Clinical pharmacology-real basis of effi cient and inoff ensive pharmacotherapy

Author(s):  
Victor Ghicavii ◽  
◽  
Tatiana Chiriac ◽  
Anastasia Caracas ◽  
◽  
...  

Clinical pharmacology play an important role in ensuring effective and inofensive pharmacotherapy. The administration of a adjusted treatment according to the pharmacokinetic and pharmacodynamic peculiarities of the drug, as well as the patient’s condition is indispensable. The rational use of medicines would increase the patient’s quality of life, as well as has important financial and public health benefits. Excessive, unreasonable prescription of drugs, polypharmacy, misuse of drugs, including expensive and unnecessary are the most common problems of irrational drug use. Many efforts have been made to improve drug use, but few evaluations have been carried out in this area. Identifying the problems that lead to irrational drug use and awareness of the importance of clinical pharmacology could ensure safe and effective pharmacotherapy.

Author(s):  
Min-Hua Lin ◽  
She-Yu Chiu ◽  
Wen-Chao Ho ◽  
Hui-Ying Huang

This study was the first institution-wide health promotion program in Taiwan to apply the five priority areas for taking action in public health highlighted in the Ottawa Charter for diabetes patients. We aimed to improve the quality of home care received by diabetic patients by training health care professionals in health promotion. This program consisted of developing personal skills, reorienting health services, strengthening community actions, creating supportive environments, and building healthy public policy. It was applied in the Yunlin Christian Hospital located in central Taiwan from August 2011 to November 2011. A health-promoting education course consisting of weight control, diabetes care, and quality management for diabetes was developed and applied to all 323 hospital staff. Then, hospital staff volunteers and diabetes patients were recruited to participate in the program. A total of 61 staff volunteers and 90 diabetes patients were involved in this study. Staff volunteers were trained to participate in communities to provide care and guidance to patients with diabetes. The World Health Organization Quality of Life(WHOQOL)-BREF-Taiwan Version questionnaires were investigated before and after implementation of this program for the patients. A health-promoting lifestyle profile questionnaire was filled by the staff. The investigation data were then analyzed by statistical methods. The diabetes patients experienced a significant increase in their satisfaction with health and health-related quality of life as well as significant improvements in health-promotion and self-management behaviors (p < 0.05). In addition, staff volunteers significantly consumes food from the five major groups than the other staff (p < 0.05). Various improvements in health-promoting behaviors were observed amongst the hospital staff and the diabetic patients. Our project could be a reference for other medical organizations to implement an institution-wide health-promotion program for diabetic patients.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Renzi ◽  
G Gasperini ◽  
V Baccolini ◽  
C Marzuillo ◽  
C De Vito ◽  
...  

Abstract Background Promoting self-care is one of the most promising strategies to manage people with chronic conditions and to improve the Public Health System resilience. In this context, the use of e-Health could facilitate self-care promotion, assure continuity of care and save time. Methods We performed an umbrella review on Cochrane, Scopus, Medline, PsychInfo, CINAHL to analyse e-Health self-care promoting intervention in patients with Type- 2 Diabetes Mellitus (T2DM), Cardiovascular Diseases (CVD) and Chronic Obstructive Pulmonary Disease (COPD) compared to traditional intervention. AMSTAR-2 was used for quality appraisal. Results 10 systematic reviews were included for an amount of 376 RCTs and 3 quasi-experimental studies. All the e-Health interventions retrieved were categorized in 4 subgroups: Phone Reminder, Telemonitoring, Psychoeducational intervention supported by PCs/Apps and Combined Intervention. Nurses (271/379 studies) and physicians (149/379 studies) were the healthcare workers mostly involved in the administration of e-Health interventions. T2DM (5 reviews; 175 studies) and CVD (7 reviews; 164 studies) patients gained more progresses in self-management than COPD patients (3 reviews; 8 studies). E-Health appeared effective both in promoting self-management and disease awareness. Globally, all the e-Health interventions seemed to improve Quality of Life and clinical outcomes. Phone reminders were most effective to increase Medication Adherence. All Causes Mortality registered a positive effect through Telemonitoring. Hospital Admission and Cost-Efficacy were explored only by telemonitoring and it did not show differences with traditional intervention. Conclusions E-Health is an effective strategy to promote self-care in patients with chronic conditions and to improve quality of life and clinical outcomes. Further research is required to test e-Health intervention in COPD patients and to examine if there is different efficacy among e-Health subgroups. Key messages E-Health should be integrated in Primary Care strategies to improve Public Health systems resilience. Nurses, as frontline Primary Health Care workers, should be advised for e-Health administration.


2017 ◽  
Vol 23 (14) ◽  
pp. 1736-1745 ◽  
Author(s):  
Trevor D. Pinho ◽  
Patricia H. Manz ◽  
George J. DuPaul ◽  
Arthur D. Anastopoulos ◽  
Lisa L Weyandt

Objective: The current study examines (a) whether ADHD among college students is associated with differences in perceptions of quality of life (QoL); (b) the moderating roles of comorbidity, drug use, psychopharmacological treatment, and psychosocial treatment; and (c) the total impact of these variables on QoL. Method: Participants were college students with and without ADHD ( N = 372) in a longitudinal study. Results: College students with ADHD were more likely to assert negative global QoL evaluations relative to non-ADHD peers. The relationship between ADHD and QoL was not altered as a function of medication treatment, comorbid psychopathology, psychosocial treatment, or drug use. Conclusion: College students with ADHD behave similarly to other adults with ADHD in that they make lower subjective global evaluations of their QoL relative to their non-ADHD agemates. Other factors associated with ADHD and QoL do not appear to moderate this relationship.


Drugs & Aging ◽  
2017 ◽  
Vol 34 (10) ◽  
pp. 785-792 ◽  
Author(s):  
Benoit Cossette ◽  
Maimouna Bagna ◽  
Modou Sene ◽  
Caroline Sirois ◽  
Gabrielle P. Lefebvre ◽  
...  

Author(s):  
Maria Aparecida Coelho de Arruda Henry

INTRODUCTION: Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.


Sign in / Sign up

Export Citation Format

Share Document