scholarly journals Assessment of Clinical Pharmacists' Assistance for Patients With Established Cardiovascular Diseases During the COVID-19 Pandemic: Insights From Southern India

2020 ◽  
Vol 7 ◽  
Author(s):  
Oliver Joel Gona ◽  
Ramesh Madhan ◽  
Sunil Kumar Shambu
Keyword(s):  
Cardiovascular Diseases ◽  
Clinical Pharmacist ◽  
Southern India ◽  
World Health ◽  
Self Management ◽  
Sign Test ◽  
Care Hospital ◽  
Post Intervention ◽  
Clinical Pharmacists ◽  
Coronary Syndrome

Objectives: We aimed to assess the clinical pharmacist-initiated telephone-based patient education and self-management support for patients with cardiovascular disease during the nationwide lockdown during COVID-19 pandemic.Methods: A prospective single-center telephone-based cross-sectional study was conducted among patients at the Cardiology Department and its speciality clinic at a 1,800-bed tertiary care hospital in Southern India. A validated 8-item clinical pharmacist aided on-call questionnaire with two Domains was administered during and after lockdown (15 March and 8 June 2020). Clinical pharmacist-provided educational assistance on self-management practices were in accordance with the guidelines of Indian Council of Medical Research (ICMR) and World Health Organization. Comparisons was performed using sign test and association of responses were analyzed using the Goodman and Kruskal's gamma test. All the tests were two-tailed, p < 0.05 was considered to be statistically significant.Results: Of the 1,080 patients, 907 consented with a response rate of (83.9%) and 574 (96.36%) patients were analyzed post-intervention. Majority of the patients were male (54.7%) and had Acute Coronary Syndrome [NSTEMI (42.10%), STEMI (33.92%) and Unstable Angina (9.86)]. The majority of subjects had at least two co-morbid conditions [(Type II Diabetes (48.33%), Hypertension (50.11%)] and were rural population (82.5%) as self-employed (43.1%) with a middle-class economy (31.6%). In the Domain-1 of checklist the awareness toward complications caused by COVID-19 in cardiovascular diseases (Z = −19.698, p = 0.000) and the importance of universal safety precautions enhanced after clinical pharmacist assistance [(Z = −8.603, p = 0.000) and (Z = −21.795, p = 0.000)]. In Domain-II of checklist there was a significant improvement in patients awareness toward fatal complications caused by COVID-19 (Z = −20.543, p = 0.000), maintenance of self-hygiene (Z = −19.287, p = 0.000), practice of universal safety precautions (Z = −16.912, p = 0.000) and self-isolation (Z = −19.545, p = 0.000). The results of our study population varied from baseline evaluation (41.7%, n = 907) to post-intervention (95%, n = 574) based on Literacy, employment status and economic status.Conclusions: The proactive role of clinical pharmacists in providing instructional services in collaboration with cardiologist during the pandemic circumstances increased patients understanding and mitigated infection exposure among patients, health care professionals and also assuring the continuity of care in patients with established cardiovascular diseases.

scholarly journals Prevalence of Modifiable Risk Factors among Acute Coronary Syndrome Patients in a Tertiary Care Hospital

2021 ◽  
pp. 765-772
Author(s):  
I. Mariraj ◽  
M. Naveen Kumar ◽  
N. S. Ani Rubitha ◽  
R. Rameshwar
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Diseases ◽  
Great Reduction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Coronary Syndrome

Background and Objectives: Acute Coronary Syndrome (ACS) is one of the major causes for mortality and morbidity among the cardiovascular diseases in India. In this study the modifiable risk factors leading to ACS are considered and its prevalence in a Tertiary care hospital is studied. Materials and Methods: This is a prospective type of study conducted in a tertiary care hospital. A total of 100 patients diagnosed with ACS were taken in this study. Their data was taken, and results were formulated in excel data sheet. Results: Among the UA patients, 65% were found to be dyslipidaemic, 60% as obese, 45% as diabetics, 47.5% as hypertensive and 40% as smokers. Among the NSTEMI patients, 66.67% were found to be dyslipidaemic, 52.78% as hypertensive, 44.44% as smokers, 30.56% as diabetics and 27.78% as obese. Among the STEMI patients, 37.50% were found to be dyslipidemic, 25% as both diabetic and obese, 20.83% as hypertensive,12.5% as smokers. Hypertension, dyslipidemia, smoking and obesity showed significance. Conclusion: The prevalence of modifiable risk factors is a major concern for developing ACS and when they are modified there will be a great reduction in the incidence of ACS.

Impact of Clinical Pharmacist Interventions in Prescribing Errors in Hospitalized Diabetic Patients with Major Polypharmacy

2020 ◽  
pp. 001857872098542
Author(s):  
Dania Abu-Naser
Keyword(s):  
Clinical Pharmacist ◽  
Endocrine System ◽  
Active Phase ◽  
Clinical Severity ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Prescribing Errors ◽  
Clinical Pharmacists ◽  
Pharmacist Interventions ◽  
Patients With Diabetes

Background: While clinical pharmacists are expected to have a potential role in minimizing prescribing errors (PEs) in patients with diabetes, the effectiveness of their interventions on the incidence and clinical significance of PEs remains unclear. Objectives: To investigate the effectiveness of clinical pharmacist interventions in correcting PEs in diabetic patients with major polypharmacy. Methods: This was a prospective pre-post study conducted in a secondary care hospital in Jordan over 4 months. There were 2 phases: Control, in which PEs were identified and categorized and active, in which clinical pharmacists intercepted and corrected PEs. Clinical severity of prescribing incidents was evaluated by an expert panel, comprising a senior clinical pharmacist, an internist, and cardiologist. SPSS V26 was used for data analysis. Results: Of 928 patients, 432 were followed and reviewed during the control phase and 496 during the active phase. Clinical pharmacist interventions reduced PEs by 89.5%; from 27.6% (control) to 2.9% (active). PEs per patient and PEs per medication orders were reduced from 2.1 to 0.2 and from 0.3 to 0.03, respectively. Electronic selection errors, wrong dose frequency, duplicate drugs, and allergy errors disappeared in the active phase. Significant, serious, and lethal errors were significantly reduced from 35.4%, 11.6%, and 0.2% (control) to 13.5%, 3.1%, and 0.0% (active), respectively. drugs related to CVS (OR = 5.2; 95% CI, 3.1-8.6; P < .05) versus drugs related to endocrine system was more likely to be associated with the occurrence of PEs versus no PEs. However, drug belonging to infectious (OR = 0.6; 95% CI, 0.1-0.9; P < .05) versus drugs related to endocrine system was less likely to be associated with the occurrence PEs versus no PEs. Conclusion: Clinical pharmacist interventions significantly reduced PEs in patients with diabetes by 89.5% and most of these interventions were clinically significant.

scholarly journals Deep learning-based ambient assisted living for self-management of cardiovascular conditions

2021 ◽  
Author(s):  
Maria Ahmed Qureshi ◽  
Kashif Naseer Qureshi ◽  
Gwanggil Jeon ◽  
Francesco Piccialli
Keyword(s):  
Deep Learning ◽  
Cardiovascular Diseases ◽  
Learning Strategies ◽  
Assisted Living ◽  
New Technologies ◽  
Ambient Assisted Living ◽  
World Health ◽  
Self Management ◽  
Ageing Population ◽  
Cloud Models

AbstractAccording to the World Health Organization, cardiovascular diseases contribute to 17.7 million deaths per year and are rising with a growing ageing population. In order to handle these challenges, the evolved countries are now evolving workable solutions based on new communication technologies such as ambient assisted living. In these solutions, the most well-known solutions are wearable devices for patient monitoring, telemedicine and mHealth systems. This systematic literature review presents the detailed literature on ambient assisted living solutions and helps to understand how ambient assisted living helps and motivates patients with cardiovascular diseases for self-management to reduce associated morbidity and mortalities. Preferred reporting items for systematic reviews and meta-analyses technique are used to answer the research questions. The paper is divided into four main themes, including self-monitoring wearable systems, ambient assisted living in aged populations, clinician management systems and deep learning-based systems for cardiovascular diagnosis. For each theme, a detailed investigation shows (1) how these new technologies are nowadays integrated into diagnostic systems and (2) how new technologies like IoT sensors, cloud models, machine and deep learning strategies can be used to improve the medical services. This study helps to identify the strengths and weaknesses of novel ambient assisted living environments for medical applications. Besides, this review assists in reducing the dependence on caregivers and the healthcare systems.

scholarly journals Study on drug use pattern in the management of the cardiovascular diseases and with comorbidities

2021 ◽  
Vol 10 (12) ◽  
pp. 1380
Author(s):  
Mutharasan M. ◽  
Manikkannan M. ◽  
Pachayappan K. ◽  
Veeramani G. ◽  
Paari N.
Keyword(s):  
Medication Adherence ◽  
Cardiovascular Diseases ◽  
Drug Use ◽  
Cardiovascular Drugs ◽  
World Health ◽  
Systemic Hypertension ◽  
Female Ratio ◽  
Coronary Syndrome ◽  
Use Pattern ◽  
Drug Use Pattern

Background: Cardiovascular drugs are the number one cause of death globally; more people die annually from CVDs then from any other cause CVD. The purpose of this study to identify the rationality of drug prescribed for cardiovascular diseases with its comorbidities. Along with medication adherence and cost analysis. To assess the drug use pattern and to observe the drug related complications in patients with cardiovascular diseases.Methods: A hospital based prospective observational study was conducted at department of medicine in RMMCH. A total of 79 patients were enrolled based on inclusion criteria and the data was collected using designed data collection form.Results: Data of 79 patients were collected over 6 months mean age of patients with 19.95-60.5. Male to female ratio was 1.43:1. In cardiovascular diseases, most common disease conditions are systemic hypertension and acute coronary syndrome seen in our study population. Average drugs prescribed per patient was 4-9. Most frequently prescribed drug classes were beta blocker, antiplatelet, hypolipidemic agent. In these few minor drug interactions have been found. Study has no adverse drug reaction. The average cost of drugs was prescribed for 2500-3200 IND. Before patient counseling medication adherence and outcomes were less after counseling, medication adherence and outcomes are increased from 5% to 65%.Conclusions: The study concludes that most of the drugs were prescribed rationally according to world health organization/ESC guidelines. As behalf of this study, we could provide the information about the risk factor, leading commodities. Importance of medication adherence and cost of medications to cardiovascular drugs.

Quantifying Clinical Pharmacist Activities in a Tertiary Care Hospital Using Key Performance Indicators

2020 ◽  
pp. 001857871989707
Author(s):  
Abdulrazaq S. Al-Jazairi ◽  
Adel O. Alnakhli
Keyword(s):  
Patient Care ◽  
Clinical Pharmacy ◽  
Clinical Pharmacist ◽  
Performance Indicators ◽  
Tertiary Care Hospital ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Key Performance Indicators ◽  
Care Hospital ◽  
Clinical Pharmacists

Background: Key performance indicators (KPIs) are a set of measures used to help an organization in assessing and achieving goals critical to success. The aim of this study was to quantify the clinical pharmacists’ contribution to patient care in a tertiary care hospital using predefined clinical pharmacy KPIs. Method: This study was a prospective, observational study conducted by the Pharmaceutical Care Division of a tertiary care hospital. Clinical pharmacy KPIs were submitted by each clinical pharmacist on a monthly basis for 12 months during 2017. All clinical pharmacists up to the managerial level were included in the study. Data were analyzed, stratified, and correlated using Microsoft Excel, JMP statistical software, and Spearman correlation. The study was approved by the hospital’s Office of Research Affairs, RAC number 2171-080. Results: A total of 42 clinical pharmacists reviewed 104 728 patient encounters. They performed an adjusted average of 1221 interventions with an acceptance rate of 91.5%, 273 medication reconciliations, 325 discharge consultations, 332 pharmacokinetic consultations, 700 total parenteral nutrition consultations and follow-ups, and 12 688 electronic order verifications per clinical pharmacist per year. These interventions collectively resulted in a cost saving of $316 087.65 per clinical pharmacist per year. Statistical significance with positive correlation was noted for a number of precepted residents/students and clinical pharmacists’ experience ( R = 0.382, P = .013) and board certification ( R = 0.428, P = .0047). Conclusion: Clinical pharmacy KPIs were able to quantify the clinical pharmacists’ contributions to patient care and cost savings, which may lead to improve, standardize, and benchmark clinical pharmacy activities in the region.

scholarly journals Effect of Prone Positioning in Patients with Moderate COVID-19 Pneumonia Admitted to Ward at a Tertiary Care Hospital

2021 ◽  
Keyword(s):  
Experimental Study ◽  
Severe Disease ◽  
Tertiary Care ◽  
Adjunctive Treatment ◽  
Sign Test ◽  
P Value ◽  
Care Hospital ◽  
X Rays ◽  
Prone Positioning ◽  
Post Intervention

COVID -19 pneumonia can progress to severe disease in 5% of patients requiring intensive care management, which can put an excessive burden on health care systems. Prone positioning has been shown to improve oxygenation and decrease lung injury in patients with COVID-19 pneumonia and can be used as an adjunctive treatment to delay intubation. The objective of this study is to assess the effect of prone positioning in patients admitted to the COVID ward, with Moderate COVID-19 Pneumonia. This experimental study was conducted at Liaquat National Hospital. A quasi-experimental study design was applied. Patients with hypoxemia SpO2 < 94% were assisted to prone and semi-prone for up to 2 hours at a time for multiple sessions. Parameters like SaO2, PaO2/FiO2, hours of proning and changes and X-rays were recorded daily and pre and post-intervention values were compared. Paired t-test and Wilcoxon sign test were used to compare continuous parameters. A two-tailed p-value less than 5% of the level of significance was defined as statistically significant. 20 patients fulfilling the inclusion criteria were enrolled. Median hours of prone positioning were 48.5. The median hospital stay was 7.5 days. At baseline, mean PaO2/FiO2 ratio was 342±91.87 and at the time of discharge, it was 412.30±105.97 which is a statistically significant improvement from baseline (p=0.040). 50% of patients showed improvement in X-rays. One patient was intubated and all the patients were discharged. The sample collected in the current showed that prone positioning is a safe and feasible approach to improve oxygenation in moderate-severe COVID-19 pneumonias. However, studies with a larger sample size are recommended to further verify the findings of this study.

scholarly journals The exosomes role in pathogenesis of cardiovascular diseases

2020 ◽  
Vol 7 (5) ◽  
pp. 17-28
Author(s):  
S. P. Schava ◽  
E. V. Stepanov ◽  
V. A. Sorokin
Keyword(s):  
Cardiovascular Diseases ◽  
Molecular Mechanisms ◽  
Cytoplasmic Membrane ◽  
World Health ◽  
Coronary Syndrome ◽  
Health Organization ◽  
Almost All ◽  
Valve Diseases ◽  
Developed World ◽  
Spherical Vesicles

According to World Health Organization, annually cardiovascular diseases cause 17,5 billion deaths in the developed world. This is the reason why the study of molecular mechanisms of these pathologies has a huge importance for the development of new diagnostic and therapeutic strategies. One of the strategies on this matter is the research of the small extracellular vesicles or exosomes and its role in pathogenesis of cardiovascular diseases. Exploring their transporting and signaling functions in the development of acute coronary syndrome, stable angina, heart valve diseases, hypertrophic cardiomyopathy, vascular atherosclerosis has a great importance.Exosomes are spherical vesicles of 30–100 nm, expressed by almost all human cells. Their cytoplasmic membrane has lipid bilayer structure with tetraspanins CD9, CD63, CD81 and CD82 as the markers. Exosomes act as effectors transferring microRNA, mRNA, cytokines and growth factors between varies cells.The aim of this review is to analyze the literature data of exosomal role in the development of main cardiologic syndrome’s and evaluation of existed literature on exosomes potential as therapeutic target.

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