scholarly journals A UTILIZAÇÃO DE MEDICAMENTOS HOMEOPÁTICOS NA REGIÃO METROPOLITANA DE CURITIBA

2004 ◽  
Vol 5 (2) ◽  
Author(s):  
Andrezza Beatriz OLIVEIRA ◽  
Sandra M. W. ZANIN ◽  
Marilis D. Miguel
Keyword(s):  
Therapeutic Option ◽  
Metropolitan Region ◽  
Pharmaceutical Service ◽  
Medicinal Treatment ◽  
Exchange Information ◽  
Patient Health ◽  
Improve Patient ◽  
Service Optimization

A Homeopatia é uma opção terapêutica que inclui o tratamento medicamentoso individualizado e unicista, com apresentação de efeitos indesejáveis nula devido ao grau de diluição infinitesimal. Estas características, junto à verificação de melhora e cura do estado patológico do paciente, têm promovido o aumento da utilização da Homeopatia. Com o objetivo de verificar a amplitude do uso desta terapêutica, realizou-se pesquisa em farmácias de manipulação homeopática de Curitiba e Região Metropolitana, buscando detectar quais os medicamentos mais solicitados pelos médicos, assim como formas farmacêuticas e escalas de diluição infinitesimal. A percepção da predominância do uso de policrestos remete à importância da presença do farmacêutico na farmácia homeopática. Este com função de esclarecimento e orientação ao paciente no que diz respeito ao tratamento e cuidados com os medicamentos, os promotores da cura. Além do acompanhamento do tratamento ao lado do médico, mantendo troca de informações com o mesmo, o que permite a otimização do atendimento farmacêutico dentro do conceito de promotor de saúde. HOMEOPATHIC MEDICINES UTILIZATION AT CURITIBA METROPOLITAN REGION Abstract Homeopathy is a therapeutic option that includes individual and unicist medicinal treatment. Since it can cure or improve patient health, its use has increased over the years. A research was realized in Homeopathic Manufacturing Pharmacies in the greater Curitiba area with the objective of verifying its utilization extent. In addition, the goal was to detect what homeopathic medicines are the most used by doctors, with its pharmaceutical presentations and dilution scale. Policrest was the most predominantly used treatment prescribed by homeopathic pharmacies. Treatment was accompanied by doctors, and the patient-doctor exchange information was crucial for treatment. That allowed a pharmaceutical service optimization under the health promoter concept.

Achieving patient health outcomes via CME: A case-study in educating oncologists in the treatment of non-small cell lung cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19104-e19104
Author(s):  
Tom Bregartner
Keyword(s):  
Health Outcomes ◽  
Educational Activities ◽  
Nccn Guidelines ◽  
Tumor Pathology ◽  
Measurement Tools ◽  
Patient Health ◽  
Chart Audits ◽  
Improve Patient

e19104 Background: The Validation Model is an educational series built on the concept of strengthening education by incorporating the patient perspective. After conducting two iterations of the Validation Model to educate oncologists in the treatment of NSCLC, Quintiles Medical Education was able to demonstrate that CME can lead to improved patient health outcomes by changing physician behaviors in practice. Educational measurement tools, including chart audits, revealed an increase in tumor histology and EGFR mutation testing. Histologic and molecular marker testing leads to optimization of treatment based on tumor pathology and genotype, respectively, as per NCCN guidelines. Personalization of treatment according to guidelines results in improved health outcomes. Methods: The Validation Model consisted of 6 educational activities for which efficacy was measured by conducting pre- and post-tests of knowledge and clinical competence among participants. Participants were then asked to complete a follow-up survey which was designed to determine if specific practices had been implemented since participation. The self-self reported behavioral data was validated by the distribution of patient surveys, designed to measure patient satisfaction and expectation with care, and chart audits, designed to determine the actual practice habits of the participating practitioners. Results: More than 500 participants have completed all 6 of the educational activities. The activities have demonstrated improved knowledge and competence in the educational setting and changes to clinical practice and, as a result, patient health outcomes. Conclusions: CME can be used as an effective tool to improve patient health outcomes in the treatment of NSCLC.

scholarly journals Interventions for Improving Outcomes in Patients With Multimorbidity in Primary Care and Community Setting: A Systematic Review

2021 ◽  
Author(s):  
Susan Smith ◽  
Emma Wallace ◽  
Barbara Clyne ◽  
Fiona Boland ◽  
Martin Fortin
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Care Coordination ◽  
Health Behaviours ◽  
Self Management ◽  
Management Support ◽  
Medicines Management ◽  
Experience Of Care ◽  
Patient Health ◽  
Improve Patient

Abstract BackgroundMultimorbidity, defined as the co-existence of two or more chronic conditions, presents significant challenges to patients, healthcare providers and health systems. Despite this, there is ongoing uncertainty about the most effective ways to manage patients with multimorbidity. This review aimed to determine the effectiveness of interventions designed to improve outcomes in people with multimorbidity in primary care and community settings, compared to usual care.MethodsWe searched eight databases and two trials registers up to 9th September 2019. Two review authors independently screened and selected studies, extracted data, evaluated study quality and judged the certainty of the evidence (GRADE). Interventions were grouped by their predominant focus into care-coordination/self-management support, self-management support and medicines management. Main outcomes were health related quality of life (HRQoL) and mental health. Meta-analyses were conducted, where possible, but the synthesis was predominantly narrative.ResultsWe included 16 RCTs with 4,753 participants, the majority being older adults with at least three conditions. There were eight care-coordination/self-management support studies, four self-management support studies and four medicines management studies. There was little or no evidence of an effect on primary outcomes of HRQoL (MD 0.03, 95% CI -0.01 to 0.07, I2 = 39%) and mental health or on secondary outcomes with a small number of studies reporting that care coordination may improve patient experience of care and self-management support may improve patient health behaviours. Overall the certainty of the evidence was graded as low due to significant variation in study participants and interventions. Conclusions There are remaining uncertainties about the effectiveness of interventions for people with multimorbidity, despite the growing number of RCTs conducted in this area. Our findings suggest that future research should consider patient experience of care, optimising medicines management and targeted patient health behaviours such as exercise.

scholarly journals MP44: TEC4Home heart failure: using home telemonitoring to decrease ED readmissions and clinical flow

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S56-S57
Author(s):  
H. Novak Lauscher ◽  
K. Ho ◽  
J. L. Cordeiro ◽  
A. Bhullar ◽  
R. Abu Laban ◽  
...  
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Total Hospital ◽  
Home Telemonitoring ◽  
Patient Health ◽  
Ed Visits ◽  
Improve Patient

Introduction: Patients with Heart failure (HF) experience frequent decompensation necessitating multiple emergency department (ED) visits and hospitalizations. If patients are able to receive timely interventions and optimize self-management, recurrent ED visits may be reduced. In this feasibility study, we piloted the application of home telemonitoring to support the discharge of HF patients from hospital to home. We hypothesized that TEC4Home would decrease ED revisits and hospital admissions and improve patient health outcomes. Methods: Upon discharge from the ED or hospital, patients with HF received a blood pressure cuff, weight scale, pulse oximeter, and a touchscreen tablet. Participants submitted measurements and answered questions on the tablet about their HF symptoms daily for 60 days. Data were reviewed by a monitoring nurse. From November 2016 to July 2017, 69 participants were recruited from Vancouver General Hospital (VGH), St. Pauls Hospital (SPH) and Kelowna General Hospital (KGH). Participants completed pre-surveys at enrollement and post-surveys 30 days after monitoring finished. Administrative data related to ED visits and hospital admissions were reviewed. Interviews were conducted with the monitoring nurses to assess the impact of monitoring on patient health outcomes. Results: A preliminary analysis was conducted on a subsample of participants (n=22) enrolled across all 3 sites by March 31, 2017. At VGH and SPH (n=14), 25% fewer patients required an ED visit in the post-survey reporting compared to pre-survey. During the monitoring period, the monitoring nurse observed seven likely avoided ED admissions due to early intervention. In total, admissions were reduced by 20% and total hospital length of stay reduced by 69%. At KGH (n=8), 43% fewer patients required an ED visit in the post-survey reporting compared to the pre-survey. Hospital admissions were reduced by 20% and total hospital length of stay reduced by 50%. Overall, TEC4Home participants from all sites showed a significant improvement in health-related quality of life and in self-care behaviour pre- to 90 days post-monitoring. A full analysis of the 69 patients will be complete in February 2018. Conclusion: Preliminary findings indicate that home telemonitoring for HF patients can decrease ED revisits and improve patient experience. The length of stay data may also suggest the potential for early discharge of ED patients with home telemonitoring to avoid or reduce hospitalization. A stepped-wedge randomized controlled trial of TEC4Home in 22 BC communities will be conducted in 2018 to generate evidence and scale up the service in urban, regional and rural communities. This work is submitted on behalf of the TEC4Home Healthcare Innovation Community.

#3108 Initial assessment structure in a specialist outpatient clinic for acquired brain injury in adults

2021 ◽  
Vol 92 (8) ◽  
pp. A16.1-A16
Author(s):  
Mark Paramlall ◽  
Himanshu Tyagi
Keyword(s):  
Brain Injury ◽  
Royal College ◽  
Outcome Measurement ◽  
Acquired Brain Injury ◽  
Initial Assessment ◽  
Liaison Psychiatry ◽  
Patient Health ◽  
And Performance ◽  
Improve Patient ◽  
Assessment Questionnaire

Consistent with the NHS quality agenda, Dept. of Health, 20111 there has been a drive to routinely incorporate outcome and performance measurement data in clinical practice. An absolute requirement within NHS services2 are Patient-Rated Outcome Measures (PROMS) which are used by some Royal College of Psychiatry faculties to quantify outcomes, improve accountability, performance management and service. They can also be used to screen for common health problems and ensure the comprehensive assessment of complex Acquired Brain Injury (ABI) Patients who typically present with various neurological and psychiatric comorbidities.The North Bristol NHS Trust Outpatient Clinic at The Frenchay Brain Injury Rehabilitation Centre and The Rosa Burden, Southmead Hospital, conducts new assessments and regular patient reviews for referrals from South West England. As part of a quality improvement initiative a semi-structured process of assessment was trialled, to improve patient experience by providing a comprehensive initial assessment, improving treatment productivity and reducing over-running clinics.MethodReferrals were audited and common reasons for referrals identified. Questionnaires and tools used in the clinic were reviewed and those most frequently used were compiled. The evidence for questionnaires utilized for different psychiatric comorbidities and applicability in ABI was examined in the literature. The finalized patient questionnaires booklet section and their sequence was decided based on expert peer recommendations and patient feedback. The collateral section was similarly developed with some questionnaires modified for operational reasons.SECTION ONE: SELF RATED PRE-ASSESSMENT QUESTIONNAIRERivermead Post Concussion Symptoms Questionnaire, Patient Health Questionnaire (15): Somatic Screen, Patient Health Questionnaire-9: Depression screen, General Anxiety Disorder 7: Anxiety screen, Mood Disorder Questionnaire: Bipolar Affective Disorder screen and the Civilian Version PTSD Checklist.SECTION TWO: CARER/FAMILY PRE-ASSESSMENT QUESTIONNAIREModified Overt Aggression Scalescreen for aggression, Neuropsychiatry Inventory Questionnaire: assesses psychiatric symptoms in patients with neurological disordersOutcomeThe final booklet was divided into three sections:Patient-Rated, ObserverRated and Clinician Section. Consultation efficiency was improved with the Patient and Observer rated sections completed prior to the initial assessment. The checklist is used for all initial assessments with good uptake and allowed for standardization of clinical information gathering. PROMs for mood are collected at each clinic appointment with other domains repeated if abnormal at initial clinic assessment or clinically relevant.References Fossey M, Parsonage M. Outcomes and performance in liaison psychiatry: developing a measurement framework. Centre for Mental Health and Royal College of Psychiatrists Report June 2014. Trigwell P, Kustow J, Santhouse A, et al. Framework for routine outcome measurement in liaison psychiatry (FROM-LP): faculty of liaison psychiatry royal college of psychiatrists faculty report. The Royal College of Psychiatrists 2015. vretveit J, Zubkoff L, Nelson EC, et al. Using patient-reported outcome measurement to improve patient care. Int J Qual Health Care 2017 Oct 1;29(6):874879.

Using Physician-Led Automated Communications to Improve Patient Health

2011 ◽  
Vol 14 (4) ◽  
pp. 175-180 ◽  
Author(s):  
Ashok Rai ◽  
Paul Prichard ◽  
Richard Hodach ◽  
Ted Courtemanche
Keyword(s):  
Patient Health ◽  
Improve Patient
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