A systematic approach to educating elderly patients about their medications

The purpose of this study was to evaluate a pharmacist-initiated, total package, patient education program based on the concepts described in the PRECEDE model. This program was directed towards 94 therapeutically complex elderly patients and consisted of a medication history, therapeutic evaluation, patient education needs assessment, patient education session, and a patient feedback/ satisfaction telephone interview. Pharmacists identified on average 5.6 medication-related problems and provided an average of 6.2 recommendations. Problems commonly identified involved inadequate drug knowledge (25.5%), noncompliance (22.7%), and inappropriate drug use (17.4%). Typical recommendations included altering drug use (35.9%), improving compliance behavior (18.1%), and improving communication with health professionals (18.1%). Patient satisfaction with the education session was overwhelmingly positive. Based on the findings of this study, it is apparent that a patient education program based on the PRECEDE model can be used successfully by pharmacists to prepare education plans that would benefit the therapeutically complex elderly patient.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30215/1/0000606.pd

Statistical Mechanics of Glass Formation in Molecular Liquids with OTP as an Example

We extend our statistical mechanical theory of the glass transition from examples consisting of point particles to molecular liquids with internal degrees of freedom. As before, the fundamental assertion is that super-cooled liquids are ergodic, although becoming very viscous at lower temperatures, and are therefore describable in principle by statistical mechanics. The theory is based on analyzing the local neighborhoods of each molecule, and a statistical mechanical weight is assigned to every possible local organization. This results in an approximate theory that is in very good agreement with simulations regarding both thermodynamical and dynamical properties

Capitalist Care : Will the Coalition Government's reforms move the NHS toward a US-style healthcare market?

The Coalition government’s plans for reform are meant to transform the NHS into a more privately run, competitive system, raising the question as to whether or not the NHS is likely to resemble the US capitalist healthcare industry. The US system will be examined for comparative purposes, followed by an analysis of how far earlier reforms under Conservative and New Labour governments have moved the NHS in that direction. The implications of the White Paper proposals are analysed to determine the degree to which the NHS is destined to become a commodity-producing industry. The tentative conclusion is that while secondary care will be similar in many ways to the US hospital industry, state funding remains a barrier to complete transformation, and what is likely to emerge is a hybrid system in which competition, consolidation, and pressure on the workforce all increase.Peer reviewe

Medication Education of Acutely Hospitalized Older Patients

OBJECTIVES: To determine the amount of time spent providing medication education to older patients, the impact of medication education on patients’ knowledge and satisfaction, and barriers to providing medication education. DESIGN: Telephone survey of patients within 48 hours of hospital discharge and direct survey of physicians and pharmacists. SETTING: Internal medicine ward in a tertiary care teaching hospital. PARTICIPANTS: Patients 65 years of age and over regularly taking at least one medication. MEASUREMENTS: Patient demographics, medication use, time spent receiving or providing medication education, and satisfaction scores. MAIN RESULTS: Forty-seven respondents with a mean age of 77.1 years reported that physicians spent a mean of 10.5 minutes (range, 0–60 minutes) and pharmacists spent a mean of 5.3 minutes (range, 0–40 minutes) providing medication education. Fifty-one percent reported receiving no education from either physician or pharmacist, and only 30% reported receiving written medication instructions. Respondents were generally quite satisfied with their education. Physicians identified one or more barriers to providing education 51% of the time and pharmacists 80%. Lack of time was the most common barrier (18%) identified by physicians, but pharmacists cited lack of notification of discharge plans (41%) and lack of time (39%) as the main barriers. Respondents made many medication errors and knew little about their medications. CONCLUSIONS: Although older hospitalized patients received little medication education or written information and made many medication errors with and without medication education, approximately one half of physicians perceived no barriers to providing education