scholarly journals The Relationship Between Treatment Adherence and Non-picked Up Medications in Community Pharmacies

2016 ◽  
Vol 7 (4) ◽  
Author(s):  
Vu Phan Hoang Nguyen ◽  
Albert Wertheimer
Keyword(s):  
Health Care ◽  
Medication Adherence ◽  
Health Care System ◽  
Conflicts Of Interest ◽  
Healthcare Providers ◽  
Drug Regimen ◽  
Adherence Rate ◽  
Adherence Behavior ◽  
Number Of Patients ◽  
Care System

Medication adherence is one of the major factors that determine an outcome of a treatment. Despite the effort of healthcare providers to improve the adherence rate, it still remains a serious issue in our health care system today. Many patients do not take their medications as directed or just simply do not want to fill or refill their prescriptions. A small survey performed by pharmacy students at Temple School of Pharmacy showed that there is a significant number of patients did not pick up their medications. Cardiovascular medications are the most common non-picked up drugs. There are various reasons that patients use to justify for this non-adherence behavior. However, they are unaware that their actions create a tremendous negative effect not only on the treatment itself but also on the entire health care system. The consequences include expensive therapies, inaccurate research data, and poor treatment outcomes. Many solutions have been utilized to solve this problem, but it is still the major problem for healthcare providers to keep in mind when planning a drug regimen. Although many people believed that pharmacists are responsible for solving this problem, it should be a multidisciplinary effort of all healthcare providers to improve the medication adherence. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Student Project

scholarly journals Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

2012 ◽  
Vol 4 (1) ◽  
pp. 41-46 ◽  
Author(s):  
James Coyle
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Aspiration Pneumonia ◽  
Hospital Admissions ◽  
Cost Savings ◽  
Advanced Training ◽  
Number Of Patients ◽  
Management Of Dysphagia ◽  
University Training ◽  
Care System

Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP), a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

Simulation-based ventilatory training for the caregivers at primary and rural health care workers in Central India for dealing with COVID-19 pandemic: recommendations

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Shraddha Aditya Patel ◽  
Gajanan Chavan ◽  
Mahendra Gudhe ◽  
Aparna Upadhye ◽  
Vandana Lohana ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Training Session ◽  
Rural Hospitals ◽  
Primary Health ◽  
Number Of Patients ◽  
Simulation Based ◽  
Care System

Abstract In 2020 COVID-19 made a major burden on health care system. The capacity of the healthcare system particularly emergency departments, ICU, hospital beds are insufficient to manage the increasing number of patients in cities and rural areas too. The primary health care centers and rural hospitals need preparedness for such disasters conditions. Novel and future oriented solutions are needed to effectively address the unprecedented pressure on the healthcare systems created by the COVID-19 pandemic. Considering the lacunae in healthcare system at primary level, various challenges encountered during pandemic has been identified and training session in consortia with simulation based training program for the training of the doctors, nurses, attendants and other related healthcare staff of Primary Health Center and Rural Hospitals intending to prepare them for future challenges in ventilatory care of COVID-19 has been carried out. After these training session certain conclusions and recommendations were drawn which could be able our health care system to be prepared for more critical situations and we can take our primary health care system at new horizon.

scholarly journals Impact of a Shared Medical Appointment on Hypertension Clinical Outcomes and Medication Adherence in a Veterans Affairs Health Care System

2017 ◽  
Vol 33 (5) ◽  
pp. 177-182 ◽  
Author(s):  
Cain Eric Kirk ◽  
Autumn N. Gordon ◽  
Kelly D. Mooney ◽  
Garrett B. Aikens ◽  
Michael H. Robinson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Medication Adherence ◽  
Clinical Outcomes ◽  
Health Care System ◽  
Antihypertensive Medications ◽  
Access And Quality ◽  
Improve Access ◽  
Care System

Background:Shared medical appointments (SMAs) are utilized across health care systems to improve access and quality of care, with limited evidence to support the use of SMAs to improve clinical outcomes and medication adherence among hypertensive patients. Objective: Improve access and quality of care provided within a Veterans Affairs health care system via implementation of a hypertension SMA to improve clinical outcomes and medication adherence. Methods: Veterans were eligible for enrollment in the SMA if they received care within the health care system, were aged ≥18 years, were receiving at least 2 antihypertensive medications, and had systolic blood pressure (SBP) >140 mm Hg or diastolic blood pressure (DBP) >90 mm Hg. A pre/post cohort design was used to evaluate the improvement in antihypertensive medication adherence as well as the change in SBP and DBP for all Veterans who attended at least 2 SMAs. Results: Twenty-one Veterans participated in at least 2 SMAs and were included in the analysis; 76.2% had a reduction in SBP with an overall average decrease of −8.3 mm Hg ( P = .02). The proportion of Veterans considered to have controlled blood pressure (BP; <140/90 mm Hg) increased from 14.3% at baseline to 42.9% during the SMA period ( P = .03). There was no significant difference found for the proportion of Veterans considered adherent to their prescribed antihypertensive medications (95.2% vs 85.7%, respectively; P = .50). Conclusions: SBP significantly improved for patients enrolled in a pharmacist-led SMA at a VA health care system, and the proportion of patients considered to have controlled BP increased significantly.

scholarly journals The impact of the COVID-19 pandemic on Polish orthopedics, in particular on the level of stress among orthopedic surgeons and the education process

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257289
Author(s):  
Łukasz Kołodziej ◽  
Dawid Ciechanowicz ◽  
Hubert Rola ◽  
Szymon Wołyński ◽  
Hanna Wawrzyniak ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Personal Protective Equipment ◽  
Negative Impact ◽  
Protective Equipment ◽  
Orthopedic Surgeons ◽  
Number Of Patients ◽  
The Impact ◽  
Care System

The Coronovirus Disease 2019 –(COVID-19) pandemic had a significant impact on the health care system and medical staff around the world. The orthopedic units were also subject to new restrictions and regulations. Therefore, the aim of our research was to assess how the COVID-19 pandemic affected orthopedic wards in the last year in Poland. We created an online survey, which was sent to 273 members of the Polish Society of Orthopedics and Traumatology. The survey contained 51 questions and was divided into main sections: Preparedness, Training, Stress, Reduction, Awareness. A total of 80 responses to the survey were obtained. In Preparedness section the vast majority of respondents (90%) replied, that they used personal protective equipment during the pandemic, however only 50% of the respondents indicated that their facility received a sufficient amount of personal protective equipment. Most of the respondents indicated that the pandemic negatively affected the quality of training of future orthopedists (69.4%) and that pandemic has had a negative impact on their operating skills (66,7%). In Reduction section most of the doctors indicated that the number of patients hospitalized in their departments decreased by 20–60% (61,2% respondents), while the number of operations performed decreased by 60–100% (60% respondents). The negative impact of pandemic on education was noticeable especially in the group of young orthopedic surgeons: 0–5 years of work experience (p = 0,029). Among the respondents, the level of stress increased over the last year from 4.8 to 6.9 (p <0.001). The greatest increase in the level of stress was observed among orthopedists working in country hospitals (p = 0,03). In section Awareness 36,3% of respondents feel well or very well informed about the latest Covid-19 regulations. In addition, most doctors (82.6%) believe that the Polish health care system was not well prepared to fight the pandemic and that the regulations applied so far are not sufficient to effectively fight the pandemic (66.2%). The COVID-19 pandemic has impact on orthopedics departments in Poland and negatively affected the quality of training of orthopedic surgeons and the level of stress.

scholarly journals The acceptance and awareness of healthcare providers towards doctor of pharmacy (Phram D) in the Palestinian health care system

2020 ◽  
Vol 28 (9) ◽  
pp. 1068-1074
Author(s):  
Hani Naseef ◽  
Afnan Amria ◽  
Alaa' Asrawi ◽  
Ni'Meh Al-Shami ◽  
Mutaz Dreidi
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Healthcare Providers ◽  
Doctor Of Pharmacy ◽  
Care System

scholarly journals Treatment-Free Remission (TFR) Is Feasible in Clinical Practice Latin-America (LA): A Real-World Cohort of Patients in Colombia

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4605-4605
Author(s):  
Virginia Abello ◽  
Isabel Munevar ◽  
Rigoberto Gomez ◽  
Monica Osuna Pérez ◽  
Carlos Daniel Bermudez Silva ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Median Time ◽  
Health Care System ◽  
Real World ◽  
Research Funding ◽  
Chronic Phase ◽  
First Line ◽  
Number Of Patients ◽  
Care System

Abstract BACKGROUND: Long-term Tirosin Kinase Inhibitor (TKI) treatment is related to notable adverse events, quality-of-life impact and significant costs to health systems. Many patients in optimal response are candidates to TKI discotinuation that has proven to be safe in clinical trials. TFR has become a new goal for CML management. Information about its implementation in clinical practice in LA is limited. The aim of this study is to describe the results, safety and assess the possible economic impact of a cohort of patients that has discontinued TKI in clinical practice in Colombia. MATERIAL AND METHODS : The Colombian Association of Hematology and Oncology (ACHO)'s hematological disease registry (RENEHOC) is a multicenter nationwide registry on hematologic malignancies that captures information from 18 academic and general community centers with Institutional Ethics Committee approval, since 2018. Since 2019, it has been collecting information on CML. This report represents a sub-analysis of CML patients in the registry in whom discontinuation was performed. Treatment was according to investigator preferences. A total of 449 CML adult patients treated in the last 20 years have been registered until now on RENEHOC. 29 patients were considered eligible for TFR; in 27 of them, TKI have been discontinued. The main outcome measured is survival without TKI re-initiation. RESULTS: At diagnosis the median age was 58 yrs. (IQR 51-65), all were in the chronic phase and 86% had intermediate-higk risk Sokal score. First line treatment was Imatinib in 11, Dasatinib 9, and Nilotinib 7. 5 patients required a second line with Nilotinib, only one of them was considered to have failed first line. 17 discontinuations were performed as a planned physician strategy, 6 were carried out by patient's decision, 3 were forced by toxicities and in one case it was carried out to search for a pregnancy. Median time on TKIs before discontinuation was 73 months (IQR 59-135) and median time in RMM before TFR was 46 moths (IQR 35-71). Due to its retrospective nature, many patients did not have exact information on MR4.5 achievement date, since it was not available in Colombia until 2016. At a median follow-up of 12.5 months (IQR 4-20), 22 (81%) patients remain on TFR. As has been previously described most patients lost MMR in the first 6 months (median time to restart TKI 6 months; IQR 2-10). Only 1 patient did not achieve the MMR after TKI reinitiated, no progressions to accelerated or blastic phase were reported. 3 patients reinitiated the same ITK and 2 changed to another. 1 patient that was initially treated with Imatinib was changed to Nilotinib after reinitiation and after 2 years in MMR 4.5 has again discontinued TKI and has not lost response after 3 months. 9 (33%) patients developed withdrawal syndrome in most cases (7) with mild symptoms, only 2 had moderate symptoms. The estimated savings on TKIs for Colombian health care system for this patients are US$1.156.937, it is calculated that the cost of the PCR analysis performed for this patients to monitor TFR safely was US$35019. CONCLUSIONS: TKI has change the landscape for CML patients, that currently have a life expectancy similar to the general population; however, indefinitely treatment is associated with significant toxicities and a very high cost for the systems. TFR has become a real goal for a selected group of patients with CML. This report represents real-world data in Colombia, showing its feasibility and safety under well-controlled settings. Also, the estimated savings for a health care system of a middle-income country as Colombia are very significant, which is an additional support to insist with the decision makers of the system in the importance of the optimal access to TKIs and the necessary tests so that a greater number of patients can reach the necessary goals for a safe TFR. Figure 1 Figure 1. Disclosures Abello: Janssen: Honoraria; Amgen: Honoraria; Dr Reddy's: Research Funding. Sossa: Amgen: Research Funding.

scholarly journals Towards for Designing Intelligent Health Care System Based on Machine Learning

2021 ◽  
Vol 17 (2) ◽  
pp. 120-128
Author(s):  
Nada Noori ◽  
Ali Yassin
Keyword(s):  
Diabetes Mellitus ◽  
Machine Learning ◽  
Health Care ◽  
Health Care System ◽  
Support Vector ◽  
Care Providers ◽  
Number Of Patients ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Care System

Health Information Technology (HIT) provides many opportunities for transforming and improving health care systems. HIT enhances the quality of health care delivery, reduces medical errors, increases patient safety, facilitates care coordination, monitors the updated data over time, improves clinical outcomes, and strengthens the interaction between patients and health care providers. Living in modern large cities has a significant negative impact on people’s health, for instance, the increased risk of chronic diseases such as diabetes. According to the rising morbidity in the last decade, the number of patients with diabetes worldwide will exceed 642 million in 2040, meaning that one in every ten adults will be affected. All the previous research on diabetes mellitus indicates that early diagnoses can reduce death rates and overcome many problems. In this regard, machine learning (ML) techniques show promising results in using medical data to predict diabetes at an early stage to save people’s lives. In this paper, we propose an intelligent health care system based on ML methods as a real-time monitoring system to detect diabetes mellitus and examine other health issues such as food and drug allergies of patients. The proposed system uses five machine learning methods: K-Nearest Neighbors, Naïve Bayes, Logistic Regression, Random Forest, and Support Vector Machine (SVM). The system selects the best classification method with high accuracy to optimize the diagnosis of patients with diabetes. The experimental results show that in the proposed system, the SVM classifier has the highest accuracy of 83%.

Off-label immunotherapy prescription: Financial implications for payers and patients.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 6-6 ◽  
Author(s):  
Jonas A. De Souza ◽  
Yen Yvonne Duong
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Scientific Evidence ◽  
Medicare Advantage ◽  
Commercial Insurance ◽  
Financial Responsibility ◽  
Off Label ◽  
Community Oncology ◽  
Number Of Patients ◽  
Care System

6 Background: Pembrolizumab (PEM) and nivolumab (NIV) are FDA-approved immunotherapy agents for specific indications. These drugs are extremely costly to the health care system, payers, and ultimately, patients, and little is known about their utilization for non-FDA labeled indications (off-label). Methods: We reviewed claims for PEM and NIV using the focalPoint database by onPoint oncology, which provides access to clearinghouse data for 168 community oncology practices and 2000+ providers throughout the US. Clearinghouse data is unique as it links claims data with remittance (payer response) data. ICD codes representing malignancies other than head and neck cancer, melanoma, non-small cell lung cancer ,and claims for 3 indications prior to their FDA-approval were considered off-label. Primary insurance for the patients, as well as patients’ financial responsibility and amounts paid by the insurance were evaluated. Results: A total of 1,570 patients received PEM or NIV from January 1st 2015 to September 1st 2016 for a cumulative total of 7,687 distinct claims. Of these patients, 285 (18%) received these agents for off-label indications for a total of 978 distinct claims. The total cost for the insurance for off-label claims was $13.36 million with the following breakdown: $7.74 million for 111 patients with commercial insurance, $125 thousand for 5 patients with Medicaid, $3.85 million for 126 patients with Original Medicare, and $1.90 million for 43 patients with Medicare Advantage. The patient responsibility for the off-label immunotherapy agents, which included the co-insurance and co-pay, totaled to $1.06 million or $3,731 per patient. Patient responsibility for off-label therapy per payer was as follows: $657 per patient for commercial insurance, $0 for Medicaid, $7,436 for Original Medicare, and $1,248 for Medicare Advantage. Conclusions: A substantial number of patients received unsupported off-label immunotherapy treatment. The costs of these therapies to the health care system, payers, and patients warrant increased efforts to regulate their use in off-label settings lacking sufficient scientific evidence or while clinical trials are in progress.

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