scholarly journals Improving Oral Oncolytic Patient Self-Management

2016 ◽  
Vol 12 (9) ◽  
pp. e864-e869 ◽  
Author(s):  
Elaine McNamara ◽  
Lindsey Redoutey ◽  
Emily Mackler ◽  
Jane A. Severson ◽  
Laura Petersen ◽  
...  
Keyword(s):  
Medical Records ◽  
Tracking System ◽  
Self Care ◽  
Self Assessment ◽  
Start Date ◽  
Phone Calls ◽  
Edmonton Symptom Assessment Scale ◽  
Care Guidelines ◽  
Oral Oncolytics

Purpose: Managing patients who are taking oral oncolytics is challenging because of the changing paradigm from frequent supervision during intravenous therapy to periodic observation with oral administration of drugs. We joined the Michigan Oncology Quality Consortium (MOQC) Oral Oncolytics Collaborative in 2013 to identify opportunities for improvement in this area. Methods: We completed MOQC’s baseline self-assessment and performed an audit of medical records for 25 patients prescribed an oral oncolytic from May 2011 to July 2013. We implemented the following MOQC resources: a tracking system for patients taking oral oncolytics, patient education with drug-specific self-care guidelines, use of a modified Edmonton Symptom Assessment Scale, and a medication adherence questionnaire to be used on scheduled follow-up calls and return visits. We modified our workflow to include a standard teaching session and consistent follow-up phone calls. We conducted a retrospective postimplementation medical records audit from August 2013 to September 2014. Results: Baseline self-assessment revealed lack of start date documentation and lack of consistent follow-up. A baseline medical records audit showed that 48% of patients discontinued their medication without consulting their physician, and start date documentation was available for only 52% of patients. After participating in the quality initiative, 100% of patients sampled had a documented start date, and no patients discontinued their drug on their own. Seventeen percent had a dose reduction as a result of toxicity, as directed by the physician. Conclusion: The introduction of new office procedures to easily identify all patients receiving oral therapy and improvement in patients’ ability to manage symptoms at home with the use of self-care guidelines contributed to an improvement in managing patients who are taking oral oncolytics.

Understanding the Obstacles to Uptake of Intervention Programmes and Services for Persons with Dementia

2020 ◽  
Vol 17 (6) ◽  
pp. 526-533
Author(s):  
Ha N.H. Lien ◽  
Emily J. Koh ◽  
Philip L.K. Yap
Keyword(s):  
Medical Records ◽  
Cognitive Engagement ◽  
Functional Improvement ◽  
Related Factors ◽  
Related Services ◽  
Phone Calls ◽  
Information Session ◽  
Adequate Information ◽  
Care At Home

Background: Utilisation of intervention programmes and services for Persons with Dementia (PWD) has been generally modest despite the growing numbers. One reason has been the lack of knowledge about dementia and information on such services. Objective: We sought to close this gap by providing caregivers with an information session about dementia and the importance and availability of related services. We explored the uptake of intervention programmes and services and reasons for non-uptake thereafter. Methods: Two hundred and seventy-five PWD and caregiver dyads attended the Dyad Education and Empowerment Programme (DEEP). At the DEEP, while caregivers underwent an information session, PWD were assessed by a multidisciplinary team on their need and suitability for programmes and services such as daycare, cognitive engagement programmes and physical rehabilitation. The dyads then received individualized recommendations on the appropriate services, if any. Follow-up through medical records review and phone calls was conducted one month after DEEP to ascertain if the dyads had acted upon the recommendations and if not, what difficulties they encountered. Results: One hundred and eleven PWD received recommendations, of which 40 (36.0%) agreed and enrolled in the services while 71 (64%) declined. Thematic analysis of the reasons for non-uptake revealed 3 themes: PWD-related factors (e.g., refusal, functional improvement or decline), caregiverrelated factors (adequacy of care at home, other care arrangements), and service-related factors (e.g., cost, timing). Conclusion: Despite adequate information, there are other reasons for non-uptake of dementia- related services, some of which should be addressed to improve service updates and to provide better care for PWD.

scholarly journals Socialization of self-care guidelines for tuberculosis patients at UPT Pulmonary Health Services in West Kalimantan Province

2021 ◽  
Vol 6 (11) ◽  
pp. 2058-2062
Author(s):  
Tri Wahyuni ◽  
Parliani Parliani ◽  
Tutur Kardiatun ◽  
Prasetyo Aji Nugroho ◽  
Al Fikri ◽  
...  
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Self Care ◽  
Psychosocial Problems ◽  
Intensive Phase ◽  
West Kalimantan ◽  
Tb Treatment ◽  
Service Activity ◽  
Care Guidelines

Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis, which can harm the lungs and attack other organs. This will result in nursing issues, the risk of infection spreading to other organs and people, ineffective airway clearance, impaired gas exchange, nutritional disorders, and psychosocial problems. Efforts are made to overcome nursing problems by increasing the participation of patients and families, who serve as the primary supporters. The intervention performed by the patient as an agent for himself is known as self-care. Self-care is concerned with an individual's ability to care for and maintain his or her own health. Treatment, family support, and nutritional fulfillment are all part of TB treatment. The outcomes of service activity at UPT Pulmonary Health Services includes teaching health workers about self-care for TB patients, as well as conducting follow-up discussions about TB patients with anxiety in the intensive phase.

Oral oncolytics: Patient-monitoring improvements in private practice.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 215-215
Author(s):  
Tallat Mahmood ◽  
Lindsey Redouty ◽  
Elaine McNamera
Keyword(s):  
Side Effects ◽  
Oral Therapy ◽  
Self Care ◽  
Oral Chemotherapy ◽  
Start Date ◽  
Time Period ◽  
Prescription Date ◽  
Oral Oncolytics ◽  
First Time ◽  
Office Procedures

215 Background: The use of oral oncolytics is becoming more common. These drugs have their own unique challenges in managing patient initiation, monitoring side effects and adherence. Methods: We conducted a baseline chart audit of patients prescribed oral oncolytics in our private oncology practice followed by a quality improvement program and subsequent reassessment. Information obtained included: prescription date, actual start date and any documented problems with the oral therapy. The baseline audit included patients from may of 2011 to July 2013. Subsequently we joined the Michigan oncology quality consortium’s oral chemotherapy collaborative and initiated the following: office procedures for identification of all patients on oral therapy, use of the Edmonton Symptoms assessment system (ESAS), and a self-care management education program including patient self-monitoring of symptoms with recommended initial treatments. A postintervention audit was conducted from August 2013 to March 2014. Results: We identified 25 patients in the first time period and 13 in the second. In the first time period we found only 13 of the 25 patients had an actual start date documented, and of these 13, 10 had a >/=4 week delay prior to starting therapy, with 3/13 having a 2-4 week delay prior to start of therapy. 12 of the 25 patients discontinued their drug within the first month due to side effects without consulting their physician. After participating in the quality initiative, we identified only one patient without a documented start date, only 1/13 that had a > 4 week delay from prescription date to starting the drug, with 12/13 having a less than 2 week lapse. We also found that there were no patients who discontinued the drug and only one dose reduction as directed by the physician. Conclusions: The introduction of new office procedures to easily identify all patients on oral therapy and improved patient management of symptoms at home with the use of self-care guidelines, and in the office with use of ESAS contributed to greater adherence to oral chemotherapy regimens.

Oral oncolytic education and adherence monitoring in poor, rural and minority patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19212-e19212
Author(s):  
Tiffany Menhorn ◽  
Amy Zarick-Jones ◽  
Moises Harari Turquie ◽  
Shenthol Sasankan ◽  
Neda Hashemi-Sadraei ◽  
...  
Keyword(s):  
Native Americans ◽  
Poverty Rate ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
University Of New Mexico ◽  
Phone Calls ◽  
Adherence Monitoring ◽  
The University ◽  
Oral Oncolytics

e19212 Background: Oral oncolytics therapy use has been exponentially growing over the last several years necessitating education and monitoring. Pharmacy driven interventions have been shown to increase side effects detection, mitigation and ensure adherence. The University of New Mexico Comprehensive Cancer Center (UNMCCC) treats a unique population composed of poor (poverty rate 19.7%), rural (22.6%) and minority (Native Americans and Hispanics constitute 10.4% and 48% of the population respectively). Methods: New patients starting oral oncolytics were enrolled from May 2019 to January 2020 with an initial 30-minute educational visit with a pharmacist. UNMCCC initiated a pharmacy driven process of tracking patients via phone calls to monitor compliance, early presence of adverse events and issues surrounding the administration of oral oncolytics. Phone calls were conducted monthly for three months and then spaced out depending on patient and drug characteristics. Late education occurred when the initial education was performed after the patient started chemotherapy. Late first follow-ups occurred when the follow-up date was greater thirty-eight days after the start of chemotherapy. Results: A total of 196 patients started on oral chemotherapy of which 70% (139) received education following prescription, 17% (35) received late education and 11% (22) missed education. Newly started actively monitored patients significantly increased to 196 patients by the ninth month of the program. A total of 296 follow ups calls were performed within the first three months, 41% (111) were considered late follow-up. The first, second and third call were missed in 18% (49), 14% (40) and 16% (45) of patients. Conclusions: The UNMCCC cares for poor, rural and minority based patients and was able to reach the majority of patients in a timely manner for education and adherence monitoring. Our efforts were significantly hampered by the increasing number of active patients needing monitoring as the program progressed which will require further resources including, a close collaboration between physicians and pharmacists to provide a service that was previously absent and process changes which we are addressing as our next steps.

scholarly journals Home visit improves knowledge, self-care and adhesion in heart failure: randomized Clinical Trial HELEN-I

2013 ◽  
Vol 21 (spe) ◽  
pp. 20-28 ◽  
Author(s):  
Cláudia Motta Mussi ◽  
Karen Ruschel ◽  
Emiliane Nogueira de Souza ◽  
Alexandra Nogueira Mello Lopes ◽  
Melina Maria Trojahn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Intervention Group ◽  
Self Care ◽  
Home Visits ◽  
Decompensated Heart Failure ◽  
Control Group ◽  
Phone Calls

OBJECTIVE: To verify the effect of an educative nursing intervention composed of home visits and phone calls on patients' knowledge about the disease, self-care and adhesion to the treatment. METHODS: Randomized clinical trial with patients with recent hospitalization caused by decompensated heart failure. There were two groups: the intervention group, which has received four home visits and four phone calls to reinforce the guidelines during six months of follow up; and the control group, which has received conventional follow up with no visits or phone calls. RESULTS: Two hundred patients were randomized (101 in the intervention group and 99 in the control group). After six months, a significant improvement was observed in self-care and knowledge about the disease in the intervention group (P=0.001 and P<0.001), respectively; the adhesion to the treatment, measured and compared between the groups, was significantly higher in the intervention group (P=0.001). CONCLUSION: the strategy of home visits to patients who were recently hospitalized with decompensated heart failure was effective in improving the outcomes assessed and its implementation deserves to be considered in Brazil aiming at avoiding unplanned hospitalizations. NCT-01213862

scholarly journals Prevalence and Determinants of Medication Adherence among Patients with HIV/AIDS in Southern Vietnam

2021 ◽  
Vol 13 (1) ◽  
pp. 126-135
Author(s):  
Phuong M. Nguyen ◽  
Anh N. Thach ◽  
Xuan D. Pham ◽  
Anh N. Lam ◽  
Thao N. P. Nguyen ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Self Assessment ◽  
Cross Sectional ◽  
Southern Vietnam ◽  
Route Of Transmission ◽  
Food And Beverage ◽  
Hiv Aids

This study was conducted to determine the prevalence and determinants of medication adherence among patients with HIV/AIDS in southern Vietnam. Methods: A cross-sectional study was conducted in a hospital in southern Vietnam from June to December 2019 on patients who began antiretroviral therapy (ART) for at least 6 months. Using a designed questionnaire, patients were considered adherent if they took correct medicines with right doses, on time and properly with food and beverage and had follow-up visits as scheduled. Multivariable logistic regression was used to identify determinants of adherence. Key findings: A total of 350 patients (from 861 medical records) were eligible for the study. The majority of patients were male (62.9%), and the dominant age group (≥35 years old) accounted for 53.7% of patients. Sexual intercourse was the primary route of transmission of HIV (95.1%). The proportions of participants who took the correct medicine and at a proper dose were 98.3% and 86.3%, respectively. In total, 94.9% of participants took medicine appropriately in combination with food and beverage, and 75.7% of participants were strictly adherent to ART. The factors marital status (odds ratio (OR) = 2.54; 95%CI = 1.51–4.28), being away from home (OR = 1.7; 95%CI = 1.03–2.78), substance abuse (OR = 2.7; 95%CI = 1.44–5.05), general knowledge about ART (OR = 2.75; 95%CI = 1.67–4.53), stopping medication after improvement (OR = 4.16; 95%CI = 2.29–7.56) and self-assessment of therapy adherence (OR = 9.83; 95%CI = 5.44–17.77) were significantly associated with patients’ adherence. Conclusions: Three-quarters of patients were adherent to ART. Researchers should consider these determinants of adherence in developing interventions in further studies.

J 5 — A Data Processing System for Medical Information

1967 ◽  
Vol 06 (01) ◽  
pp. 1-6
Author(s):  
P. Hall ◽  
Ch. Mellner ◽  
T. Danielsson
Keyword(s):  
Medical Records ◽  
Medical Information ◽  
Health Care Systems ◽  
Processing System ◽  
Linear Pattern ◽  
Flexible Form ◽  
Care Systems ◽  
Pattern Recognition Analysis ◽  
Numeric Information

A system for medical information has been developed. The system is a general and flexible one which without reprogramming or new programs can accept any alphabetic and/or numeric information. Coded concepts and natural language can be read, stored, decoded and written out. Medical records or parts of records (diagnosis, operations, therapy, laboratory tests, symptoms etc.) can be retrieved and selected. The system can process simple statistics but even make linear pattern recognition analysis.The system described has been used for in-patients, outpatients and individuals in health examinations.The use of computers in hospitals, health examinations or health care systems is a problem of storing information in a general and flexible form. This problem has been solved, and now it is possible to add new routines like booking and follow-up-systems.

Testing the health literacy of twenty Bangladeshi patients before and 5 months after they begin to access their GP electronic record

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697133
Author(s):  
Richard Fitton ◽  
Amir Hannan ◽  
Ingrid Brindle ◽  
Shafia Begum ◽  
Sarwar Shah
Keyword(s):  
Health Literacy ◽  
Health Outcomes ◽  
Medical History ◽  
Medical Records ◽  
Practice Nurse ◽  
Electronic Record ◽  
Phone Calls ◽  
Before And After ◽  
Medical Histories ◽  
Memory Knowledge

BackgroundPatients with higher health literacy enjoy better health outcomes and are more compliant with treatment. Health literacy is a product of memory, reason and imagination. Patients who can access their records have potentially more memory (knowledge) and make less phone calls to and have less consultations with their GP, practice nurse, HCA and other professionals.AimThe study aims to measure the knowledge that twenty Bangladeshi patients with poor English have of their medical history before and after access to their electronic record.Method55% of patients at Thornley House have access to their medical records. A simple questionnaire was given to 20 Bangladeshi patients before and 5 months after access to their electronic record. The questionnaires recorded the patients’ knowledge of their medical histories. The scores of the completed before and after questionnaires were compared to see if record access had increased patients’ knowledge.ResultsFive patients completed before and after questionnaires. Each achieved a higher score after record access. The differences in scores for the five patients were 2, 5, 1, 10, and 1, respectively.ConclusionHealth literacy for patients is similar to medical literacy for doctors. It requires knowledge, skills and attitudes. We will see whether record access can increase knowledge. Further studies might measure whether that increased knowledge improves skills and attitudes.

scholarly journals Personality Prototypes in People with Type 1 Diabetes and Their Relationship with Adherence

2021 ◽  
Vol 18 (9) ◽  
pp. 4818
Author(s):  
Carmen Sánchez-Urbano ◽  
María J. Pino ◽  
Carlos Herruzo
Keyword(s):  
Type 1 Diabetes ◽  
Personality Traits ◽  
Psychological Health ◽  
Treatment Guidelines ◽  
Control Sample ◽  
Self Care ◽  
Self Report ◽  
Cross Sectional ◽  
Care Guidelines

Type 1 diabetes (Dm1) is a chronic endocrine and metabolic disease that affects the whole person and requires active, decisive treatment. However, personality traits may influence a patient’s adherence to treatment guidelines. The objective of this work is firstly to identify the 3 Asendorpf personality prototypes (resilient, undercontrolled and overcontrolled) in a sample of Dm1 individuals and determine whether there are any differences in comparison with a control sample; and, secondly, to study their association with adherence to self-care guidelines using both physiological indicators (HbA1C) and self-report measures. To achieve these objectives, a descriptive cross-sectional study was carried out. The sample comprised 294 participants, of whom 104 were people with Dm1 and 190 were controls. The participants, aged between 14 and 34 years, were classified by their scores in NEO-FFI-R, according to the personality characteristics inherent to Asendorpf’s prototypes. Asendorpf’s 3 prototypical personality patterns were found both in the group of people with Dm1 and in the control sample. These patterns showed different degrees of association with adherence to self-care guidelines for this disease and with psychological health factors. Importance should therefore be attached to the personality traits and Asendorpf prototypes of people with Dm1 when proposing interventions to address medical, psychological, and behavioral aspects.

scholarly journals Factors associated with preterm birth at Wachemo University Nigist Eleni Mohammed memorial hospital, southern Ethiopia: case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Negeso Gebeyehu Gejo ◽  
Melaku Tesfaye W/mariam ◽  
Biruk Assefa Kebede ◽  
Ritbano Ahmed Abdo ◽  
Abebe Alemu Anshebo ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Antenatal Care ◽  
Medical Records ◽  
Case Control Study ◽  
Southern Ethiopia ◽  
Preterm Neonates ◽  
Factors Associated ◽  
Induced Hypertension ◽  
Control Study

Abstract Background Preterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia. Methods An institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05. Result The current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study. Conclusions The present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.

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