scholarly journals “Lessons Learned” Preventing Recurrent Ischemic Strokes through Secondary Prevention Programs: A Systematic Review

2021 ◽  
Vol 10 (18) ◽  
pp. 4209
Author(s):  
Clare McGarvey Lambert ◽  
Oluwaseyi Olulana ◽  
Lisa Bailey-Davis ◽  
Vida Abedi ◽  
Ramin Zand
Keyword(s):  
Secondary Prevention ◽  
Prevention Programs ◽  
Lessons Learned ◽  
Care Plan ◽  
Care Plans ◽  
Supervised Exercise ◽  
Fitness Education ◽  
Literature Search Strategy ◽  
Recurrent Strokes ◽  
Underserved Groups

Recurrent ischemic strokes are a cause of significant healthcare burdens globally. Patients with uncontrolled vascular risk factors are more likely to develop recurrent ischemic strokes. This study aims to compile information gained from current secondary prevention programs. A pre-defined literature search strategy was applied to PubMed, SCOPUS, CINAHL, and Google Scholar databases, and studies from 1997 to 2020 were evaluated for quality, study aims, and outcomes. The search produced 1175 articles (1092 after duplicates were removed) and titles were screened; 55 titles were retained for the full-text analysis. Of the remaining studies, 31 were retained for assessment, five demonstrated long-term effectiveness, eight demonstrated short-term effectiveness, and 18 demonstrated no effectiveness. The successful studies utilized a variety of different techniques in the categories of physical fitness, education, and adherence to care plans to reduce the risk of recurrent strokes. The lessons we learned from the current prevention programs included (1) offer tailored care for underserved groups, (2) control blood pressure, (3) provide opportunities for medication dosage titration, (4) establish the care plan prior to discharge, (5) invest in supervised exercise programs, (6) remove barriers to accessing care in low resource settings, and (7) improve the transition of care.

scholarly journals Exploring the impact of pharmacist comprehensive annual care plans on perceived quality of chronic illness care by patients in Alberta, Canada

2021 ◽  
pp. 171516352110203
Author(s):  
Candace Necyk ◽  
Jeffrey A. Johnson ◽  
Ross T. Tsuyuki ◽  
Dean T. Eurich
Keyword(s):  
Quality Of Care ◽  
Chronic Illness ◽  
Care Plan ◽  
Short Version ◽  
Chronic Illness Care ◽  
Online Questionnaire ◽  
Care Plans ◽  
Funding Program ◽  
The Impact

Background: In 2012, the Government of Alberta introduced a funding program to remunerate pharmacists to develop a comprehensive annual care plan (CACP) for patients with complex needs. The objective of this study is to explore patients’ perceptions of the care they received through the pharmacist CACP program in Alberta. Methods: We invited 3442 patients who received a pharmacist-billed CACP within the previous 3 months and 6888 matched controls across Alberta to complete an online questionnaire. The questionnaire consisted of the short version Patient Assessment of Chronic Illness Care (PACIC-11), with 3 additional pharmacy-specific assessment questions added. Additional questions related to health status and demographics were also included. Results: Overall, most patients indicated a low level of chronic illness care by pharmacists, with few differences noted between CACP patients and non-CACP controls. Of note, controls reported higher quality of care for 5 domains within the adapted PACIC-like tool compared with CACP patients ( p < 0.05 for all). Interestingly, only 79 (44%) of CACP patients reported that they had received a CACP, whereas only 192 (66%) of control patients reported that they did not receive a care plan. In a sensitivity analysis including only these respondents, individuals who received a CACP perceived a significantly higher quality of chronic illness care across all PACIC domains. Conclusion: Overall, chronic illness care incentivized by the pharmacist CACP program in Alberta is perceived to be moderate to low. When limited to respondents who explicitly recognized receiving the service or not, the perceptions of quality of care were more positive. This suggests that better implementation of CACP by pharmacists may be associated with improved quality of care and that some redesign is needed to engage patients more. Can Pharm J (Ott) 2021;154:xx-xx.

Dresdener Network Osteoporosis

2020 ◽  
Author(s):  
Tim Fülling ◽  
Philipp Bula ◽  
Alexander Defèr ◽  
Felix Alois Bonnaire
Keyword(s):  
Health Care ◽  
Secondary Prevention ◽  
Health Care Systems ◽  
Trauma Surgery ◽  
Specific Treatment ◽  
Fragility Fractures ◽  
Osteoporosis Treatment ◽  
Prevention Programs ◽  
Global Scale ◽  
Limited Mobility

Abstract Purpose On a global scale the main focus of traumatological therapy lies in the treatment of unintentional injuries or victims of violence. People of all ages and through all economic groups can be affected. Due to demographic change in Western industrial countries, however, this focus increasingly shifts towards fragility fractures. In Europe osteoporosis is the most common bone disease in advanced age. Secondary prevention programs like the Fracture Liaison Service (FLS) are becoming increasingly prevalent, especially in Anglo-American health care systems. In German orthopedic and trauma wards and hospitals, however, the FLS is still relatively uncommon. This article will examine the question whether secondary prevention programs like FLS need to be established in the German health care system. This study aims at finding out, whether in the area of a medium sized German city there is a difference regarding the initiation of osteoporosis diagnosis and therapy between the regular aftercare by the general practitioner or the orthopedic surgeon and the aftercare by a specialist trained in osteology (Osteologe). Materials and Methods For the open, randomized prospective study 70 patients with low energy fractures were recruited, who were older than 60 years and have been treated in our department. Results 58 out of 70 patients have completed the study, which amounts to a follow-up of 82.9%. Limited mobility and a high degree of organizational effort were the main reasons for early termination of the study. While in the group with regular aftercare, only 2 out of 29 patients received a specific osteoporosis treatment, in group who were directly transferred to a specialist trained in osteology 17 out of 29 patients received specific treatment. After re-evaluation of group with regular aftercare in 21 out of 29 cases a specific osteoporosis treatment was recommended. Conclusions It could be established that there is a significant diagnosis and treatment gap regarding the aftercare of patients with fractures caused by osteoporosis between general practitioners or orthopedic surgeons on the one hand and the specialists trained in osteology on the other hand. To improve the aftercare of fracture patients, cross sectoral networks with a background in geriatrics and orthopedic-trauma surgery like a FLS need to be established in the German healthcare system.

scholarly journals Creating an Age-Friendly Community in Affordable Housing Using a Resident Health Risk Assessment Focused on the 4Ms

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 49-49
Author(s):  
Jennifer DeGennaro ◽  
Sherry Pomerantz ◽  
Margaret Avallone ◽  
Melonie Handberry ◽  
Elyse Perweiler
Keyword(s):  
Risk Assessment ◽  
Health Risk ◽  
Health Risk Assessment ◽  
Affordable Housing ◽  
Risk Function ◽  
Well Being ◽  
Screening Tools ◽  
Care Plan ◽  
Care Plans

Abstract The NJGWEP team in partnership with Fair Share Housing/Northgate II (NGII), an affordable housing complex in Camden, NJ, employed an iterative quality improvement process to collaboratively develop a Resident Health Risk Assessment (RHRA) to meet the needs of the housing facility and incorporate the essential elements of the 4Ms framework (Mentation, Medication, Mobility, and What Matters). Using the RHRA, NG II social services staff and Rutgers School of Nursing (RSoN) students were trained to collect health information and administer several evidence-based screening tools (i.e., MiniCog, TUG, PHQ-2). A final element of the RHRA still in development is the documentation process of referral and follow-up based on personalized care plans. Since July 2019, 43 RHRAs have been completed (60% female, mean age 66, age range=43 to 88). Almost all residents (94%) have at least 1 chronic condition (HTN, DM, COPD, CHF), although only 26% have an advance care plan. Most (81%) were screened for future fall risk; function (ADLs/IADLs) was assessed for all (100%). Every resident who was able or did not refuse (88%) was screened for cognitive impairment. Just 7% were taking a high-risk medication (i.e., an opioid or benzodiazepine). The NJGWEP team has initiated an age-friendly community at NGII by providing education on geriatric-focused topics and implementing the 4Ms-focused RHRA to detect issues impacting the resident’s well-being. Establishing a follow-up process to track referrals to available resources will enable NGII to allow residents to age in place with appropriate supports.

Intimate Partner Violence Prevention Among Underserved and Understudied Groups: The Roles of Culture and Context

2017 ◽  
Author(s):  
Carlos A. Cuevas ◽  
Rebecca M. Cudmore
Keyword(s):  
Intimate Partner Violence ◽  
Ethnic Minorities ◽  
Partner Violence ◽  
People With Disabilities ◽  
Prevention Programs ◽  
Intimate Partner ◽  
Diverse Populations ◽  
Racial And Ethnic Minorities ◽  
Prevention Techniques ◽  
Underserved Groups

This chapter discusses how intimate partner violence (IPV) prevention programs can be adapted to recognize the experiences of underserved groups, including underrepresented racial and ethnic minorities; LGBTQ and other sexual minorities; and people with disabilities. The chapter also examines the development of culturally sensitive prevention techniques and approaches. The chapter considers various types of prevention strategies and how they may be tailored to account for the unique needs of diverse populations and communities. The chapter further emphasizes the need to recognize inter-group heterogeneity when developing prevention programs.

scholarly journals Needs of patients with dementia and their caregivers in primary care: lessons learned from the Alzheimer plan of Quebec

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Vladimir Khanassov ◽  
Laura Rojas-Rozo ◽  
Rosa Sourial ◽  
Xin Qiang Yang ◽  
Isabelle Vedel
Keyword(s):  
Primary Care ◽  
Unmet Needs ◽  
Social Care ◽  
Phase 1 ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Care Plan ◽  
Phase 2 ◽  
Care Needs ◽  
Health And Social Care

Abstract Background Persons living with dementia have various health and social care needs and expectations, some which are not fully met by health providers, including primary care clinicians. The Quebec Alzheimer plan, implemented in 2014, aimed to cover these needs, but there is no research on the effect this plan had on the needs and expectations of persons living with dementia. The objective of this study is to identify persons living with dementia and caregivers’ met and unmet needs and to describe their experience. Methods This is a sequential mixed methods explanatory design: Phase 1: cross-sectional study to describe the met and unmet health and social care needs of community-dwelling persons living with dementia using Camberwell Assessment of Need of the Elderly and Carers’ Assessment for Dementia tools. Phase 2: qualitative descriptive study to explore and understand the experiences of persons living with dementia and caregivers with the use of social and healthcare services, using semi-structured interviews. Data from phase 1 was analyzed with descriptive statistics, and from phase 2, with inductive thematic analysis. Results from phases 1 and 2 were compared, contrasted and interpreted together. Results The mean total number of needs reported by the patients was 5.03 (4.48 and 0.55 met and unmet needs, respectively). Caregivers had 0.52 met needs (3.16 unmet needs). The main needs for both were memory, physical health, eyesight/hearing/communication, medication, looking after home, money/budgeting. Three categories were mentioned by the participants: Persons living with dementia and caregiver’s attitude towards memory decline, their perception of community health services and of the family medicine practice. Conclusions Our study confirms the findings of other studies on the most common unmet needs of the patients and caregivers that are met partially or not at all. In addition, the participants were satisfied with access to care, and medical services in primary practices, being confident in their family. Our results indicate persons living with dementia and their caregivers need a contact person, a clear explanation of their dementia diagnosis, a care plan, written information on available services, and support for the caregivers.

Caring Interactions in Secondary Prevention Programs

2019 ◽  
Vol 42 (3) ◽  
pp. 167-175 ◽  
Author(s):  
Lindsey E. Greviskes ◽  
Leslie Podlog ◽  
Maria Newton ◽  
Leland E. Dibble ◽  
Ryan D. Burns ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Prevention Programs

scholarly journals Development and implementation of a structured ward round in acute adult psychiatry

2018 ◽  
Vol 7 (3) ◽  
pp. e000035 ◽  
Author(s):  
Anna Rebecca Mattinson ◽  
Sarah Jane Cheeseman
Keyword(s):  
Improve Patient Safety ◽  
Quality Care ◽  
General Medicine ◽  
Multidisciplinary Care ◽  
Ward Round ◽  
Care Plan ◽  
Care Plans ◽  
Adult Psychiatry ◽  
Paired Male ◽  
Ward Rounds

Delivering high quality care in acute psychiatry requires a coordinated approach from a multidisciplinary team (MDT). Weekly ward rounds are an important forum for reviewing a patient’s progress and developing a personalised care plan for the coming week. In general medicine, structured ward rounds and check lists have been shown to prevent omissions and improve patient safety; however, they are not widely used in psychiatry. At the Royal Edinburgh Hospital, the format of ward rounds differed between psychiatry wards and clinical teams, and care plans were not standardised. An audit in October 2015 found only 5% of acute psychiatric inpatients had a documented nursing care plan. It was agreed that a clear multidisciplinary care plan from the weekly ward round would be beneficial. A group of consultant psychiatrists identified seven key domains for ward round (Social needs, Community Mental Health Team liaison, Assessments required, Mental Health Act, Prescriptions: medication electroconvulsive therapy (ECT), T2/T3, Engagement with relatives and carers, Risk Assessment and Pass Plans). This was given the acronym SCAMPER. Following this, a clinical MDT on a paired male and female ward, developed and introduced a structured ward round sheet. Within 8 weeks this was being used for 100% of patients. It was subsequently introduced into three other acute adult psychiatry wards and the intensive psychiatric care unit. Staff feedback was sought verbally and via a questionnaire. This was positive. The form was widely accepted and staff felt it improved patient care and ward round quality.

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