Factors Influencing a Community Pharmacist's Interventions in Asthma Care

2009 ◽  
Vol 142 (5) ◽  
pp. 240-246 ◽  
Author(s):  
Natalie Nadaira ◽  
Catherine Ouellet ◽  
Nola René-Henri ◽  
Yvonne Khamla ◽  
Johanne Collin ◽  
...  

Background: Little is known about current pharmacists' interventions related to drug counselling and monitoring in asthma, along with the barriers and facilitators to these, in the province of Quebec. Objectives: To identify and explore organizational, relational and professional factors that influence community pharmacists' interventions in asthma care and propose solutions to overcome the barriers to these interventions. Methods: In 2006, a survey and an invitation to participate in a focus group were sent to community pharmacists in Quebec. Three focus groups were held to discuss the results of the survey about community pharmacists' interventions in asthma and the factors influencing these interventions, along with solutions to identified barriers. Each focus group lasted for approximately 120 minutes and was moderated by 2 investigators. Results: Seventeen community pharmacists participated in the study. One focus group was held with pharmacy owners, 1 with salaried pharmacists who graduated before 1990 and 1 with salaried pharmacists who graduated after 1996. Owners and salaried pharmacists of different years of graduation generally made the same comments. Most pharmacists reported intervening with asthma patients, especially when initial prescriptions were filled. Lack of time and unclear definition of tasks were reported as barriers. Solutions were proposed to resolve barriers, such as clearly defining tasks and ensuring quick access to support materials for patient education and drug monitoring. Conclusion: Community pharmacists report intervening in asthma care mostly when patients fill their initial prescription. Several barriers to follow-up interventions were identified.

2020 ◽  
Vol 11 (1) ◽  
pp. 581-588
Author(s):  
Arulprakasam K C ◽  
Senthilkumar N

The failure to stick to a recommended remedial program for the treatment of an incessant illness might be mindful to some extent for proceeding with the infection movement. Adherence the key territories of enthusiasm for Asthma. The focal point of examination were to recognize issues detailed by families to influence their Adherence to asthma care. To evaluate the effect of patient education to Self-reported Adherence, Management, and Barriers. Children introducing during an intense assault of asthma were enrolled in this investigation. The restorative record of the experience were preoccupied and contrasted and data that were acquired at first visit and after 3 months. There are 986 youngsters 4 to 15 years old living in city evaluation tracts in the examination. The parental report of drugs endorsed, and the data on the disconnected report concurred 95.15% of the ideal opportunity β-Agonists, 86.24% are steroids, and 7.71% are cromolyn. Meds were overlooked a portion of time by 45.2% of the kids, and 52.8% attempted to escape to taking medication. Arrangements of follow-up consideration were kept by 69% of those given an arrangement, by an expected 60.0% of the individuals who were advised explicitly to require an arrangement. Just a single third of guardians report that they had the option to fend off the youngster from realized asthma triggers about constantly. After the subsequent, the huge changes are seen. Adherence to asthma-the executives program includes various territories: prescription, arrangement keeping, avoidance, and applying a crisis strategy. A barrier to Adherence may exist in one or every one of the four of these areas, prompting ineffectual control of asthma. The patient education improving the patient-doctor organization and furthermore improve Adherence.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Cajetan Chigozie Onyedum ◽  
Olufemi Olumuyiwa Desalu ◽  
Kingsley Nnanna Ukwaja ◽  
Chinwe Chukwuka ◽  
Nnamdi Ikechukwu Nwosu ◽  
...  

Asthma care imposes economic burden on affected patients. Patient costs for asthma care have not been documented in Africa. We aimed to determine the out-of-pocket cost of asthma follow-up care incurred by patients in Nigeria. We conducted a cross-sectional study in three tertiary hospitals in southeastern and northwestern Nigeria. Poorly controlled asthma patients attending a follow-up visit in the respiratory clinic of the hospitals were surveyed. Sociodemographic, health-seeking behavior, and cost data were collected using a structured questionnaire. Of the 110 patients who completed the study, 56 (51%) were females. Also, 72 (65%) of the patients had known about their asthma illness for more than four years. Mean annual direct cost of asthma care was US$368.4 (±228) per patient. Medication cost accounted for the majority (87%) of this cost. Patient costs of care incurred did not differ significantly across age (P = 0.15), education (P = 0.23), marital status (0.49), residence (P = 0.47), or gender (P = 0.65) categories. We conclude that direct cost of care was found to be substantial among poorly controlled asthma patients. Further studies to estimate the costs incurred by patients with exacerbation and differing severity of the disease should be conducted.


2003 ◽  
Vol 10 (4) ◽  
pp. 195-202 ◽  
Author(s):  
William Mclean ◽  
Jane Gillis ◽  
Ron Waller

OBJECTIVES: Despite advances in recent years, asthma morbidity and mortality have been noted to be on the increase in the past decade. The present study examined the failures and recommendations of past studies and introduced a new milieu for asthma care - the community pharmacy. The study incorporated a care protocol with the important ingredients of asthma education on medications, triggers, self-monitoring and an asthma plan, with pharmacists taking responsibility for outcomes, assessment of a patient's readiness to change and tailoring education to that readiness, compliance monitoring and physician consultation to achieve asthma prescribing guidelines.METHODS: Thirty-three pharmacists in British Columbia, specially trained and certified in asthma care, agreed to participate in a study in which experienced pharmacists would have asthma patients allocated to enhanced (pharmaceutical) care (EC) or usual care (UC). Pharmacists less experienced were clustered by geography and had their pharmacies randomized to two levels of care; each pharmacy then had patients randomized to EC versus control, UC versus control or EC versus UC depending on their pharmacy randomization. Six hundred thirty-one patients provided consent, of which 225 in EC or UC were analyzed for all outcomes. Patients were followed for one year.RESULTS: Compared with patients in the UC group, the results of those in the EC group were as follows: symptom scores decreased by 50%; peak flow readings increased by 11%; days off work or school were reduced by approximately 0.6 days/month; use of inhaled beta-agonists was reduced by 50%; overall quality of life improved by 19%, and the specific domains of activity limitations, symptoms and emotional function also improved; initial knowledge scores doubled; emergency room visits decreased by 75%; and medical visits decreased by 75%. A patient satisfaction survey revealed that the population was extremely pleased with their pharmacy services. Cost analysis reinforces the EC model, which is more cost effective than UC in terms of most direct and indirect costs in asthma patients.CONCLUSION: Specially trained community pharmacists in Canada, using a pharmaceutical care-based protocol, can produce impressive improvements in clinical, economic and humanistic outcome measures in asthma patients. The health care system needs to produce incentives for such care.


2019 ◽  
Vol 58 (05) ◽  
pp. 371-378
Author(s):  
Alfred O. Ankrah ◽  
Ismaheel O. Lawal ◽  
Tebatso M.G. Boshomane ◽  
Hans C. Klein ◽  
Thomas Ebenhan ◽  
...  

Abstract 18F-FDG and 68Ga-citrate PET/CT have both been shown to be useful in the management of tuberculosis (TB). We compared the abnormal PET findings of 18F-FDG- and 68Ga-citrate-PET/CT in patients with TB. Methods Patients with TB on anti-TB therapy were included. Patients had a set of PET scans consisting of both 18F-FDG and 68Ga-citrate. Abnormal lesions were identified, and the two sets of scans were compared. The scan findings were correlated to the clinical data as provided by the attending physician. Results 46 PET/CT scans were performed in 18 patients, 11 (61 %) were female, and the mean age was 35.7 ± 13.5 years. Five patients also had both studies for follow-up reasons during the use of anti-TB therapy. Thirteen patients were co-infected with HIV. 18F-FDG detected more lesions than 68Ga-citrate (261 vs. 166, p < 0.0001). 68Ga-citrate showed a better definition of intracerebral lesions due to the absence of tracer uptake in the brain. The mean SUVmax was higher for 18F-FDG compared to 68Ga-citrate (5.73 vs. 3.01, p < 0.0001). We found a significant correlation between the SUVmax of lesions that were determined by both tracers (r = 0.4968, p < 0.0001). Conclusion Preliminary data shows 18F-FDG-PET detects more abnormal lesions in TB compared to 68Ga-citrate. However, 68Ga-citrate has better lesion definition in the brain and is therefore especially useful when intracranial TB is suspected.


2020 ◽  
Vol 27 (12) ◽  
pp. 1231-1245
Author(s):  
Filippo Maffezzoni ◽  
Teresa Porcelli ◽  
Andrea Delbarba ◽  
Letizia Pezzaioli ◽  
Carlo Cappelli ◽  
...  

: Biological markers (biomarkers) play a key role in drug development, regulatory approval and clinical care of patients and are linked to clinical and surrogate outcomes. : Both acromegaly and Growth Hormone Deficiency (GHD) are pathological conditions related to important comorbidities that, in addition to having stringent diagnostic criteria, require valid markers for the definition of treatment, treatment monitoring and follow-up. GH and insulin-like growth factor-I (IGF-I) are the main biomarkers of GH action in children and adults while, in acromegaly, both GH and IGF-I are established biomarkers of disease activity. : However, although GH and IGF-I are widely validated biomarkers of GHD and acromegaly, their role is not completely exhaustive or suitable for clinical classification and follow-up. Therefore, new biological markers for acromegaly and GH replacement therapy are strongly needed. : The aim of this paper is to review and summarize the current state in the field pointing out new potential biomarkers for acromegaly and GH use/abuse.


1974 ◽  
Vol 3 (1) ◽  
pp. 112-124 ◽  
Author(s):  
Bruce E. Lindsay ◽  
Cleve E. Willis

The spread of suburbs into previously rural areas has become commonplace in the United States. A rather striking aspect of this phenomenon has been the discontinuity which results. This aspect is often manifest in a haphazard mixture of unused and densely settled areas which has been described as “sprawl”. A more useful definition of suburban sprawl, its causes, and its consequences, is provided below in order to introduce the econometric objectives of this paper.


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