Effective Pharmacist led interventional strategies to improve outcomes in hypertensive patients: a narrative review

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Samra Bashir ◽  
Akash Syed
Keyword(s):  
Pharmaceutical Care ◽  
Cost Effective ◽  
Pharmacist Intervention ◽  
Care Plan ◽  
Hypertensive Patients ◽  
Disease Outcomes ◽  
Cost Effective Alternative ◽  
The Impact

The role of pharmacist intervention as a cost-effective alternative to physician in disease management is increasingly been recognized. Studies have demonstrated that pharmaceutical care can improve drug therapy as well as patient satisfaction in chronic health conditions including cardiovascular diseases. This study is aimed to review and outline a comprehensive pharmaceutical care plan from the randomized controlled trials previously conducted to assess the impact of pharmacist-managed care on disease outcomes in hypertensive patients. Compared with usual care, the pharmaceutical intervention involved patient evaluation, patient education and counselling, medication review and management, patient monitoring and follow-up, and feedback to the primary physician as major strategies.

Pharmacist contributions in the treatment of diabetes mellitus in Southeast Asia: a narrative review

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Ayu Wulan Dwiputri ◽  
Liza Pristianty ◽  
Andi Hermansyah
Keyword(s):  
Diabetes Mellitus ◽  
Southeast Asia ◽  
Pharmacist Intervention ◽  
Narrative Review ◽  
Patient Counselling ◽  
Treatment Of Diabetes ◽  
Pharmacist Services ◽  
The Impact

AbstractBackgroundThe growing burden of diabetes mellitus (DM) in Southeast Asia puts pharmacists in the ideal position to provide management of DM. This narrative review aims to describe the evidence of pharmacist contribution in improving DM in Southeast Asia.ContentA literature search was conducted to identify relevant research articles published from 2010 to 2018 in four databases (Scopus, Pubmed, MEDLINE, and Springerlink) describing pharmacist roles and activities intended to improve management of DM in Southeast Asian countries. Results were synthesized narratively and divided into three main sections: (1) the role of pharmacist in DM management, (2) the impact of pharmacist role, and (3) the barriers to the implementation of services in DM management. A total of 16 studies were identified, of which ten studies mentioned services that were conducted exclusively by a pharmacist and the remaining collaborated with other health professionals. A number of pharmacist services were reported including prevention, dispensing, medication review, drug information services, patient counselling and education, monitoring, follow-up, and referral. Barriers related to individual, organizational, and public recognition were described.Summary and outlookThe Pharmacist can contribute to improve DM management in a variety of settings. Action research on pharmacist intervention in DM is recommended.

scholarly journals Therapeutic Value of Single Nucleotide Polymorphisms on the Efficacy of New Therapies in Patients with Multiple Sclerosis

2021 ◽  
Vol 11 (5) ◽  
pp. 335
Author(s):  
María José Zarzuelo Romero ◽  
Cristina Pérez Ramírez ◽  
María Isabel Carrasco Campos ◽  
Almudena Sánchez Martín ◽  
Miguel Ángel Calleja Hernández ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mechanism Of Action ◽  
Dimethyl Fumarate ◽  
Response To Treatment ◽  
Nucleotide Polymorphisms ◽  
New Therapies ◽  
Therapeutic Value ◽  
The Impact

The introduction of new therapies for the treatment of multiple sclerosis (MS) is a very recent phenomenon and little is known of their mechanism of action. Moreover, the response is subject to interindividual variability and may be affected by genetic factors, such as polymorphisms in the genes implicated in the pathologic environment, pharmacodynamics, and metabolism of the disease or in the mechanism of action of the medications, influencing the effectiveness of these therapies. This review evaluates the impact of pharmacogenetics on the response to treatment with new therapies in patients diagnosed with MS. The results suggest that polymorphisms detected in the GSTP1, ITGA4, NQO1, AKT1, and GP6 genes, for treatment with natalizumab, ZMIZ1, for fingolimod and dimethyl fumarate, ADA, for cladribine, and NOX3, for dimethyl fumarate, may be used in the future as predictive markers of treatment response to new therapies in MS patients. However, there are few existing studies and their samples are small, making it difficult to generalize the role of these genes in treatment with new therapies. Studies with larger sample sizes and longer follow-up are therefore needed to confirm the results of these studies.

Quantitative Selection of Variation Reduction Plans

1998 ◽  
Author(s):  
Anna C. Thornton
Keyword(s):  
Risk Mitigation ◽  
Cost Effective ◽  
Variation Reduction ◽  
Multiple Quality Characteristics ◽  
Cost Effective Approach ◽  
Manufacturing Performance ◽  
The Impact ◽  
Manufacturing Variation ◽  
Selection Of

Abstract Quality has been a rallying call in the design and manufacturing world for the last two decades. One way to improve quality is to reduce the impact of manufacturing variation. Variation risk mitigation is challenging especially when a product has multiple quality characteristics and complex production and assembly. It is common wisdom that companies should identify and mitigate the risk associated with variation throughout the design process. As yield problems are identified, they should be mitigated using the most cost effective approach. One approach to variation risk mitigation is variation reduction (VR). VR targets reduction of variation introduced by existing manufacturing processes using tools such as Design of Experiments (DOE) and robust design. Many companies have specialized groups that specialize in these methods. VR teams have the role of improving manufacturing performance; however, these teams are limited in their resources. In addition, no tools exist to quantitatively determine where a VR team’s efforts are most effectively deployed. This paper provides a mathematical and optimization model to best allocate VR resources in a complex product.

The Future of Phlebology in Europe

2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 181-185 ◽  
Author(s):  
Brahman Dharmarajah ◽  
Tristan RA Lane ◽  
Hayley M Moore ◽  
HA Martino Neumann ◽  
Eberhard Rabe ◽  
...  
Keyword(s):  
Cost Effective ◽  
Research Strategy ◽  
Clinical Severity ◽  
Venous Disease ◽  
Vein Thrombosis ◽  
Venous Diseases ◽  
Thrombus Removal ◽  
Deep Vein ◽  
The Impact

Background Worldwide superficial and deep venous diseases are common and associated with significant individual and socioeconomic morbidity. Increasing burden of venous disease requires Phlebology to define itself as an independent specialty representing not only patients but the multidisciplinary physicians involved in venous care. Methods & Results In this article the scope of venous disease in Europe and subsequent future governance for treatment in the region is discussed. Superficial venous disease is common with 26.9-68.6% of European populations reported to have C2-C6 disease according to the CEAP (Clinical severity, Aetiology, Anatomy and Pathophysiology) scoring system. However, a significant disparity is observed in the treatment of superficial venous disease across Europe. Post thrombotic syndrome (PTS) after deep vein thrombosis (DVT) contributes to the increasing burden of deep venous disease. Aggressive thrombus removal for acute ileofemoral DVT provides a cost-effective 14.4% risk reduction in the development of PTS. Additionally, deep venous lesions requiring endovascular intervention are being increasingly performed to prevent recurrent thrombosis. The European College of Phlebology (ECoP) has been formed to provide a responsible body for the care of the European patient with venous disease. The role of the ECoP includes unifying European member states through standardised guideline production, identification of research strategy and provision of training and accreditation of physicians. Conclusion Creation of a European venous disease specific speciality will provide a patient centred approach through understanding of the impact of disease in the region and delivery of high quality diagnostics and treatment from an appropriately certified Phlebologist.

Exploring the scope of homoeopathy in combating the unfortunate consequences of post-COVID-19 survivors based on non-COVID conditions: a narrative review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ashish Kumar Dixit ◽  
Nibha Giri ◽  
Shishir Singh
Keyword(s):  
Chronic Fatigue ◽  
Cardiac Insufficiency ◽  
Medical Database ◽  
Fatigue Syndrome ◽  
Tract Infections ◽  
The Impact

Abstract Objectives The long-term consequences of COVID-19 survivors care and post-coronavirus infection are not yet well understood. The review aims to see whether homoeopathy can help COVID-19 survivors recover from its consequences and improve their quality of life. Content A systematic search of published articles for post-COVID sequelae and the impact of Homoeopathy were conducted. For the literature search, the major electronic bio-medical database PubMed/MEDLINE was used. In addition, supplementary searches were conducted through the references of those published articles. Summary A total of 113 records were identified of which 61 studies included for this review. Homoeopathy is effective in the treatment of mental disorders including anxiety and depressive disorder (ADD), some research studies have found, although systematic reviews disagree. Likewise, some medical societies denounce homoeopathy for pain management; other literature shows that it can be used to treat pain effectively. Homoeopathy can aid in the treatment of cardiovascular diseases, as Crataegus, a homoeopathic medication, was found to be just as effective as a standard angiotensin-converting enzyme (ACE) inhibitor and diuretic treatment for minor cardiac insufficiency. The outcomes for Chronic Fatigue Syndrome (CFS), Influenza, and Acute Respiratory Tract Infections (ARTIs) are also promising. Outlook Based on the results of homoeopathy in non-COVID conditions, it can be thought of in the management of post-COVID-19 outcomes. Consequently, we propose that while investigating post-COVID-19 patient rehabilitation, homoeopathic management may be included as part of the follow-up route and as much data as possible in the context of homoeopathy should be collected, so that in future, the role of homoeopathy in dealing with it can be better demonstrated.

scholarly journals Pharmaceutical care in a school pharmacy: from consultation to resolution of drug-related problems

2019 ◽  
Vol 41 (1) ◽  
pp. 42470
Author(s):  
Amanda Thiemy Chiozzi Watanabe ◽  
Fernando Henrique Zonzini ◽  
Maurício Fumio Sybui ◽  
Angela Maria Campanha
Keyword(s):  
Pharmaceutical Care ◽  
Anatomical Therapeutic Chemical ◽  
Descriptive Analysis ◽  
State University ◽  
Drug Related Problems ◽  
Relevant Role ◽  
Professional Information ◽  
General Community

This study aimed to provide pharmaceutical care for the general community served by Pharmacy students from the Pharmacy School of the State University of Maringá [Universidade Estadual do Maringá] (UEM). Pharmacotherapeutic follow-up was performed with the identification, classification and resolution of drug-related problems (DRPs) through pharmaceutical consultations. A descriptive analysis was conducted. A total of 59 patients were interviewed; they were mostly women (75%) with average age of 63 years, and each of them was taking 8 medicines on average. The most frequently mentioned drugs were classified according to the Anatomical Therapeutic Chemical Code and related to cardiovascular system (28%), alimentary tract and metabolism (23%), and nervous system (20%). An average of 1.49 DRP per patient was detected (88), and treatment non-compliance was the most frequent DRPs found (45%). In view of this, 63 pharmaceutical interventions were carried out, with most of them (52%) being related to patient education on the treatment; approximately 20% of the patients were referred to another health professional. Information supplied by this study shows the relevant role of pharmacists face the lack of pharmacotherapeutic follow-up of polymedicated patients.

scholarly journals Long-term follow-up of children with neuroblastoma receiving radiotherapy to metastatic lesions within the German Neuroblastoma Trials NB97 and NB 2004

2020 ◽  
Author(s):  
Danny Jazmati ◽  
Sarina Butzer ◽  
Barbara Hero ◽  
Jerome Doyen ◽  
Dalia Ahmad Khalil ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Primary Tumor ◽  
Secondary Malignancy ◽  
Primary Tumor Site ◽  
Free Survival ◽  
Stage 4 ◽  
Metastatic Sites ◽  
The Impact

Abstract Purpose Neuroblastoma (NB) is the most common extracranial solid malignancy during childhood. Despite a multimodal treatment approach, the prognosis of patients with metastatic NB is not satisfactory. Although radiotherapy (RT) has become an integral part of treatment of the primary tumor, the role of RT in osteomedullary lesions is not well defined. A retrospective analysis was conducted to evaluate the impact of RT for metastatic sites in children with high-risk NB. Methods All patients with stage 4 NB from the prospective, multicenter NB trials NB97 and NB2004 who received RT to metastatic sites during frontline treatment were included in this retrospective analysis. Results A total of 18 children were irradiated with a median dose of 36 Gray (Gy; range 20–45 Gy) to one or more (range 1–3) osteomedullary metastases with or without concomitant RT to the primary tumor site. The median follow-up time was 149 months (range 55–220) in survivors. At 5 years, local relapse-free survival (LRFS) at irradiated metastatic sites and metastases-free survival (MFS) at distant, non-irradiated site rates were 51.4 and 39.9%, respectively. The estimated overall survival (OS) rate at 5 years was 49.4%. No high-grade acute or late toxicity and no secondary malignancy was reported. Conclusion RT to metastases is feasible for patients with stage 4 NB. However, an impact of RT to residual metastatic sites on outcome was not found. Studies with larger cohorts or prospective trials would be desirable in order to elucidate the role of RT for metastases.

Disruptive Experiences as Tools for Teacher Education: Unearthing the Potential of Experiential Education

2019 ◽  
Vol 43 (1) ◽  
pp. 21-36
Author(s):  
Cheryl M. Bolick ◽  
Jocelyn Glazier ◽  
Christoph Stutts
Keyword(s):  
Teacher Education ◽  
Experiential Education ◽  
Social And Emotional ◽  
Teachers Beliefs ◽  
Emotional Aspects ◽  
Field Notes ◽  
Multiple Domains ◽  
The Impact

Background: This study examines the role of a weeklong experiential residency program on teachers’ beliefs about self and practice. Purpose: The goal of two separate intensive experiences was to help teachers generate new insight about the place of students, the teacher, and the school that extended beyond a surface-level understanding of experiential education. Methodology/Approach: Through a qualitative approach, the research team used field notes, course documents, participant reflections, researcher journals, and follow-up interviews to analyze the impact of participants’ immersion in either of the experiential outdoor residencies. Findings/Conclusions: The unpredictable nature of the physical and social environment of the experiential week helped teachers to see the central role of community in the learning process. Furthermore, teacher responses to the experience defied simple categorization along a prior theoretical construct. Teachers indicated a growing confidence in their ability to seek out and overcome challenges across multiple domains. Implications: These teachers were challenged to integrate multiple social and emotional aspects of self into their learning, while envisioning the same for their own students. Their experiences and reflections support an expanded role for immersive experiences outside of the traditional classroom in teacher education.

scholarly journals Ethnic Diversity, Social Trust and the Moderating Role of Subnational Integration Policy

2016 ◽  
Vol 65 (2) ◽  
pp. 413-431 ◽  
Author(s):  
Birte Gundelach ◽  
Anita Manatschal
Keyword(s):  
Ethnic Diversity ◽  
Social Trust ◽  
Negative Relationship ◽  
The United States ◽  
Integration Policy ◽  
Integration Policies ◽  
Mere Existence ◽  
The Impact

Increasing ethnic diversity and whether or not it impacts on social trust are highly debated topics. Numerous studies report a negative relationship between diversity and trust, particularly in the United States. A growing body of follow-up studies has examined the extent to which these findings can be transferred to Europe, but the results remain inconclusive. Moving beyond the discussion of the mere existence or absence of diversity effects on trust, this study is concerned with the moderation of this relationship. It addresses the neglected role of subnational integration policies influencing the impact of diversity on trust. Empirical tests not only indicate that integration policies moderate the relationship but also suggest that the influence of policies varies substantively according to the specific policy aspect under consideration.

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