22 research outputs found
Recent results of exenatide use as adjunctive therapy in the treatment of patients with type 2 diabetes
Exenatide is a GLP-1 receptor agonist approved for use in type 2 diabetes mellitus. In clinical trials, significant reductions in serum glucose and weight were demonstrated for exenatide with primary glycemic effects of the twice daily formulation on prandial glucose control. In this paper, we review recent research with exenatide as adjunctive therapy in type 2 diabetes mellitus. In particular, studies demonstrate ongoing benefit on glycemic control and weight reduction with continued therapy up to 82 weeks duration and efficacy as adjunctive therapy for patients taking metformin, thiazolidinediones, and/or a sulfonylurea and as compared to sitagliptin and various insulin formulations. Compared to insulin, exenatide likely has greatest benefit for those patients who are overweight or who need improved prandial glucose control. The new long-acting release formulation of exenatide has demonstrated slightly improved efficacy compared to the twice daily formulation as well as a reduction in gastrointestinal side effects. Emerging research is further exploring novel benefits of exenatide as adjunctive DM therapy, effects on prandial glycemic control, markers of hepatic inflammation, alternative dosage forms including intra-nasal administration, and effects on beta cell function
Interprofessional collaboration: three best practice models of interprofessional education
Interprofessional education is a collaborative approach to develop healthcare students as future interprofessional team members and a recommendation suggested by the Institute of Medicine. Complex medical issues can be best addressed by interprofessional teams. Training future healthcare providers to work in such teams will help facilitate this model resulting in improved healthcare outcomes for patients. In this paper, three universities, the Rosalind Franklin University of Medicine and Science, the University of Florida and the University of Washington describe their training curricula models of collaborative and interprofessional education
An Elective Course to Train Student Pharmacists to Deliver a Community-based Group Diabetes Prevention Program
Objective. To develop and assess the impact of an elective course aimed at improving student knowledge of and confidence in delivering a group diabetes prevention program. Design. Two colleges of pharmacy collaborated to develop a 2-credit elective course using didactic and active-learning strategies to prepare students to serve as lifestyle coaches offering a proven group diabetes prevention program. Assessment. Students' confidence in their ability to deliver a group diabetes prevention program increased as a result of the class. However, their knowledge of diabetes prevention facts was unchanged from baseline. Conclusion. A diabetes prevention elective course improved students' confidence in their ability to teach a diabetes prevention program
Pharmacists’ journey to clinical pharmacy practice in Ethiopia: Key informants’ perspective
Objective: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding and supplying drugs to roles more directly in caring for patients and providing medication consultation to staff. This area of practice is at the infant stage in Ethiopia. The aim of this study was to explore key informants’ perspective in the implementation of clinical pharmacy practice in Jimma University Specialized Hospital, Ethiopia. Method: A qualitative study was conducted through in-depth interviews with the heads of departments (internal medicine, paediatrics, surgery, nurse, pharmacy, medical director, administration) and pharmacy student representatives. Qualitative data analysis was done after audiotapes were transcribed verbatim and notes were compiled. Results: All of the respondents interviewed express diverse and conflicting perspectives on pharmacists’ role, varying from a health-care professional to a business man. Despite this, the current pace of change worldwide takes the professions’ mission to that of a provider of clinical pharmacy services. The data ascertained the change in pharmacy practice, and integrating clinical pharmacy services within the health-care system should be seen as a must. Pharmacists should delineate from a business perspective and focus on widening the scope of the profession of pharmacy and should come close to the patient to serve directly. Conclusions: Although the perception of people on traditional roles of pharmacists was weak, there were promising steps in developing clinical pharmacy practice within the health-care system. Moreover, the results of this study revealed a high demand for this service among health-care providers
Implementing ward based clinical pharmacy services in an Ethiopian University Hospital
Background: Clinical pharmacy practice has
developed internationally to expand the role of a
pharmacist well beyond the traditional roles of
compounding, dispensing and supplying drugs to
roles more directly in caring for patients. Studies on
the activities of the clinical pharmacist in an
inpatient ward in resource constrained settings are
scarce, however.
Objective: To assess ward based clinical pharmacy
services in an internal medicine ward of Jimma
University Specialized Hospital.
Methods: The study was carried out in the internal
medicine ward from March to April, 2011 at Jimma
University Specialized Hospital. The study design
was a prospective observational study where
pharmaceutical care services provided by clinical
pharmacists for inpatients were documented over a
period of two months. Interventions like optimization
of rational drug use and physician acceptance of
these recommendations were documented. Clinical
significance of interventions was evaluated by an
independent team (1 internist, 1 clinical
pharmacologist) using a standardized method for
categorizing drug related problems (DRPs).
Results: A total of 149 drug related interventions
conducted for 48 patients were documented; among
which 133(89.3%) were clinical pharmacists initiated
interventions and 16(10.7%) interventions were
initiated by other health care professionals. The
most frequent DRPs underlying interventions were
unnecessary drug therapy, 36(24.2%); needs
additional drug therapy, 34(22.8%) and
noncompliance, 29(19.5%). The most frequent
intervention type was change of dosage/instruction
for use, 23(15.4%). Acceptance rate by physicians
was 68.4%. Among the interventions that were
rated as clinically significant, 46(48.9%) and
25(26.6%) had major and moderate clinical
importance respectively.
Conclusion: Involving trained clinical pharmacists
in the healthcare team leads to clinically relevant
and well accepted optimization of medicine use in a
resource limited settings. This approach can likely be generalized to other health care settings in the
country to improve medication outcomes.Antecedentes: El ejercicio de la farmacia clínica se
ha desarrollado internacionalmente para expandir el
papel del farmacéutico más allá de los papeles
tradicionales de formulación, dispensación y
distribución de medicamentos a papeles más
directamente relacionados con los cuidados de los
pacientes. Sin embargo, son escasos los estudios de
las actividades del farmacéutico clínico en los
departamentos en establecimientos de recursos
escasos.
Objetivo: Evaluar los servicios de farmacia clínica
en un departamento de medicina interna del
hospital universitario especializado de Jimma.
Métodos: El estudio fue realizado en el
departamento de medicina interna desde marzo a
abril de 2011 en el hospital Universitario
especializado de Jimma. El diseño del estudio fue
observacional prospectivo donde se documentaron
los servicios de atención farmacéutica
proporcionados por un farmacéutico clínico a
pacientes internados durante un periodo de dos
meses. Se documentaron intervenciones como la
optimización del uso racional y la aceptación de los
médicos de estas recomendaciones. Un equipo
independiente (1 internista y 1 farmacólogo clínico)
evaluó la significación clínica de estas
intervenciones usando un método estandarizado de
clasificar los problemas relacionados con
medicamentos (PRM).
Resultados: Se realizó un otal de 149
intervenciones para 48 pacientes.; de ellos, 133
(83,9%) fueron intervenciones iniciadas por el
farmacéutico clínico y 16 (10,7%) fueron iniciadas
por otros profesionales de la salud. Los PRM más
frecuentes subyacentes a cada intervención fueron
medicación innecesaria 36 (24,2%); necesidad de
medicación adicional 34 (22,8%); e incumplimiento
29 (19,5%). El tipo de intervención más frecuente
fue el cambio de dosis/instrucciones de uso
23(15.4%). La tasa de aceptación por médicos fue
del 68,4%. Entre las intervenciones que fueron
calificadas de clínicamente significativas, 46 (48,9%) y 25 (26,6%) tuvieron grande y moderada
importancia clínica, respectivamente.
Conclusión: Envolver a un farmacéutico clínico en
el equipo de salud lleva a la optimización
clínicamente relevante y aceptada del uso de
medicamentos en un establecimiento de recursos
limitados. Este abordaje puede, probablemente,
generalizarse a otros establecimientos en el país
para mejorar los resultados de la medicación