A Study on Impact of Clinical Pharmacist Interventions on Medication Adherence and Quality of Life in Rural Hypertensive Patients

Hypertension is the very common chronic disease in rural, urban and semi-urban areas of today's world, which needs continuous monitoring and treatment through out the life. Lack of education, lifestyle modification, and low level of understanding on disease management in rural people will influence directly on their quality of life (QOL). The objective of this study was to know the impact of clinical pharmacist interventions on medication adherence and QOL. It was a prospective, randomized and interventional study. Fifty-six patients were enrolled; only 52 patients completed the study. Interventional group patients received patient counselling, patient information leaflets (PILS), and frequent telephonic reminding. In the baseline, first and second follow-ups, medication adherence and QOL were assessed by using Morisky Medication Adherence Scale (MMAS) and Medication Adherence Report Scale (MARS) Questionnaires and SF-12v2 Quality of life Questionnaire in both the groups. The results showed that systolic blood pressure P value in the second follow-up was 0.086+ when compared to baseline follow-up P value 0.094. The diastolic blood pressure reading of the intervention group at the second follow-up was 77.73 ± 3.63 in mmHg when compared to the baseline, i.e. 86.62 ± 11.35 in mmHg. The MMAS and MARS scores P values were 0.007**, 1.000, <0.001**; 0.007, 0.014 and 0.000 at the baseline, first and second follow-ups, respectively. The QOL score P values of physical component scale and mental component scale showed highly significant. This study concluded/showed that the impact of clinical pharmacist provided patient counselling had a positive impact on medication adherence and QOL

Pharmacotherapy review: a proposal to improve medication adherence among hypertensive patients

Abstract Pharmacotherapy review is a structured assessment of medicines, which aims to obtain a partnership with patients to achieve drug treatment goals and agreement about drug dosage, as well as when and how the drugs should be administered. The objective was to analyze the influence of pharmacotherapy review, by scheduling drug administration to improve medication adherence among antihypertensive patients. This study was an uncontrolled intervention developed in three distinct stages. The first stage included data collection on the profile of patients and their medications, and a preliminary assessment of medication adherence. In the second stage, the review report was delivered to patients. In the third stage, the results of blood pressure and medication adherence were assessed. The influence of the revision was measured through statistical tests (p<0.05). The study included 40 patients with a mean age of 58.0 (SD:11.3) years; 72.5% were women. Thirty-three (82.5 %) patients required some intervention, after when there was a significant increase in the number of daily doses (p=0.039) and drug intakes (p=0.025). There was a significant increase in the adherence rate, according to both the Morisky-Green test (p<0.001) and self-reported assessment (p=0.004). There was also an improvement in the levels of systolic (p<0.001) and diastolic (p=0.002) blood pressure and in the number of patients with controlled hypertension (p=0.006). The pharmaceutical service enhanced medication adherence and control of systemic blood pressure; however, it increased the complexity of treatment

Adherence to medication before and after the use of a Drug-Dispensing System with usage control

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.</p

Measurement of prompt D0^{0} and D‾\overline{D}0^{0} meson azimuthal anisotropy and search for strong electric fields in PbPb collisions at root SNN\sqrt{S_{NN}} = 5.02 TeV

The strong Coulomb field created in ultrarelativistic heavy ion collisions is expected to produce a rapiditydependent difference (Av2) in the second Fourier coefficient of the azimuthal distribution (elliptic flow, v2) between D0 (uc) and D0 (uc) mesons. Motivated by the search for evidence of this field, the CMS detector at the LHC is used to perform the first measurement of Av2. The rapidity-averaged value is found to be (Av2) = 0.001 ? 0.001 (stat)? 0.003 (syst) in PbPb collisions at ?sNN = 5.02 TeV. In addition, the influence of the collision geometry is explored by measuring the D0 and D0mesons v2 and triangular flow coefficient (v3) as functions of rapidity, transverse momentum (pT), and event centrality (a measure of the overlap of the two Pb nuclei). A clear centrality dependence of prompt D0 meson v2 values is observed, while the v3 is largely independent of centrality. These trends are consistent with expectations of flow driven by the initial-state geometry. ? 2021 The Author. Published by Elsevier B.V. This is an open access article under the CC BY licens

Observation of electroweak production of Wγ with two jets in proton-proton collisions at √s = 13 TeV

A first observation is presented for the electroweak production of a W boson, a photon, and two jets in proton-proton collisions. The W boson decays are selected by requiring one identified electron or muon and an imbalance in transverse momentum. The two jets are required to have a high dijet mass and a large separation in pseudorapidity. The measurement is based on data collected with the CMS detector at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb$^{-1}$. The observed (expected) significance for this process is 4.9 (4.6) standard deviations. After combining with previously reported CMS results at 8 TeV, the observed (expected) significance is 5.3 (4.8) standard deviations. The cross section for the electroweak W$_{γjj}$ production in a restricted fiducial region is measured as 20.4 +/- 4.5 fb and the total cross section for W$_{γ}$ production in association with 2 jets in the same fiducial region is 108 +/- 16 fb. All results are in good agreement with recent theoretical predictions. Constraints are placed on anomalous quartic gauge couplings in terms of dimension-8 effective field theory operators

Measurements of production cross sections of polarized same-sign W boson pairs in association with two jets in proton-proton collisions at s=13 TeV

The first measurements of production cross sections of polarized same-sign W±W±boson pairs in proton-proton collisions are reported. The measurements are based on a data sample collected with the CMS detector at the LHC at a center-of-mass energy of 13TeV, corresponding to an integrated luminosity of 137fb−1. Events are selected by requiring exactly two same-sign leptons, electrons or muons, moderate missing transverse momentum, and two jets with a large rapidity separation and a large dijet mass to enhance the contribution of same-sign W±W±scattering events. An observed (expected) 95% confidence level upper limit of 1.17 (0.88)fbis set on the production cross section for longitudinally polarized same-sign W±W±boson pairs. The electroweak production of same-sign W±W±boson pairs with at least one of the Wbosons longitudinally polarized is measured with an observed (expected) significance of 2.3 (3.1) standard deviations.SCOAP

Portable Acceleration of CMS Computing Workflows with Coprocessors as a Service

Computing demands for large scientific experiments, such as the CMS experiment at the CERN LHC, will increase dramatically in the next decades. To complement the future performance increases of software running on central processing units (CPUs), explorations of coprocessor usage in data processing hold great potential and interest. Coprocessors are a class of computer processors that supplement CPUs, often improving the execution of certain functions due to architectural design choices. We explore the approach of Services for Optimized Network Inference on Coprocessors (SONIC) and study the deployment of this as-a-service approach in large-scale data processing. In the studies, we take a data processing workflow of the CMS experiment and run the main workflow on CPUs, while offloading several machine learning (ML) inference tasks onto either remote or local coprocessors, specifically graphics processing units (GPUs). With experiments performed at Google Cloud, the Purdue Tier-2 computing center, and combinations of the two, we demonstrate the acceleration of these ML algorithms individually on coprocessors and the corresponding throughput improvement for the entire workflow. This approach can be easily generalized to different types of coprocessors and deployed on local CPUs without decreasing the throughput performance. We emphasize that the SONIC approach enables high coprocessor usage and enables the portability to run workflows on different types of coprocessors