scholarly journals Addressing Adherence to Treatment: A Longstanding Concern. The Patients’ Perspective

2014 ◽  
Vol 4 (3) ◽  
pp. 27-28
Author(s):  
Mahmoud Hadipour Dehshal
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Working Hours ◽  
Well Being ◽  
Point Of View ◽  
Inherited Disease ◽  
Treatment Team ◽  
Health Providers ◽  
Adherence To Treatment ◽  
Related Factors

Adherence to treatment is a great concern for patients who need long-life treatment. Thalassaemia is an inherited disease for whose treatment team-working is of a considerable importance. To logically face the problem of poor compliance patients, all members of the team ought to be aware of the causing factors and the ways to handle the problem. The factors which cause the lack of compliance among patients could be stratified into economic and structural facto. Furthermore, patient-related factors including ethnicity, gender, age, and regimen complexity such as dosing are also noteworthy. The supportive relationship between the health providers and the patients should be also established such as patients’ trust in their doctors. Last but not least, the pattern of health care delivery including the availability of health care requisites and operation of flexible hours and floating working hours. From the patients’ point of view, it is important to be aware of the significance of the adherence to treatment and the importance of providing prompt-routine reminders to patients to understand the consequence of incomplete treatment. Trained and motivated staffs play an effective role to enhance patients’ tendency to pursue the determined treatment. Health decision makers would be better to reinterpret the concept of health to “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. The patients’ role in self-management should not be ignored and “medicalization” has to be altered by the patient centered care.

Direct Primary Care: A Successful Financial Model for the Clinical Practice of Lifestyle Medicine

2021 ◽  
pp. 155982762110066
Author(s):  
Amy R. Mechley
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Well Being ◽  
The United States ◽  
Fee For Service ◽  
Financial Model ◽  
Lifestyle Medicine ◽  
Direct Primary

Primary care has been shown to significantly decrease the overall cost of a population’s health care while improving the quality of each person’s well-being. Lifestyle medicine (LM) is ideally positioned to be delivered via primary care and has been shown to improve short- and long-term health outcomes of patients and populations. Direct primary care (DPC) represents a viable alternative to the fee-for-service reimbursement model. It has been shown to be economically and financially sustainable. Furthermore, it has the potential to fulfill the Quadruple Aim of health care in the United States. LM practiced in a DPC model has the potential to transform health care delivery. This article will discuss the need for health care systems change, provide an overview of the DPC model, demonstrate a basic understanding of the benefits, and review the steps needed to de-risk the investment of time, money, and resources for our future DPC providers.

scholarly journals Improving Retention in Care and Promoting Adherence to HIV Treatment: Protocol for a Multisite Randomized Controlled Trial of Mobile Phone Text Messaging (Preprint)

2019 ◽  
Author(s):  
Elvis Asangbeng Tanue ◽  
Dickson Shey Nsagha ◽  
Nana Njamen Theophile ◽  
Jules Clement Nguedia Assob
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Mobile Phones ◽  
Text Messaging ◽  
Care Delivery ◽  
Retention In Care ◽  
Hiv Treatment ◽  
Text Messages ◽  
Adherence To Treatment ◽  
Randomized Controlled

BACKGROUND The World Health Organization has prioritized the use of new technologies to assist in health care delivery in resource-limited settings. Findings suggest that the use of SMS on mobile phones is an advantageous application in health care delivery, especially in communities with an increasing use of this device. OBJECTIVE The main aim of this trial is to assess whether sending weekly motivational text messages (SMS) through mobile phones versus no text messaging will improve retention in care and promote adherence to treatment and health outcomes among patients receiving HIV treatment in Fako Division of Cameroon. METHODS This is a multisite randomized controlled single-blinded trial. Computer-generated random block sizes shall be used to produce a randomization list. Participants shall be randomly allocated into the intervention and control groups determined by serially numbered sealed opaque envelopes. The 156 participants will either receive the mobile phone text message or usual standard of care. We hypothesize that sending weekly motivational SMS reminders will produce a change in behavior to enhance retention; treatment adherence; and, hence, health outcomes. Participants shall be evaluated and data collected at baseline and then at 2, 4, and 6 months after the launch of the intervention. Text messages shall be sent out, and the delivery will be recorded. Primary outcome measures are retention in care and adherence to treatment. Secondary outcomes are clinical (weight, body mass index), biological (virologic suppression, tuberculosis coinfection), quality of life, treatment discontinuation, and mortality. The analysis shall be by intention-to-treat. Analysis of covariates shall be performed to determine factors influencing outcomes. RESULTS Recruitment and random allocation are complete; 160 participants were allocated into 3 groups (52 in the single SMS, 55 in the double SMS, and 53 in the control). Data collection and analysis are ongoing, and statistical results will be available by the end of August 2019. CONCLUSIONS The interventions will contribute to an improved understanding of which intervention types can be feasible in improving retention in care and promoting adherence to antiretroviral therapy. CLINICALTRIAL Pan African Clinical Trial Registry in South Africa PACTR201802003035922; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3035 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15680

scholarly journals Addressing Adherence to Treatment: A Longstanding Concern. The Health Care Professional

2014 ◽  
Vol 4 (3) ◽  
pp. 25-26
Author(s):  
Farrukh Shah
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Iron Overload ◽  
Effective Treatment ◽  
Cardiac Failure ◽  
Short Paper ◽  
Thalassaemia Major ◽  
Adherence To Treatment ◽  
Related Factors ◽  
Adequate Provision

Today a patient born with thalassaemia major can expect to have a near normal life expectancy and remain free of complications of iron overload with good monitoring and excellent transfusion and chelation regimes. Unfortunately patients still develop complications as a consequence of iron overload including endocrinopathies and cardiac failure. The main reason behind this failure of effective treatment is inadequate treatment. This can be due to either clinician related factors, patient related factors or lack of adequate provision of medicines and services. In this short paper I will highlight where the challenges lie with regards adherence to treatment and suggest approaches to manage this.

Broadband for Health in Developing Countries

2011 ◽  
pp. 581-592 ◽  
Author(s):  
Aradhana Srivastava
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Information And Communication Technologies ◽  
Information Dissemination ◽  
Care Delivery ◽  
Health Sector ◽  
Health Providers ◽  
Policy Direction ◽  
Immense Potential

This chapter highlights the major issues in the use of broadband technologies in health care in developing countries. The use of Internet technologies in the health sector has immense potential in developing countries, especially in the context of public health programs. Some of the main uses of information and communication technologies (ICT) in health include remote consultations and diagnosis, information dissemination and networking between health providers, user groups, and forums, Internet-based disease surveillance and identification of target groups for health interventions, facilitation of health research and support to health care delivery, and administration. The technology has immense potential, but is also constrained by lack of policy direction, problems with access to technology, and lack of suitable infrastructure in developing nations. However, given its crucial role in public health, comprehensive efforts are required from all concerned stakeholders if universal e-health is to become a reality.

scholarly journals Patient Views of Behavioral Health Providers in Primary Care: A Qualitative Study of 2 Southeastern Clinics

2019 ◽  
Vol 7 (4) ◽  
pp. 527-533
Author(s):  
Aubry N Koehler ◽  
Grisel Trejo ◽  
Joanne C Sandberg ◽  
Brittany H Swain ◽  
Gail S Marion ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Care Delivery ◽  
Behavioral Health Care ◽  
Patient Care Team ◽  
Care Team ◽  
Care Practice ◽  
Health Providers ◽  
Integrated Behavioral Health

Background: Limited research is available around patient experience of integrated behavioral health care in primary care settings. Objective: We sought to identify the major themes through which patients described their integrated behavioral health care experiences as a means of informing and improving clinic processes of integrated health care delivery. Methods: We captured viewpoints from 16 patients who experienced an integrated behavioral health care model from 2 primary care clinics and completed at least 3 visits with a behavioral health provider (BHP). Using grounded theory analyses, we coded and analyzed transcriptions for emergent themes. Analysis: The interview process yielded 3 major themes related to the BHP including (a) the BHPs’ clinic presence made behavioral health care more convenient and accessible, (b) BHPs worked within time and program limitations, and (c) BHPs helped with coping, wellness, and patient-care team communication. Conclusion: The BHPs serving in a large primary care practice and a Federally Qualified Health Center played an important role in connecting patients with behavioral health care and improving care team collaboration, both in terms of communication within the team and between the team and the patient/family.

Adult Care in Cystic Fibrosis

2019 ◽  
Vol 40 (06) ◽  
pp. 857-868 ◽  
Author(s):  
J. Stuart Elborn
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Care Delivery ◽  
Health Care Systems ◽  
Well Being ◽  
Models Of Care ◽  
Adult Care ◽  
Care Systems ◽  
Expanding Population ◽  
Almost All

AbstractCystic fibrosis (CF) is now more common in adults than children in countries with well-developed health care systems. The number of adults continues to increase and will further increase if the new cystic fibrosis transmembrane conductance regulator (CFTR) modulators are disease modifying. Most of the complex morbidity and almost all the mortality of CF occur in adults and will increasingly follow this pattern even with new effective modulator therapies. Maintaining good quality of life including social functioning and maximizing survival for adults are the key priorities. This requires a highly knowledgeable and adaptable multidisciplinary team, which, though focused on maintaining lung health, requires an increasing range of other disciplines and specialties to maximize well-being. Changes in health care systems will require current models of care to adapt to provide care for the large number of adult patients. With increasing survival and age, many are likely to have both CF morbidities and additional diseases of aging. New models are needed for health care delivery for this expanding population with complex medical conditions.

scholarly journals Occupational Well-Being in Beginning Early Childhood Educators of Hong Kong and the Prediction of Job-Related Factors: Variable-Centered and Person-Centered Approaches

2021 ◽  
Vol 12 ◽  
Author(s):  
Jian-Bin Li ◽  
An Yang ◽  
Rui Zhang ◽  
Tuen Yung Leung ◽  
Zhouxing Li
Keyword(s):  
Early Childhood ◽  
Regression Analysis ◽  
Hong Kong ◽  
Job Demands ◽  
Working Hours ◽  
Well Being ◽  
Early Childhood Educators ◽  
Job Resources ◽  
Spring Semester ◽  
Related Factors

The occupational well-being (OWB) of early childhood educators (ECEs) play a crucial role in their job performance, the development of a child, and the operation of early childhood education sectors. OWB of ECEs has been an increasing concern in recent years and this concern might be particularly salient for beginning ECEs given the multiple adaptive changes and challenges they encounter during the transition from training to teaching. However, research on the beginning ECEs’ OWB has been scarce. In this study, we employed both variable-centered and person-centered approaches to explore OWB and examined job demands and resources as predictors in 117 Hong Kong beginning ECEs (113 females, Mage = 21.71 years). They first reported job demands (i.e., class size, working hours, dealing with children with special education needs) and job resources (i.e., salary and job support) at the end of the first month of the fall semester upon working as in-service teachers. They then reported on four OWB variables (i.e., job satisfaction, work engagement, job stress, and job burnout) at the beginning of the spring semester. Results of the variable-centered analysis revealed that beginning ECEs reported medium or above-medium levels on the positive OWB indicators and medium or below-medium levels on the negative OWB indicators. Regression analysis found that despite some exceptions, job demands and job resources negatively (positively) and positively (negatively) predicted positive (negative) OWB indicators, respectively. Results of person-centered analysis suggested that the complex pattern of different OWB indicators could be categorized into two OWB profiles (medium well-being vs. relatively weak well-being – emotional exhaustion). Results of regression analysis showed that beginning ECEs with higher job demands were less likely, whereas those with more job resources were more likely, to be assigned to the medium well-being profile. These results inform which leverage points could be targeted to enhance a specific OWB indicator and identify who would be in dire need to enhance their OWB at the very beginning of their teaching career.

scholarly journals Do no harm

2020 ◽  
Author(s):  
Hasan Hawilo ◽  
Elise Quint
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Care Delivery ◽  
Organizational Factors ◽  
Well Being ◽  
Professional Challenges ◽  
Do No Harm ◽  
Canadian Health ◽  
Canadian Health Care

Physician wellness and burnout have long been important topics in Canadian health care. Though burnout presents in various occupations, physicians experience unique professional challenges that predispose them to experience burnout. Elements inciting this chronic condition are introduced early in medical education, reinforced during residency training, and poorly addressed during clinical practice. Substantial evidence demonstrates that burnout has significant and undesirable impacts on patient outcomes and care delivery. Physician quality of life and well-being as well as health care spending are also negatively impacted by burnout. However, there is an ongoing need to apply these research results in the clinical setting. Currently, research suggests that individual, cultural, and organizational factors play a role in the development and maintenance of burnout. Best practices to prevent burnout and manage its effects, including interventions during medical education and greater work autonomy, are required to address barriers to wellness at each of these levels.

scholarly journals Determinants of utilization of maternal health care services among mothers in Harare, Zimbabwe

2019 ◽  
Author(s):  
Eunice Nyarambi ◽  
Paddington Tinashe Mundagowa ◽  
Prosper Chonzi ◽  
Elizabeth Chadambuka
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Maternal Health Care ◽  
Health Facilities ◽  
Related Factors ◽  
Care Services ◽  
Maternal Health Care Services

Abstract Background: Provision of quality maternal health care services is an essential component in ensuring a healthy mother-baby dyad both pre- and post-delivery. In Africa, antenatal care, postnatal care, and skilled birth attendances are very low when compared to high-income countries. The continent has a high burden of maternal and infant morbidity as well as mortality rates. According to the Harare Annual Report of 2016, the number of women seeking maternal health care services was gradually declining from 2014 and pregnant women reported various challenges in accessing health care services. Methods: A 1 to 1 case-control study was conducted in Harare West South Western District using pretested interviewer-administered questionnaires. The study was carried out at all three clinics in the district and a total of 73 cases and 73 controls were selected using a systematic random sampling method. Quantitative data were analyzed using Epi Info statistical package and qualitative data was analyzed thematically. Results: The median ages for cases and controls were 29 and 24 years, respectively and the age-group 19 to 24 years constituted the majority of participants (41%). Predictors of utilization of services were young age ( < 24 years), birth order of < 2, maternal and paternal occupation, and religion. Enabling factors included: asking for permission to seek care, absence of transport challenges, a shorter distance to the health facility, affordability of health services, and a higher household income. Besides the shortage of skilled staff at the clinics, mothers endured long waiting hours to be served. The majority of the cases (78.1 %) and controls (72.6%) preferred to be attended by male nurses. Mothers were required to pay a $25 fee for booking and city medical staff rarely visited the clinics. Conclusion: The utilization of maternal health care services in Harare is dependent on the individual, household, and system-related factors. There was a need to articulate policies and design maternal health care programs that target socially and economically marginalized women. Creating women-friendly health facilities with extended hours for the antenatal care, delivery care and post-natal care services for mothers can help to decongest the health facilities.

Emotional burden and distress among caregivers of cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20722-e20722
Author(s):  
Harpreet Sidhu ◽  
Mir Asif Alikhan ◽  
Michael Glasser
Keyword(s):  
Health Care ◽  
Physical Health ◽  
Family Member ◽  
Health Care Providers ◽  
Cancer Diagnosis ◽  
Emotional Health ◽  
Family Members ◽  
Well Being ◽  
Health Providers ◽  
Care Providers

e20722 Background: Due to the nature of the disease, caregivers of patients with cancer encounter high levels of burden and distress. Very little research has examined the needs of cancer caregivers and ways to address these needs. Health providers might overlook the emotional aspects of a disease and diagnosis, being occupied and busy with other aspects of patient care. Methods: Questionnaires with a focus on personal physical health, emotional health, care received, and medical care in general were handed out to patients and family members. Health providers were given similar questionnaires. Results: There were 45 participants in total: 18 health providers, 10 patients, and 17 family members. Similarities or differences between the attitudes of family members, health providers, and patients were found. Providers more negatively assessed the effect of a patient’s cancer on the well-being of family members than did patients/family members. Family member physical health was more negatively rated [P < 0.001] by providers, as was family member emotional health [P< 0.001]. Providers were also more likely to check distresses on the NCCN distress thermometer than were patients/family members. Responses were similar between urban and rural participants. Conclusions: Family members did not feel that the cancer diagnosis had affected their overall well-being in an overtly negative way. Health care providers believed that the cancer diagnosis had more of a negative effect on family member well-being. Future studies should look at attitudes of doctors/physicians versus other health providers to family member well-being after a patient’s cancer diagnosis.

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