Impact of a pharmaceutical care programme on health-related quality of life among women with epilepsy: a randomised controlled trial (IPHIWWE study)

This paper was presented in part at the II Congreso Colombiano de Atención Farmacéutica, Medellín, Colombia, September 27, 2013.Background: Epilepsy is a complex chronic disorder which affects health-related quality of life (HRQOL), especially in women. Pharmaceutical care (PC) allows direct intervention between the pharmacist, the patient and the other healthcare team members to optimise treatments in order to reduce negative outcomes related to medication and contribute to improving HRQOL. The aim of the study was to establish the impact of the application of a pharmaceutical care programme on the HRQOL of women with epilepsy.Methods: This study is a pragmatic randomised controlled trial involving women with epilepsy (WWE) over 18 years of age. The intervention group (IG) received a pharmaceutical care programme consisting of medication review follow-up according to Dáder’s method, health education and therapeutic drug monitoring of anticonvulsants. The impact was assessed by changes in seizure frequency, in the self-administered questionnaires (the QOLIE-31, Liverpool AEP, CES-D, Haynes-Sackett test and Moriski-Green test) and between the first interview and the one at the end of six months of follow-up. A Student’s t-test was performed to compare the final QOLIE-31 score between groups and a paired Student’s t-test was used to determine the change in each group between the start and the end of follow-up.Results: One hundred eighty-two WWE entered the study and 144 (79.1%) completed it. The t-test for comparing the final QOLIE-31 scores between groups yielded a t = −2.166 and confidence interval (CI) (95%): −10.125; −0.4625, p-value =0.0319. The change (Δ) in the QOLIE-31 score for the IG was 12.45 points (p-value <0.001) and for the control group it was 2.61 (p-value =0.072). With 10.7 as the minimally important change we found a relative risk of 2.17 (CI: 1.37; 3.43) and a number needed to treat (NNT) of 3.5.Conclusions: The study demonstrated that the application of a pharmaceutical care programme significantly improves HRQOL in WWE. The NNT we found allows a recommendation to implement the PC programme for the additional benefit that would be obtained in patients’ HRQOL.This study was funded by a competitive investigator grant award from the Universidad Nacional de Colombia (Colombia) - Research Division of Bogotá (ref: 202010011419 Quipu Code)

Dark Energy Survey Year 3 results: Constraints on extensions to ΛcDM with weak lensing and galaxy clustering

We constrain six possible extensions to the Λ cold dark matter (CDM) model using measurements from the Dark Energy Survey's first three years of observations, alone and in combination with external cosmological probes. The DES data are the two-point correlation functions of weak gravitational lensing, galaxy clustering, and their cross-correlation. We use simulated data vectors and blind analyses of real data to validate the robustness of our results to astrophysical and modeling systematic errors. In many cases, constraining power is limited by the absence of theoretical predictions beyond the linear regime that are reliable at our required precision. The ΛCDM extensions are dark energy with a time-dependent equation of state, nonzero spatial curvature, additional relativistic degrees of freedom, sterile neutrinos with eV-scale mass, modifications of gravitational physics, and a binned σ8(z) model which serves as a phenomenological probe of structure growth. For the time-varying dark energy equation of state evaluated at the pivot redshift we find (wp,wa)=(-0.99-0.17+0.28,-0.9±1.2) at 68% confidence with zp=0.24 from the DES measurements alone, and (wp,wa)=(-1.03-0.03+0.04,-0.4-0.3+0.4) with zp=0.21 for the combination of all data considered. Curvature constraints of ωk=0.0009±0.0017 and effective relativistic species Neff=3.10-0.16+0.15 are dominated by external data, though adding DES information to external low-redshift probes tightens the ωk constraints that can be made without cosmic microwave background observables by 20%. For massive sterile neutrinos, DES combined with external data improves the upper bound on the mass meff by a factor of 3 compared to previous analyses, giving 95% limits of (ΔNeff,meff)≤(0.28,0.20 eV) when using priors matching a comparable Planck analysis. For modified gravity, we constrain changes to the lensing and Poisson equations controlled by functions ς(k,z)=ς0ωΛ(z)/ωΛ,0 and μ(k,z)=μ0ωΛ(z)/ωΛ,0, respectively, to ς0=0.6-0.5+0.4 from DES alone and (ς0,μ0)=(0.04±0.05,0.08-0.19+0.21) for the combination of all data, both at 68% confidence. Overall, we find no significant evidence for physics beyond ΛCDM