ASSESSMENT OF KNOWLEDGE, ATTITUDE, PRACTICE TOWARDS ASTHMA AND THE IMPACT OF PATIENT COUNSELLING ON INHALATION TECHNIQUES IN ASTHMATICS

Introduction Clinical pharmacist can enthusiastically involve in oncology department through utilizing the skills and knowledge to support wide variety of functions in patient care. The impact of pharmaceutical care services in oncology department were analysed through various approaches including the analysis of knowledge level of patients towards the disease and its management through patient counselling, monitoring of performance status, observing of ADR and drug safety. Incidence of cancer was scrutinized during the study. Methodology: A Prospective interventional study was conducted from November 2019 to March 2020 with the support of institutional ethical approval at oncology department of Lourdes hospital, Ernakulam. 133 patients were included with all type of cancer. Data collected through Performa with KAP questionnaire and direct interview was conducted. Statistical significance was evaluated through p value of <0.001 Result: 123 patients were completed both questionnaire. Among this 69.91% were females and most of the patients belonged to 50 – 65yeras age group and carcinoma was frequently reported type. End of the study showed significant change in the knowledge level of patients after interaction with the clinical pharmacist. 26 ADRs were reported including solitary and multiple ADRs. Recommendations associated with drug reconstitution, administration were frequently given to the nurses. Most of the interventions to improve therapeutic outcome of the patients were accepted by the oncologist. Conclusion Clinical pharmacist can actively participate in all aspects of the oncology department in association with physician and other health care providers to improve the therapeutic outcome and quality of life of patients.

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A PROSPECTIVE STUDY ON IMPACT OF PATIENT COUNSELLING ON QUALITY OF LIFE AND MEDICATION ADHERENCE IN EPILEPTIC PATIENTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i1.13106 ◽

2016 ◽

Vol 10 (1) ◽

pp. 67

Author(s):

Sathesh Kumar Sukumaran ◽

Ayswarya P

Keyword(s):

Quality Of Life ◽

Medication Adherence ◽

Patient Counseling ◽

Chi Square ◽

Patient Counselling ◽

T Score ◽

Epileptic Patients ◽

A Prospective Study ◽

The Impact

ABSTRACTObjective: To study the impact of patient counseling on medication adherence and quality of life (QOL) in epileptic patients and to assess the factorsaffecting medication adherence.Methods: This study is a prospective observational study involving 100 patients with an age limit of 8-60 years and those taking Antiepilepticdrugs for at least 3 months. The study population received patient counseling during their first visit. The impact of patient counseling on QOL andmedication adherence was assessed using self-reported questionnaire QOLIE-31 and MMAS-8 between the first visit and the second visit. Statisticalanalysis (Paired t-test and Paired Chi-square test) was performed to analyze the impact of patient counseling on QOL and medication adherence inepileptic patients.Results: A total of 100 patients were included in the study. After providing patient counseling, it was observed that there was a statistically significant(p<0.05) improvement in all domains of QOLIE-31 and MMAS-8 scores. Before counseling, mean overall T-score of QOLIE-31 was 44.08±2.07whichwas changed to 49.14±1.27 after patient counseling with a mean change of 5.06 in overall T-score. In the case of medication adherence, beforecounseling 77% subjects were nonadherent to therapy, after counseling it was reduced to 41%. The common reasons for medication adherence wereforgetfulness, unawareness, therapy related, and economics related. Out of which forgetfulness along with unawareness was the major one.Conclusion: The study described that patient counseling plays a major role in improving QOL and medication adherence.Keywords: QOLIE-31, MMAS-8, Epilepsy, Antiepileptic drugs, Patient counseling.

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The impact of Charlson Comorbidity Index on survival outcomes in men with prostate cancer who underwent definitive prostate radiotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.114 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 114-114

Author(s):

Ahmed I. Ghanem ◽

Remonda M Khalil ◽

Gehan Abd Elatti Khedr ◽

Amy Tang ◽

Amr A. Elsaid ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Charlson Comorbidity Index ◽

Treatment Options ◽

Patient Counselling ◽

Prostate Radiotherapy ◽

Survival Endpoints ◽

Comorbidity Index ◽

The Impact

114 Background: Life expectancy is very essential in deciding treatment options in men with prostate cancer (PCa); however, the impact of comorbidities on outcomes is not well-established. We investigated the influence of Charlson Comorbidity Index (CCI) on survival endpoints in men with localized PCa who were treated with prostate radiotherapy (RT). Methods: Men with intermediate and high risk PCa who were treated with definitive RT between 1/2007 and 12/2012 were included. Groups were created according to their baseline CCI score at diagnosis into no, mild and severe comorbidity (CCI 0, 1 or 2+). The groups were then compared based on patients’ characteristics and prognostic factors. Kaplan-Meier curves and Uni/multivariate analyses (MVA) were used to examine the impact of CCI groups on overall (OS), disease specific (DSS), and biochemical relapse free (BRFS) survival. Results: 257 patients were identified after excluding low risk, metastatic cases and those with inadequate follow up. Median follow-up was 92 months (range: 2-135) and median age was 73 years (range: 48-85). 53% of the cases were black and 67% were of intermediate risk. Median RT dose was 76 Gy and 47% received androgen deprivation therapy. CCI groups 0, 1 and 2+ encompassed 76 (30%), 54 (21%) and 127 (49%) patients, respectively. Groups were generally well-balanced. 10 and 15 years OS was significantly different across CCI groups (76% & 53%, 46% & 31% and 55% & 14%, for CCI-0, 1 and 2+ respectively; p < 0.001). CCI-0 had better DSS than CCI-2+ ( p = 0.03) with no difference for CCI-0 vs 1 ( p = 0.1). BRFS was non-different among CCI groups ( p = 0.99). On MVA, increased CCI was deterministic for OS ( p < 0.001) after adjusting for age, Gleason’s score and T-stage. For DSS, only age and T3 vs T1/2 were independently prognostic ( p < 0.001); whereas CCI-1 vs 0 was only marginal ( p = 0.05). Conclusions: Higher CCI was a significant predictor of shorter OS in intermediate and high-risk PCa. Baseline comorbidities should be taken into consideration during patient counselling for treatment options and in designing prospective trials for men with localized prostate cancer.

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EVALUATION OF IMPACT OF PHARMACEUTICAL CARE ON IMPROVING KNOWLEDGE AND MEDICATION ADHERENCE IN CKD PATIENTS

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i1.15053 ◽

2016 ◽

Vol 9 (1) ◽

pp. 63

Author(s):

Bebit Baby ◽

Chippy Lee Antony ◽

Shivil Wilson ◽

Theertha Xavier ◽

T. Tamilselvan

Keyword(s):

Medication Adherence ◽

Pharmaceutical Care ◽

Patient Counselling ◽

Information Leaflets ◽

High Adherence ◽

And Gender ◽

Collection Form ◽

The Impact

Objectives: Evaluation of the impact of pharmaceutical care on improving knowledge and medication adherence in Chronic Kidney Disease (CKD) patients.Methods: Patient data were recorded on a data collection form after informed consent. Their knowledge and medication adherence were evaluated by questionnaire and it was quantified. Patients were counselled using patient information leaflets. Re-assessment was made during follow-up.Results: Medication adherence among patients was classified as low, medium and high adherence. Knowledge was classified under three categories excellent, average and poor. There was a considerable improvement in knowledge and medication adherence irrespective of age and gender. The study was statistically significant with P<0.05.Conclusion: The efforts to increase awareness on CKD patients such as providing patient counselling and continuous education could enhance adherence to therapies and thus could improve clinical outcomes and quality of life.

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Nutritional assessment and therapy in COPD: a European Respiratory Society statement

European Respiratory Journal ◽

10.1183/09031936.00070914 ◽

2014 ◽

Vol 44 (6) ◽

pp. 1504-1520 ◽

Cited By ~ 106

Author(s):

Annemie M. Schols ◽

Ivone M. Ferreira ◽

Frits M. Franssen ◽

Harry R. Gosker ◽

Wim Janssens ◽

...

Keyword(s):

Nutritional Status ◽

Dietary Habits ◽

Nutritional Assessment ◽

Task Force ◽

Nutritional Intervention ◽

Chronic Obstructive ◽

European Respiratory Society ◽

Patient Counselling ◽

Clinical Awareness ◽

The Impact

Nutrition and metabolism have been the topic of extensive scientific research in chronic obstructive pulmonary disease (COPD) but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have on COPD incidence, progression and outcome is limited. A multidisciplinary Task Force was created by the European Respiratory Society to deliver a summary of the evidence and description of current practice in nutritional assessment and therapy in COPD, and to provide directions for future research. Task Force members conducted focused reviews of the literature on relevant topics, advised by a methodologist. It is well established that nutritional status, and in particular abnormal body composition, is an important independent determinant of COPD outcome. The Task Force identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design and patient counselling. Nutritional intervention is probably effective in undernourished patients and probably most when combined with an exercise programme. Providing evidence of cost-effectiveness of nutritional intervention is required to support reimbursement and thus increase access to nutritional intervention. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential pulmonary benefits, but also for its proven benefits in metabolic and cardiovascular risk.

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Clinical summary guide: reproduction in women with previous abdominopelvic radiotherapy or total body irradiation

Human Reproduction Open ◽

10.1093/hropen/hoaa045 ◽

2020 ◽

Vol 2020 (4) ◽

Author(s):

G Rozen ◽

P Rogers ◽

S Chander ◽

R Anderson ◽

O McNally ◽

...

Keyword(s):

Radiation Exposure ◽

Total Body Irradiation ◽

English Language ◽

Conflicts Of Interest ◽

Case Reports ◽

Adult Women ◽

Patient Counselling ◽

Uncomplicated Pregnancy ◽

Total Body ◽

The Impact

Abstract STUDY QUESTION What is the evidence to guide the management of women who wish to conceive following abdominopelvic radiotherapy (AP RT) or total body irradiation (TBI)? SUMMARY ANSWER Pregnancy is possible, even following higher doses of post-pubertal uterine radiation exposure; however, it is associated with adverse reproductive sequelae and pregnancies must be managed in a high-risk obstetric unit. WHAT IS KNOWN ALREADY In addition to primary ovarian insufficiency, female survivors who are treated with AP RT and TBI are at risk of damage to the uterus. This may impact on its function and manifest as adverse reproductive sequelae. STUDY DESIGN, SIZE, DURATION A review of the literature was carried out and a multidisciplinary working group provided expert opinion regarding assessment of the uterus and obstetric management. PARTICIPANTS/MATERIALS, SETTING, METHODS Reproductive outcomes for postpubertal women with uterine radiation exposure in the form of AP RT or TBI were reviewed. This included Pubmed listed peer-reviewed publications from 1990 to 2019, and limited to English language.. MAIN RESULTS AND THE ROLE OF CHANCE The prepubertal uterus is much more vulnerable to the effects of radiation than after puberty. Almost all available information about the impact of radiation on the uterus comes from studies of radiation exposure during childhood or adolescence. An uncomplicated pregnancy is possible, even with doses as high as 54 Gy. Therefore, tumour treatment doses alone cannot at present be used to accurately predict uterine damage. LIMITATIONS, REASONS FOR CAUTION Much of the data cannot be readily extrapolated to adult women who have had uterine radiation and the publications concerning adult women treated with AP RT are largely limited to case reports. WIDER IMPLICATIONS OF THE FINDINGS This analysis offers clinical guidance and assists with patient counselling. It is important to include patients who have undergone AP RT or TBI in prospective studies to provide further evidence regarding uterine function, pregnancy outcomes and correlation of imaging with clinical outcomes. STUDY FUNDING/COMPETING INTEREST(S) This study received no funding and there are no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.

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The Impact of Patient Education on the Quality of Inpatient Bowel Preparation for Colonoscopy

Canadian Journal of Gastroenterology ◽

10.1155/2010/718628 ◽

2010 ◽

Vol 24 (9) ◽

pp. 543-546 ◽

Cited By ~ 48

Author(s):

Greg Rosenfeld ◽

Darin Krygier ◽

Robert A Enns ◽

Janakie Singham ◽

Holly Wiesinger ◽

...

Keyword(s):

Patient Education ◽

Bowel Preparation ◽

Rating Scale ◽

Tertiary Care ◽

Intervention Group ◽

Control Group ◽

Inpatient Setting ◽

Care Hospital ◽

Patient Counselling ◽

The Impact

BACKGROUND: For patients requiring colonoscopy while admitted to hospital, achieving adequate cleansing of the colon is often difficult.OBJECTIVES: To assess the impact of patient education, in the form of both counselling and written instructions, on bowel cleanliness at colonoscopy.METHODS: A total of 38 inpatients at a tertiary care hospital in Vancouver, British Columbia, who were referred to the gastroenterology service for colonoscopy were enrolled in the present study. Sixteen patients were randomly assigned to the intervention group, while 22 patients comprised the control group. Both groups received a clear liquid diet and 4 L of a commercially available bowel preparation. The intervention group also received a brief counselling session and written instructions outlining the methods and rationale for bowel preparation before colonoscopy. Bowel cleanliness was assessed by the endoscopist using a five-point rating scale.RESULTS: The two groups were similar with respect to demographics, the indication for colonoscopy and findings at colonoscopy. The median bowel cleanliness scores in the control group and the enhanced-instruction group were 3.0 and 2.0, respectively (P=0.001).CONCLUSION: Patient counselling and written instructions are inexpensive, safe and simple interventions. Such interventions are an effective means of optimizing colonoscopy preparation in the inpatient setting.

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P28 Implementation of clinical pharmacy services at weekends within a tertiary children’s hospital

Archives of Disease in Childhood ◽

10.1136/archdischild-2017-314585.37 ◽

2018 ◽

Vol 103 (2) ◽

pp. e2.31-e2

Author(s):

Rachel Smith

Keyword(s):

Clinical Pharmacy ◽

Drug Dose ◽

Project Work ◽

Clinical Pharmacy Service ◽

Multiple Drug ◽

List Type ◽

Pharmacy Services ◽

Patient Counselling ◽

Service Specification ◽

The Impact

AimThe need to improve the provision of Pharmacy services across seven days was highlighted in the initial findings of a report commissioned by the Medical Director of NHS England.1 The authors commented that Pharmacy services should be regarded as a priority in the first stages of transformational project work.The aim of this study was to evaluate the impact of specialist paediatric pharmacists working directly within the children’s wards of a tertiary paediatric centre within a large teaching hospital at weekends.MethodClinical pharmacists within our organisation have not routinely provided ward based services at weekends. Pharmacists were based within the inpatient dispensary or aseptic preparative service managing supply requests for medicines from a range of adult and paediatric specialities. Information queries were managed by the dispensary teams, or referred to the duty Medicines Information pharmacist.Changes were made to the weekend service specification to ensure a paediatric specialist pharmacist was available to provide ward based clinical pharmacy service to paediatric areas at the weekend.Requests for medicines for children’s areas were referred to a specialist paediatric pharmacist. The service specification included requests for supply of non-stock medicines, medicines for discharge and orders for aseptically prepared items. All orders for medicines supply were managed within the ward environment. The pharmacist was available to patients and carers, had access to medical and nursing teams, patient information and could assess patients own drugs for discharge.The duty paediatric pharmacist was available to answer clinical pharmacy related enquiries from ward staff. Details of complex patients who may need weekend review were transferred from weekday teams to the weekend duty pharmacist. Records were kept of the weekend workloadResultsA median of 7 clinical queries per weekend were managed by the weekend paediatric pharmacist. On average, 20 patients per weekend required discharge prescription management, including clinical validation, patient counselling and assessment of patients own medicines suitable for use on discharge. Twelve requests for non-stock medicines were made on a typical weekend. Staff feedback was sought following the initiation of the new weekend service. Pharmacists reported increased satisfaction in the service they provided and felt it was a more appropriate use of their skill set.Details of enquiries from children’s wards were recorded. One patient story involved a patient with haemophagocytic lymphohistiocytosis who required multiple drug dose adjustments due to haemodialysis. The paediatric pharmacist was able to review the patient’s medicines and advise appropriate dose adjustments. A patient with newly diagnosed acute leukaemia required urgent chemotherapy. The request was managed by the paediatric pharmacist enabling treatment to be commenced without delay.ConclusionThe presence of a paediatric pharmacist on children’s wards at the weekend enables medicines supply issues to be managed effectively. Requests for information on the use of medicines occur in a timely manner.ReferenceNHS England. NHS services, 7 days a week forum: Summary of initial findingsDecember 2013. https://www.england.nhs.uk/wp-content/uploads/2013/12/forum-summary-report.pdf accessed 29th July 2016.

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Assessing the impact on pharmacists’ time by introducing a technician screening process for clinical trial prescriptions

International Journal of Pharmacy Practice ◽

10.1093/ijpp/riab015.057 ◽

2021 ◽

Vol 29 (Supplement_1) ◽

pp. i46-i47

Author(s):

D Mistry ◽

S Awan ◽

E Lundy ◽

C Bedford ◽

H Thorp ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Trials ◽

Data Collection ◽

Hospital Pharmacy ◽

Good Practice ◽

Advisory Group ◽

Service Improvement ◽

Data Collection Tool ◽

Patient Counselling ◽

The Impact

Abstract Introduction Various national guidance from the Lord Carter 2016 report to the NHS Long term plan have emphasised the need to transform traditional hospital pharmacy and make work streams more efficient.[1] A clinical trials pharmacist has historically validated clinical trial medicines. Whilst this is good practice for non-chemotherapy prescriptions, it is not a requirement of the Clinical Trial Regulations.[2] Interruption to validate trial prescriptions can have a negative impact on pharmacists’ duty and consequently patient outcomes. With limited data available, this issue has been highlighted by anecdotal evidence. Due to the often complex requirements associated with trials, the research team are responsible for assessing the suitability of treatment. This includes checking interactions with concomitant medication, reviewing blood results and patient counselling. The clinical aspect of the pharmacist validation is therefore removed, allowing technicians to be involved in the screening of suitable prescriptions. Much is written on technicians extending their roles in the clinical setting, but this service improvement focuses on enhancing their role within the pharmacy clinical trials department. Aim To evaluate the amount of pharmacists’ time saved by the introduction of technician screening of clinical trial prescriptions. Method A risk-based proforma was created and used by a pharmacist to assess clinical trial prescriptions for the suitability of screening by a Band 7 technician. Only prescriptions with pre-printed doses, no aseptic preparation or additional medicines, were approved for technician screening. The process of screening therefore only involves the checking of patient and prescriber details, allergy status and possibly a medication randomisation. The technicians under-went an in-house training including the screening of prescriptions under pharmacist supervision. A quantitative data collection tool was used to review the screening / validation of all nonchemotherapy clinical trial prescriptions received at two sites over a two-week period in September 2020. The data collection tool was piloted and all data was analysed using Microsoft Excel. Results A total of 89 prescriptions were received. 56 (63%) were eligible for technician screening, of which a suitable technician validated 50%. Across both sites a total time of 360 minutes were spent validating/screening prescriptions including solving prescription related issues. Combining the time taken by a pharmacist to return from a clinical area and screening time consequently saved a total of 227 minutes of pharmacists’ time. Conclusion Distributing the workload amongst trained staff saves pharmacist’s time, which can be utilised on clinical and complex tasks. This does not eliminate the requirement of a pharmacist to validate prescriptions however; it reduces the frequency and streamlines the service. Further data collection is required to analyse the direct impact on patients’ and any changes in the number of reported errors. A limitation to the study is the lack of data prior to implementation as a comparator. Additionally, during data collection there were no suitable technicians available at one site due to the Covid-19 pandemic, resulting in only 50% of eligible prescriptions being screened by a technician. Ultimately, this does not change the outcome; enhancing technician’s roles allows pharmacists’ time to be used more efficiently. References 1. Royal Pharmaceutical Society. Shaping Pharmacy for the future. Hospital Pharmacy: A briefing for members in England. 2017. Available at: https://www.rpharms.com/Portals/0/Hospital%20pharmacy%20briefing%20-%20final.pdf [Accessed: 11/10/20] 2. National Pharmacy Clinical Trials Advisory Group. Professional Guidance on Pharmacy Services for Clinical Trials v2.1. 2019. Available at: https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Hospital%20Pharmacy%20Hub/Practice_Guidance_on_Pharmacy_Services_for_Clinical_Trials_v2.1.pdf?ver=2020-09-18-095937-733 [Accessed: 09/10/20]

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The Impact of Endoscopy Sedation Information Sheets on the Level of Concern Regarding Possible Awareness in Patients Undergoing Endoscopy Sedation

Healthcare ◽

10.3390/healthcare10010034 ◽

2021 ◽

Vol 10 (1) ◽

pp. 34

Author(s):

Zi Ping Tong ◽

Lincoln Gan Gan Lim ◽

Alison Pighills ◽

Matthew Hiskens ◽

Danny Bartlett

Keyword(s):

Intervention Group ◽

Control Group ◽

Patient Counselling ◽

Unmet Expectations ◽

Level Of Concern ◽

The Difference ◽

Future Work ◽

The Impact ◽

Video Material

Sedation encompasses a continuum from complete unconsciousness to drowsiness and anxiolysis where some awareness might be expected. Most patients undergoing endoscopy sedation expect to be completely unconscious during the procedure and thus have unmet expectations regarding their state of consciousness. This study aimed to evaluate whether endoscopy sedation information sheets reduce the level of concern regarding possible awareness during endoscopy sedation at a major regional hospital. Our findings were that 28.8% of patients who received the endoscopy sedation information sheet (n = 82) were concerned about awareness during the procedure, compared to 36.5% of patients in the control group (n = 105). However, the difference was not statistically significant. We also found that the incidence of awareness was higher (13.9%) in the intervention group compared to 8.8% in the control group but, again, not statistically different. This study allowed us to elucidate the level of concern regarding possible awareness during sedation and the incidence of awareness during endoscopy sedation. This will enable future work investigating the role of endoscopy sedation information methods involving written and video material in assisting pre-procedure patient counselling.

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