Sills MR. Medication Adherence PROM Measures Updates and Pilot Results. Slides for teleconference to facilitate discussion of Cardiovascular PRO Measure Selection and Refinement by SAFTINet Stakeholders. 2 July 2012.
The development of a Patient Safety Programme for Primary Care is being informed by the learning from two ongoing primary care safety projects. This session highlights the approaches used, the early findings and describes how to sustain and spread the success of this work.
The document discusses tips for preparing for an annual check-up. It provides vocabulary related to check-ups and outlines the typical process, including discussing health history, tests that may be administered based on age and gender, and important questions to ask the doctor. The document emphasizes that annual check-ups are important to catch any health issues early and to discuss prevention with your doctor.
Other mother way of dealing with j & k disasterOther Mother
This document provides information from a presentation on safe medication use for older adults. It discusses the benefits and risks of prescription and over-the-counter medications. It emphasizes the importance of communicating with healthcare providers, maintaining an updated medication list, and reading labels carefully to understand dosages and potential side effects. It also highlights strategies for avoiding common medication problems like drug interactions and non-adherence to dosage instructions.
This document provides an overview of medication use for older adults and their caregivers. It discusses the risks and benefits of both prescription and over-the-counter medications. It emphasizes the importance of communicating with healthcare providers, keeping an updated medication list, and reading labels carefully to improve medication safety and avoid problems like interactions, overuse, or not following instructions properly. The document is intended to help older adults and caregivers have informed discussions about medication use.
Pharmacists perform a variety of roles in different settings such as dispensing medications, checking for drug interactions, educating patients, and determining treatment plans. They work in places like drug stores, hospitals, nursing homes, and insurance companies. Pharmacists require seven years of schooling including courses in chemistry, biology, and math to obtain their degree and must complete ongoing continuing education. Being a pharmacist provides advantages such as a trusted profession, flexible hours, competitive pay, and the ability to help many people on a daily basis.
The document discusses quality healthcare for Medicare beneficiaries. It notes that 90% of Medicare beneficiaries are not receiving recommended preventative services like annual physicals and screenings. These services help uncover chronic conditions and manage patient health. The document outlines various quality measures used by CMS like HEDIS, HOS, CAHPS, and Star Ratings which evaluate preventative services, medication adherence, patient experience, and health outcomes. Maintaining high quality is important for increasing business, ensuring future benefits, and managing patient populations. Local quality teams provide practices with reporting, support, and resources to improve care quality.
The document discusses how pharmaceutical companies can enhance brand recall among doctors through a diabetes management software called DiaSof. DiaSof allows patients to better manage their condition by sending reminders for tests and storing medical records. It provides graphs and reports to doctors that save time and improve treatment. Pharmaceutical companies can promote brand recall by giving doctors co-branded DiaSof subscription cards to distribute to patients, demonstrating their support for better diabetes management. Both doctors and patients benefit from DiaSof, increasing visits and prescriptions of the sponsoring brands.
The development of a Patient Safety Programme for Primary Care is being informed by the learning from two ongoing primary care safety projects. This session highlights the approaches used, the early findings and describes how to sustain and spread the success of this work.
The document discusses tips for preparing for an annual check-up. It provides vocabulary related to check-ups and outlines the typical process, including discussing health history, tests that may be administered based on age and gender, and important questions to ask the doctor. The document emphasizes that annual check-ups are important to catch any health issues early and to discuss prevention with your doctor.
Other mother way of dealing with j & k disasterOther Mother
This document provides information from a presentation on safe medication use for older adults. It discusses the benefits and risks of prescription and over-the-counter medications. It emphasizes the importance of communicating with healthcare providers, maintaining an updated medication list, and reading labels carefully to understand dosages and potential side effects. It also highlights strategies for avoiding common medication problems like drug interactions and non-adherence to dosage instructions.
This document provides an overview of medication use for older adults and their caregivers. It discusses the risks and benefits of both prescription and over-the-counter medications. It emphasizes the importance of communicating with healthcare providers, keeping an updated medication list, and reading labels carefully to improve medication safety and avoid problems like interactions, overuse, or not following instructions properly. The document is intended to help older adults and caregivers have informed discussions about medication use.
Pharmacists perform a variety of roles in different settings such as dispensing medications, checking for drug interactions, educating patients, and determining treatment plans. They work in places like drug stores, hospitals, nursing homes, and insurance companies. Pharmacists require seven years of schooling including courses in chemistry, biology, and math to obtain their degree and must complete ongoing continuing education. Being a pharmacist provides advantages such as a trusted profession, flexible hours, competitive pay, and the ability to help many people on a daily basis.
The document discusses quality healthcare for Medicare beneficiaries. It notes that 90% of Medicare beneficiaries are not receiving recommended preventative services like annual physicals and screenings. These services help uncover chronic conditions and manage patient health. The document outlines various quality measures used by CMS like HEDIS, HOS, CAHPS, and Star Ratings which evaluate preventative services, medication adherence, patient experience, and health outcomes. Maintaining high quality is important for increasing business, ensuring future benefits, and managing patient populations. Local quality teams provide practices with reporting, support, and resources to improve care quality.
The document discusses how pharmaceutical companies can enhance brand recall among doctors through a diabetes management software called DiaSof. DiaSof allows patients to better manage their condition by sending reminders for tests and storing medical records. It provides graphs and reports to doctors that save time and improve treatment. Pharmaceutical companies can promote brand recall by giving doctors co-branded DiaSof subscription cards to distribute to patients, demonstrating their support for better diabetes management. Both doctors and patients benefit from DiaSof, increasing visits and prescriptions of the sponsoring brands.
The challenge for pharmacists is how to protect themselves from dispensing illegitimate prescriptions without interfering in the patient-doctor treatment plan.
This is a draft e-learning module for the Prescribe Project (http://ow.ly/uO53A). It is about how to improve communication with patients and colleagues around prescribing decisions.
1. If a person's viral load starts to rise after being undetectable, they should repeat the viral load test on the same day to confirm the results and ensure it is not just a lab error or random blip.
2. If the viral load continues to rise in the second test, it is recommended to change treatment early before drug resistance develops further. The earlier treatment is changed, the less resistance will develop and the easier it will be to reduce the viral load again.
3. It is important to understand why the current treatment combination failed, whether it was due to drug resistance, problems with adherence, or other factors. This will help determine the best new treatment combination and ensure adherence issues don't
Medication reconciliation is the process of comparing a patient's medication list to a physician's orders to minimize errors. It occurs at admission, transfer, discharge, and after surgery. Nurses document the patient's home medications and ED medications. Physicians then reconcile all current and home medications within 24 hours, noting any changes. Discharge reconciliation reviews chronic, new, and active medications to prevent duplication or interactions and provide a complete list for continued care.
Learn best practices based on literature and how to perform a complex and accurate medication history. Recognize gaps/inconsistencies in systems that impede medication reconciliation and identify next steps in improving current medication reconciliation within your own practice.
Speaker:
Mary Pat Friedlander, MD
Lawrenceville Family Health Center
Pittsburgh, PA
This document summarizes a presentation about pharmaceutical manufacturing and expectations. It discusses challenges in data and the need for critical thinking to move forward. The presentation explores differences between treating infections versus managing diseases long-term. It also examines regulatory standards for generic drugs and reviews data showing higher hospitalization rates after generics entered the market for certain drugs compared to the innovator drugs. The presentation emphasizes understanding drug concentrations in blood and how generics may have levels outside the qualifying zone compared to innovators.
This document summarizes key topics related to epilepsy treatment and healthcare management. It discusses various treatment options like medication, diet, and surgery. It provides guidance on communicating with healthcare providers, including preparing for appointments, discussing medication changes or concerns, understanding insurance coverage, and transitioning from pediatric to adult care. The document also introduces some digital tools to help manage epilepsy like Texting4Control and WebEase. The next meeting will cover lifelong health topics.
It is a very important topic in healthcare. Pharmacists must be aware of few important counselling points for every medicine. Community Pharmacist must be aware of counselling.
This session will introduce delegates to medicines reconciliation and its role in reducing the opportunity for error and harm to patients by making sure they are given the right medicines at every stage of their care.
This study investigated the influence of hospital safety climate on patient satisfaction and nursing care quality. Data was collected from nurses and patients at an Egyptian emergency hospital using questionnaires on safety climate, patient satisfaction, and quality of nursing care. The results found that 50% of respondents reported a low safety climate score and only 29.5% of patients were highly satisfied. Nurses reported that the quality of care was low for 69% of patients. A significant relationship was found between safety climate and both patient satisfaction and nursing care quality. The study concluded that improving the hospital safety climate can positively influence patient outcomes like satisfaction and quality of care.
The document summarizes recommendations from an FTC workshop on Internet of Things (IoT) security and privacy. The FTC decided that IoT-specific legislation was unnecessary, but Congress should enact general data security laws. Workshop recommendations included companies implementing security before design, using multiple layers of security, strong authentication, monitoring products and issuing patches. It also recommends training employees on security practices and data minimization. Major tech companies like Google, Amazon, and Samsung were highlighted for their IoT security approaches like encryption, access controls, and anomaly detection.
This PowerPoint presentation summarizes the poem "From a Railway Carriage" by Robert Louis Stevenson. It discusses how the poem describes the speed of a passing train as faster than fairies and witches, charging through the countryside like troops in battle. Key images are analyzed, such as the train rushing past bridges, houses, hedges and ditches with horses and cattle in the meadows. The presentation was submitted by a student as part of their English coursework.
Our group plans to conduct an isolation experiment with at least 2 participants confined to a room for a period of time. We will interview the participants periodically to understand how the confinement is affecting their mood and psychological state. The goal is to observe the effects of isolation on the individuals.
This document describes a study that generated and verified VHDL code for a modified repetitive controller to control a dynamic voltage restorer (DVR) power quality conditioner. The controller is designed to limit fault current during downstream faults and compensate for voltage sags, harmonics, and imbalances. The MATLAB HDL Coder was used to generate VHDL code from a MATLAB model of the repetitive controller. The generated code was then verified in the Modelsim simulator, demonstrating the controller design's hardware compatibility for implementation in an FPGA. The repetitive controller incorporates a feedforward term for fast response and feedback term to ensure zero steady-state error. A logic circuit detects downstream faults by monitoring load current.
Este documento presenta información sobre la intuición. Define la intuición como la habilidad para comprender las cosas de manera inmediata y clara sin necesidad de razonamiento complejo. Explica que la intuición se refiere tanto a la habilidad para intuir como al resultado de intuir. Además, ofrece dos definiciones de intuición, la primera como la habilidad para conocer o percibir algo de forma clara e inmediata sin intervención de la razón, y la segunda como el conocimiento o percepción inmediata de algo sin intervención de la razón.
This document provides a list of resources for supporting parenting including: websites that offer parenting advice and videos; information on parental rights regarding children's education records; academic articles on family diversity and the rights of parents in Europe. It also includes policy documents from the European Parents Association on issues such as cyberbullying, balancing work and family life, legal representation of parents, and reforming secondary education examinations.
This document welcomes the reader and provides the Latin and English names for several common elements and their chemical symbols. It asks review questions about which system elements are named after and asks to provide symbols for some elements. It concludes with a follow up activity asking which system elements are named according to.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness, happiness and focus.
The challenge for pharmacists is how to protect themselves from dispensing illegitimate prescriptions without interfering in the patient-doctor treatment plan.
This is a draft e-learning module for the Prescribe Project (http://ow.ly/uO53A). It is about how to improve communication with patients and colleagues around prescribing decisions.
1. If a person's viral load starts to rise after being undetectable, they should repeat the viral load test on the same day to confirm the results and ensure it is not just a lab error or random blip.
2. If the viral load continues to rise in the second test, it is recommended to change treatment early before drug resistance develops further. The earlier treatment is changed, the less resistance will develop and the easier it will be to reduce the viral load again.
3. It is important to understand why the current treatment combination failed, whether it was due to drug resistance, problems with adherence, or other factors. This will help determine the best new treatment combination and ensure adherence issues don't
Medication reconciliation is the process of comparing a patient's medication list to a physician's orders to minimize errors. It occurs at admission, transfer, discharge, and after surgery. Nurses document the patient's home medications and ED medications. Physicians then reconcile all current and home medications within 24 hours, noting any changes. Discharge reconciliation reviews chronic, new, and active medications to prevent duplication or interactions and provide a complete list for continued care.
Learn best practices based on literature and how to perform a complex and accurate medication history. Recognize gaps/inconsistencies in systems that impede medication reconciliation and identify next steps in improving current medication reconciliation within your own practice.
Speaker:
Mary Pat Friedlander, MD
Lawrenceville Family Health Center
Pittsburgh, PA
This document summarizes a presentation about pharmaceutical manufacturing and expectations. It discusses challenges in data and the need for critical thinking to move forward. The presentation explores differences between treating infections versus managing diseases long-term. It also examines regulatory standards for generic drugs and reviews data showing higher hospitalization rates after generics entered the market for certain drugs compared to the innovator drugs. The presentation emphasizes understanding drug concentrations in blood and how generics may have levels outside the qualifying zone compared to innovators.
This document summarizes key topics related to epilepsy treatment and healthcare management. It discusses various treatment options like medication, diet, and surgery. It provides guidance on communicating with healthcare providers, including preparing for appointments, discussing medication changes or concerns, understanding insurance coverage, and transitioning from pediatric to adult care. The document also introduces some digital tools to help manage epilepsy like Texting4Control and WebEase. The next meeting will cover lifelong health topics.
It is a very important topic in healthcare. Pharmacists must be aware of few important counselling points for every medicine. Community Pharmacist must be aware of counselling.
This session will introduce delegates to medicines reconciliation and its role in reducing the opportunity for error and harm to patients by making sure they are given the right medicines at every stage of their care.
This study investigated the influence of hospital safety climate on patient satisfaction and nursing care quality. Data was collected from nurses and patients at an Egyptian emergency hospital using questionnaires on safety climate, patient satisfaction, and quality of nursing care. The results found that 50% of respondents reported a low safety climate score and only 29.5% of patients were highly satisfied. Nurses reported that the quality of care was low for 69% of patients. A significant relationship was found between safety climate and both patient satisfaction and nursing care quality. The study concluded that improving the hospital safety climate can positively influence patient outcomes like satisfaction and quality of care.
The document summarizes recommendations from an FTC workshop on Internet of Things (IoT) security and privacy. The FTC decided that IoT-specific legislation was unnecessary, but Congress should enact general data security laws. Workshop recommendations included companies implementing security before design, using multiple layers of security, strong authentication, monitoring products and issuing patches. It also recommends training employees on security practices and data minimization. Major tech companies like Google, Amazon, and Samsung were highlighted for their IoT security approaches like encryption, access controls, and anomaly detection.
This PowerPoint presentation summarizes the poem "From a Railway Carriage" by Robert Louis Stevenson. It discusses how the poem describes the speed of a passing train as faster than fairies and witches, charging through the countryside like troops in battle. Key images are analyzed, such as the train rushing past bridges, houses, hedges and ditches with horses and cattle in the meadows. The presentation was submitted by a student as part of their English coursework.
Our group plans to conduct an isolation experiment with at least 2 participants confined to a room for a period of time. We will interview the participants periodically to understand how the confinement is affecting their mood and psychological state. The goal is to observe the effects of isolation on the individuals.
This document describes a study that generated and verified VHDL code for a modified repetitive controller to control a dynamic voltage restorer (DVR) power quality conditioner. The controller is designed to limit fault current during downstream faults and compensate for voltage sags, harmonics, and imbalances. The MATLAB HDL Coder was used to generate VHDL code from a MATLAB model of the repetitive controller. The generated code was then verified in the Modelsim simulator, demonstrating the controller design's hardware compatibility for implementation in an FPGA. The repetitive controller incorporates a feedforward term for fast response and feedback term to ensure zero steady-state error. A logic circuit detects downstream faults by monitoring load current.
Este documento presenta información sobre la intuición. Define la intuición como la habilidad para comprender las cosas de manera inmediata y clara sin necesidad de razonamiento complejo. Explica que la intuición se refiere tanto a la habilidad para intuir como al resultado de intuir. Además, ofrece dos definiciones de intuición, la primera como la habilidad para conocer o percibir algo de forma clara e inmediata sin intervención de la razón, y la segunda como el conocimiento o percepción inmediata de algo sin intervención de la razón.
This document provides a list of resources for supporting parenting including: websites that offer parenting advice and videos; information on parental rights regarding children's education records; academic articles on family diversity and the rights of parents in Europe. It also includes policy documents from the European Parents Association on issues such as cyberbullying, balancing work and family life, legal representation of parents, and reforming secondary education examinations.
This document welcomes the reader and provides the Latin and English names for several common elements and their chemical symbols. It asks review questions about which system elements are named after and asks to provide symbols for some elements. It concludes with a follow up activity asking which system elements are named according to.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness, happiness and focus.
This document defines cult films and explores some of their key characteristics and genres. It states that cult films are often strange, quirky films that break conventions and cultural taboos. They frequently feature violence, gore and controversial topics. The document examines some notable cult directors like David Lynch and genres like musicals and westerns. It provides timelines of early and modern cult classics and discusses how cult followings have developed with social media. Three films - Reefer Madness, A Clockwork Orange, and Fight Club - are highlighted as examples of "social issues" cult films that explore influential realities in society.
Trishna Misra is the chief financial officer of Southern African Shipyards, a leading shipbuilding company in Durban. As a woman in a male-dominated industry, she has empowered other women to rise to leadership roles traditionally held by men. Under her leadership, the number of women employed at SAS has grown from 18 to over 100. SAS was recently awarded a R1.4 billion contract from Transnet, the largest in the company's history. Misra oversees the finances and day-to-day operations to ensure the successful completion of this contract. Though the work is challenging, Misra enjoys getting involved in all aspects of the business and believes South Africa's maritime industry has a bright future.
This document discusses an experimental investigation into the emission characteristics of a marine diesel engine equipped with a catalytic converter. The study aimed to minimize sulfur oxides, nitrogen oxides, and particulate matter from the engine emissions using the catalytic converter. Tests were conducted both before and after diluting the emissions to validate that the catalytic converter brings the engine into compliance with MARPOL regulations on air pollutants. The MARPOL regulations establish standards to reduce pollution from ships, including several annexes that set limits on sulfur oxides, nitrogen oxides, garbage, and other emissions.
This document summarizes a study that analyzed the transient elasto-plastic response of bridge piers subjected to vehicle collision through finite element analysis. Six bridge pier designs with varying geometry and three different concrete grades were simulated when impacted by two types of vehicles. The results revealed how the pier's response depends on its geometry, concrete grade, vehicle speed and mass. The study aimed to investigate the effects of these parameters on the pier considering the material nonlinearity of concrete.
This document summarizes a research paper on data security in distributed systems. It begins by defining distributed systems and client/server systems. It then discusses some of the general problems with data security management in these systems, such as unsecure login processes and users not changing passwords regularly. Finally, it proposes a model for an access security system for distributed systems that includes an access security server with communication, session, and application layers to manage authentication, authorization, and access controls for users and systems.
This document introduces partial derivatives and differentiable functions of several variables. It defines partial derivatives as the rates of change of a function with respect to one variable, while holding the other variables constant. The differential of a function is defined as its best linear approximation near a point, and is expressed in terms of partial derivatives. Examples are provided to illustrate calculating partial derivatives, differentials, and tangent planes to surfaces.
Sills MR. Medication Adherence PROM Measures and Self Efficacy. Slides for teleconference to facilitate discussion of Cardiovascular PRO Measure Selection by SAFTINet Stakeholders. 21 May 2012.
This webinar slide-set illustrates the stepwise process of engaging Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) practice stakeholders in
selecting and adapting a measure of patient-reported medication adherence.
For more information on SAFTINet, please see http://www.ucdenver.edu/academics/colleges/medicalschool/programs/outcomes/COHO/saftinet/Pages/default.aspx
This document provides an overview of medication adherence and strategies to improve it. It begins with an example patient case of Mr. Avery, a man with poorly controlled diabetes. It then discusses defining adherence, common reasons for non-adherence, assessment strategies, and evidence-based approaches to address non-adherence, including education, motivational interviewing, addressing barriers, self-management training, and making medication-taking a habit. Templates for the EHR and after-visit summaries are also presented.
Mr. Avery, a 62-year-old man with diabetes, has poor medication adherence as evidenced by his hemoglobin A1c of 9.0. The provider hopes to address modifiable factors impacting his behavior and establish strategies to improve his medication adherence. Effective approaches include education, motivational interviewing to explore importance and build confidence, addressing specific barriers, training in self-management, and establishing medication-taking as a daily habit. Documentation templates and other resources can help providers structure discussions and monitor adherence over time.
This document provides an overview of pharmacotherapy and the patient care process. It defines pharmacotherapy as the treatment of disease with medication. The key aspects covered include:
1) Identifying drug therapy problems through assessment of indication, effectiveness, safety, and compliance.
2) Developing a care plan to address problems or ensure goals are met, including establishing goals of therapy and selecting interventions.
3) Providing follow-up and evaluation to determine if the care plan is working or needs adjustment.
The overall focus is optimizing individual patient outcomes through appropriate medication selection and management.
The document discusses medication history interviews, which are used to obtain a complete record of all medications a patient is currently taking or has taken recently. A medication history interview provides valuable insights into a patient's allergies, adherence to treatments, and use of alternative medicines. The goal is to collect information that can be used to prevent prescription errors, detect drug-related issues, and inform an overall care plan for the patient. Common questions asked during an interview include what medications the patient is currently taking, any allergies or side effects, adherence to past treatments, and use of over-the-counter or herbal remedies.
This document discusses the role of pharmacists in promoting self-care. It notes that over 80% of medical visits are for minor health problems that could be addressed through self-care. The pharmacist's role is to ensure safe and effective use of nonprescription drugs by providing patients with information and advice. The pharmacist follows the pharmaceutical care process of assessment, care planning, and evaluation to identify any drug-related problems and design treatment plans. Key aspects of the pharmacist's role include conducting therapeutic interviews, identifying issues, suggesting self-care strategies, and making appropriate treatment recommendations or referrals.
This document outlines plans for a workshop on safer medicine management among older people living at home. The workshop aims to develop a whole system understanding of issues and identify top priorities to address. The agenda includes introductions, discussions of systems thinking, risk thinking, and issue prioritization. The project team is introduced, and baseline challenges are described, such as older adults taking multiple medications and high rates of medication-related hospital admissions. Target users like "Jeff" will be examined to understand medication issues. Systems mapping and design thinking methods will be used to engage stakeholders and identify problems and solutions. The workshop seeks to apply lean, design and risk thinking approaches to develop ideas for short and long-term improvements.
A medication history interview involves collecting detailed information about all medications a patient is currently taking or has taken in the past. This includes prescription drugs, over-the-counter medications, herbal remedies, vitamins and supplements. The interview provides insights into a patient's allergies, adherence to treatment, and use of alternative medicines to create an accurate medical record and care plan. Information is gathered from the patient, family, medication bottles and pharmacy to prevent errors and detect potential issues from drug therapy.
Team based opioid management - talking pointsPaul Coelho, MD
The document provides guidance for healthcare providers on discussing opioid risks, safety monitoring, and treatment changes with patients. It emphasizes focusing on patient well-being and quality of life rather than just pain elimination. It suggests discussing risks of opioids while treating all patients the same to reduce stigma. It also provides sample language for introducing monitoring, unexpected findings, and treatment changes while maintaining an empathetic and supportive approach.
This document provides information and guidance about properly taking medications. It emphasizes the importance of taking medications correctly as prescribed by a doctor and outlines several key points: taking medications as directed so they are effective; not skipping doses which can cause harm; and asking medical providers questions about medications. It also discusses forming a medication management team and offers tips to remember taking medications and overcome barriers like cost or side effects.
This document summarizes research on improving adherence to oral chemotherapy through nursing interventions. It describes barriers to adherence such as side effects and costs. It then outlines several studies that tested nursing interventions like education using tools like MOATT, follow-up calls, and oral chemotherapy clinics. These interventions showed improvements in medication knowledge and adherence and reduced side effects and health care costs. The document advocates for standardizing oral chemotherapy education and monitoring to help patients better manage treatment at home.
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
The document summarizes three medication management programs:
1. The London Older Peoples Service Development Programme uses a specialist pharmacist assessment and care plan coordinated by a case manager to address older patients' medication access, compliance, and clinical issues.
2. Imperial College's My Medication Passport provides patients a consolidated list of their medications, allergies, and contacts to improve information sharing between care settings.
3. Optimize Adherence Service uses accredited community pharmacists to conduct adherence assessments, develop support plans, and provide ongoing reviews to both address unintentional non-compliance barriers and provide cognitive support to improve intentional medication taking.
Clinical Research in CAM: Requirements, Complexities and PossibilitiesAyurveda Network, BHU
1) Medical pluralism, using multiple medical systems, is a global trend recognized in many countries.
2) Clinical research in alternative medicine like Ayurveda faces many complexities due to issues with blinding treatments, placebos, and ethical concerns.
3) Suggested study designs for Ayurvedic research include observational studies, elimination and re-challenge studies, and whole system research comparing full Ayurvedic management to address current gaps in evidence.
Empowered Use, Health Consciousness and Prescription Drugs with Special Focus On Parents And The WorkplaceNational data show prescription drug abuse is growing at rates that wellness/lifestyle practitioners can no longer ignore. Coaches and wellness coordinators can benefit from knowledge about prescription misuse in topical areas the presenter will discuss: neuroscience, motivators (pain, mood energy), at-risk populations, and policy as well as mind-body practices as antidotes to the growing epidemic. The presenter will share a presentation developed for Substance Abuse & Mental Health Services Administration (SAMHSA) and that participants can use in their own setting. This presentation has a focus on the workplace and working parents. As this is a relatively new topic not often discussed in wellness practice, participants will be asked to complete a brief follow-up survey asking about the relevance and utility of this topic to their work in the wellness profession.
Strategies to improve adherence to antihypertensive medicationmagdy elmasry
Challenges in hypertension treatment.What is the definition of medication non-adherence?Who is at risk? How should
patients at risk be screened and identified?What are the negative impacts of non-adherence?What is the
practical approach for improving adherence? The ABC taxonomy for medication adherence
Adherence :3 quantifiable components: initiation , implementation , and discontinuationThe five dimensions
of non-adherence
.
This document discusses the importance of patient involvement in health technology assessment (HTA). It notes that HTA evaluates new drugs and medical technologies but typically does not incorporate patient perspectives on factors like quality of life. The document advocates that patients should play a role in HTA processes by providing input on treatment outcomes, tolerability, and other real-world considerations to ensure funding decisions align with patient values and needs. It provides examples of how patients could be engaged as representatives, through surveys or public input, and highlights the need for HTA to consider individual patient impacts rather than just average population effects.
Measuring and Enhancing Your Academic Medical ImpactMarion Sills
Overview of measuring and enhancing the impact of your scholarly work in academic medicine. The talk reviews how impact is defined and measured, how to improve your own impact metrics and how to describe the impact of your scholarly contributions to science.
Adding Social Determinant Data Changes Children’s Hospitals’ Readmissions Per...Marion Sills
Adding social determinant data to risk adjustment models for pediatric readmissions led to minimal changes in model performance at the discharge level, but resulted in changes to hospital performance rankings. Specifically:
- Adding social determinant variables from electronic health records and zip codes to existing clinical risk adjustment models did not meaningfully improve the accuracy or fit of models predicting individual readmissions.
- However, accounting for social determinants did change some hospitals' risk-adjusted readmission rates and performance deciles compared to peers. This suggests social determinants may influence hospital performance evaluations and penalties if unadjusted.
- Including social determinants in readmissions modeling more fully captures factors influencing readmissions and provides a more accurate assessment of hospital quality.
Stakeholder Engagement in a Patient-Reported Outcomes Implementation by a Pra...Marion Sills
Kwan BM, Sills MR, Graham D, Hamer MK, Fairclough DL, Hammermeister KE, Kaiser A, Diaz-Perez MJ, Schilling LM. Stakeholder Engagement in a Patient-Reported Outcomes Implementation by a Practice-Based Research Network. JABFM. In Press.
Practice Variability in and Correlates of Patient-Centered Medical Home Chara...Marion Sills
Schilling LM, Sills MR, Fairclough D, Kwan MB. Practice Variability in and Correlates of Patient-Centered Medical Home Characteristics. SAFTINet Convocation. Aurora, Colorado. 13 Feb 2013.
This document describes the design and methods of a prospective cohort study examining the association between practice-level medical home characteristics and asthma outcomes in children and adults. The study will use surveys of medical home characteristics and secondary data from 2011-2013. Asthma control and exacerbations will be measured repeatedly from July 2012 to December 2013. Hierarchical linear models will assess the relationship between medical home scores and asthma outcomes, adjusting for potential confounders. Sensitivity analyses will address issues like misclassification bias. Results will be presented separately for children and adults.
Sills MR. Inpatient capacity margin at children's hospitals during the fall 2009 H1N1 influenza pandemic. Presentation to the Colorado Emergency Medicine Research Center. 14 June 2010.
Sills MR. Overview of the SAFTINet Program. Presented to the Emergency Department Research Committee, Department of Pediatrics, University of Colorado School of Medicine. 6 January 2015.
Patient-reported outcomes for asthma in children and adultsMarion Sills
Patient-reported outcomes for asthma in children and adults. Guided Discussion to Facilitate SAFTINet Stakeholders' Selection of an Asthma PROM. Teleconference. 1 April 2011
Sills MR. Cardiovascular Cohorts PROM Measures Updates and Action Items. Slides for teleconference to facilitate discussion of Cardiovascular PRO Measure Selection by SAFTINet Stakeholder Community. 21 March 2012.
Sills MR. Evolution of PRO Measure for Cardiovascular Cohorts in SAFTINet. Slides for teleconference to facilitate discussion of Cardiovascular PRO Measure Selection by SAFTINet Stakeholders. 2 May 2012.
Cer safti net overview edrc 1 feb 2011Marion Sills
Sills MR. Overview of Comparative Effectiveness Research Using SAFTINet as an Example. Methods Talk presented to the Emergency Department Research Conference, Department of Pediatrics, 1 February 2011.
At Apollo Hospital, Lucknow, U.P., we provide specialized care for children experiencing dehydration and other symptoms. We also offer NICU & PICU Ambulance Facility Services. Consult our expert today for the best pediatric emergency care.
For More Details:
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Name: Apollo Hospital
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DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
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Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
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Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
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This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
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This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
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2. +
Overview
PEC preference regarding the medication adherence measure
Instrument
Pilot test
Feedback on the instrument
Feedback on the pilot
How would we use the findings in our research?
3. +
Overview
PEC preference regarding the medication adherence measure
Instrument
Pilot test
Feedback on the instrument
Feedback on the pilot
How would we use the findings in our research?
4. +
Proposed Med Adherence Instrument
and Pilot Test
A single medication adherence question (derived from the Gehi
question) and a single checklist of barriers
Pilot test by 1-2 providers in each organization for a few weeks
5. +
Proposed Med Adherence Instrument:
Adherence Question
Patient Instructions:
It can be difficult to take all of our medications as the doctor has told
us to. Please tell us how often taking your medications is difficult for
you.
In the past month, how often did you take your medications as the
doctor or provider prescribed?1 Please check one (1) answer.
“All of the time” (100%)
“Nearly all of the time” (90%)
“Most of the time” (75%)
“About half the time” (50%)
“Less than half the time” (<50%)
“None of the time” (0%)
6. +
Proposed Med Adherence Instrument:
Barriers Checklist
In the past month, why have you not taken your medicine as
your doctor prescribed? Check all that apply.
My medicine makes me feel bad (I have “side effects”). Please
describe: ________________
I don’t feel like my medicine is working
I feel like taking my medicine will not improve my health
There are too many doses of medicine to take each day
I cannot afford my medicine
I forget to take my medicine
7. +
Proposed Med Adherence
Instrument: Barriers Checklist
Domains for Barriers:
Side effects
No improvement in symptoms
Belief medication won’t change outcomes
Complexity of regimen
Financial cost
Forgetting
Some options for wording on next slides
8. +
Proposed Med Adherence
Instrument: Barriers Checklist
Domain for Barriers: Side effects
Options
proposed: My medicine makes me feel bad (I have “side effects”).
Please describe: ________________
ASK-12: Have you skipped or stopped taking a medicine because it
made you feel bad?
Morisky-8: Have you ever cut back or stopped taking your medicine
without telling your doctor because you felt worse when you took it?
Morisky-4: At times, if you feel worse if you take your medicines, do
you stop taking them?
9. +
Proposed Med Adherence
Instrument: Barriers Checklist
Domain for Barriers: No improvement in symptoms
Options
proposed: I don’t feel like my medicine is working
ASK-12:
I feel confident that each one of my medicines will help me
Have you skipped or stopped taking a medicine because you did
not think it was working?
10. +
Proposed Med Adherence
Instrument: Barriers Checklist
Domain for Barriers: Belief medication won’t change outcomes
Options
proposed: I feel like taking my medicine will not improve my health
ASK-12:
I feel confident that each one of my medicines will help me
Have you skipped or stopped taking a medicine because you did
not think it was working?
11. +
Proposed Med Adherence Instrument:
Barriers Checklist
Domain for Barriers: Complexity of regimen
Options
proposed: There are too many doses of medicine to take each day
ASK-12: Taking medicines more than once a day is inconvenient
12. +
Proposed Med Adherence Instrument:
Barriers Checklist
Domain for Barriers: Financial cost
Options
proposed: I cannot afford my medicine
ASK-12:
I feel confident that each one of my medicines will help me
Have you skipped, stopped, not refilled, or taken less medicine
because of the cost?
13. +
Proposed Med Adherence Instrument:
Barriers Checklist
Domain for Barriers: Forgetting
Options
proposed: I forget to take my medicine
ASK-12:
I just forget to take my medicines some of the time
I run out of my medicine because I don’t get refills on time
Morisky-8:
Do you sometimes forget to take your pills?
How often do you have difficulty remembering to take all your
medications?
When you travel or leave home do you sometimes forget to bring
your medicine?
Morisky-4: Have you ever forgotten to take your medicine?
14. +
Med Adherence Instrument: Provider
Guidance, 1st slide
Provider Instructions: Please review the patient’s responses and
considering adjusting the treatment plan if patients exhibit difficulty
taking their medications. Encouraging adherence to medications is
one of the best ways to improve outcomes! Some ideas for helping
patients take their medications include:
Side effects: Switch medications, adjust the dose, or recommend
other mitigation strategies (e.g., taking the medication with food,
reducing salt intake)
Feeling as though the medication does not or will not improve their
health: indicate a range of time before seeing results, encourage
logging or home monitoring (e.g., blood pressure) so patients can
see change
15. +
Med Adherence Instrument: Provider
Guidance, 2nd slide
Complex regimens: Consider reducing medications, use
combination therapies, design a treatment plan that is easier to
follow (e.g., all medications should be taken in the morning),
use organizing systems (pillboxes)
Cost: Switch to lower cost medications, facilitate sign-up for
prescription assistance plans
Forgetting: Encourage routines, pairing medications with other
daily activities, use of memory aids (alarms, pillboxes,
calendars), use health IT tools to remind patients to proactively
refill prescriptions
16. +
Pilot Timeline
July 10, 2012: Feedback from PEC partners on summary of the
instrument
July 20, 2102: Spanish translation of instrument completed
July 20, 2012: Partners’ providers for Pilot Test identified
Aug 1, 2012: PEC and providers participating in Pilot meet at
regularly scheduled PEC meeting
Aug 1, 2012: Feedback questionnaires provided to PEC
partners
Aug 13, 2012: Feedback questionnaires returned to SAFTINet
research team
17. +
Pilot Survey, 1st slide
Is the information in the survey useful to you as a clinical
provider? Are there questions that are not useful? Are there
questions that would be really useful to you that are missing?
Do the respondents feel comfortable answering the questions?
Is the wording of the survey clear? Are there questions that
respondents consistently misunderstand? Is there some
wording that needs to be changed? Do you have suggestions
for better wording?
How long does this survey take to administer?
18. +
Pilot Survey, 2nd slide
Is the survey too long? If so, what question(s) do you suggest we
drop? Is there a question we are missing?
Are the “provider instructions” about how to adjust the treatment
plan helpful to you? Are they too common-sense? Are they too
context-dependent (would be different at different practice sites)?
Did it make sense to administer this survey at the patient’s visit to
the clinic? Would it be better administered by phone or by other
strategies? If so, how do you suggest we administer it?
Do you prefer to administer the survey to all patients? To only
patients with hyperlipidemia or hypertension?
19. +
Overview
PEC preference regarding the medication adherence measure
Instrument
Pilot test
Feedback on the instrument
Feedback on the pilot
How would we use the findings in our research?
20. +
Overview
PEC preference regarding the medication adherence measure
Instrument
Pilot test
Feedback on the instrument
Feedback on the pilot
How would we use the findings in our research?
21. +
Research Utility
Which domains would we use?
medication adherence scale
barriers measure total count, or focus on specific barrier(s)
How would we use these in an analytic model?
PCMH
Medication adherence
Barriers
Disease control
Editor's Notes
data completeness—how many will fill this out?
If we look at med adherence as an outcome of PCMH we could just look at those with med adherence data
To look at the whole framework here is very complicated—this is a path analysis. Not sure there’s a good way to do it to account for clustering.
you would need to use average med adherence on the practice level