Determinants of glycemic control and quality of Life in type 2 diabetic patients

The aim of this study was to evaluate the influence of socio-economic, clinical and pharmacotherapeutic determinants, adherence to therapy on the quality of life and glycemic control in patients with type 2 diabetes mellitus. We conducted a cross-sectional study exploratory. Data collection was conducted through structured interviews and analysis of medical records. We interviewed 146 adult patients. Increasing age, body mass index, number of antidiabetic medications used and blacks, were related to higher levels of glycated hemoglobin. The results indicate that glycemic control was negatively influenced by non-adherence to drug treatment and a higher complexity of pharmacotherapy was related to noncompliance. Health-Related Quality of life (HRQOL) as assessed by the Nottingham Health Profile has negative influence of diabetes complications. HRQOL, as assessed by the Diabetes Quality of Life (DQOL), was negatively affected by poor glycemic control.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Quality of life among people living with hypertension in a rural Vietnam community

Background - To respond to growing prevalence of hypertension in Vietnam, it is critical to have an in-depth understanding about quality of life (QOL) among people living with hypertension and related factors. This study aimed to measure QOL among hypertensive people in a rural community in Vietnam, and its association with socio-demographic characteristics and factors related to treatment. Methods - This study was conducted in a rural community located 60 km from Ho Chi Minh City. Face-to-face interviews were conducted among 275 hypertensive people aged 50 years and above using WHOQOL-BREF questionnaire. Descriptive statistics were used to examine mean scores of quality of life. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement between different domains of WHOQOL-BREF, respectively. Independent T-test and ANOVA test followed by multiple linear regression analyses were used to measure the association between QOL domains and independent variables. Results - Both overall WHOQOL-BREF and each domain had a good internal consistency, ranging from 0.65 to 0.88. The QOL among hypertensive patients was found moderate in all domains, except for psychological domain that was fairly low (mean = 49.4). Backward multiple linear regressions revealed that being men, married, attainment of higher education, having physical activities at moderate level, and adherence to treatment were positively associated with QOL. However, older age and presence of co-morbidity were negatively associated with QOL. Conclusion - WHOQOL-BREF is a reliable instrument to measure QOL among hypertensive patients. The results revealed low QOL in psychological domain and inequality in QOL across socio-demographic characteristics. Given the results, encouraging physical activities and strengthening treatment adherence should be considered to improve QOL of hypertensive people, especially for psychological aspect. Actions to improve QOL among hypertensive patients targeted towards women, lower educated and unmarried patients are needed in the setting

Performance evaluation of scheduling policies for the DRCMPSP

In this study, we consider the dynamic resource-constrained multi-project scheduling problem (DRCMPSP) where projects generate rewards at their completion, completions later than a due date cause tardiness costs and new projects arrive randomly during the ongoing project execution which disturbs the existing project scheduling plan. We model this problem as a discrete Markov decision process and explore the computational limitations of solving the problem by dynamic programming. We run and compare four different solution approaches on small size problems. These solution approaches are: a dynamic programming algorithm to determine a policy that maximises the average profit per unit time net of charges for late project completion, a genetic algorithm which generates a schedule to maximise the total reward of ongoing projects and updates the schedule with each new project arrival, a rule-based algorithm which prioritise processing of tasks with the highest processing durations, and a worst decision algorithm to seek a non-idling policy to minimise the average profit per unit time. Average profits per unit time of generated policies of the solution algorithms are evaluated and compared. The performance of the genetic algorithm is the closest to the optimal policies of the dynamic programming algorithm, but its results are notably suboptimal, up to 67.2\%. Alternative scheduling algorithms are close to optimal with low project arrival probability but quickly deteriorate their performance as the probability increases

Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation

This study investigated the clinical effects of using a supragingival biofilm control regimen (SUPRA) as a step prior to scaling and root planing (SRP). A split-mouth clinical trial was performed in which 25 subjects with periodontitis (47.2 ± 6.5 years) underwent treatment (days 0–60) and monitoring (days 90–450) phases. At Day 0 (baseline) treatments were randomly assigned per quadrant: SUPRA, SRP and S30SRP (SUPRA 30 days before SRP). The full-mouth visible plaque index (VPI), gingival bleeding index (GBI), periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were examined on days 0, 30, 60, 90, 120, 270, and 450. Baseline data were similar among all groups. From days 0 to 60, the groups showed similar significant decreases in VPI and GBI. Reductions in PPD for the SRP (3.39 ± 0.17 to 2.42 ± 0.16 mm) and S30SRP (3.31 ± 0.11 to 2.40 ± 0.07 mm) groups were greater (p < 0.05) than those for the SUPRA group. This pattern was also observed for BOP. Attachment gain was similar and greater for the SRP (3.34 ± 0.28 to 2.58 ± 0.26 mm) and S30SRP (3.25 ± 0.21 to 2.54 ± 0.19 mm) groups compared to the SUPRA group. Results were maintained from day 90 forward. Overall, the S30SRP treatment reduced the subgingival treatment needs in 48.16%. Performance of a SUPRA step before SRP decreased subgingival treatment needs and maintained the periodontal stability over time

Quality of life perception of type 1 diabetic patients treated with insulin analogs and receiving medication review with follow-up in a public health care service from Ponta Grossa-PR, Brazil

ABSTRACT Glycemic control in patients with diabetes mellitus type 1 (DM1) reduces the risk of complications but requires a rigorous health care routine. Thus, diabetes education is central to increasing treatment compliance and self-care practices. This study aimed to evaluate the quality of life (QoL) and glycemic control of DM1 patients being treated with insulin analogs and receiving medication review with follow-up. This was a transversal study that included 110 patients registered at the 3rd Health Regional of Ponta Grossa-PR, aged &#8805; 18 years, and receiving pharmaceutical care for at least 1 year. The Diabetes Quality of Life Measure (DQOL)-Brazil was used to evaluate QoL. The data were statistically analyzed using SPSS version 17.0 with 95% confidence levels. Of the 110 patients, 58.2% were women. The average age was 33.7 years (±10.5), and the average glycated hemoglobin (HbA1c) value was 8% (±1.4). The mean total DQOL-Brazil score was 2.11 (95% confidence interval, 2.02 - 2.21). All DQOL-Brazil scores were lower in patients with HbA1c &#8804; 8%, indicating a better QoL. Good glycemic control, thus, appears to have a positive influence on the QoL, and pharmaceutical interventions are able to contribute to the achievement of therapeutic targets

Medication dispensing as an opportunity for patient counseling and approach to drug-related problems

ABSTRACT The objective was to describe and evaluate a model of drug dispensing developed and implemented in a community pharmacy in Brazil. This was a descriptive, observational, quasi-experimental study performed in the period between 21 January 2013 and 20 April 2013. The model was evaluated and described in terms of three parameters: structure, process and outcome. The description and assessment of each parameter was performed as follows: (I) Structure: profile of patients, pharmacist's professional profile, physical facility, informational material; (II) Process: drug-related problems, pharmaceutical interventions performed, results of pharmaceutical interventions; (III) Outcome: patient knowledge of medications. Dispensing service improved patient knowledge of medications (p < 0.05), which was associated with pharmacotherapy complexity (p < 0.05). The main problems identified were related to lack of patient knowledge regarding their medication (52.9%). Pharmaceutical interventions were mostly performed directly to the patients (86.3%) by verbal (95.4%) and written (68.2%) information, and most of the problems were completely solved (62.7%). The medicine dispensing model was able to identify and solve drug-related problems and promote an improvement in patient knowledge about medication

Dynamic order acceptance and capacity planning in a stochastic multi-project environment with a bottleneck resource

We study the integration of order acceptance and capacity planning in multi-project environments with dynamically arriving projects. We model this planning problem as a continuous-time Markov decision process to determine long-term optimal decisions. We examine whether macro-process planning should be performed before or after order acceptance. We characterize the structure of optimal policies, and explore the dependence on a number of parameters such as project payoff, project cost, and order arrival time. We also look into the effects of setup costs and the use of non-regular capacity.status: publishe