25 research outputs found
Pharmaceutical consultation as a tool to improve health outcomes for patients with type 2 diabetes
This study develops and evaluates a pharmaceutical consultation program (PCP) to improve treatment for Type 2 diabetes patients (T2DP) and reduce risk factors for diabetic complications with possible application in other chronic diseases. We recruited T2DP receiving conventional medical treatment but with fasting glycemia >140mg/dl and/or glycated hemoglobin >7%. The PCP includes strategies obtained from Dader's method, the PWDT (Pharmacist's Workup of Drug Therapy method) model of pharmaceutical care, the SOAP (Subjective data, Objective data, Assessment, and Plan of care) method, and concepts based on a nursing care model. The PCP evaluated lifestyle, pharmacotherapy and monitoring it using laboratory tests, vital signs, and anthropometry. These procedures were repeated every 4 months for 1 year. Data obtained in each consultation were used to provide patient education focusing on healthy lifestyles and medications. Fifty patients completed the PCP. There were reductions in glycemia (PNeste estudo, desenvolvemos e avaliamos um programa de consulta farmacĂȘutica (PCF) visando melhorar o tratamento de pacientes diabĂ©ticos tipo 2 (PDT2) e reduzir os fatores de risco de complicaçÔes diabĂ©ticas com possibilidade de aplicação em outras doenças crĂŽnicas. Para alcançar este propĂłsito, PDT2 recebendo tratamento mĂ©dico convencional, apresentando glicemia de jejum > 140 mg/dl e/ou hemoglobina glicada >7% foram selecionados. O PCF inclui estratĂ©gias obtidas a partir do mĂ©todo de Dader, do modelo de cuidados farmacĂȘuticos PWDT (Pharmacist's Workup of Drug Therapy method), do mĂ©todo SOAP (Subjective data, Objective data, Assessment, and Plan of care) e conceitos baseados em um modelo de cuidados em enfermagem. O PCF avaliou o estilo de vida, farmacoterapia e seu monitoramento atravĂ©s de exames laboratoriais, sinais vitais e antropometria. Estes procedimentos foram repetidos a cada 4 meses durante 1 ano. Os dados obtidos em cada consulta possibilitaram oferecer educação focada no estilo de vida e uso de medicamentos. Para os 50 pacientes que concluiram o PCF houve redução da glicemia (P < 0.0001), hemoglobina glicada (P = 0.0022), colesterolemia (P = 0.0072), triacilgliceridemia (P= 0.0204) e pressĂŁo arterial (P < 0.0001). O aumento da concordĂąncia e a correção dos problemas relacionados a medicamentos contribuĂram para melhoria do tratamento. Assim, podemos concluir que o PCF foi adequado para melhorar a saĂșde de PDT2 ao reduzir fatores de risco de complicaçÔes diabĂ©ticas
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Experimental study of the dynamic viscosity of some anhydrous silicate melts to 1953 K at 150 kPa. [Alluvium]
The dynamic viscosity was measured for six anhydrous silicate melts, obtained by fusing various rocks collected from the Department of Energy's Nevada Test Site, from 1393 to 1953 K at 150 kPa. These silicate melts exhibit Newtonian behavior in this temperature interval. Experimental results indicate that tuff viscosity > alluvium viscosity > basalt viscosity. At 1673 K, viscosities of Schooner tuff (Ue20..mu..-330'), alluvium (U10ba), and Danny Boy basalt (Ue18q No. 2) are 28,460 Pa.s, 4,820 Pa.s, and 12.6 Pa.s, respectively. Activation energies for viscous flow in the interval between 1393 and 1953 K range from 268 to 393 kJ/mole
Apparatus for the measurement of radionuclide transport rates in rock cores
An apparatus and procedure for the study of radionuclide transport in intact rock cores are presented in this report. This equipment more closely simulates natural conditions of radionuclide transport than do crushed rock columns. The apparatus and the procedure from rock core preparation through data analysis are described. The retardation factors measured are the ratio of the transport rate of a non-retarded radionuclide, such as /sup 3/H, to the transport rate of a retarded radionuclide. Sample results from a study of the transport of /sup 95m/Tc and /sup 85/Sr in brine through a sandstone core are included
Communication in medical records : Intergroup language and patient care
Communication failures in the complex environment of hospital care affect the quality of care and occurrence of inadvertent harm. This study investigated doctors' written communication using a sample of medical records, specifically doctors' progress notes, and the frameworks of social identity and communication accommodation theories. These records include standardized and stylized language, and are intended to record assessment and treatment of patients according to known guidelines for practice. An interpretive analysis of the language and discourse in these records revealed that doctors used medical record entries both to express their specialty identity and to negotiate intergroup conflict. Nonaccommodation and interspecialty conflict sometimes took precedence over facilitation of patient treatment and management. Thus, intergroup communication in this context can constitute a serious threat to the quality of patient care