medium effects for increased self-compassion and small-to-medium effects for increased cognitive reappraisal. However, pre-to-post intervention differences for the comparison group were relatively unchanged on most indicators. Results for secondary traumatic stress was remarkable, as the comparison group demonstrated a medium-to-large effect for an increase at post-intervention. This measure, however, revealed no effect in change for program participants. This finding is noteworthy and suggests that participation in SCORE or a similar program may help mitigate the potentially harmful effects of exposure to secondary trauma. Overall, this study’s results support arguments for including stress management training during pre-service teaching internships.

Effectiveness of a Job Search Training Program for Youth With Visual Impairments

2018 ◽  
Vol 42 (4) ◽  
pp. 214-224 ◽  
Author(s):  
Jennifer L. Cmar ◽  
Michele C. McDonnall
Keyword(s):  
Job Search ◽  
Work Experience ◽  
Comparison Group ◽  
Visual Impairments ◽  
Intervention Group ◽  
Work Experiences ◽  
Effective Work ◽  
Quasi Experimental ◽  
Search Training ◽  
And Behavior

Early work experiences predict future employment for youth with visual impairments, particularly when youth find jobs independently, but research has not supported the efficacy of sponsored work for this population. The most effective work experience programs include additional components such as job search assistance, and job search interventions are effective at improving employment outcomes. Thus, we conducted a quasi-experimental study to evaluate the effectiveness of adding job search training to a summer work experience program with 42 youth with visual impairments. Intervention group youth significantly increased job search knowledge and behavior compared with comparison group youth, and both groups increased in job search self-efficacy. Although additional research is needed, this study provides initial evidence of the job search program’s effectiveness.

scholarly journals A Nursery-Based Cooking Skills Programme with Parents and Children Reduced Food Fussiness and Increased Willingness to Try Vegetables: A Quasi-Experimental Study

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2623
Author(s):  
Ada L. Garcia ◽  
Emma Brown ◽  
Tom Goodale ◽  
Mairi McLachlan ◽  
Alison Parrett
Keyword(s):  
Experimental Study ◽  
Comparison Group ◽  
Vegetable Intake ◽  
Intervention Group ◽  
Average Score ◽  
Cooking Skills ◽  
Parents And Children ◽  
Sensory Learning ◽  
Quasi Experimental ◽  
Food Fussiness

Children’s fussy eating is associated with a reduced vegetable intake. This quasi-experimental study evaluated “Big Chef Little Chef” (BCLC), a nursery-based cooking skills programme aimed at reducing food fussiness and increasing willingness to try green vegetables by incorporating repeated exposure and sensory learning. Parent and child (3–5 years) dyads attended BCLC for four/1.5 h weekly sessions. A comparison group was recruited after BCLC completion and attended a single education session at week 1. A questionnaire measured food fussiness at week 1 and week 4. At week 4, all children were offered six green vegetables (raw and cooked) and an average score (1 = did not try; 2 = tried it/ate some; 3 = ate it all) was calculated for willingness to try vegetables. In total, 121 dyads (intervention: n = 64; comparison: n = 57) participated. The food fussiness score (1 min–5 max) in the intervention group decreased significantly from 3.0 to 2.6 (p < 0.01) between time points, while there was no change in the comparison group (3.1 (week 1) and 3.0 (week 4)). The intervention group was more willing to try green vegetables with significantly higher (p < 0.001) median scores for raw and cooked vegetables (2.5 for both) compared with the comparison group (2.0 and 1.7, respectively). The BCLC reduced food fussiness and increased willingness to try green vegetables.

scholarly journals Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study

2015 ◽  
Vol 7 (2) ◽  
pp. 172-184 ◽  
Author(s):  
E. W. Kimani-Murage ◽  
S. A. Norris ◽  
M. K. Mutua ◽  
F. Wekesah ◽  
M. Wanjohi ◽  
...  
Keyword(s):  
Experimental Study ◽  
Community Health ◽  
Exclusive Breastfeeding ◽  
Urban Poor ◽  
Standard Care ◽  
Comparison Group ◽  
Intervention Group ◽  
Potential Effectiveness ◽  
Health Strategy ◽  
Quasi Experimental

Early nutrition is critical for later health and sustainable development. We determined potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies [Pre-intervention (2007–2011; n=5824), Intervention (2012–2015; n=1110) and Comparison (2012–2014; n=487)], which followed mother–child pairs longitudinally to establish EBF rates from 0 to 6 months. The Maternal, Infant and Young Child Nutrition (MIYCN) study was a cluster randomized trial; the control arm (MIYCN-Control) received standard care involving community health workers (CHWs) visits for counselling on antenatal and postnatal care. The intervention arm (MIYCN-Intervention) received standard care and regular MIYCN counselling by trained CHWs. Both groups received MIYCN information materials. We tested differences in EBF rates from 0 to 6 months among four study groups (Pre-intervention, MIYCN-Intervention, MIYCN-Control and Comparison) using a χ2 test and logistic regression. At 6 months, the prevalence of EBF was 2% in the Pre-intervention group compared with 55% in the MIYCN-Intervention group, 55% in the MIYCN-Control group and 3% in the Comparison group (P<0.05). After adjusting for baseline characteristics, the odds ratio for EBF from birth to 6 months was 66.9 (95% CI 45.4–96.4), 84.3 (95% CI 40.7–174.6) and 3.9 (95% CI 1.8–8.4) for the MIYCN-Intervention, MIYCN-Control and Comparison group, respectively, compared with the Pre-intervention group. There is potential effectiveness of the Kenya national Community Health Strategy in promoting EBF in urban poor settings where health care access is limited.

scholarly journals Smart Phone Apps: An Innovative Approach to Improving Pediatric Medication Adherence

2015 ◽  
Vol 6 (4) ◽  
Author(s):  
Rebecca M. Wytiaz ◽  
Hyung M. Lee ◽  
Olufunmilola K. Odukoya
Keyword(s):  
Medication Adherence ◽  
Mobile Apps ◽  
Pediatric Population ◽  
Smart Phone ◽  
Community Pharmacists ◽  
Chronic Illnesses ◽  
Innovative Technology ◽  
Medication Therapy ◽  
Transition Into Adulthood ◽  
Optimal Population

Children suffering from chronic illnesses often struggle to adhere to their medication regimens and are rarely involved in the management of their medications. The use of innovative technology, such as medication adherence mobile apps, may be beneficial in increasing medication adherence rates and self-care knowledge in the pediatric population. Children serve as an optimal population with which to use mobile apps as intervention tools, as children utilize smart phone technology far more than most other populations. By striving to improve children’s medication perceptions, adherence and willingness to continue medication therapy for a chronic condition may improve during adolescent years and may persist as they transition into adulthood. As community pharmacists interact with children with chronic conditions during routine visits, they can also engage them in conversations about their medication adherence through use of mobile apps. Although many medication adherence apps are currently available on the market, none of these apps are tailored towards pediatric patients. Thus, further research should be conducted in order to develop mobile apps conducive to this population.   Type: Student Project

scholarly journals The Effect of an Authentic Acute Physical Education Session of Dance on Elementary Students’ Selective Attention

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
P. H. Kulinna ◽  
M. Stylianou ◽  
B. Dyson ◽  
D. Banville ◽  
C. Dryden ◽  
...  
Keyword(s):  
Physical Education ◽  
Selective Attention ◽  
Comparison Group ◽  
Intervention Group ◽  
Significant Group ◽  
Significant Time ◽  
Aotearoa New Zealand ◽  
Physical Education Lesson ◽  
Quasi Experimental ◽  
Potential Benefits

There have been calls to test the potential benefits of different forms of physical activity (PA) to executive function, particularly in authentic settings. Hence, the purpose of this study was to investigate the effect of an acute dance session within an existing physical education class on students’ selective attention. The study employed a pre/posttest quasi-experimental design with a comparison group in one Aotearoa, New Zealand, primary school. Participants were 192 students (comparison group = 104 students) in Years 5 and 6. The intervention group participated in a dance-based physical education lesson while the comparison group continued their regular classroom work. PA during the physical education lesson was monitored using accelerometers. Selective attention was assessed at pretest and after the comparison/physical education sessions with the d2 Test of Attention. 2 × 2 ANOVA results suggested a significant time effect for all three measures, no significant group effects for any measures, and significant time by group interactions for TN and CP but not for E%. The intervention group improved significantly more than the comparison group for TN and CP. This study’s findings suggest that existing school opportunities focused on cognitively engaging PA, such as dance, can improve aspects of students’ selective attention.

scholarly journals The effect of an educational intervention to improve tuberculosis infection control among nurses in Ibadan, South-West Nigeria: a quasi-experimental study

2019 ◽  
Author(s):  
Patrick Aboh Akande
Keyword(s):  
Experimental Study ◽  
Infection Control ◽  
Educational Intervention ◽  
Comparison Group ◽  
Intervention Group ◽  
Health Facilities ◽  
Post Intervention ◽  
South West ◽  
Quasi Experimental ◽  
Mixed Approach

Abstract Background: Nurses are particularly vulnerable to acquiring TB because they are in the frontline of patient care. There is inadequate implementation of cost-effective TB infection control (TBIC) measures at most health facilities. Training has been shown to be effective in improving the knowledge and work practices of nurses. This study sought to utilize a mixed-approach educational intervention to improve the TBIC-related knowledge and practices of nurses in two secondary health facilities in Ibadan, South-West Nigeria. Methods: This quasi-experimental study involved 200 (100 each in the intervention and comparison groups). Baseline data was collected in May 2014. This was followed by training of the nurses in the intervention group. After 6 months, the second wave of data was collected and the nurses in the comparison group also received the training after this. The final wave of data collection took place 12 months after the commencement of the study. Mean scores of the nurses were determined and comparison made between both groups at different time points using independent t -test. Results: The nurses in both groups were statistically comparable in their socio-demographic characteristics and baseline mean knowledge (68.6% and 67.7%) and practice scores (79.1% and 80.6%) respectively. After the intervention group received the training, there were appreciable improvements in the post-intervention scores of the group at 6 months (knowledge-85.9%; practice-98.5%), which were significantly different from those of the comparison group (knowledge-69.5%, practice-78.8%). A large effect size was demonstrated in the improvement in knowledge score in the intervention group at 6 months compared with the other group (Cohen’s d = 1.7). Similarly, there were improvements in the scores of the nurses in the comparison group at 12 months after the group had also received the training (knowledge-88.2%, practice-93.5%). At this point, the mean scores between both groups were no longer significantly different. Conclusions: The improvement in post-intervention scores implies that the mixed-approach educational intervention adopted in this study was effective in improving TBIC among the nurses. It also underscores the importance of continuous training/retraining of nurses and other healthcare workers in improving and sustaining TBIC at health facilities.

scholarly journals Effect of care for child development training on cadres’ knowledge, attitude, and efficacy in Yogyakarta, Indonesia

2021 ◽  
Author(s):  
Akhmadi Akhmadi ◽  
Sunartini Sunartini ◽  
Fitri Haryanti ◽  
Ema Madyaningrum ◽  
Mei Neni Sitaresmi
Keyword(s):  
Public Health ◽  
Child Development ◽  
Self Efficacy ◽  
Comparison Group ◽  
Intervention Group ◽  
Health Centers ◽  
Median Score ◽  
Quasi Experimental ◽  
Nutritional Status Of Children ◽  
Children Development

Background: Stunting is a common malnutrition problem among children in the world. The Care for Children Development (CCD) intervention is a strategy to reduce stunting. Objective: This study aimed to identify the effect of culturally modified CCD training on the knowledge, attitude, and efficacy (KAE) of cadres about stunting in the community.Methods: We conducted a community-based study with a quasi-experimental research design using a comparison group. The study was conducted from March 2018 to February 2019 at three Public Health Centers in Yogyakarta, Indonesia. The total participants were 69 in the intervention group and 53 in the comparison group. Cadres in the intervention group received two days of training on a culturally modified CCD guideline. In contrast, cadres in the comparison group received a brief explanation (a one-day training) on that program. The nurses from three public health centers were facilitators in this training. Knowledge and self-efficacy were assessed using a modified Caregiver Knowledge of Child Development Inventory and General Self-efficacy Scale, respectively. Data were analyzed using Mann-Whitney U tests and Wilcoxon tests.Results: All 122 cadres completed the training. In the intervention group, CCD training significantly increased cadres’ knowledge (median score 14 vs. 11), attitude (58 vs. 55), and efficacy (30 vs. 28), all with p <0.001. In the comparison group, the short explanation of CCD significantly improved cadres’ knowledge (median score 12 vs. 10) and efficacy (29 vs. 27) but not their attitude. The delta or change in score before and after CCD training for cadres’ attitude in the intervention group was significantly higher than that of the comparison group (3.78 vs. 0.72; p = 0.050). Conclusion: A culturally modified CCD training significantly improves cadres’ KAE in the intervention group and cadres’ knowledge in the comparison group. The learning delivery methods with demonstrations and role-plays significantly improved the cadres’ attitudes as health educators for stunted mothers in the community. For sustainability, community health nurses should regularly collaborate with cadres to improve the nutritional status of children in their area.

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