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Drug therapy is a common method to cure diseases and relieve symptoms.The value of patient-reported outcome(PRO)in evaluating the effect of drug therapy has been increasingly paid attention.The PRO scale is a standardized questionnaire,which can scientifically evaluate the experiences and subjective effects of drug use from a patient-centered perspective,and help patients and clinicians make more reasonable medication decisions.By reviewing and sorting out relevant global literature,this paper found that the content of the PRO scales relevant to drug therapy focused on five fields:"medication satisfaction""medication adherence""drug treatment burden""medication-related quality of life"and"adverse drug reactions".This paper described the basic information,measurement characteristics and application of common scales in recent years respectively,and summarized and analyzed the problems and enlightenment of scale development,aiming to provide theoretical reference for the selection,application and development of PRO scales.
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Objective:To study the clinical characteristics and management strategies of patients with chronic obstructive pulmonary disease (COPD) in high-altitude areas.Methods:An observational cross-sectional study was conducted in 79 stable COPD patients who visited the outpatient of Respiratory Medicine at Tibet Autonomous Region People′s Hospital and Peking University Third Hospital from August 3 rd 2020 to November 30 th 2020. Patients were divided into Lhasa group ( n=44) and Beijing group ( n=35). The differences of clinical characteristics including demographic characteristics, risk factors, respiratory symptoms, comorbidities, medications and spirometry were analyzed. Further comparative analysis was conducted on the clinical characteristics of smokers ( n=15) and non-smokers ( n=29) in Lhasa group. Results:The proportion of female patients and biofuel exposure in Lhasa group was significantly higher than Beijing group (56.8% vs 0, 86.4% vs 0, both P<0.001). The proportion of smokers in Lhasa group was significantly lower than Beijing group (34.1% vs 100%, P<0.001). The mean score of COPD assessment test (CAT) in Lhasa group was significantly higher than Beijing group (21.27 vs 9.17, P<0.001). The proportion of acute exacerbations ≥2 in the past year in Lhasa group was significantly higher than Beijing group (31.8% vs 11.4%, P=0.032). The median percentage of forced vital capacity in the first second of predicted value (FEV 1%pred) of patients in Lhasa group was significantly higher than Beijing group (63% vs 38%, P<0.001). The proportion of patients treated by inhaled corticosteroid/long-acting β 2-agonist (ICS/LABA) and inhaled long-acting muscarinic antagonists (LAMA) in Lhasa group was significantly lower than Beijing group (4.5% vs 60.0%, 0 vs 65.7%, both P<0.001). There were no significant differences in CAT score, number of acute exacerbations in the past year and lung function between smokers and non-smokers in Lhasa group. Conclusions:Compared with those patients in Beijing, the majority of patients with COPD living in Lhasa are female, with a low proportion of smokers and a high proportion of biofuel exposure. Although their lung function is better, their respiratory symptoms are more severe with more acute exacerbations in the past year, and most patients do not receive standardized medication.
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BACKGROUND: Spinal pain is most common symptom in pain clinic. In most cases, before the treatment of spinal pain, physician explains the patient's disease and treatment. We investigated patient's satisfaction and physician's explanation related to treatments in spinal pain patients by questionnaires. METHODS: Anonymous questionnaires about physician's explanation and patient's satisfaction in each treatment and post-treatment management were asked to individuals suffering from spinal pain. Patients who have spinal pain were participated in our survey of nationwide university hospitals in Korea. The relationships between patient's satisfaction and other factors were analyzed. RESULTS: Between June 2016 and August 2016, 1007 patients in 37 university hospitals completed the questionnaire. In the statistical analysis, patient's satisfaction of treatment increased when pain severity was low or received sufficient preceding explanation about nerve block and medication (P < 0.01). Sufficient explanation increased patient's necessity of a post-treatment management and patients' performance rate of post-treatment management (P < 0.01). CONCLUSIONS: These results show that sufficient explanation increased patients' satisfaction after nerve block and medication. Sufficient explanation also increased the practice of patients' post-treatment management.
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Humanos , Anônimos e Pseudônimos , Hospitais Universitários , Coreia (Geográfico) , Bloqueio Nervoso , Clínicas de Dor , Satisfação do PacienteRESUMO
Objective To discuss the effect of intensive medication nursing on drug compliance and blood pressure control of patients during oral medication treatment of hypertension. Methods 76 patients with primary hypertension were randomly divided into the intervention group (strengthen medication 38 cases) and the conventional group (routine nursing group, 38 cases) in the Hangzhou Geriatric hospital from March 2016 to April 2017. SBP and DBP were measured before and after treatment in two groups. Results The drug compliance of the patients in the intervention group was significantly higher than that in the conventional group (P<0.05). There was no significant difference in SBP and DBP between of two groups before intervention. After intervention treatment, the levels of SBP and DBP in the intervention group were lower than those in the conventional group (P<0.05). Conclusion Intensive medication nursing of hypertension during oral medication could significantly improve the drug compliance of patients and improve the effects of blood pressure control in patients.
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Objective To discuss the effect of intensive medication nursing on drug compliance and blood pressure control of patients during oral medication treatment of hypertension. Methods 76 patients with primary hypertension were randomly divided into the intervention group (strengthen medication 38 cases) and the conventional group (routine nursing group, 38 cases) in the Hangzhou Geriatric hospital from March 2016 to April 2017. SBP and DBP were measured before and after treatment in two groups. Results The drug compliance of the patients in the intervention group was significantly higher than that in the conventional group (P<0.05). There was no significant difference in SBP and DBP between of two groups before intervention. After intervention treatment, the levels of SBP and DBP in the intervention group were lower than those in the conventional group (P<0.05). Conclusion Intensive medication nursing of hypertension during oral medication could significantly improve the drug compliance of patients and improve the effects of blood pressure control in patients.
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Objective:To investigate the clinical diagnosis and treatment of idiopathic subglottic stenosis.Methods:From May 2012 to January 2014,four patients with idiopathic subglottic stenosis admitted in the Department of Otolaryngology,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China were selected for review.Results:All the four patients with idiopathic subglottic stenosis were resolved after the resection of the pathological tissues and subsequent hormone treatment.Conclusions:The confirmed diagnosis of idiopathic subglottic stenosis mainly relied on the medical history and pathological examination.Favorable treatment effects might be obtained by combining surgical resection and hormone treatment.
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Objective:To compare the therapeutic efficacy and the recurrence rate between the simple repositioning method and the reposition manoeuvre plus medication in the treatment of horizontal semicircular canal otolith benign paroxysmal positional vertigo (HSC-BPPV). Method:Sixty-two patients diagnosed with otolith HSC-BPPV by roll maneuver test were randomly divided into canalith repositioning group (32 patients) and reposition plus drug treatment group (30 patients). Patients in the canalith repositioning group were treated only with Barbecue reposition maneuver; patients in the reposition plus drug treatment group were treated firstly with Barbecue reposition maneuver and then were given Alprostadil, Cinepazide and Betahistine drug treatment. Both groups were evaluated after 7 days and 28 days treatment, and the recurrence rate was analyzed after 3 months. Result:After 7 days of the treatment , the recovery rate of the two groups was 62.5% and 73.3%, respectively. There's no significant difference between the two groups. However, the total effective power of the reposition plus drug treatment group was 96.7%, which was significantly higher than that of the canalith repositioning group (75.0%) (χ²=5.858, P<0.05). There were 8 patients in the canalith repositioning group showed changes of BBPV types after treatment, while only 1 patient in the reposition plus drug treatment group showed lesion changes. The difference was statistically significant (χ²=4.061, P<0.05). After 28 days of the treatment, the recovery rate and the total effective power of the two groups was 100%, respectively. There is no statistical difference in the total effective rate between the two groups. After 3 months follow-up, 2 patients in the canalith repositioning group (6.25%) and in the reposition plus drug treatment group (6.67%) showed BBPV recurrence, and no significant difference in the recurrence rate was found between the two groups (P>0.05). Conclusion:The repositioning maneuver is the preferred method for treating HSC BPPV. Canalith reposition maneuver plus medication has no obvious effect on the recovery rate and the recurrence rate, it only increases the effective rate and reduces the changes of the BBPV types.
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The aim of the present work was to assess the adherence to medication from polymedicated patients before and after the use of a Drug-dispensing System with Usage Control (DDSUC) and compare the levels of the clinical parameters - blood pressure, postprandial glycemia, glycated hemoglobin, triglycerides and cholesterol. DDSUC consisted of a monthly drug-dispensing package, in the shape of a blister with a calendar. This quasi-experimental study was performed in a Basic Health Unit. Twenty four patients were selected to use DDSUC for 4 months. Medication adherence was assessed through Morisky-Green test. Among the participants of the study, 62.5% were women and the average age was 67 years old. Before the use of DDSUC, 83.3% of the patients were considered as "less adherent". After the use of the system, 100% were considered as "more adherent" (p < 0.01), the means of the systolic blood pressure decreased 23.7 mmHg (p=0.000), the diastolic blood pressure decreased 12.1 mmHg (p=0.004) and glycemia diminished 79.3 mg/dl (p=0.000). The use of DDSUC improved the adherence to medication and decreased the values of the clinical parameters, making patients safer when it comes to respecting the correct use of their medication...
O objetivo deste estudo foi avaliar a adesão ao tratamento medicamentoso de pacientes polimedicados antes e após o uso de um Sistema de Dispensação de Medicamentos e Controle de Uso (SDMCU) e comparar os níveis dos parâmetros clínicos - pressão arterial, glicemia pós-prandial, hemoglobina glicada, triglicérides e colesterol. O SDMCU foi constituído por uma embalagem mensal de dispensação de medicamentos, em forma de
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Humanos , Masculino , Feminino , Idoso , Assistência Farmacêutica/provisão & distribuição , Adesão à Medicação , Ensaio Clínico , Doenças Metabólicas/terapiaRESUMO
Analisar os medicamentos das lactantes em tratamento na rede pública de saúde e as ações envolvidas. Métodos: Estudo transversal, quantitativo e descritivo realizado com 100 lactantes selecionadas através de amostragem não probabilística e por conveniência no Hospital Municipal de Duque de Caxias-RJ, no ano de 2012. Aplicou-se um questionário contendo as seguintes variáveis: informações sociodemográficas, medicamentos prescritos, efeitos indesejados nos lactentes, e profissionais envolvidos nas orientações quanto ao uso desses medicamentos. Analisaram-se os dados através da estatística descritiva, a partir de frequências absolutas e relativas. Resultados: Identificou-se que 46% (n=46) das lactantes tinham entre 21 e 30 anos, 54% (n=54) eram primíparas, 52% (n=52) tinham ensino fundamental completo e 72% (n=72) receberam o acompanhamento pré-natal. Verificouse que 78% (n=78) faziam uso de algum tipo de medicamento, dentre eles, um percentual significativo de analgésicos/anti-inflamatórios não esteroidais, com 61,54% (n=48) das lactantes. Todos os medicamentos prescritos estavam na categoria de uso compatível com a amamentação. Constatou-se presença de sintomas indesejados em 19,2% das lactantes (n=15). Das lactantes em terapia medicamentosa, 76,92 % (n=60) tiveram orientação durante o tratamento, sendo 55% (n= 33) por médicos e 45% (n=27) por enfermeiros. Nesta pesquisa, 100% das lactantes ficaram satisfeitas com o aprendizado. Conclusão: Observou-se número elevado de lactantes da amostra fazendo uso de medicamentos, todos compatíveis com a amamentação. Ressalta-se a participação restrita da equipe multidisciplinar nas orientações...
To analyse the medications used by breastfeeding women treated in the public health network, and correlated actions. Methods: Cross-sectional, quantitative and descriptive study carried out with 100 breastfeeding women, recruited through nonprobabilistic convenience sampling, at the Municipal Hospital of Duque de Caxias, RJ, in 2012. A questionnaire was applied containing the following variables: prescribedmedications, unwanted effects in nursing infants, and professionals involved in guidance on the edication. The data was analysed through descriptive statistics, based on absolute and relative frequencies. Results: It was found that 46% (n=46) of the breastfeeding women were aged 21 to 30 years, 54% (n=54) were primiparae, 52% (n=52) had complete fundamental level, and 72% (n=72) received prenatal care. It was verified that 78% (n = 78) of the sample were receiving some type of medicine and, among these, a significant percentage of nonsteroidal analgesic/anti-inflammatory medication, with 61.54% (n=48) of the breastfeeding women. All the prescribed medicines were in the category of compatible use with breastfeeding. The incidence of some unwanted symptoms was evidenced in 19.2% (n=15) of the breastfeeding women. Among the women undergoing medication therapy, 76.92% (n=60) received guidance during treatment, 55% (n=33) by doctors and 45% (n=27) by nurses. In this research, 100% of the breastfeeding women were satisfied with the acquired knowledge. Conclusion: It was noted a high percentage of breastfeeding women in the sample taking medicines, all compatible with breastfeeding. It stands out the limited engagement of the multidisciplinary team in the orientations...
Analizar los medicamentos de las lactantes asistidas en la red pública de salud y las acciones involucradas. Métodos: Estudio transversal, cuantitativo y descriptivo con 100 lactantes seleccionadas a través de muestreo no probabilístico y por conveniencia en el Hospital Municipal de Duque de Caxias-RJ en el año de 2012. Se aplico un cuestionario con las siguientes variables: informaciones sociodemograficas, medicamento prescrito, efectos no deseados en las lactantes y profesionales involucrados con las orientaciones sobre el uso de estos medicamentos. Los datos fueron analizados a través de estadística descriptiva a partir de frecuencias absolutas y relativas. Resultados: Se identifico que el 46% (n=46) de las lactantes tenían entre 21 y 30 años, el 54% (n=54) eran primíparas, el 52% (n=46) tenían la educación secundaria completa y el 72% (n=72) realizaron el prenatal. Se verifico que el 78% (n=78) usaban algún tipo de medicamento, entre ellos, un porcentaje significativo de analgésicos/antiinflamatorios no esteroideo en el 61,54% (n=48) de las lactantes. Todos los medicamentos prescritos eran de uso compatible con la lactancia. Se constató la presencia de sintomas no deseados en el 19,2% (n=15) de las lactantes. De las que estaban en terapia medicamentosa el 76,92 % (n=60) tuvieron orientación durante el tratamiento siendo el 55% (n= 33) por médicos y el 45% (n=27) por enfermeros. En esta investigación El 100% de las lactantes se quedaron satisfechas con el aprendizaje. Conclusión: Se observó un elevado número de lactantes de La muestra en terapia medicamentosa compatible con la lactancia. Se destaca la participación restricta del equipo multidisciplinario en las orientaciones...
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Humanos , Aleitamento Materno , Tratamento Farmacológico , Sistema Único de SaúdeRESUMO
Objetivo: describir y analizar la adherencia a tratamientos farmacológicos y no farmacológicos en personas con hipertensión arterial, inscritas en el programa de control de una empresa social del Estado (ese) de baja complejidad enMontería. Metodología: diseño descriptivo transversal, con abordaje cuantitativo, con una muestra aleatoria de 177 personas que asistieron al servicio de consulta externa a control de la hipertensión arterial, mediante el instrumento "Factores que influyen en la adherencia a tratamientos farmacológicos y no farmacológicos en pacientes con factores de riesgo de enfermedad cardiovascular" de Bonilla y de Reales. Resultados: la mayoría de las personas se encontró en riesgo de no desarrollar comportamientos de adherencia al tratamiento farmacológico y no farmacológico, lo cual guarda relación con los factores socioeconómicos y los relacionados con el proveedor. Los factores relacionados con la terapia y con el paciente reflejaron una situación de ventaja para la adherencia. La relación entre los veinticuatro ítems del instrumento utilizado y la situación adherencia encontrada es lineal y, en general, la relación es fuerte con tendencia positiva. Conclusiones: Se recomienda a los profesionales de enfermería continuar realizando investigaciones sobre el fenómeno de la adherencia al tratamiento en personas con riesgo cardiovascular, con el propósito de contribuir al desarrollo disciplinar y así mejorar las prácticas de cuidado como un aporte a la solución del problema de altos índices de morbimortalidadpor enfermedades cardiovasculares.
Objective: This study aims at describing and analyzing adherence to pharmacological and non-pharmacological treatments of people with arterial hypertension registered in the control program of a State-Owned Social Company (ESE) of low complexity in Monteria. Methodology: Quantitative transversal descriptive design with a random population of 177 people who attended to the outpatient service for control of arterial hypertension through the instrument "Factors having an influence on adherence to pharmacological and non-pharmacological treatments in patients with heart disease risk factors" of Bonilla and Reales. Results: Most people were found to be at risk of not developing behaviors of adherence to the pharmacological and non-pharmacological treatment, which is related to socioeconomic factors and supplier-related factors. The factors related to therapy and the patient proved to have an advantage in adherence. The relation between the twenty-four items of the instrument used is linear and, in general, the relation is strong with a positive trend. Conclusion: Nursing professionals are advised to continue researching about the phenomenon of adherence of people with cardiovascular risk for the purpose of contributing to discipline development and, thus, improving care practices as an input to help solve the problem of high rates of morbimortality for heart diseases.
Objetivo: descrever e analisar a aderência a tratamentos farmacológicos e não farmacológicos em pessoas com hipertensão arterial, inscrita no programa de controle de uma empresa social do Estado (ESE) de baixa complexidade em Montería. Metodologia: desenho descritivo transversal com abordagem quantitativa com uma amostra aleatória de 177 pessoas que compareceram no serviço de consulta externa para controle da hipertensão arterial, mediante o instrumento "Fatores que influem na aderência a tratamentos farmacológicos e não farmacológicos em pacientes com fatores de risco de doença cardiovascular" de Bonilla e Reales. Resultados: verificou-se que a maioria das pessoas não tinham risco de desenvolver comportamentos de aderência ao tratamento farmacológico e não farmacológico, sendo que existe uma relação entre os fatores socioeconómicos e àqueles relacionados com o fornecedor. Os fatores relacionados com a terapia e com o paciente refletiram uma situação de vantagem para a aderência.A relação entre os vinte e quatro itens do instrumento utilizado e a situação de aderência encontrada é linear e, em geral, a relação é forte com tendência positiva. Conclusões: Recomenda-se aos profissionais de enfermagem continuar pesquisando sobre o fenómeno da aderência ao tratamento em pessoas com risco cardiovascular, no intuito de contribuir para o desenvolvimento disciplinar e assim melhorar as práticas de cuidado de modo a contribuir para a solução do problema dos altos índices de morbimortalidade por doenças cardiovasculares.
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Humanos , Cooperação e Adesão ao Tratamento , Hipertensão , Estudos TransversaisRESUMO
OBJECTIVES: The current review aimed to describe the major findings of the NIMH Collaborative Multisite Multimodal Treatment Study of Children with Attention-Deficit Hyperactivity Disorder (MTA) with regard to the treatment of children with attention-deficit hyperactivity disorder (ADHD). METHODS: We performed a general review of the literature regarding the efficacy of the MTA's proposed treatments. RESULTS: There is a large and still increasing body of evidence regarding the MTA's treatment outcomes. We present and discuss details of the findings at each follow-up point. CONCLUSION: Currently, findings regarding the MTA's treatments suggest children with combined-type ADHD exhibit significant impairment in adolescence, despite their initial symptom improvement. Further studies, using innovative treatment approaches and targeting specific areas of adolescent impairment, are needed in order to enhance ADHD treatment outcomes.
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Adolescente , Criança , Humanos , Terapia Combinada , Seguimentos , Glutamatos , Guanina , PemetrexedeRESUMO
OBJECTIVES: This study was performed to investigate the consensus about medication algorithms, including long-term medication treatment strategies, in the treatment of generalized anxiety disorder (GAD). METHODS: The executive committee of the Korean Medication Algorithm Project for GAD developed questionnaires about the psychopharmacologic treatment strategies for patients with GAD. Fifty-five (65%) of 84 experts of a reviewing committee answered the questionnaires. The consensus of expert opinion was classified into three categories, and the treatments of choice were selected by use of 95% confidence intervals and chi-square-tests. RESULTS: The consensus on the first-line treatment strategy for GAD was as follows. Step 1 is the use of the one of a selective serotonin reuptake inhibitor (SSRI), a serotonin and noradrenaline reuptake inhibitor (SNRI) and buspirone for at least four to six weeks. Step 2 is to switch from a SSRI to a SNRI or buspirone or vice versa. Step 3 is to augment medication with an atypical antipsychotic or add a benzodiazepine or antihistamine. Step 4 is to switch to another combination, which includes a SSRI, a SNRI, mirtazapine or a tricyclic antidepressant Step 6 is to review the diagnosis, and 'benzodiazepines including clonazepam and alprazolam can be combined with another drug even from the initial period'. In terms of long-term medication treatment, the consensus first-line tr-eatment strategy involved the use of venlafaxine XR, escitalopram, fluoxetine, paroxetine CR, sertraline and buspirone. CONCLUSION: This study provided information about the consensus among Korean experts regarding medication algorithms, including long-term medication treatment strategies, in the treatment of GAD.