scholarly journals Adherence to Long-Term Drug Regimen After Hospital Discharge: General Practitioners’ Attitude

2016 ◽  
Vol 64 (3) ◽  
pp. 657-659 ◽  
Author(s):  
Catherine Takeda-Raguin ◽  
Thomas Vogel ◽  
Nabila Ferahta ◽  
Cindi Smith ◽  
Barbara Poloni ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
General Practitioners ◽  
Drug Regimen

scholarly journals Survey-Based Analysis of Current Trends for Prescribing Gastrointestinal Protectants among Small-Animal General Practitioners in Portugal

2021 ◽  
Vol 8 (5) ◽  
pp. 70
Author(s):  
Rita Baptista ◽  
Ryane Englar ◽  
Berta São Braz ◽  
Rodolfo Oliveira Leal
Keyword(s):  
General Practitioners ◽  
Healthcare Providers ◽  
Small Animal ◽  
Cross Sectional Study ◽  
Online Forums ◽  
Educational Strategies ◽  
Cross Sectional ◽  
Current Trends ◽  
Therapeutic Value

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.

scholarly journals Prospective observational study to examine health-related quality of life and develop models to predict long-term patient-reported outcomes 6 months after hospital discharge with blunt thoracic injuries

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049292
Author(s):  
Edward Baker ◽  
Ceri Battle ◽  
Abhishek Banjeri ◽  
Edward Carlton ◽  
Christine Dixon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hospital Discharge ◽  
Brief Pain Inventory ◽  
Thoracic Injuries ◽  
Patient Reported ◽  
Related Quality ◽  
Paindetect Questionnaire ◽  
Health Related

ObjectiveThis study aimed to examine the long-term outcomes and health-related quality of life in patients with blunt thoracic injuries over 6 months from hospital discharge and develop models to predict long-term patient-reported outcomes.DesignA prospective observational study using longitudinal survey design.SettingThe study recruitment was undertaken at 12 UK hospitals which represented diverse geographical locations and covered urban, suburban and rural areas across England and Wales.Participants337 patients admitted to hospital with blunt thoracic injuries were recruited between June 2018–October 2020.MethodsParticipants completed a bank of two quality of life surveys (Short Form-12 (SF-12) and EuroQol 5-Dimensions 5-Levels) and two pain questionnaires (Brief Pain Inventory and painDETECT Questionnaire) at four time points over the first 6 months after discharge from hospital. A total of 211 (63%) participants completed the outcomes data at 6 months after hospital discharge.Outcomes measuresThree outcomes were measured using pre-existing and validated patient-reported outcome measures. Outcomes included: Poor physical function (SF-12 Physical Component Score); chronic pain (Brief Pain Inventory Pain Severity Score); and neuropathic pain (painDETECT Questionnaire).ResultsDespite a trend towards improving physical functional and pain at 6 months, outcomes did not return to participants perceived baseline level of function. At 6 months after hospital discharge, 37% (n=77) of participants reported poor physical function; 36.5% (n=77) reported a chronic pain state; and 22% (n=47) reported pain with a neuropathic component. Predictive models were developed for each outcome highlighting important data collection requirements for predicting long-term outcomes in this population. Model diagnostics including calibration and discrimination statistics suggested good model fit in this development cohort.ConclusionsThis study identified the recovery trajectories for patients with blunt thoracic injuries over the first 6 months after hospital discharge and present prognostic models for three important outcomes which after external validation could be used as clinical risk stratification scores.

Association between functional status at hospital discharge and long-term survival after out-of-hospital-cardiac-arrest

Resuscitation ◽  
2021 ◽  
Vol 164 ◽  
pp. 30-37
Author(s):  
Richard Chocron ◽  
Carol Fahrenbruch ◽  
Lihua Yin ◽  
Sally Guan ◽  
Christopher Drucker ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Functional Status ◽  
Hospital Discharge ◽  
Term Survival ◽  
Long Term Survival ◽  
Hospital Cardiac Arrest

Continuity and Adherence to Long-Term Drug Treatment by Geriatric Patients after Hospital Discharge

Drugs & Aging ◽  
2008 ◽  
Vol 25 (10) ◽  
pp. 861-870 ◽  
Author(s):  
Nariman Mansur ◽  
Avraham Weiss ◽  
Amnon Hoffman ◽  
Tsipora Gruenewald ◽  
Yichayaou Beloosesky
Keyword(s):  
Drug Treatment ◽  
Hospital Discharge ◽  
Geriatric Patients

Long-Term Weight Gain Associated With High Omentin Levels at Hospital Discharge Improves Prognosis of Patients Following Acute Heart Failure

2018 ◽  
Vol 12 (3) ◽  
pp. 231-239
Author(s):  
Rosa M. Agra-Bermejo ◽  
Rocio Gonzalez-Ferreiro ◽  
J. Nicolos Lopez-Canoa ◽  
Alfonso Varela-Roman ◽  
Ines Gomez-Otero ◽  
...  
Keyword(s):  
Heart Failure ◽  
Weight Gain ◽  
Hospital Discharge ◽  
Acute Heart Failure

scholarly journals Quality of life of long term ICU patients at 6 months after hospital discharge

Critical Care ◽  
10.1186/cc295 ◽  
1998 ◽  
Vol 2 (Suppl 1) ◽  
pp. P166
Author(s):  
I Novák ◽  
V Šrámek ◽  
E Bokrová ◽  
M Bílek ◽  
M Matejovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hospital Discharge ◽  
Icu Patients

Fenofibrate Potentiates Warfarin Effects

2003 ◽  
Vol 37 (2) ◽  
pp. 212-215 ◽  
Author(s):  
Karissa Y Kim ◽  
Michael A Mancano
Keyword(s):  
White Woman ◽  
Chart Review ◽  
Warfarin Therapy ◽  
Dosage Reduction ◽  
International Normalized Ratio ◽  
Drug Regimen ◽  
Warfarin Dosage ◽  
Therapeutic Doses ◽  
Anticoagulant Response

OBJECTIVE: To describe 2 patients in whom the initiation of fenofibrate potentiated warfarin's anticoagulant effects. CASE SUMMARY: A 71-year-old white woman and an 80-year-old white woman with multiple medical conditions were both stabilized on long-term warfarin therapy. During the course of anticoagulation, both patients were prescribed fenofibrate and experienced threefold and twofold increases in international normalized ratio (INR), respectively, requiring total weekly warfarin dosage reductions of 30–40%. Before starting fenofibrate therapy, both patients' coagulation values were within the therapeutic range. When interviewed, patients and caregivers denied bleeding, bruising, changes in diet, alcohol ingestion, nonadherence with therapy, or changes in drug regimen except for the addition of fenofibrate. Upon chart review, evaluation of potentially contributory parameters, such as other changes in drug therapy, thyroid function, liver function, and drug–disease interactions, showed that these parameters remained stable and were ruled noncontributory. DISCUSSION: The addition of fenofibrate in 2 patients on stable and therapeutic doses of warfarin increased the anticoagulant response to warfarin. A clear temporal relationship with the addition of fenofibrate and the appearance of the interaction was seen. Fenofibrate is highly protein bound, with the potential to displace warfarin from its binding protein, leading to an enhanced hypoprothrombinemic effect. Fenofibrate is also a mild to moderate inhibitor of CYP2C9, the enzyme responsible for warfarin metabolism. The combination of these effects — displacement of warfarin by fenofibrate coupled with decreased metabolism of warfarin — may increase the anticoagulant response to warfarin. Using the Naranjo probability scale, these interactions were designated as probable. CONCLUSIONS: We suggest serial monitoring of INR and consider an empiric 20% reduction in warfarin dosage when fenofibrate is initiated, with the possibility for a greater warfarin dosage reduction based on INR results.

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