scholarly journals Physician and Pharmacist Care of Varenicline Users in a Real-World Setting

2013 ◽  
Vol 8 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Mai Frandsen ◽  
Stuart G. Ferguson
Keyword(s):  
Side Effects ◽  
Real World ◽  
Psychiatric Illness ◽  
Drug Side Effects ◽  
Pharmacy Staff ◽  
Serious Adverse Events ◽  
Treatment Side Effects ◽  
Real World Setting ◽  
Pharmacist Care

Since its launch as a smoking cessation aid, varenicline use has been linked to a number of serious adverse events, notably the exacerbation of pre-existing psychiatric illness, depressed mood and suicidal ideation. Regulators’ fears have been somewhat allayed by varenicline's status as a prescription only medication. The purpose of this study was to examine the care provided by physicians – or general practitioners – and pharmacists to varenicline users under real-world conditions. Participants were 141 patients who had filled a prescription for varenicline at a participating pharmacy within the previous six-months. Identified patients were mailed a survey to complete that included items on interactions with their physician and pharmacy staff, and knowledge of treatment side-effects. Most participants reported that their physician encouraged them to set a quit date (82.5%) and provided additional cessation materials (57.2%). While most (79.0%) physicians discussed whether varenicline was appropriate for the patient, fewer asked about psychiatric illness (40.1%), or asked to be informed about mood or behaviour change during treatment (48.1%). Participants (78.4%) reported that their physician had discussed a follow-up consultation, but only 59.4% of patients who had finished treatment at the time of the survey reported having one. Most reported discussing potential drug side-effects with their physician (71.0%) and or pharmacist (52.9%); when probed, knowledge was variable. These results suggest that many patients do not receive the level of support that physicians and pharmacists are assumed to provide.

EFFICACY OF TENOFOVIR IN PATIENTS OF HBV-RELATED CIRRHOSIS

2016 ◽  
pp. 25-29
Author(s):  
Van Huy Tran ◽  
Thi Huyen Thuong Nguyen
Keyword(s):  
Side Effects ◽  
Serum Creatinine ◽  
Key Words ◽  
Tenofovir Disoproxil Fumarate ◽  
Hbv Dna ◽  
Treatment Side Effects ◽  
Background Data ◽  
Key Words Cirrhosis

Background: Data about efficacy of Tenofovir in patients of HBV –related cirrhosis in Vietnam was still limited. This study is aimed at: - evaluating the clinical, biochemical, virological and Child-Pugh score responses 3,6,9 months after Tenofovir therapy; - assessing possible side effects of tenofovir. Patients and methods: 40 patients with HBV-related cirrhosis were enrolled. All has received Tenofovir disoproxil fumarate 300mg/day. Follow-up after 3,6 and 9 months. Results: Anorexia, oedema and ascites were significantly improved after treatment. HBV DNA became undetectable in 92.5%, 94.55 and 100% after 3,6 and 9 months, respectively. Child- Pugh score was improved after treatment (5.94±0.22 after treatment vs 7.47±0.28 before treatment). Side effects were minors (nausea, vomiting). No case of increase in serum creatinine was found. Conclusion: Tenofovir showed effective and safe in patients of HBV-related cirrhosis. Key words: Cirrhosis, tenofovir, HBV. Key words: cirrhosis, tenofovir, HBV

scholarly journals Real-World Clinical Outcomes Associated with Canagliflozin in Patients with Type 2 Diabetes Mellitus in Spain: The Real-Wecan Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2275
Author(s):  
Juan J. Gorgojo-Martínez ◽  
Manuel A. Gargallo-Fernández ◽  
Alba Galdón Sanz-Pastor ◽  
Teresa Antón-Bravo ◽  
Miguel Brito-Sanfiel ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Real World ◽  
Primary Outcome ◽  
Baseline Hba1c ◽  
Real World Setting ◽  
Antihyperglycemic Therapy ◽  
The Mean ◽  
Hba1c Levels

The aims of this multicentric retrospective study were to assess in a real-world setting the effectiveness and safety of canagliflozin 100 mg/d (CANA100) as an add-on to the background antihyperglycemic therapy, and to evaluate the intensification of prior sodium–glucose co-transporter type 2 inhibitor (SGLT-2i) therapy by switching to canagliflozin 300 mg/d (CANA300) in patients with T2DM. One cohort of SGLT2i-naïve patients with T2DM who were initiated on CANA100 and a second cohort of patients with prior background SGLT-2i therapy who switched to CANA300 were included in the study. The primary outcome of the study was the mean change in HbA1c over the follow-up time. In total, 583 patients were included—279 in the cohort of CANA100 (HbA1c 8.05%, weight 94.9 kg) and 304 in the cohort of CANA300 (HbA1c 7.51%, weight 92.0 kg). Median follow-up periods in both cohorts were 9.1 and 15.4 months respectively. CANA100 was associated to significant reductions in HbA1c (−0.90%) and weight (−4.1 kg) at the end of the follow-up. In those patients with baseline HbA1c > 8% (mean 9.25%), CANA100 lowered HbA1c levels by 1.51%. In the second cohort, patients switching to CANA300 experienced a significant decrease in HbA1c (−0.35%) and weight (−2.1 kg). In those patients with baseline HbA1c > 8% (mean 8.94%), CANA300 lowered HbA1c levels by 1.12%. There were significant improvements in blood pressure in both cohorts. No unexpected adverse events were reported. In summary, CANA100 (as an add-on therapy) and CANA300 (switching from prior SGLT-2i therapy) significantly improved several cardiometabolic parameters in patients with T2DM.

scholarly journals Assessing post-radiotherapy handover notes from a family physician perspective

2018 ◽  
Vol 25 (1) ◽  
pp. 49
Author(s):  
A. Dang ◽  
S. Miller ◽  
D. Horvat ◽  
T. Klassen-Ross ◽  
M. Graveline ◽  
...  
Keyword(s):  
Side Effects ◽  
Family Physicians ◽  
Essential Information ◽  
Treatment Side Effects ◽  
Counselling Services ◽  
Contact Information ◽  
Score Improvement ◽  
Information Treatment ◽  
Treatment Intent

Background Across our province, post-radiotherapy (rt) handover notes are sent to family physicians (fps) after rt. Based on previous fp feedback, we created a revised post-radiotherapy handover note with more information requested by fps. The purpose of this study was to determine whether the revised handover note improved the note as a communication aid.Methods Potential common and rare treatment side effects, oncologist contact information, and treatment intent were added to the revised handover note. Both versions were sent alongside a questionnaire to fps. Paired t-tests were carried out to compare satisfaction differences.Results There was a response rate of 37% for the questionnaires. Significantly greater clarity in the following categories was observed: responsibility for patient follow-up (mean score improvement of 1.2 on a 7-point Likert scale, p < 0.001), follow-up schedule (1.1, p < 0.001) as well as how and when to contact the oncologist (1.4, p = 0.001). Family physicians were also more content with how the institute transitioned care back to them (1.5, p = 0.012). Overall, fps were generally satisfied with the content of the revised post-rt handover note and noted improvement over the previous version. The frequency of investigations and institute supports initiated such as counselling services were suggested further additions.Conclusions The inclusion of potential treatment side effects, oncologist contact information, treatment intent and a well-laid out follow-up schedule were essential information needed by fps for an effective post-rt completion note. With these additions, the revised post-rt handover note showed significant improvement.

scholarly journals Real world experience with coronary sinus reducer implantation for the treatment of refractory angina: a single-centre experience

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J P Dias Ferreira Reis ◽  
R Ramos ◽  
P Rio ◽  
A Fiarresga ◽  
D Cacela ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Real World ◽  
Therapeutic Option ◽  
Objective Evaluation ◽  
Short Version ◽  
Refractory Angina ◽  
Single Centre ◽  
Real World Data ◽  
Serious Adverse Events

Abstract Background Coronary sinus Reducer device (CSF) implantation is a novel therapeutic option to relieve symptoms in patients with refractory angina (RA). There is limited real-world data describing its use outside of clinical trials. Aim To assess the safety and efficacy of this procedure in a real-world setting. Methods This is a report of a single centre prospective registry of consecutive patients with RA (CCS II-IV) deemed unsuitable for revascularization. Between May 2017 and August 2019, 17 patients were referred to CSF implantation. Baseline and follow-up evaluation consisted of clinical assessment, including completion of the short version of the Seattle Angina Questionnaire (SAQ-7) and CCS class evaluation and objective evaluation by transthoracic echocardiography and cardiopulmonary exercise test (CPET). Results A total of 13 patients (70,6±6,5 years, 76,9% male) underwent CSF implantation with a procedural success of 84.6%. No cases of periprocedural serious adverse events were reported. At 12-month follow-up, any reduction in CCS Class was achieved in 72.7% of cases, with 27.2% reducing 2 CCS classes. Baseline CCS score was reduced from 2.8±0.4 to 1.7±0.8 (p=0.009). Quality of life (QoL) was significantly improved as assessed by the improvement seen in all items of SAQ-7 (p&lt;0.017 for all). CPET duration was significantly increased (p=0.034), but no change was noted in the remainder CPET variables. During follow-up, 3 patients suffered myocardial infarction, resulting in 1 death. Conclusion CSF implantation in patients with RA was safe and led to a significant reduction of the angina burden and improvement of QoL at 12-month follow-up. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Factors Associated with Persistence with Teriparatide Therapy: Results from the DANCE Observational Study

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Deborah T. Gold ◽  
David L. Weinstein ◽  
Gerhardt Pohl ◽  
Kelly D. Krohn ◽  
Yi Chen ◽  
...  
Keyword(s):  
Side Effects ◽  
Observational Study ◽  
Trend Test ◽  
Factors Associated ◽  
Treatment Side Effects ◽  
Patient Reported ◽  
Proper Training ◽  
Improper Use ◽  
Armitage Trend Test

Purpose. Determine patient-reported reasons for discontinuation with teriparatide.Methods. Patients taking teriparatide in a multicenter, prospective, and observational study were given three questionnaires: baseline, follow-up questionnaire 1 (QF1, 2 to 6 months), and follow-up questionnaire 2 (QF2, 12 months). Discontinuation reported at QF1 and QF2 was defined as “early” and “late,” respectively, and remaining patients were considered persistent. Cochran-Armitage trend test was used to identify factors associated with discontinuation.Results. Side effects, concern about improper use, injection difficulties, and several patient-perceived physician issues were associated with early discontinuation. Low patient-perceived importance of continuing treatment, side effects, difficulty paying, and low patient-perceived physician knowledge were associated with late discontinuation. The most common specific reasons selected for discontinuing treatment were “concerns about treatment outweighing the benefits” (n=53) and “difficulty paying” (n=47).Conclusions. Persistence with teriparatide is dependent on managing side effects, addressing financial challenges, proper training, and obtaining support from the healthcare provider.

scholarly journals N15 A ‘real-world’ observational multi-centre study comparing the side effects and patient acceptability of budesonide MMX with prednisolone in patients with mild to moderate ulcerative colitis

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S664-S665
Author(s):  
J Kearns ◽  
L Scullion ◽  
C Masterson ◽  
N Kennedy ◽  
C Butcher
Keyword(s):  
Ulcerative Colitis ◽  
Side Effects ◽  
Real World ◽  
Additional Data ◽  
Patient Acceptability ◽  
Multi Centre Study ◽  
Real World Evidence ◽  
Randomised Controlled ◽  
The Impact

Abstract Background Budesonide MMX is indicated for the induction of remission in mild to moderate Ulcerative Colitis (UC) patients when 5-ASA treatment is not sufficient. Unlike traditional first-generation glucocorticoid steroids such as prednisolone, budesonide MMX has demonstrated a robust safety profile, comparable to placebo in several randomised controlled trials1,2,3. There is however limited real-world evidence to substantiate this safety claim in clinical practice. The aim of this observational analysis is to evaluate the tolerability and ease of administration of budesonide MMX in the real-world setting using prednisolone as a benchmark. Methods Patients receiving treatment for mild to moderate UC were identified in 3 treatment centres between April and October 2019. After providing privacy and data consent, patients completed a detailed nurse-led questionnaire regarding their experiences with prednisolone treatment. Following 6 weeks of therapy with budesonide MMX, patients were sent a follow-up questionnaire. Data from both the initial and subsequent questionnaires were entered by the nurse into a database for assimilation and analysis. Results Twenty-eight patients completed initial and follow-up questionnaires. Of these, 78.6% (n = 22) had experienced ≥1 prednisolone-related side effects. In comparison, following treatment with budesonide MMX, 21.4% (n = 6) reported ≥1 side effects. Instances of these side effects are shown in Figure 1. 46.4% of patients (n = 13) reported the impact of prednisolone-related side effects on daily life as moderate or severe vs. 7.1% (n = 2) following treatment with budesonide MMX. By week 2 of treatment with budesonide MMX, rectal bleeding was resolved in 32.1% of patients (n = 9) and stool frequency in 35.7% (n = 10). 93.1% (n = 27) found the instructions to take budesonide MMX given by the health care professional very easy to understand and of those expressing a preference, 71.1% of patients (n = 19) would take budesonide MMX again if prescribed. Additional data will be presented. Conclusion Data from this ‘real-world’ observational study appear to support the safely profile of budesonide MMX reported in clinical trials. The incidence of patients who experienced &gt; 1 side-effect was nearly 4 times lower for budesonide vs. prednisolone. In addition, budesonide MMX therapy was acceptable to the majority of patients and accompanying instructions easy to understand. Additional data will be presented. References

Long-term follow-up of patients undergoing decompressive hemicraniectomy for malignant stroke: Quality of life and caregiver’s burden in a real-world setting

2020 ◽  
Vol 197 ◽  
pp. 106168
Author(s):  
Pedro Tadao Hamamoto Filho ◽  
Lucas Braz Gonçalves ◽  
Nicholas Falcomer Koetz ◽  
Aline Maria Lara Silvestrin ◽  
Aderaldo Costa Alves Júnior ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Real World ◽  
Decompressive Hemicraniectomy ◽  
Real World Setting ◽  
Long Term Follow Up

scholarly journals TCT-350 Safety and Performance of the Resorbable Magnesium Scaffold, Magmaris in a Real World Setting - First 400 Subjects at 12-month Follow-up of the BIOSOLVE-IV Registry

2018 ◽  
Vol 72 (13) ◽  
pp. B142-B143
Author(s):  
Michael Lee ◽  
Adrian Wlodarczak ◽  
Johan Bennett ◽  
Jan Torzewski ◽  
Michael Haude ◽  
...  
Keyword(s):  
Real World ◽  
Real World Setting ◽  
And Performance

scholarly journals 087 Endovascular clot retrieval (ECR) in the elderly. For better or worse in the real world?

2019 ◽  
Vol 90 (e7) ◽  
pp. A28.1-A28
Author(s):  
Stacey K Jankelowitz ◽  
Kylie Tastula ◽  
Nicola Mitchell ◽  
Patrick Tang ◽  
Tim Ang ◽  
...  
Keyword(s):  
Real World ◽  
Stroke Risk ◽  
The Elderly ◽  
Early Improvement ◽  
Transcatheter Aortic Valve ◽  
Real World Setting ◽  
Multicentre Trials ◽  
Valve Implantation ◽  
Lost To Follow Up

IntroductionAcross multicentre trials ECR is safe and effective in octogenarians. Despite RCT evidence elderly patients may be denied ECR due to perceived poor risk-benefit. We examine impact of age on ECR outcomes and outcomes in transcatheter aortic valve implantation (TAVI) cases (where stroke risk is high), in a real world setting.MethodsWe analysed 311 consecutive ECR cases between 2016 and 2019 in 10 year age bands for ECR outcomes including 90 day mRS and mortality. Impact of premorbid function (mRS), NIHSS, recorded co-morbidities, and aetiology was assessed. TAVI case outcomes were examined.ResultsThirty one percent of ECR outcome cases were over 79 years of age; 90 day mortality was 34%; 25% had a 90 day mRS 0–2. Early NIHSS improvement was 5. Ninety-day mortality and mRS 0–2 for 10–19 (n=3), 20–29 (n=2), 30–39 (n=4), 40–49 (n=23), 50–59 (n=27), 60–69 (n=69), 70–79 (n=84),80–89 (n=62) and 90–99 (n=11) years were 0 and 100%, 0 and 100%, 33 and 67%, 4 and 78%, 15 and 52%, 13 and 49%, 17 and 33%, 24 and 2% and 55 and 18%, respectively. There was 9% lost to follow-up.Six TAVI cases had a NIHSS of 8–20 and pre-morbid mRS<3, four with mRS 0. Mean 24 hour NIHSS improvement was 8.ConclusionWithout age exclusions older patients had worse unadjusted outcomes. However, patients over 79 years had clinically important early improvement in NIHSS score and ninety day outcomes were comparable to favourable RCT data and TAVI patients also had early improvement.

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