scholarly journals The Impact of Pharmacist Interventions on Quality Use of Medicines, Quality of Life, and Health Outcomes in People with Dementia and/or Cognitive Impairment: A Systematic Review

2019 ◽  
Vol 71 (1) ◽  
pp. 83-96 ◽  
Author(s):  
Tuan Anh Nguyen ◽  
Julia Gilmartin-Thomas ◽  
Edwin Chin Kang Tan ◽  
Lisa Kalisch-Ellett ◽  
Tesfahun Eshetie ◽  
...  
2021 ◽  
Author(s):  
Martins Nweke ◽  
Mshunqane Nombeko ◽  
Nalini Govender ◽  
Aderonke O. Akinpelu ◽  
Maryjane Ukwuoma

Abstract Background: HIV-associated neurocognitive disorder (HAND) is an important sequela of HIV infection. Combined antiretroviral therapy (cART) has improved the health outcomes of many people living with HIV but has given rise to a less severe but limiting form of HAND. The study aimed to evaluate the impact of HAND on medication adherence, activities of daily living (ADL), quality of life and frailty.Methods: This systematic review adheres to the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched MEDLINE, PubMed, CINAHL, Academic Search Complete, and PsycINFO online databases. Studies were included if they examined the relationship between HAND and medication adherence, ADL, quality of life and frailty, and were conducted between 1997 and 2021. We used a random-effects meta-analysis model to assess the impact of HAND on outcome variables.Results: Forty papers, totalling 11540 participants, were included in the narrative and quantitative syntheses. Forty papers were included in the narrative and quantitative syntheses. The 40 studies provided data for 11540 participants. Cognitive impairment was associated with poorer medication adherence (r=0.601, CI 0.338 to 0.776, p =0.001, I2= 94.66). Cognitive impairment did not influence ADL (r=0.167, CI-0.215 to 0.505, p= 0.393) and quality of life (r= 0.244, CI 0.117 to 0.548, p =0.182).Conclusions: In the cART era, HAND appears to be associated with adherence to medication, which may influence future health outcomes. In PLWHIV who are adherent to ART, cognitive impairment does not appear to interfere with ADL and quality of life. Registration: PROSPERO- CRD42021240726.


Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001257 ◽  
Author(s):  
Celine Gallagher ◽  
Karin Nyfort-Hansen ◽  
Debra Rowett ◽  
Christopher X Wong ◽  
Melissa E Middeldorp ◽  
...  

ObjectiveTo undertake a systematic review and meta-analysis examining the impact of polypharmacy on health outcomes in atrial fibrillation (AF).Data sourcesPubMed and Embase databases were searched from inception until 31 July 2019. Studies including post hoc analyses of prospective randomised controlled trials or observational design that examined the impact of polypharmacy on clinically significant outcomes in AF including mortality, hospitalisations, stroke, bleeding, falls and quality of life were eligible for inclusion.ResultsA total of six studies were identified from the systematic review, with three studies reporting on common outcomes and used for a meta-analysis. The total study population from the three studies was 33 602 and 37.2% were female. Moderate and severe polypharmacy, defined as 5–9 medicines and >9 medicines, was observed in 42.7% and 20.7% of patients respectively, and was associated with a significant increase in all-cause mortality (Hazard ratio [HR] 1.36, 95% CI 1.20 to 1.54, p<0.001; HR 1.84, 95% CI 1.40 to 2.41, p<0.001, respectively), major bleeding (HR 1.32, 95% CI 1.14 to 1.52, p<0.001; HR 1.68, 95% CI 1.35 to 2.09, p<0.001, respectively) and clinically relevant non-major bleeding (HR 1.12, 95% CI 1.03 to 1.22, p<0.01; HR 1.48, 95% CI 1.33 to 1.64, p<0.01, respectively). There was no statistically significant association between polypharmacy and stroke or systemic embolism or intracranial bleeding. Among other examined outcomes, polypharmacy was associated with cardiovascular death, hospitalisation, reduced quality of life and poorer physical function.ConclusionsPolypharmacy is highly prevalent in the AF population and is associated with numerous adverse outcomes.PROSPERO registration numberCRD42018105298.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dominic O’Connor ◽  
Malcolm Brown ◽  
Martin Eatock ◽  
Richard C. Turkington ◽  
Gillian Prue

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.


Author(s):  
Juliana Vianna Pereira ◽  
Ana Gabriela Costa Normando ◽  
Carla Isabelly Rodrigues-Fernandes ◽  
César Rivera ◽  
Alan Roger Santos-Silva ◽  
...  

2015 ◽  
Vol 30 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Matthew J Tanti ◽  
Anthony G Marson ◽  
Emmanuel Chavredakis ◽  
Michael D Jenkinson

2018 ◽  
Vol 12 (3) ◽  
pp. 220-232 ◽  
Author(s):  
Elizabeth Karol ◽  
Dianne Smith

Aim:The objective of this article is to identify and analyze what is known about characteristics in and around the home that support well-being for those with cognitive impairment. This could provide direction for designers of homes in general, but specifically for designers trying to meet the needs of people with cognitive impairment.Background:It has been established that there is a relationship between psychological well-being and a person’s environment. Research also shows that particular design aspects can reduce the impact of cognitive impairment. However, there is limited design expertise in the Australian housing market to create supportive spaces which will help to reduce the impact of the disability for those with cognitive impairment.Method:A literature review was carried out to determine the extent and details of what is known about the relationship of home design and its impact on emotional, psychological, or social well-being for people with cognitive impairment.Conclusions:The study indicates that researchers in various disciplines understand that pragmatic design inputs such as thermal comfort and adequate lighting are important for people with cognitive impairment. In addition, some researchers have shown or surmise that there are other “intangible” designer-controlled elements that have beneficial impacts on people with cognitive impairment. Details of these intangible elements are sparse, and how much they might improve the quality of life for a person with cognitive impairment is not well understood. Further research is required to meet a growing need.


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