Care Program For Patients Research Articles

An analysis of Plan, Do, Study, Act for a supportive care program for patients with metastatic breast cancer.

376 Background: Patients with metastatic cancer have unique survivorship needs. Recent studies show patients with advanced cancer have unmet needs in the following categories: health information (31%), psychosocial support (27%), symptom management and general wellness support (23%) (Hart, et al., 2022). The Living Well with Advanced Breast Cancer Clinic (LWABC) was established in 2017 to address these unmet needs. This multidisciplinary clinic provides the patient and caregiver(s) an individual visit with a medical oncologist, integrative medicine physician, palliative medicine physician, dietitian, and nurse navigator. The patient is provided in-depth education and personalized supportive care plans. Methods: Over recent years, clinic staff have utilized the Plan, Do, Study, Act (PDSA) (Taylor, et al., 2014 ) methodology to refine operations and improve patient care. In 2021, the plan phase was initiated with incorporation of a nurse navigator and program manager for the clinic. Nurse navigation services have been shown to improve patient and caregiver knowledge as well as quality of life and was deemed an important addition to the program (Oncology Nursing Society, 2018). At the beginning of calendar year 2022, in the “do” phase, the nurse navigator/program manager was hired and implemented pre-visit phone calls as well as navigation services for patients. These services include assessment of needs, patient education, provision of community resources, and assistance with scheduling referrals. At the beginning of calendar year 2023, use of the NCCN distress thermometer and problem list was initiated. The current phase, “study,” includes development of a dashboard for monitoring clinic operations. Review and assessment of distress thermometer data is ongoing. Results: When comparing calendar year 2021 to 2022, the clinic has seen increases in referrals (40 in 2021 to 65 in 2022), number of patients seen (31 in 2021 to 46 in 2022), and unique patient zip codes (28 in 2021 to 42 in 2022). There was also a reduction in late cancellation rates from 15.9% (2021) to 7.2% (2022). Late cancellation is defined as any appointment cancelled 24 hours or less prior to scheduled visit. Conclusions: Utilizing the PDSA cycle clinic staff have seen operational improvements over the last two years. Currently, this supportive care program remains in a “study” phase and will continue to evaluate progress and patient outcomes. Results from the act phase will be utilized to continue expansion of the clinic and services in the future. Further aiding this endeavor is an embedded patient advocate and ongoing outreach and collaboration with patient support organizations.

General practitioners’ perceptions of the roles of community pharmacists and their willingness to collaborate with pharmacists in primary care

BackgroundCommunity pharmacists (CPs) have the capacity to contribute to patient care given their expertise in medication and accessibility to residents in the community. However, multidisciplinary patient care programmes where CPs collaborate with general practitioners (GPs) in patient care is rare in Singapore despite increasing healthcare demand.ObjectivesThis study explores GPs’ perceptions of CPs’ current roles and GPs’ ideas for and attitudes towards interprofessional collaboration.MethodsSemi-structured qualitative interviews were conducted with 20 private GPs from August to December 2020 via an online video-chat platform. GPs were recruited from the Primacy Care Research Network (pcRn), primary care networks, and using snowballing strategies. All interviews were recorded, transcribed and coded thematically.ResultsCurrent working relationships between GPs and CPs appeared amicable but limited. GPs appreciate the existing roles of CPs: dispensing drugs not stocked in their practices and clarifying prescription details. Still, GPs appeared to rarely consider collaborative working. GPs acknowledged that CPs could enhance patient care with initiatives including medication reconciliation and advising on using medical devices. It was suggested that CPs could coordinate the purchase of drugs for primary care networks to improve GPs’ inventory management, but less enthusiasm was expressed for clinical collaborations with CPs. Major concerns about GP–CP clinical collaborations included direct competition with GPs’ own business interests, perceived low acceptability of pharmacy-led services by patients (citing extra time and cost), threat to continuity of care and the absence of a shared patient electronic health record system. Current funding mechanisms do not enable reimbursement of clinical services provided by CPs. Adoption of telemedicine technologies and governmental financial support were identified as possible enablers of GP–CP collaboration.ConclusionsGPs saw potential in CPs’ increased involvement in patient care, but perceived multiple barriers. Strategies focusing on overcoming these barriers could enable GP–CP collaboration to enhance patient care.

Effectiveness of Self Care program for Patients with Nephrolithiasis on Their Practices Regarding Nutrition

Effectiveness of Self Care program for Patients with Nephrolithiasis on Their Practices Regarding Nutrition

2136P Prostate cancer supportive care (PCSC) program for patients and partners: A model for meeting an unmet need for PC patients

2136P Prostate cancer supportive care (PCSC) program for patients and partners: A model for meeting an unmet need for PC patients

Determining The Effect of Education Given to Home Patient Care Program Students on Patient Privacy

Hasta mahremiyeti, hasta ya da sağlıklı bireyin tanı, tedavi ve sağlık bakım esnasında sağlık hizmeti aldığı bireylere açıklamak zorunda kaldığı ancak; toplumdaki diğer bireylerden gizli tutulmasını istediği yaşam alanıdır. Dolayısıyla sağlık ekibinde tüm personelin bu konuda dikkatli olması önemlidir. Bu araştırmada amaç, evde hasta bakımı programı öğrencilerine hasta mahremiyeti konusunda verilen eğitimin etkisinin belirlenmesidir. Yarı deneysel olarak tasarlanan araştırma Ekim 2022-Ocak 2023 tarihleri arasında bir meslek yüksekokulunun evde hasta bakımı programı öğrencileri (n=30) ile klinik uygulama alanlarında yürütüldü. Öğrencilere yüz yüze ve hasta başında hasta mahremiyeti ile ilgili eğitim verildi. Veriler, “Öğrenci Tanıtıcı Bilgi Formu” ve “Hasta Mahremiyet Ölçeği” ile eğitim öncesi ve sonrası değerlendirme ile toplandı. Öğrencilerin eğitim öncesi %20’sinin, eğitim sonrası ise %83.3’ünün hasta mahremiyeti hakkında bilgi sahibi olduğu bulundu. Öğrencilerin eğitim sonrası Hasta Mahremiyet Ölçeği’nden aldıkları puanın eğitim öncesi aldıkları puana göre istatistiksel olarak anlamlı derecede yüksek olduğu saptanmıştır (p

The beneficial effects of transitional care for patients with stroke: A meta-analysis.

Transitional care interventions have emerged as a promising method of ensuring treatment continuity and health care coordination when patients are discharged from hospital to home. However, few studies have investigated the frequency and duration of interventions and the effects of interventions on physical function. Therefore, this study aimed to determine the efficacy of transitional care for patients with stroke. Six databases and the grey literature were searched to obtain relevant articles from October 1, 2022 to March 10, 2023. The primary outcomes studied were motor performance, walking speed, activities of daily living (ADLs) and caregiver burden following hospital-to-home transitional care. The quality of the studies was assessed with Cochrane risk of bias version 2. The quality and sensitivity of the evidence were assessed to ensure rigour of the findings. Meta-analyses were performed using stata 17.0. A total of 2966 patients were identified from 23 studies. Transitional care improved post-stroke motor performance, walking speed and ADLs, and reduced caregiver burden. The findings suggest that provision of transitional care model implementation in patients with stroke is important because it reduces disability in stroke patients and helps to decrease caregivers' burden. The findings of the study emphasize the importance of transitional care programmes for stroke patients after they are discharged from the hospital and returned to their homes. To meet the needs of patients, all levels of health professionals including nurses should be aware of the discharge process and care plan.

Mental and nutritional habits at the beginning of the COVID-19 pandemic: impact, perspectives and recommendations

Besides the severe impact on the mortality rate in the world, the COVID-19 pandemic demonstrated the importance of having an optimal physical and mental health, since subjects with chronic diseases were the most affected. The aim of this review was to describe the consequences of nutritional and mental health during the beginning of the pandemic. In developing countries, such as Mexico, the prevalence of mental illnesses including depression, anxiety, stress, and suicide increased considerably. In addition, it was found an increase rate of sedentary lifestyles due to the confinement established as a preventive measure to avoid COVID-19 infections. Concerning eating habits, it was reported a decrease in fruits and vegetables consumption and an increase in energy-dense foods, as well as alcohol consumption or smoking, as compensatory measures for mental disorders of anxiety and depression. Based on the information we look up on the impact of COVID-19 on human health, we suggest as prevention measures multidisciplinary care strategies aimed at promoting mental health, diet, and physical activity habits in a comprehensive context. Likewise, information it is highlighted the importance of establishing care and monitoring programs for patients with chronic diseases, because this factor was decisive for mortality after COVID-19 infection.

Development and implementation of a continuing care program for patients with intellectual and developmental disabilities in family medicine.

In the United States, individuals with intellectual and developmental disabilities (IDD) consistently experience health disparities. One factor is limited access to quality healthcare services equipped to meet the needs of those with IDD, particularly as they transition to adulthood. The purpose of this work is to describe the development and implementation of Jefferson's Continuing Care Program (JCCP), which was designed to address this care gap. We share how the idea, logistics, and support for the clinic were developed; how JCCP was designed to be uniquely accessible both via physical space and clinic flow; and how those challenges encountered have been crucial for fine-tuning optimal patient care. Since its inception in 2019, JCCP has made large strides towards educating the next generation of medical providers to care for patients with IDD. Looking to the future, JCCP plans to broaden its impact by serving more patients, continuing our advocacy and education work, and continuing to adapt to the needs of our community.

Holistic management of patients with progressive pulmonary fibrosis.

To identify the main needs of patients with PF and their caregivers.To describe the components of a comprehensive approach to a supportive care programme for patients with PF.To identify further areas of research to address technical issues related to the management of patients with PF.

Barriers to the implementation of virtual care programmes for patients with chronic wounds: Qualitative empirical research.

To assess the barriers to the implementation of virtual care for patients with chronic wounds from wound therapists' perspective. A qualitative study. The study was conducted in two consecutive phases: (1) literature review, (2) descriptive qualitative study. In the first phase, texts published in English until 2023 were identified using international databases. The entire text of the selected studies was evaluated independently by two reviewers. Data analysis was carried out using textual content analysis. In the second phase of the study, twelve participants from Iranian wound care clinics participated. Data were collected through focus group discussion and analysed using conventional content analysis. Integration of both phases was conducted in the data analysis stage. The most important barriers in providing virtual care to patients with chronic wounds were identified into five categories including lack of policymaking in virtual care, ethical challenges in virtual information and communication technology, social, economic and cultural issues, IT users' insufficient knowledge and limitation of virtual care scope of practice. The findings of the present study identified different barriers in the implementation of virtual care for patients with chronic wounds. In order to successfully develop a virtual care programme, it is necessary to adopt suitable policies regarding information and communication technology, provide the necessary legal frameworks, assign an adequate budget and consider the ethical, cultural, social and social issues. Identifying barriers to developing a virtual care programme will help manage patients with chronic wounds at home. This study accurately identifies barriers to providing virtual care for patients with chronic wounds and helps plan to address these barriers and facilitate the development of a virtual care programme for these patients at home. This research has adhered to the SRQR reporting guideline. The involvement of patients or the public in the design, or conduct, or reporting, or dissemination plans of this research was not suitable.

Effectiveness of the integration of a palliative care team in the follow-up of patients with advanced chronic obstructive pulmonary disease: The home obstructive lung disease study

BackgroundAccess to palliative care for patients with end-stage chronic obstructive pulmonary disease (COPD) is still very poor. ObjectivesEvaluate our palliative care program for patients with advanced COPD by assessing whether the referral criteria for advanced COPD patients were adequate in identifying patients in end-of-life care and determine the results of the palliative care team's intervention MethodsThis was a prospective observational study of patients admitted to a multidisciplinary unit for advanced COPD. Data on sociodemographic variables, survival, symptomatology, quality of life, ACP, and health resource utilization were analyzed. ResultsEighty-three patients were included in this study. By the end of the follow-up period, 69 (83%) patients had died, mainly due to respiratory failure (96%). The median duration of survival from the start of follow-up was 4.27 months (95% confidence interval, 1.97–16.07). Most patients (94%) had a dyspnea level of 4. Sixty (72%) patients required opioids for dyspnea control. There were no significant differences in the quality of life of the patients during follow-up. Thirty (43%) patients died at home, 26 (38%) in a palliative care unit, and 13 (19%) in an acute care hospital. ACP was performed for 50 (72%) patients. Forty (57%) patients required palliative sedation during follow-up. Dyspnea was the reason for sedation in 34 (85%) patients. Hospital admissions and emergency room visits decreased significantly (p = 0.01) during follow-up. ConclusionsOur integrated model allows for adequate selection of patients, facilitates symptom control and ACP, reduces resource utilization, and favors death at home.

Transitional care programs for trauma patients: A scoping review

BackgroundTransitional care programs establish comprehensive outpatient care after hospitalization. This scoping review aimed to define participant characteristics and structure of transitional care programs for injured adults as well as associated readmission rates, cost of care, and follow-up adherence. MethodsWe conducted a scoping review in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews standard. Information sources searched were Medline, the Cochrane Library, CINAHL, and Scopus Plus with Full Text. Eligibility criteria were systematic reviews, clinical trials, and observational studies of transitional care programs for injured adults in the United States, published in English since 2000. Two independent reviewers screened all full texts. A data charting process extracted patient characteristics, program structure, readmission rates, cost of care, and follow-up adherence for each study. ResultsA total of 10 studies described 9 transitional care programs. Most programs (60%) were nurse/social-worker-led post-discharge phone call programs that provided follow-up reminders and inquired regarding patient concerns. The remaining 40% of programs were comprehensive interdisciplinary case-coordination transitional care programs. Readmissions were reduced by 5% and emergency department visits by 13% among participants of both types of programs compared to historic data. Both programs improved follow-up adherence by 75% compared to historic data. ConclusionTransitional care programs targeted at injured patients vary in structure and may reduce overall health care use.

Le programme PRADO–IC, programme d'aide au retour à domicile des patients insuffisants cardiaques : description, évaluation, perspectives

IntroductionReturn to home after discharge for congestive heart failure (CHF) is associated with prolonged and recurrent hospitalizations, the prognosis remains poor. Since 2013, the Caisse Nationale d'Assurance Maladie (CNAM) with the Société Française de Cardiologie (SFC) has set up a support program PRADO-IC (support program for returning home after hospitalization for heart failure). The aim of this studywas to describe the program, to present epidemiologic data, and the evaluations by the CNAM, and by clinical studies, then to expose strengths limits and perspectives. ResultsAfter the inclusion a CPAM advisor organize the outcome, the care of the outpatient is based on his general practitioner (GP) and a private nurse trained in CHF care during a three-months program. Between 2017 and 2019, 20 264 patients per year were hospitalized in Ile de France, 8.8% were included in PRADO-IC. The retrospective CNAM evaluations were positive: follow up criteria were improved and mortality rate at 6 months was lower (10.3% vs. 14.1%). However, clinical retrospective study of Troyes hospital (n = 89), and Paris Saint Joseph Hospital (n = 633), did not confirm these results: rate mortality and/or re-hospitalization were not different between patients and control. Several prospective studies are underway; results will be soon available.Limits of PRADO-IC are discussed like the lack of inclusion criteria, lack of geriatric evaluation, or the pivotal role based on GP, and the short term of duration. Strengths are its existence, national reach, multi-disciplinary approach, educational contents. Clinical studies showed that the PRADO-IC program concerned to the most severe patients. Despite this, the one-year mortality and the HF readmission rate are the same than out-program patients. ConclusionPRADO-IC is the one and the only national transition of care program for IC patients. First evaluations are positive but prospective evaluation studies are needed in order to limit methodologic bias.

9-Year Evaluation of a Transitional Care Program for Congenital Neurogenic Bladder Patients

To evaluate short and long-term adherence and nonadherence patterns within a staged transition clinic developed in 2014 to assist congenital neurogenic bladder patients transfer from pediatric to adult urologic care. We performed a retrospective chart review of all congenital neurogenic bladder patients who had been prospectively identified in the transition clinic and adult urology clinic since 2014. Demographic and clinical data were collected and analyzed to determine patient adherence with transfer of care, to study long-term compliance with follow-up, and to identify factors that positively and negatively influenced transition clinic success. 157 patients participated in the transition clinic. 76/79 (96.2%) patients ready to transition successfully transferred to adult care. 55/76 (72.4%) remain active. Greater number of visits between transition stages was significant among patients who maintained active follow-up after transition (P=.006). 171 patients initiated care in our adult urology clinic without transition. Irrespective of nontransitioned patients longer follow-up, formally transitioned adult patients had higher yearly participation rates, with 55 (72.4%) transitioned patients compared to 63 (36.8%) nontransitioned patients remaining active (P<.001). Congenital neurogenic bladder patients who participated in a transition clinic were successful transferring from pediatric to adult care, with improved clinic adherence in adulthood, compared to patients who initiated adult care without structured transition. Early introduction to adult providers and increased number of visits positively impacted adherence upon transition to adult care. Noncompliance with pediatric provider visits negatively impacted transition adherence.

COVID-19 and non-steroid anti-inflammatory drugs

The literature review deals with the analysis of the results of studies on the effectiveness and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) in the intensive care programs for patients with COVID-19 in 2020–2021. NSAIDs used for other indications or low-dose aspirin do not increase the body’s sensitivity to SARS-CoV-2 and are not additional risk factors for the severity of the course and mortality from COVID-19. Therefore, in patients receiving NSAIDs or low-dose aspirin for comorbid conditions, these drugs should not be withdrawn and may be used during the treatment of COVID-19. It has now been clarified that the pro-inflammatory effect in SARS-CoV-2 is caused by prostaglandins. Suppression of their production with the help of NSAIDs can have a positive effect during the initial phase of a viral infection, before the development of acute respiratory distress syndrome. To date, the clinical benefits of low-dose aspirin for the primary prevention of thrombotic complications in hospitalized patients with COVID-19 have not been proven, and therefore it is not recommended to use aspirin for this purpose.

The effect of expressive writing on Chinese cancer patients: A systematic review and meta-analysis of randomized control trails.

Cancer patients in China encounter distinctive challenges stemming from cultural disparities and variations in the healthcare systems. This meta-analysis aimed to provide a synthesis of the expressive writing (EW) interventions delivered to Chinese cancer patients and assess the pooled effect of EW on their well-being. The review adheres to the latest PRISMA 2020 guidelines to ensure transparency and rigour. Randomized control trials (RCTs) published before 1 April 2023, and meeting the inclusion criteria were included. Keywords searching was performed in both English and Chinese electronic databases. Ten RCTs were identified and included in the analysis. The results showed that EW usually encompassed four to six writing sessions; the most common writing themes were 'emotional expression', 'cognitive appraisal', 'benefit finding', 'coping strategies' and 'looking to the future'. The meta-analysis suggested that EW had a substantial impact on reducing anxiety levels (Hedges' g = -1.22, 95% CI [-1.54, -0.90], I2 = 0.00%). It is worth noting that although the results of these studies could not be statistically synthesized, their individual findings suggest that EW may be beneficial in reducing anxiety, self-perceived burden and depressive symptoms, as well as increasing self-efficacy in Chinese cancer patients. In conclusion, this review highlights the importance and effectiveness of Ewin alleviating anxiety among Chinese cancer patients and underscores the potential benefits of incorporating EW into comprehensive care programmes for cancer patients in China. More RCTs are needed to explore the broader impact of EW in China.

Transitional Care for Patients with Congenital Colorectal Diseases: An EUPSA Network Office, ERNICA, and eUROGEN Joint Venture

BackgroundTransition of care (TOC; from childhood into adulthood) of patients with anorectal malformations (ARM) and Hirschsprung disease (HD) ensures continuation of care for these patients. The aim of this international study was to assess the current status of TOC and adult care (AC) programs for patients with ARM and HD. MethodsA survey was developed by members of EUPSA, ERN eUROGEN, and ERNICA, including patient representatives (ePAGs), comprising of four domains: general information, general questions about transition to adulthood, and disease-specific questions regarding TOC and AC programs. Recruitment of centres was done by the ERNs and EUPSA, using mailing lists and social media accounts. Only descriptive statistics were reported. ResultsIn total, 82 centres from 21 different countries entered the survey. Approximately half of them were ERN network members. Seventy-two centres (87.8%) had a self-reported area of expertise for both ARM and HD. Specific TOC programs were installed in 44% of the centres and AC programs in 31% of these centres. When comparing centres, wide variation was observed in the content of the programs. ConclusionDespite the awareness of the importance of TOC and AC programs, these programs were installed in less than 50% of the participating centres. Various transition and AC programs were applied, with considerable heterogeneity in implementation, content and responsible caregivers involved. Sharing best practice examples and taking into account local and National Health Care Programs might lead to a better continuation of care in the future. Level of EvidenceIII.

HSD38 Operational Savings Generated in an Integrated Care Program for Patients with Complex Respiratory Diseases

To describe the savings generated in an integrated care program for complex respiratory pathologies.

Survival Study on Medical Disease Diagnosis with Coronavirus Database

Abstract: Data mining is a new technology with enormous potential to focus on important information and collected customer behaviour. Healthcare services used to have incredible potential for data mining because of this exponential development in the number of electronic health records. Medical data is health-related data related to regular patient care and clinical trial program. The feature selection process is choosing the relevant features for efficient disease diagnosis. With healthcare data, the classification and clustering methods had used for efficient disease diagnosis. In this paper, several researchers researched different disease diagnosis methods. However, time complexity had not reduced, and existing disease diagnosis methods did not enhance the accuracy. To address the proposed methods and different disease diagnosis schemes appraised.

COST ANALYSIS OF HOME PHARMACY CARE PROGRAM AMONG DIABETES PATIENTS IN PHARMACY

Background: Home pharmacy care is expected to be able to provide a pharmaceutical service that not only reduces the incidence of drug interactions and side effects but also increases the effectiveness of therapy and patient compliance in using drugs. Aims: The study aimed to analyze the costs incurred for the home pharmacy care program for diabetic patients at the pharmacy. Methods: This analysis used the independent variable by providing a program of home pharmacy care. The dependent variable was the cost of running the program of home pharmacy care. The sample was the pharmacist in charge of the pharmacies in the Banyumas and Cilacap districts, which provide a home pharmacy care service program. The sample was conducted by purposive sampling method. Sampling was done by direct interviews with pharmacists who signed informed consent. Break Even Point (BEP) was calculated to determine the number of patients who must be served. The pharmacoeconomic analysis used is Cost Analysis using the activity-based costing (ABC) method. Results: The lowest rate for home pharmacy care services is Rp. 17,000, and the highest is Rp.31,000 without including home pharmacy care services. Conclusions: Pharmacies continue to benefit from the home pharmacy care program, and there is no provision for home pharmacy care service rates. Keywords: Activity Based Costing (ABC), Diabetes Mellitus, Home pharmacy care (HPC)