Current Issue : January - March Volume : 2015 Issue Number : 1 Articles : 6 Articles
Abnormal uterine bleeding causes significant health care burden on women, their families and society as a whole. There is a large population presenting with abnormal uterine bleeding due to uterine fibroids and polycystic ovarian disease. To evaluate the causes, risk factors and management of abnormal uterine bleeding (AUB) in south Indian tertiary care hospital setting single centered, prospective and retrospective observational study was conducted for a period of 6 months. The study was done by identifying patients with AUB due to uterine fibroids and poly cystic ovarian disease (PCOD). There were 62% cases due to fibroids and 38% cases were due to poly cystic ovarian disease. Incidence of fibroids was found to be more in 40-50 years age group. The main risk factors identified in the patient population with fibroids were age>40, BMI>25kg/m² and nulliparity. Out of all fibroid patients, 76% patients underwent non-pharmacological therapy and 24% received pharmacological therapy. The incidence of poly cystic ovarian disease was more in 20-30 years age group. Around 94% patients were found to be overweight. Overweight was observed to be main risk factor for patients with poly cystic ovarian disease. Uterine fibroids were found to be major cause of abnormal uterine bleeding. The prevalence of fibroids was more in the age group of 40-50 years and that of poly cystic ovarian disease in the age group of 20-30 years. Risk factors for fibroids were found to be age, overweight and nulliparity. The main risk factor for poly cystic ovarian disease was found to be overweight. Treatment options were based on location and size of fibroid, age and patient preference....
Background: Pharmacist interventions are one of the pivotal parts of a clinical pharmacy service within a hospital.\nThis study estimates the cost avoidance generated by pharmacist interventions due to the prevention of adverse\ndrug events (ADE). The types of interventions identified are also analysed.\nMethods: Interventions recorded by a team of hospital pharmacists over a one year time period were included in\nthe study. Interventions were assigned a rating score, determined by the probability that an ADE would have\noccurred in the absence of an intervention. These scores were then used to calculate cost avoidance. Net cost\nbenefit and cost benefit ratio were the primary outcomes. Categories of interventions were also analysed.\nResults: A total cost avoidance of ââ??¬708,221 was generated. Input costs were calculated at ââ??¬81,942. This resulted in\na net cost benefit of ââ??¬626,279 and a cost benefit ratio of 8.64: 1. The most common type of intervention was the\nidentification of medication omissions, followed by dosage adjustments and requests to review therapies.\nConclusion: This study provides further evidence that pharmacist interventions provide substantial cost avoidance\nto the healthcare payer. There is a serious issue of patientââ?¬â?¢s regular medication being omitted on transfer to an\ninpatient setting in Irish hospitals...
Background: Adherence to medication is often low. Pharmacists may improve adherence, but a one-size-fits-all\napproach will not work: different patients have different needs. Goal of the current study is to assess the effectiveness\nof a patient-tailored, telephone-based intervention by a pharmacist at the start of pharmacotherapy aimed at improving\nmedication adherence, satisfaction with information and counselling and the beliefs about medicines.\nMethods/Design: A cluster randomized controlled intervention trial in 30 Dutch pharmacies, randomly assigned to 1\nof 2 intervention groups. Each group consists of an intervention arm and an usual care arm. The intervention arm in\nthe first group is the usual care arm in the second group and vice versa. One intervention arm focuses on patients\nstarting with antidepressants or bisphosphonates and the other on antilipaemic drugs or renin angiotensin system\n(RAS)-inhibitors. The intervention consists of a telephone call by a pharmacist 2 or 3 weeks after a new\nprescription. A random sample of pharmacies will send questionnaires 3 months after the first prescription. This\ncontains socio-demographic questions, a measure of beliefs about medicines (BMQ), satisfaction with information\nreceived (SIMS, abbreviated) and frequency of pharmacy counselling (Consumer Quality Index, CQI, abbreviated).\nThe primary outcome measure will be medication adherence calculated from dispensing records retrieved\n12 months after the intervention. Patients� beliefs on medication, perception of the quality of information received\nand pharmacy counselling are secondary outcomes.\nDiscussion: The TelCIP study will determine the effectiveness of telephone counselling to improve adherence in\npatients initiating a new treatment. By measuring satisfaction with information and counselling and beliefs about\nmedication the study will also give clues for the reason of a potential increase in adherence. Finally the study will\nprovide information on which patients are most likely to benefit from this intervention....
Background: Written medicine information can play an important role in educating consumers about their\nmedicines. In Australia, standardised, comprehensive written information known as Consumer Medicine Information\n(CMI) is available for all prescription medicines. CMI is reportedly under-utilised by general practitioners (GPs) and\ncommunity pharmacists in consultations, despite consumer desire for medicine information. This study aimed to\ndetermine consumers�, GPs� and community pharmacists� preferences for CMI provision and identify barriers and\nfacilitators to its use.\nMethod: Structured questionnaires were developed and administered to a national sample of Australian consumers\n(phone survey), community pharmacists and GPs (postal surveys) surrounding utilisation of CMI. Descriptive and\ncomparative analyses were conducted.\nResults: Half of consumers surveyed wanted to receive CMI for their prescription medicine, with spoken\ninformation preferable to written medicine information for many consumers and healthcare professionals. GPs and\npharmacists remained a preferred source of medicine information for consumers, although package inserts were\nappealing to many among all three cohorts. Overall pharmacists were the preferred provider of CMI primarily due\nto their medicine expertise, accessibility and perceived availability. GPs preferred CMI dissemination through both\nthe GP and pharmacist. Some consumers preferred GPs as the provider of medicines information because of their\nknowledge of the patients� medicines and/or medical history, regularity of seeing the patient and good relationship\nwith the patient. Common barriers to CMI provision cited included: time constraints, CMI length and perceptions\nthat patients are not interested in receiving CMI. Facilitators to enhance provision included: strategies to increase\nconsumer awareness, longer consultation times and counseling appointments, and improvements to pharmacy\nsoftware technology and workflow.\nConclusion: Medicine information is important to consumers, whether as spoken, written or a combination of\nboth. A tailored approach is needed to ascertain individual patient preference for delivery and scope of medicine\ninformation desired so that appropriate information is provided. The barriers of time and perceived attitudes of\nhealthcare practitioners present challenges which may be overcome through changes to workplace practices,\nadoption of identified facilitators, and education about the positive benefits of CMI as a tool to engage and\nempower patients....
Background: The Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE) instrument\ncontains 10 items, 3 factors (interprofessional teamwork and team-based practice, roles/responsibilities for collaborative\npractice, and patient outcomes from collaborative practice), and utilizes a five-point response scale (1 = strongly\ndisagree, 5 = strongly agree). Given the SPICE instrumentââ?¬â?¢s demonstrated validity and reliability, the objective of\nthis study was to evaluate whether it was capable of measuring changes in medical (MS) and pharmacy studentsââ?¬â?¢\n(PS) perceptions following an interprofessional education (IPE) experience.\nMethods: In this prospective cohort study, MS and PS completed the SPICE instrument before and after participation\nin a predefined IPE experience. Descriptive statistics were used to characterize students and pre-post responses.\nIndependent samples t tests and Fisherââ?¬â?¢s Exact tests were used to assess group difference in demographic variables.\nMann Whitney U tests were used to assess between-group differences in item scores. Wilcoxon Signed-Rank tests\nwere used to evaluate post-participation changes in item scores. Spearman correlations were calculated to assess\nassociations between ordinal demographic variables and item scores, and whether the number of clinic visits\ncompleted was associated with post-test responses. Paired samples t tests were used to calculate mean score\nchanges for each of the factors.\nResults: Thirty-four MS and 15 PS were enroled. Baseline differences included age (25.3. Ã?± 1.3 MS vs. 28.7 Ã?± 4.4 PS;\np = 0.013), years full-time employment (0.71 Ã?± 0.97 MS vs. 4.60 Ã?± 4.55 PS; p < 0.001), and number of prior IPE rotations\n(1.41 Ã?± 1.74 MS vs. 3.13 Ã?± 2.1 PS; p < 0.001). Two items generated baseline differences; 1 persisted post-participation:\nwhether MS/PS should be involved in teamwork (3.91 MS vs. 4.60 PS; p < 0.001). For all students, significant mean score\nincreases were observed for role clarity (ââ?¬Å?my roleââ?¬Â [3.72 vs. 4.11; p = 0.001] and ââ?¬Å?othersââ?¬â?¢ rolesââ?¬Â [3.87 vs. 4.17; p = 0.001]),\nimpact of teamwork on patient satisfaction (3.72 vs. 4.34; p < 0.001), and ideal curricular location for IPE (4.06 vs.\n4.34; p = 0.002). Significant increases were observed for all three factors (teamwork, p = 0.003; roles/responsibilities\nand patient outcomes, p < 0.001).\nConclusions: This study demonstrated the SPICE instrumentââ?¬â?¢s ability to measure changes in perception for medical\nand pharmacy students exposed to an IPE experience, both at the individual item level and at the factor level....
Objectives: To determine the impact that the presence of a\npharmacist has on the care a trauma patient in the emergency\ndepartment.\nMethods: Single center, retrospective, observational study that\nassessed the charts of all trauma patients that presented as Priority\n1 or Priority 2 trauma alerts from December 1, 2009-November 30,\n2010. Patients were separated into two categories, pharmacist present\nand pharmacist not present. Patient age, gender, weight, past medical\nhistory, allergies and injuries sustained from trauma, medications\ngiven during trauma, and time from arrival to administration of\nmedications.\nResults: 508 charts were included in this study. Pharmacists\nwere present for 26% of these patients. When the pharmacist was\npresent it was more likely that the patient received the appropriate\ndose of antibiotic (99% vs 79%, p-value <0.05). In adult patients\nwhen the pharmacist was present the antibiotics were given faster\n(17.9 min vs 36.6 min, p-value <0.05).\nConclusion: The presence of pharmacists at trauma alerts can\nimprove the care that trauma patients receive....
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