Adherence is defined as the extent to which patients follow the instructions they are given for prescribed treatments. Until recently, adherence expertise was hard to find, assemble and empower. The study shall solely aim at investigating the influence of patients’ health education on Tuberculosis drug adherence. It will be guided by the following specific objectives; to identify the level of adherence among TB patients at MTRH, to assess the level of patient’s health education on TB drugs, to identify barriers of TB education, to investigate the challenges facing TB patients on treatment and to determine the level of training given to health workers on TB drug adherence. These objectives will enable the researcher to elaborate more on the topic and ensure that those who read through this research shall have a better perspective on the effects of health education on tuberculosis drug adherence. It will take place between the months of July and August. The study will target 17 doctors, 119 nurses and 143 patients of Tuberculosis. The study will employ a case study research design. The case study will enable the researcher be able to collected detailed information as to the influence of patients’ health education on TB drug adherence. The study will employ purposive sampling to sample the doctors and simple random sampling to select both the nurses and the patients who will participate in the study. The researcher will use one research instrument to collect data from the respondents selected to participate in the study which is a questionnaire that will be issued to the respondents on the day of the data collection.
Complementary therapy use by patients and parents of children with asthma and...home
Complementary therapy use reflects patients' and parents' underlying desire for greater selfcare
and need of opportunities to address some of their concerns regarding NHS asthma care. Selfmanagement
of chronic conditions is increasingly promoted within the NHS but with little attention to
complementary therapy use as one strategy being used by patients and parents. With their desire for selfhelp,
complementary therapy users are in many ways adopting the healthcare personas that current
policies aim to encourage.
My talk at the Scientific Research Day of Medical colleges, UQU
5 March 2019
where I presented my publication (Patient-Centered Pharmacovigilance: A review)
Quality Use of Medicines means:
• Selecting management options wisely by:
Considering the place of medicines in treating illness and maintaining health, and
recognising that there may be better ways than medicine to manage many disorders.
• Choosing suitable medicines if a medicine is considered necessary so that the best available option is selected by taking into account:
- the individual
- the clinical condition
- risks and benefits
- dosage and length of treatment
- any co-existing conditions
- other therapies
- monitoring considerations
- costs for the individual, the community and the health system as a whole.
1) The study aims to understand barriers to obtaining oral cancer treatment and the impact on patient experience by assessing financial toxicity, psychosocial burden, and factors associated with treatment satisfaction.
2) Preliminary findings show that while wait times and costs cause distress, receiving treatment reduces worry. Higher costs were not significantly associated with more distress. Patients waited an average of 8-9 days for medications.
3) Increased costs and wait times may be linked to greater psychosocial stress, though receiving treatment lessened worry. Further analysis of factors like memory, mood, and finances could provide more insights into adherence.
Patient Reported Outcomes (PRO) - Challenge and potential solutions.
Why and how can medical device and pharmaceutical companies, as well as the entire healthcare sector, leverage patient engagement with next-generation ePRO solutions?
Discover our white paper...
Dose Escalations In the First Year For CNP = AberrancyPaul Coelho, MD
This study analyzed data from 246 opioid-naive patients with chronic musculoskeletal pain who were prescribed long-term opioids for one year to identify factors associated with opioid dose escalation during the first year of treatment. The study found that 9% of patients experienced a dose escalation of at least 30 mg morphine equivalents over the year. Patients with dose escalation had higher rates of substance use disorders and more frequent non face-to-face outpatient encounters compared to patients without escalation. Differences in demographics like age and race between the groups were not statistically significant.
Medication non-adherence is a growing concern, as it is increasingly associated with negative health outcomes and higher cost of care. Tackling the burden of non-adherence requires a collaborative, patient-centric approach that considers individual patient needs and results in intelligent interventions that combine high-tech with high-touch.
This document provides information on drug information resources and how to evaluate them. It discusses primary sources like research studies, secondary sources like abstracts and indexes, and tertiary sources like textbooks. Primary sources provide the most current evidence but have a narrow scope, while tertiary sources have a broad scope but are often out of date. The document outlines strategies for selecting the best sources depending on the type of question, and how to critically evaluate clinical studies and other drug information.
Complementary therapy use by patients and parents of children with asthma and...home
Complementary therapy use reflects patients' and parents' underlying desire for greater selfcare
and need of opportunities to address some of their concerns regarding NHS asthma care. Selfmanagement
of chronic conditions is increasingly promoted within the NHS but with little attention to
complementary therapy use as one strategy being used by patients and parents. With their desire for selfhelp,
complementary therapy users are in many ways adopting the healthcare personas that current
policies aim to encourage.
My talk at the Scientific Research Day of Medical colleges, UQU
5 March 2019
where I presented my publication (Patient-Centered Pharmacovigilance: A review)
Quality Use of Medicines means:
• Selecting management options wisely by:
Considering the place of medicines in treating illness and maintaining health, and
recognising that there may be better ways than medicine to manage many disorders.
• Choosing suitable medicines if a medicine is considered necessary so that the best available option is selected by taking into account:
- the individual
- the clinical condition
- risks and benefits
- dosage and length of treatment
- any co-existing conditions
- other therapies
- monitoring considerations
- costs for the individual, the community and the health system as a whole.
1) The study aims to understand barriers to obtaining oral cancer treatment and the impact on patient experience by assessing financial toxicity, psychosocial burden, and factors associated with treatment satisfaction.
2) Preliminary findings show that while wait times and costs cause distress, receiving treatment reduces worry. Higher costs were not significantly associated with more distress. Patients waited an average of 8-9 days for medications.
3) Increased costs and wait times may be linked to greater psychosocial stress, though receiving treatment lessened worry. Further analysis of factors like memory, mood, and finances could provide more insights into adherence.
Patient Reported Outcomes (PRO) - Challenge and potential solutions.
Why and how can medical device and pharmaceutical companies, as well as the entire healthcare sector, leverage patient engagement with next-generation ePRO solutions?
Discover our white paper...
Dose Escalations In the First Year For CNP = AberrancyPaul Coelho, MD
This study analyzed data from 246 opioid-naive patients with chronic musculoskeletal pain who were prescribed long-term opioids for one year to identify factors associated with opioid dose escalation during the first year of treatment. The study found that 9% of patients experienced a dose escalation of at least 30 mg morphine equivalents over the year. Patients with dose escalation had higher rates of substance use disorders and more frequent non face-to-face outpatient encounters compared to patients without escalation. Differences in demographics like age and race between the groups were not statistically significant.
Medication non-adherence is a growing concern, as it is increasingly associated with negative health outcomes and higher cost of care. Tackling the burden of non-adherence requires a collaborative, patient-centric approach that considers individual patient needs and results in intelligent interventions that combine high-tech with high-touch.
This document provides information on drug information resources and how to evaluate them. It discusses primary sources like research studies, secondary sources like abstracts and indexes, and tertiary sources like textbooks. Primary sources provide the most current evidence but have a narrow scope, while tertiary sources have a broad scope but are often out of date. The document outlines strategies for selecting the best sources depending on the type of question, and how to critically evaluate clinical studies and other drug information.
The document discusses strategies to increase patient engagement in their own healthcare. It outlines three key areas: improving health literacy, promoting shared decision-making, and supporting self-management of chronic conditions. Effective interventions include providing tailored written and online health information, training healthcare professionals in communication skills, using decision aids and question prompts, and delivering self-management education programs. Governments need a coherent strategy targeting multiple levels to inform and empower patients in their care.
This document discusses pharmacoeconomics, drug compliance, and therapeutic failure. It begins by defining pharmacoeconomics as the analysis of costs and consequences of pharmaceutical products and services. It then discusses various pharmacoeconomic methods like cost-benefit analysis and cost-effectiveness analysis. The document also explains drug compliance, adherence, and the consequences of non-compliance. It notes that non-compliance can result in therapeutic drug failure and increased costs. It concludes by discussing common interventions to improve compliance like patient education and simplifying drug regimens.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
This study examined self-medication practices for oral health problems among dental patients in Bangalore, India. The study found that 100% of the 175 dental patients surveyed practiced self-medication. Toothache was the most common triggering factor reported. Analgesics and herbal remedies were commonly used for self-treatment. Most participants consulted pharmacists for advice on self-medication and would see a dentist only if problems persisted after self-medicating. The high prevalence of self-medication indicates a need for education programs to increase awareness of risks.
An analysis of wrong practices among pharmacies and pharmacists in India-• Disadvantages of Self Medications Adverse Drug Reactions.Lack of knowledge about dose.Chances of using wrong medication.Risk of disease aggravation Drug interactions.
Supporting medicines adherence developing the pharmacist contributionPM Society
This document summarizes a presentation by Professor Graham Davies on supporting medicine adherence for patients with diabetes. It discusses a project in South London to train community pharmacists to help patients with diabetes better manage their medication. Key challenges discussed include the high rates of non-adherence to medications for long-term conditions and the need for integrated care approaches across health professionals to address patients' multiple conditions and needs.
Capella university improving quality of care and patient safety assignment ...DrWillow1
This presentation focuses on developing a safety improvement plan using the Teach-back Method to prevent medication errors through enhanced patient-provider communication and education. Poor communication is a leading cause of errors. The plan aims to evaluate patient comprehension by having them explain medication instructions in their own words. Audience members like nurses and doctors will learn the Teach-back Method to improve engagement with patients and reduce errors. Their successful adoption of this role is critical to the plan's success.
Concept of risk in pharmacoepidemiology PresentationMdshams244
This document discusses concepts of risk in pharmacoepidemiology. It defines risk as the likelihood of experiencing harm or loss, and risk factors as variables that increase the likelihood of developing a problem. Risk factors can be biological, environmental, or psychosocial. Risk is not certain - not everyone exposed will have an adverse outcome. Risk is also relative and depends on multiple interacting factors over time. In pharmacoepidemiology, risk refers to the probability of developing an outcome from drug exposure, which depends on factors like age, sex, and other medications. Risk is measured using metrics like attributable risk, relative risk, and odds ratio.
Evaluations of and Interventions for Non Adherence to Oral Medications as a P...NiyotiKhilare
The focus of this presentation will be medical non-adherence as a psychosocial issue in diabetes. The presentation will also focus elaborately on empowerment as an intervention amongst other interventions.
perception and practice of self-medication among student of Yaba college of E...Enwere Enweremchi David
This document discusses self-medication among students. It begins by defining self-medication and distinguishing between responsible and non-responsible self-medication. It then discusses students' knowledge and perceptions of self-medication, sources of knowledge about medicines, and factors that influence self-medication practices. The document provides background on self-medication globally and in Nigeria specifically. It aims to understand students' perceptions and practices of self-medication in Nigeria by investigating the most common drugs and conditions self-medicated for.
Stop TB Partnership focus group session 10-20-17Bruce Thomas
The Arcady Group founder, Bruce Thomas, led the Stop TB Partnership's Focus Group Workshop On Digital Adherence Technologies. At this meeting, innovators such as Everwell Health (99DOTS), Wisepill Technologies (evriMED medication monitor), Keheala (SMS-based behavioral counseling) and SureAdhere Mobile Technology (V-DOT) were connected with representatives of key NGO implementers and country programs (including Zimbabwe, Philippines, Moldova, and South Africa) to discuss opportunities for experimentation and uptake of digital adherence technologies through TB REACH Wave 6 grants. Bruce and Ram Subbaraman shared new evidence and insights about the importance of treatment adherence to avoid TB relapse.
A Mobile-Phone Tele-Medicine System That Promotes Self-Management of Blood Pr...IJERA Editor
The current practice adopted by hypertensive patients in managing hypertension is making frequent visits to a health center as recommended by medical specialists. However, very few patients adhere to this practice as it is time consuming and tiresome especially if they have to travel for long distances to have their BP checked. This practice is also not practical for critically-ill patients. Consequently, most patients neglect BP check-ups and therefore focus on medication alone. This puts the patients’ at risk as uncontrolled BP can lead to fatal complications. The overall objective of this research was to design, develop and pilot-test a mobile telemedicine system that helps patients’ to self-manage their BP condition from the comfort of their homes. Participatory action research design was used in this study. Testing for performance, usability and utilityof the tele-medicine system was conducted.
The document discusses various methods for measuring outcomes in pharmacoepidemiology studies. It describes outcome measures like functional status, symptom status, patient satisfaction, and quality of life. It also discusses approaches to measuring outcomes, including outcome measures and drug use measures. It provides definitions and explanations of key epidemiological terms used to measure outcomes, such as prevalence, incidence rates, morbidity, mortality, case fatality rates, and survival rates. It also defines various ways to measure drug use, including monetary units, prescriptions, drug units dispensed, defined daily doses, and adherence measurements.
The document discusses Quality Use of Medicines (QUM), which aims to ensure optimal health outcomes from medication use. QUM focuses on selecting management options wisely, choosing suitable medicines appropriately, and using medicines safely and effectively. The National Medicines Policy also aims to ensure timely access to medicines, quality products, quality use, and a viable medicines industry. Key partners in achieving QUM include healthcare providers and recipients, as well as governments, industry, and educators.
The document discusses the field of public health dentistry. It provides definitions of key terms like public health and dental public health. It describes the historical development of public health and changing concepts in public health from disease control to health promotion to social engineering to health for all. It outlines tools used in dental public health like epidemiology and biostatistics. It discusses characteristics of ideal public health measures and services provided through public health dentistry.
The document discusses a study on self-medication in Slovenia. It found that 71.8% of 564 patients studied used some form of self-medication, with herbal teas and over-the-counter medications being most common. Reasons for self-medication included believing it is more natural than medical treatment. 53.5% of self-medicating patients wanted more information, and 70.9% thought doctors best to provide advice. Female sex, higher education, and psychiatric disorders predicted higher rates of self-medication. The study had some limitations, such as unclear definitions and questions.
This study compared information on medication use and drug-related problems (DRPs) obtained via a patient questionnaire versus a patient interview. 97 patients aged 65+ years with polypharmacy or geriatric problems completed the questionnaire and were then interviewed. There was 87.6% agreement between the questionnaire and interview for reported medications. More medications and DRPs were reported in interviews than questionnaires. Agreement on complete medication lists was 45.4% of patients. Vulnerable patients with many chronic diseases or medications showed lower agreement. The questionnaire provided reasonably similar but not identical information as interviews and may be suitable for medication reviews in most patients.
โรคเรื้อรังเกี่ยวกับระบบทางเดินหายใจ นับว่าเป็นปัญหาสาธารณสุขที่กระทบต่อคุณภาพชีวิตประชาชนมากเป็นอันดับต้นๆ การพัฒนาระบบการดูแลที่เรียกว่า chronic care model นับว่าจะช่วยทั้ง health and well being คนไข้ ครอบครัว และช่วยทางด้าน equity efficiency ระบบบริการสาธารณสุขด้วย
This document summarizes a presentation on predictive analytics and real-time business insights. The presentation discusses what real-time analytics are, challenges in implementing them, and key aspects of building an effective analytical framework. It provides examples of potential use cases in various business functions and outlines considerations for data collection, analysis, and taking appropriate actions in response to insights. The goal is to demonstrate how real-time analytics can provide value when properly optimized and integrated into an organization.
The Role of Data Wrangling in Driving Hadoop AdoptionInside Analysis
The Briefing Room with Mark Madsen and Trifacta
Live Webcast September 1, 2015
Watch the archive: https://bloorgroup.webex.com/bloorgroup/onstage/g.php?MTID=eb655874d04ba7d560be87a9d906dd2fd
Like all enterprise software solutions, Hadoop must deliver business value in order to be a success. Much of the innovation around the big data industry these days therefore addresses usability. While there will always be a technical side to the Hadoop equation, the need for user-friendly tools to manage the data will continue to focus on business users. That’s why self-service data preparation or "data wrangling" is a serious and growing trend, one which promises to move Hadoop beyond the early adopter phase and more into the mainstream of business.
Register for this episode of The Briefing Room to hear veteran Analyst Mark Madsen of Third Nature explain why business users will play an increasingly important role in the evolution of big data. He’ll be briefed by Trifacta's Will Davis and Alon Bartur, who will demonstrate how Trifacta's solution empowers business users to “wrangle" data of all shapes and sizes faster and easier than ever before. They’ll discuss why a new approach to accessing and preparing diverse data is required and how it can accelerate and broaden the use of big data within organizations.
Visit InsideAnalysis.com for more information.
On the ground experiences & challenges of a connected diagnostics GxAlert in ...SystemOne
This document summarizes Nigeria's experience implementing the GxAlert connectivity tool for GeneXpert machines. Key points include:
- GxAlert allows GeneXpert machines to report test results in real-time via a secure online network, making results actionable within the health system.
- Over 200 GeneXpert machines in Nigeria are now connected via GxAlert. This enables real-time notification of test results, machine errors, and stock levels.
- Challenges include inconsistent internet availability, incomplete primary data, and a need to better integrate GxAlert with other electronic reporting systems like e-TB Manager and DHIS2. Support is also needed to sustain connectivity and uniquely identify patients.
Data Wrangling and the Art of Big Data DiscoveryInside Analysis
The Briefing Room with Dr. Robin Bloor, Trifacta and Zoomdata
Live Webcast March 10, 2015
Watch the Archive: https://bloorgroup.webex.com/bloorgroup/lsr.php?RCID=dd9fed3c7c476ae3a0f881ae6b53dcc5
Square pegs and round holes don't get along, which is one reason why traditional data management approaches simply won't work for Big Data. The variety and velocity of data types flying at us today require a new strategy for identifying, streamlining and utilizing information assets and processes. Decades-old technology won’t cut it – a combination of new tools and techniques must be used to enable effective discovery of insights in a timely fashion.
Register for this episode of The Briefing Room to hear veteran Analyst Dr. Robin Bloor explain why today's data landscape calls for a much different data management approach. He'll be briefed by Trifacta and Zoomdata, who will show how their technologies use a range of functionality – including machine learning – to help companies "wrangle" their data. They'll also demonstrate the optimal step-by-step process of working with new data types.
Visit InsideAnalysis.com for more information.
The document discusses strategies to increase patient engagement in their own healthcare. It outlines three key areas: improving health literacy, promoting shared decision-making, and supporting self-management of chronic conditions. Effective interventions include providing tailored written and online health information, training healthcare professionals in communication skills, using decision aids and question prompts, and delivering self-management education programs. Governments need a coherent strategy targeting multiple levels to inform and empower patients in their care.
This document discusses pharmacoeconomics, drug compliance, and therapeutic failure. It begins by defining pharmacoeconomics as the analysis of costs and consequences of pharmaceutical products and services. It then discusses various pharmacoeconomic methods like cost-benefit analysis and cost-effectiveness analysis. The document also explains drug compliance, adherence, and the consequences of non-compliance. It notes that non-compliance can result in therapeutic drug failure and increased costs. It concludes by discussing common interventions to improve compliance like patient education and simplifying drug regimens.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
This study examined self-medication practices for oral health problems among dental patients in Bangalore, India. The study found that 100% of the 175 dental patients surveyed practiced self-medication. Toothache was the most common triggering factor reported. Analgesics and herbal remedies were commonly used for self-treatment. Most participants consulted pharmacists for advice on self-medication and would see a dentist only if problems persisted after self-medicating. The high prevalence of self-medication indicates a need for education programs to increase awareness of risks.
An analysis of wrong practices among pharmacies and pharmacists in India-• Disadvantages of Self Medications Adverse Drug Reactions.Lack of knowledge about dose.Chances of using wrong medication.Risk of disease aggravation Drug interactions.
Supporting medicines adherence developing the pharmacist contributionPM Society
This document summarizes a presentation by Professor Graham Davies on supporting medicine adherence for patients with diabetes. It discusses a project in South London to train community pharmacists to help patients with diabetes better manage their medication. Key challenges discussed include the high rates of non-adherence to medications for long-term conditions and the need for integrated care approaches across health professionals to address patients' multiple conditions and needs.
Capella university improving quality of care and patient safety assignment ...DrWillow1
This presentation focuses on developing a safety improvement plan using the Teach-back Method to prevent medication errors through enhanced patient-provider communication and education. Poor communication is a leading cause of errors. The plan aims to evaluate patient comprehension by having them explain medication instructions in their own words. Audience members like nurses and doctors will learn the Teach-back Method to improve engagement with patients and reduce errors. Their successful adoption of this role is critical to the plan's success.
Concept of risk in pharmacoepidemiology PresentationMdshams244
This document discusses concepts of risk in pharmacoepidemiology. It defines risk as the likelihood of experiencing harm or loss, and risk factors as variables that increase the likelihood of developing a problem. Risk factors can be biological, environmental, or psychosocial. Risk is not certain - not everyone exposed will have an adverse outcome. Risk is also relative and depends on multiple interacting factors over time. In pharmacoepidemiology, risk refers to the probability of developing an outcome from drug exposure, which depends on factors like age, sex, and other medications. Risk is measured using metrics like attributable risk, relative risk, and odds ratio.
Evaluations of and Interventions for Non Adherence to Oral Medications as a P...NiyotiKhilare
The focus of this presentation will be medical non-adherence as a psychosocial issue in diabetes. The presentation will also focus elaborately on empowerment as an intervention amongst other interventions.
perception and practice of self-medication among student of Yaba college of E...Enwere Enweremchi David
This document discusses self-medication among students. It begins by defining self-medication and distinguishing between responsible and non-responsible self-medication. It then discusses students' knowledge and perceptions of self-medication, sources of knowledge about medicines, and factors that influence self-medication practices. The document provides background on self-medication globally and in Nigeria specifically. It aims to understand students' perceptions and practices of self-medication in Nigeria by investigating the most common drugs and conditions self-medicated for.
Stop TB Partnership focus group session 10-20-17Bruce Thomas
The Arcady Group founder, Bruce Thomas, led the Stop TB Partnership's Focus Group Workshop On Digital Adherence Technologies. At this meeting, innovators such as Everwell Health (99DOTS), Wisepill Technologies (evriMED medication monitor), Keheala (SMS-based behavioral counseling) and SureAdhere Mobile Technology (V-DOT) were connected with representatives of key NGO implementers and country programs (including Zimbabwe, Philippines, Moldova, and South Africa) to discuss opportunities for experimentation and uptake of digital adherence technologies through TB REACH Wave 6 grants. Bruce and Ram Subbaraman shared new evidence and insights about the importance of treatment adherence to avoid TB relapse.
A Mobile-Phone Tele-Medicine System That Promotes Self-Management of Blood Pr...IJERA Editor
The current practice adopted by hypertensive patients in managing hypertension is making frequent visits to a health center as recommended by medical specialists. However, very few patients adhere to this practice as it is time consuming and tiresome especially if they have to travel for long distances to have their BP checked. This practice is also not practical for critically-ill patients. Consequently, most patients neglect BP check-ups and therefore focus on medication alone. This puts the patients’ at risk as uncontrolled BP can lead to fatal complications. The overall objective of this research was to design, develop and pilot-test a mobile telemedicine system that helps patients’ to self-manage their BP condition from the comfort of their homes. Participatory action research design was used in this study. Testing for performance, usability and utilityof the tele-medicine system was conducted.
The document discusses various methods for measuring outcomes in pharmacoepidemiology studies. It describes outcome measures like functional status, symptom status, patient satisfaction, and quality of life. It also discusses approaches to measuring outcomes, including outcome measures and drug use measures. It provides definitions and explanations of key epidemiological terms used to measure outcomes, such as prevalence, incidence rates, morbidity, mortality, case fatality rates, and survival rates. It also defines various ways to measure drug use, including monetary units, prescriptions, drug units dispensed, defined daily doses, and adherence measurements.
The document discusses Quality Use of Medicines (QUM), which aims to ensure optimal health outcomes from medication use. QUM focuses on selecting management options wisely, choosing suitable medicines appropriately, and using medicines safely and effectively. The National Medicines Policy also aims to ensure timely access to medicines, quality products, quality use, and a viable medicines industry. Key partners in achieving QUM include healthcare providers and recipients, as well as governments, industry, and educators.
The document discusses the field of public health dentistry. It provides definitions of key terms like public health and dental public health. It describes the historical development of public health and changing concepts in public health from disease control to health promotion to social engineering to health for all. It outlines tools used in dental public health like epidemiology and biostatistics. It discusses characteristics of ideal public health measures and services provided through public health dentistry.
The document discusses a study on self-medication in Slovenia. It found that 71.8% of 564 patients studied used some form of self-medication, with herbal teas and over-the-counter medications being most common. Reasons for self-medication included believing it is more natural than medical treatment. 53.5% of self-medicating patients wanted more information, and 70.9% thought doctors best to provide advice. Female sex, higher education, and psychiatric disorders predicted higher rates of self-medication. The study had some limitations, such as unclear definitions and questions.
This study compared information on medication use and drug-related problems (DRPs) obtained via a patient questionnaire versus a patient interview. 97 patients aged 65+ years with polypharmacy or geriatric problems completed the questionnaire and were then interviewed. There was 87.6% agreement between the questionnaire and interview for reported medications. More medications and DRPs were reported in interviews than questionnaires. Agreement on complete medication lists was 45.4% of patients. Vulnerable patients with many chronic diseases or medications showed lower agreement. The questionnaire provided reasonably similar but not identical information as interviews and may be suitable for medication reviews in most patients.
โรคเรื้อรังเกี่ยวกับระบบทางเดินหายใจ นับว่าเป็นปัญหาสาธารณสุขที่กระทบต่อคุณภาพชีวิตประชาชนมากเป็นอันดับต้นๆ การพัฒนาระบบการดูแลที่เรียกว่า chronic care model นับว่าจะช่วยทั้ง health and well being คนไข้ ครอบครัว และช่วยทางด้าน equity efficiency ระบบบริการสาธารณสุขด้วย
This document summarizes a presentation on predictive analytics and real-time business insights. The presentation discusses what real-time analytics are, challenges in implementing them, and key aspects of building an effective analytical framework. It provides examples of potential use cases in various business functions and outlines considerations for data collection, analysis, and taking appropriate actions in response to insights. The goal is to demonstrate how real-time analytics can provide value when properly optimized and integrated into an organization.
The Role of Data Wrangling in Driving Hadoop AdoptionInside Analysis
The Briefing Room with Mark Madsen and Trifacta
Live Webcast September 1, 2015
Watch the archive: https://bloorgroup.webex.com/bloorgroup/onstage/g.php?MTID=eb655874d04ba7d560be87a9d906dd2fd
Like all enterprise software solutions, Hadoop must deliver business value in order to be a success. Much of the innovation around the big data industry these days therefore addresses usability. While there will always be a technical side to the Hadoop equation, the need for user-friendly tools to manage the data will continue to focus on business users. That’s why self-service data preparation or "data wrangling" is a serious and growing trend, one which promises to move Hadoop beyond the early adopter phase and more into the mainstream of business.
Register for this episode of The Briefing Room to hear veteran Analyst Mark Madsen of Third Nature explain why business users will play an increasingly important role in the evolution of big data. He’ll be briefed by Trifacta's Will Davis and Alon Bartur, who will demonstrate how Trifacta's solution empowers business users to “wrangle" data of all shapes and sizes faster and easier than ever before. They’ll discuss why a new approach to accessing and preparing diverse data is required and how it can accelerate and broaden the use of big data within organizations.
Visit InsideAnalysis.com for more information.
On the ground experiences & challenges of a connected diagnostics GxAlert in ...SystemOne
This document summarizes Nigeria's experience implementing the GxAlert connectivity tool for GeneXpert machines. Key points include:
- GxAlert allows GeneXpert machines to report test results in real-time via a secure online network, making results actionable within the health system.
- Over 200 GeneXpert machines in Nigeria are now connected via GxAlert. This enables real-time notification of test results, machine errors, and stock levels.
- Challenges include inconsistent internet availability, incomplete primary data, and a need to better integrate GxAlert with other electronic reporting systems like e-TB Manager and DHIS2. Support is also needed to sustain connectivity and uniquely identify patients.
Data Wrangling and the Art of Big Data DiscoveryInside Analysis
The Briefing Room with Dr. Robin Bloor, Trifacta and Zoomdata
Live Webcast March 10, 2015
Watch the Archive: https://bloorgroup.webex.com/bloorgroup/lsr.php?RCID=dd9fed3c7c476ae3a0f881ae6b53dcc5
Square pegs and round holes don't get along, which is one reason why traditional data management approaches simply won't work for Big Data. The variety and velocity of data types flying at us today require a new strategy for identifying, streamlining and utilizing information assets and processes. Decades-old technology won’t cut it – a combination of new tools and techniques must be used to enable effective discovery of insights in a timely fashion.
Register for this episode of The Briefing Room to hear veteran Analyst Dr. Robin Bloor explain why today's data landscape calls for a much different data management approach. He'll be briefed by Trifacta and Zoomdata, who will show how their technologies use a range of functionality – including machine learning – to help companies "wrangle" their data. They'll also demonstrate the optimal step-by-step process of working with new data types.
Visit InsideAnalysis.com for more information.
Tuberculosis is a global disease caused by the bacterium Mycobacterium tuberculosis. It infects around a third of the world's population and causes millions of deaths each year. Common symptoms include cough, weight loss, and fever. Diagnosis involves sputum smear microscopy, chest x-ray, and culture. Treatment requires prolonged multi-drug chemotherapy over 6-24 months to prevent drug resistance. Directly observed therapy is recommended to ensure treatment adherence and cure.
Lessons learned in implementing community tb prevention programme in south we...John Bako
1. The document summarizes a community tuberculosis (TB) prevention program implemented in Southwestern Nigeria by The Society for Family Health (SFH).
2. The program assessed TB treatment centers, educated communities about TB prevention, and referred TB suspects to centers. It reached over 13,000 people and referred 129 suspects, of which 47 tested positive.
3. Lessons learned include high community acceptance of education, importance of using local educators, and need to address poor awareness, drug stockouts, and stigma to improve TB case detection and treatment in Nigeria.
Companies are finding that data can be a powerful differentiator and are investing heavily in infrastructure, tools and personnel to ingest and curate raw data to be "analyzable". This process of data curation is called "Data Wrangling"
This task can be very cumbersome and requires trained personnel. However with the advances in open source and commercial tooling, this process has gotten a lot easier and the technical expertise required to do this effectively has dropped several notches.
In this tutorial, we will get a feel for what data wranglers do and use R, RStudio, Trifacta Wrangler, Open Refine tools with some hands-on exercises available at http://akuntamukkala.blogspot.com/2016/05/data-wrangling-examples.html
Summary Report / R&D Evaluation Methodology and Funding PrinciplesMEYS, MŠMT in Czech
This study has been undertaken under a contract to the Ministry of Education, Youth
and Sports of the Czech Republic by a team from Technopolis, the Technology Centre
ASCR, NIFU, and Infoscience Praha.
Tuberculosis Infection Control Symposia, presented at Hôpital Sacré Coeur in Milot, Haiti, 2011.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
The document discusses key details from India's 2011 Census:
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- Uttar Pradesh and Maharashtra have the highest populations, while Thane district has the most people of any district.
- India's sex ratio improved to 940 females per 1000 males, the highest since 1971.
- Literacy rates vary widely by state, from over 98% in Mizoram to 37% in one MP district.
- Mobile phone ownership exceeds access to toilets, with landlines at 10% and mobiles at 59% penetration.
This presentation gives the idea about Data Preprocessing in the field of Data Mining. Images, examples and other things are adopted from "Data Mining Concepts and Techniques by Jiawei Han, Micheline Kamber and Jian Pei "
This document discusses loading data from Hadoop into Oracle databases using Oracle connectors. It describes how the Oracle Loader for Hadoop and Oracle SQL Connector for HDFS can load data from HDFS into Oracle tables much faster than traditional methods like Sqoop by leveraging parallel processing in Hadoop. The connectors optimize the loading process by automatically partitioning, sorting, and formatting the data into Oracle blocks to achieve high performance loads. Measuring the CPU time needed per gigabyte loaded allows estimating how long full loads will take based on available resources.
This document discusses the evolution of database technology and data mining. It provides a brief history of databases from the 1960s to the 2010s and their purposes over time. It then discusses the motivation for data mining, noting the explosion in data collection and need to extract useful knowledge from large databases. The rest of the document defines data mining, outlines the basic process, discusses common techniques like classification and clustering, and provides examples of data mining applications in industries like telecommunications, finance, and retail.
Together to eliminate tuberculosis , alaa alsawyalaa alsawy
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1) Contact information for Dr. Alaa elsawy and his location in Egypt.
2) Details on the global burden of TB, with an estimated 8 million new cases and 2 million deaths annually.
3) Descriptions of TB transmission through airborne droplets, symptoms of active TB disease, and risk factors for progression from latent to active TB.
- India has the highest burden of tuberculosis (TB) in the world, accounting for over 20% of global TB cases.
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- New diagnostic technologies like molecular diagnostics, urine lipoarabinomannan tests, and breathalyzer tests have improved TB detection rates. The shorter daily drug regimen has also improved treatment outcomes.
- Initiatives to address TB among high-risk groups like people with diabetes, tobacco users, and in private healthcare settings have expanded
Real-Time Analytics with Apache Cassandra and Apache SparkGuido Schmutz
This document provides an overview of real-time analytics with Apache Cassandra and Apache Spark. It discusses how Spark can be used for stream processing over Cassandra for storage. Spark Streaming ingests real-time data from sources like Kafka and processes it using Spark transformations and actions. The processed data can be stored in Cassandra for querying. Cassandra is well suited for high write throughput and storing large amounts of data, while Spark enables fast in-memory processing and machine learning capabilities. Together, Spark and Cassandra provide a scalable solution for real-time analytics and querying of large datasets.
- The document discusses a study that assessed the attitudes and behaviors of pharmacy professionals towards patient counseling in Awi Zone, North West Ethiopia.
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- Lack of knowledge and confidence was the primary barrier preventing respondents from counseling patients more. Most respondents felt counseling promotes rational drug use.
Patient Safety in Indian Ambulatory Care settings By.Dr.Mahboob ali khan PhdHealthcare consultant
This document discusses patient safety in ambulatory care settings in India. It outlines three key factors that influence safety: patient and caregiver behaviors, provider-patient interactions, and the role of the community and health system. Common safety issues in ambulatory care include medication errors, diagnostic errors, poor care coordination and transitions. Improving safety will require reforms like using electronic health records more widely and engaging patients to take a more active role in managing their own care and acting as a check on the care they receive.
Factors associated to adherence to DR-TB treatment in Georgia, Policy Brief (...Ina Charkviani
Tuberculosis (TB) is a widely spread disease globally that causes millions of people’s death worldwide. Treatment for TB is complex and usually involves taking several antibiotics at once for a long time (sometimes up to two years). Considering the severity of the treatment regimen, it becomes hard for the patients to adhere and complete proposed treatment and particularly for those who are infected with drug-resistant strain of TB. Poor adherence to treatment remains significant problem that prevents countries from obtaining high treatment success rates that is essential for health systems to control the epidemic and decrease spread of the disease. A new study from Georgia looks at adherence to treatment factors among drug resistant TB (DR-TB) patients and provides evidence that may help policy-makers develop effective strategies for improving treatment outcomes among DR-TB patients. The study findings might be helpful for other countries in the region where TB burden is also high.
Medication adherence is essential for achieving positive therapeutic outcomes, especially in chronic diseases. Non-adherence has many causes like patients not believing treatment is necessary, complex regimens, or poor communication with providers. Pharmacists can play an important role in improving adherence through patient education, simplifying dosing, minimizing side effects, reminder calls/texts, and identifying individual barriers. Proper adherence monitoring is also important, as it allows interventions when non-adherence is detected. Both direct methods like biological fluid testing and indirect methods like pill counting can assess adherence, though indirect methods are less expensive.
NURS 438 Trends And Issues In Nursing And Health Systems.docxstirlingvwriters
This document discusses trends and issues related to medical errors in nursing and health systems. It outlines several common causes of medical errors, including communication problems, inadequate information flow, and technical errors. Communication issues between nurses and patients can lead to medication errors, while inadequate discharge instructions and a lack of information for patients post-hospitalization can also result in errors. Technical failures of medical equipment during procedures have caused patient injuries and deaths. Reducing these types of errors will help improve safety and outcomes in healthcare.
The document describes the process of medication reconciliation to ensure accurate medical information at care transitions. It involves obtaining a best possible medication history, comparing it to admission orders, and reconciling any discrepancies. Key steps include interviewing patients, comparing medication lists to orders, and resolving unintentional discrepancies. The goal is to mitigate errors from poor communication and improve safety during admissions, discharges, and transfers of care.
Clinical pharmacy is defined as the science and practice of optimizing medication therapy and promoting health. It encompasses patient care in healthcare settings and applies therapeutic guidelines, evidence-based practices, and relevant principles. The practice of clinical pharmacy began in the 1920s and has expanded globally. Barriers to its development include lack of management support, training opportunities, and incentives for pharmacists. Evidence-based medicine emphasizes using research evidence in healthcare decisions. Therapeutic guidelines aim to reduce medication errors and ensure proper medication use through complete, clear prescriptions and instructions.
This article reviews literature on primary non-adherence of prescribed pharmaceutical treatments. It identified 53 studies, including 16 on cost-related non-adherence. Commonly cited factors for non-adherence included age, gender, race, mental health, comorbidities, polypharmacy, medication beliefs, side effects, affordability, education, healthcare utilization, patient-physician relationship, prescriber traits, and forgetfulness. Issues related to affordability were the most frequently cited factor. The relevance of predictors and causes varied between studies. The review aims to inform future research by compiling known factors associated with primary non-adherence.
Introduction: Medication adherence is defined by the World Health Organisation as “The degree to which the person's behaviour corresponds with the agreed recommendations from a health care provider
Factor Affecting Non-Adherance:Poor adherence or non-adherence to medical treatment severely compromises patient outcomes and increases patient mortality.
Non-adherence is a very common phenomenon in all patients with drug-taking behaviour.
The complexity of adherence is the result of an interplay of a range of factors, including patient views and attributes, illness characteristics, social contexts, access, and service issues.
Non-adherence: Non-adherence is the failure or refusal to comply with advice and can imply disobedience on the part of patient
5 step Factors: Social/economic and Economic Factors
Provider-patient/health care system factors
Condition-related factors
Therapy-related factors
Patient-related factors
Behavioural Factors:
Life style (smoking, alcohol, coffee use) Psychological and personality factors: anxiety, depression, coping style
Biological factors:
Gender, age, and genetic predisposition
Social and cultural factors:
Educational level, living situation, price of medication, policies.
Information Factors:
Have you received enough information? Satisfaction with the last visit?
Awareness factors:
Severity of the complaints (Baseline) quality of life,
Locus of control about patient adherence:
internal and external, stability and control about the cause of the complaints: internal and external, stability and controllability.
Stages to Overcome This Barrier
Medical noncompliance, or a patient not following a doctor's prescribed treatment, is common. Half of newly diagnosed patients stop taking medication within 10 days, often because of costs, difficult regimens, or apathy. Doctors must provide detailed information on diagnoses, treatments, and costs to help patients make informed decisions. Both doctors and patients asking each other questions can help ensure patients understand how treatments may impact their lives. Strategies like pill boxes and phone reminders can help patients adhere to medication schedules. Open communication and trust between doctors and patients is key to preventing medical noncompliance.
This randomized clinical trial tested an intervention using interactive voice response (IVR) technology to provide tailored behavioral support to improve statin medication adherence. The trial involved 497 patients from a large health plan who were randomized to an experimental group receiving up to 3 tailored IVR calls and printed materials, or a control group receiving a single generic IVR call and generic printed materials. The primary outcome was 6-month statin adherence based on pharmacy claims. Patients in the experimental group had significantly higher adherence (70.4%) than controls (60.7%), suggesting tailored behavioral support using IVR can effectively improve statin medication adherence.
1) The document examines medical aliteracy among senior medical personnel in Akoko South West local government area of Ondo State, Nigeria. It finds that factors like ineffective supervision, low patient literacy, and lack of patient engagement can lead to medical aliteracy among senior personnel.
2) The study revealed an average level of aliteracy, with most personnel receiving medical journals annually and reading them often. The majority had reading rooms at home. Reading rates were average. Personnel preferred reading anytime and topics like surgery, physiology and pathology.
3) All personnel enjoyed reading about medical breakthroughs and other areas aside their specialty. Most interests were in public medicine and surgery. The study found no gender differences in
The document discusses health literacy as it relates to medication and the use and delivery of healthcare. It analyzes reports from the National Academies of Sciences on these topics. For medication, it describes progress made in standardizing drug labels but notes more is needed. It also discusses using technology like apps and electronic records to promote health literacy. For healthcare delivery, it highlights the importance of health literacy in reducing complexity and disparities. While policies have helped, stronger communication skills are still required. The document proposes a case study on screening for low health literacy using the Newest Vital Sign assessment tool to test hypotheses about time and cost constraints.
This document discusses guidelines for rational and appropriate pharmacotherapy in geriatric patients. It notes that older patients are more susceptible to adverse drug effects due to multiple illnesses, physiological changes, and reduced organ function. When prescribing for older adults, doctors should balance potential harms and benefits, regularly review prescriptions, use appropriate formulations, avoid symptomatic prescribing, consider non-prescribed medications, anticipate pharmacological differences in aging bodies, and be aware that adverse drug reactions may present atypically. The guidelines emphasize cautious, individualized prescribing tailored to each older patient's needs and risks.
Dr. Harold Freeman founded the first patient navigation program in 1990 to help reduce barriers to care for low-income cancer patients. A study he conducted between 1995-2000 found that the five-year cancer survival rate increased to 70% for low-income patients who received help from patient navigators, compared to only 39% in an earlier study without navigators. Research has shown that patient navigators increase patient compliance, decrease delays in care, and can increase patient satisfaction scores by explaining treatment plans and helping patients overcome barriers to care. While start-up costs may be high initially, patient navigators ultimately save health systems money by reducing unnecessary emergency room visits and improving health outcomes.
Medication Safety- Administration and monitoring.pptxLatha Venkatesan
The document discusses medication safety and reducing medication errors. It covers several key points:
1) Medication errors are common, especially during transitions of care between settings. The WHO aims to reduce medication-related harm by 50% through their "Medication Without Harm" challenge.
2) Medication errors can occur at various stages like prescribing, transcribing, dispensing, and administering. High-risk medications and situations like polypharmacy also increase error risk.
3) Strategies to improve safety include training, protocols, technology like CPOE, reconciliation, and empowering patients. A multidisciplinary team approach is important to strengthen systems and practices.
Evaluation of the Inpatient Hospital Experience while on PrecautionsKathryn Cannon
This study assessed patient satisfaction of those under contact/airborne isolation precautions versus those not under precautions at Yale-New Haven Hospital. 87 patients were interviewed using a survey measuring satisfaction with communication, treatment explanations, help from staff, pain control, and overall experience. Small variations were found between groups in nurse communication, timely help, pain control, and overall satisfaction. No significant difference was seen in doctor communication, but those under precautions expressed higher satisfaction with treatment explanations. The study aimed to understand differences to improve hospital processes and performance under new CMS reimbursement policies tied to patient satisfaction.
Similar to Impact of health education on tuberculosis drug adherence (20)
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
2. ABSTRACT Adherence is defined as the extent to which patients follow the instructions
they are given for prescribed treatments. Until recently, adherence expertise
was hard to find, assemble and empower. The study shall solely aim at
investigating the influence of patients’ health education on Tuberculosis drug
adherence. It will be guided by the following specific objectives; to identify the
level of adherence among TB patients at MTRH, to assess the level of patient’s
health education on TB drugs, to identify barriers of TB education, to
investigate the challenges facing TB patients on treatment and to determine
the level of training given to health workers on TB drug adherence. These
objectives will enable the researcher to elaborate more on the topic and
ensure that those who read through this research shall have a better
perspective on the effects of health education on tuberculosis drug adherence.
It will take place between the months of July and August. The study will target
17 doctors, 119 nurses and 143 patients of Tuberculosis. The study will employ a
case study research design. The case study will enable the researcher be able
to collected detailed information as to the influence of patients’ health
education on TB drug adherence. The study will employ purposive sampling
to sample the doctors and simple random sampling to select both the nurses
and the patients who will participate in the study. The researcher will use one
research instrument to collect data from the respondents selected to
participate in the study which is a questionnaire that will be issued to the
3. CHAPTER ONE
INTRODUCTION
This chapter introduces the study and it will consist of the
background of the study, statement of the problem, the objectives of
the study, research questions, scope and significance of the study as
well as the limitations of the study.
Background of the study
Adherence is defined as the extent to which patients follow the
instructions they are given for prescribed treatments. Until recently,
adherence expertise was hard to find, assemble and empower. Pleio
Health Support Systems began bringing people together to create an
adherence solution in 2006. They have worked closely with innovative
pharmacy chains, pharmaceutical manufacturers and more than a
dozen technology and database providers, to build a platform that
provides patients a variety of medication adherence support services
when they need them, how they want them and where they want
them. Pleio Good Start offers a variety of resources to help people get
off to a good start on new prescriptions, so that they can get the most
of their medication (Garner, 2000).
4. Around the world, for most patients, getting a good start with a new
medication is easier said than done: accepting their disease,
understanding dosing instructions and creating a new habit are just a
few of the barriers that await them after they have left the pharmacy,
prescription in hand. Inhaled and injected medications can be
challenging to administer properly, but even blood pressure pills can
become a low priority when people do not understand how they work
or what they do. For most people, there is no silver bullet that will
suddenly cause them to become completely compliant, as adherence
is a complex process (Melbourne, 2000).
Prescription refill records prove that the first few months on a new
medication are the most challenging. In fact, Pleio Health Support
Systems has observed that, for many drugs, most patients become
non-compliant with dosing instructions within just 5 days of picking
up their prescription. So connecting with patients as soon as they fill
their first prescription and staying with them during the adoption
phase is a good fit for pharmacists, who normally see patients more
than any other healthcare provider during this critical adoption phase
(San Francisco Health Department, 2004).
5. In Africa, although the challenge of poor medication adherence has been
discussed and debated for at least three decades, these problems have
generally been overlooked as a serious public health issue and, as a result,
have received little direct, systematic, or sustained intervention. As a
consequence, Africans have inadequate knowledge about the significance of
medication adherence as a critical element of their improved health. Further,
adherence rates suffer from the fragmented approach by which hospitals,
health care providers, and other parts of the health delivery system intervene
with patients and caregivers to encourage adherence. Consequently, many
leading medical societies are now advocating a multidisciplinary approach
through coordinated action by health professionals, researchers, health
planners and policymakers (McKinley, 1997).
Unfortunately, however, these calls for action have yet to be heeded and rates
of medicine adherence have not improved. Thus, action is needed now to
reduce the adverse health and economic consequences associated with this
pervasive problem. While no single strategy will guarantee that patients will
fill their prescriptions and take their medicines as prescribed, elevating
adherence as a priority issue and promoting best practices, behaviours, and
technologies may significantly improve medication adherence in the African
medicines. For example, a common reason why patients don’t take their
medicines is simply forgetfulness (Salomon, 1997).
6. Another significant barrier is the inability to understand and act on
instructions for taking the medication. In fact, a study found that 0
percent or more of patients being followed could not correctly report
what their physicians told them about medication use 0 to 80 minutes
after receiving the information. While problems such as these are
significant, public health officials are increasingly concerned about
patients and especially those with chronic conditions requiring long-
term therapy, such as asthma, diabetes, and hypertension, which
make a conscious choice not to fill the prescription, not to take their
medicine as prescribed, or to discontinue therapy. Influencing these
decisions is a number of factors related to the patient’s experiences,
perceptions, and understanding about his or her disease in this case,
tuberculosis (Salihu, 2001).
7. Statement of the problem
Although the challenge of poor medication adherence has been discussed and debated
for at least three decades, these problems have generally been overlooked as a serious
public health issue and, as a result, have received little direct, systematic, or sustained
intervention. However, these calls for action have yet to be heeded and rates of
medicine adherence have not improved. Thus, action is needed now to reduce the
adverse health and economic consequences associated with this pervasive problem.
It is against this background that the researcher found it necessary to investigate the
impact of health education on TB drug adherence among TB patients at the Moi
Teaching and Referral Hospital, Eldoret.
1.3 Objectives of the study
Main objective
To determine the impact of health education on TB drug adherence at Moi teaching and
referral hospital.
Specific objective
The study will be guided by the following specific objectives;
To identify the level of adherence among TB patients at Moi teaching and referral
hospital.
To assess the level of patient’s health education on TB drugs.
To identify barriers of TB education.
To investigate the challenges facing TB patients on treatment.
To determine the level of training given to health workers on TB drug adherence.
8. Research questions
The study will aim at answering the following research questions;
What is the level of adherence among TB patients’ at MTRH?
What is the level of patents’ health education on TB drugs?
What are the barriers of TB Education?
What are some of the challenges facing TB patients on treatment?
What is the level of training given to health workers on TB drug adherence?
Significance of the study
The study will be of great importance to the Moi Teaching and Referral
Hospital due to the fact that the doctors and nurses there will come up with
efficient ways of offering their patients’ health education on the need to
adhere to their drug prescriptions for the sake of their health.
The study shall also be of great importance to the society as it will enlighten
the people on the effects of TB and the importance of adhering to the drugs
issued to them and the treatment so as to avoid a recap of the same.
The study will also indirectly benefit the country economically as it through
health education to all citizens; the government shall save on costs that are
incurred as a result of lack of adherence to treatment of TB.
9. Scope of the study
The study will aim at investigating the impact of health education on
Tuberculosis drug adherence. It will take place between the months of July
and August. The study will target 17 doctors, 119 nurses and 143 patients of
Tuberculosis of MTRH.
Limitations of the study
The study will be limited by a number of factors; firstly, consolidating the
respondents shall be a difficult task because the hospital is a busy hospital and
it might be quite difficult to gather the respondents who will participate in the
study.
Secondly, the respondents especially the patients might refrain from giving
full and truthful responses to the researcher for fear of being victimized.
However, the researcher assured them that their responses shall be treated
with utmost confidentiality.
10. CHAPTER TWO
LITERATURE REVIEW
This chapter will focus on the literature review of the study and it will also
discuss the specific objectives laid out in this study.
2.1 Concept of TB patient adherence
Patient adherence to prescribed medicine has long been identified as a
problem by clinical, behavioural and social science researchers (Carder et al
2003). Non- adherence to treatment is considered one of the most serious
problems in the control of tuberculosis since it may contribute to the spread
of tuberculosis and the emergence of drug resistant strains of TB.
11. Failure to take tuberculosis medication as prescribed can easily result in ongoing
or recurrent disease. Having a health care worker present to directly observe
patients taking each dose of anti-TB medicine has been touted as the best way to
ensure adherence to treatment, thereby diminishing the risk of trans mission,
relapse/reactivation and drug resistance. However, even with this approach
patient non-adherence to DOT still occurs. One problem cited is, that it is difficult
to anticipate who will comply with treatment. It has been shown that
demographic factors such as age, sex, ethnicity, education and socio- economic
status are not accurate predictors of adherence (Weis et al 1994; Chaulk et al
1998).
On the other hand, psychiatric illness, substance abuse (alcohol and drug) and
homelessness do typically predict non-adherence (Weis et al 1994; Davidson et al
2000). In general, however, the best predictor of non-adherence is a previous
history of non-adherence (Pablos-Mendez et al 1997). Patients’ own belief systems
and the constraints of their everyday life can also act as barriers to effective
treatment. For example, in a Canadian study of socio-cultural factors influencing
prevention and treatment of tuberculosis in immigrant and Aboriginal
communities conducted by Gibson et al (2005), some participants thought that TB
was caused by an irresponsible lifestyle, while others felt that they contracted TB
because they had not taken proper care of themselves. Moreover, a number of
participants in this study (primarily Aboriginal) believed that there was a stigma
associated with having TB that influenced their attitude toward prevention and
treatment (Gibson et al 2005).
12. CHAPTER THREE
METHODOLOGY
This section presents the research design, location of the study, target
population, sample and sampling techniques, sample size, instrument of the
study, piloting of study, data collection procedure, data analysis procedures
and legal and ethical considerations.
Research design
The study will employ a case study research design. The case study was
chosen since it allows for an investigation within a real life context. The case
study will be carried out at the Moi Teaching and Referral Hospital.
Study Area
The study area shall be the Moi Teaching and Referral Hospital which is
situated in Eldoret town, Uasin Gishu County. The researcher chose this study
area as the hospital is the second largest hospital in the country and it has
quite a number of patients suffering from tuberculosis.
13. Target Population
The target population will comprise of 17 doctors, 119 nurses and 320 patients
suffering from tuberculosis.6
Target population Frequency
Doctors 17
Nurses 119
Patients 320
TOTAL 456
14. Sample and sampling techniques
The study will employ simple random sampling to select the respondents who
will participate in the study. Simple random sampling was chosen since it is
not biased.
Target population Frequency procedure Sample size
Doctors 17 100% * 17 17
Nurses 119 30% * 119 36
Patients 320 30% * 320 96
TOTAL 456 149
15. Research instruments
The researcher will employ the use of both primary and secondary sources of data.
Questionnaires and interview schedule will be used to collect the primary data while
documented data (TB facility registers) will be sources of secondary data.
Inclusion Criteria
All patients who have finished intensive phase of TB treatment
All patients who have completed continuation phase.
Exclusion criteria
All patients not on TB treatment
Newly diagnosed patients
Questionnaires
The researcher will prepare and administer questionnaires to the TB patients, nurses
and doctors.
Questionnaires offers considerable advantages as it presents an even stimulus to a large
number of people simultaneously and provide investigator with a relatively easy
accumulation of data, further the use of questionnaires allows the respondents time on
questions that would require reflections on to avoid nasty responses, however they
require a lot of time in traveling hence a lot of expenses that inflate research cost, and
some respondents do not answer all the questions.
16. Data analysis procedures
The data from the questionnaire will be coded as the first step of data
analysis. The information obtained will summarized and presented
using frequency tables, pie charts and histograms.
Editing will be done to detect errors and omissions thus ensuring that
the data are accurate, consistent with other facts gathered, uniformly
entered, as complete as possible and arranged to facilitate and
improve the quality of the data for coding and tabulation by reading
through and correcting any topographical errors resulting from
respondents not having been too careful when responding.
The study will adopt both the qualitative and quantitative analysis in
order to achieve the objective of the study.
17. Ethical considerations
The researcher shall seek permission from the director and head of
departments of the hospital so as to ensure that she follows the right
procedure while collecting data from the respondents who will
participate in the study.
To ensure informed consent, the researcher will explain the purpose
of the evaluation prior to beginning the answering of questions. In all
cases, interviewees will be assured that the responses are confidential
and that no personal information about the respondents will be
conveyed in the report.
18. WORK PLAN
ACTIVITY March2013 April 2013 May 2013 June 2013 July 2013 August 2013
Proposal
development
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Proposal
Defense
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Data collection xxxxxx
Data Analysis xxxxxx
Report Writing xxxxxx
Final Defense xxxxxx
Correction and
Handing over
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