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Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program  [PDF]
Mallory C. McKenzie, PharmD,Thomas L. Lenz, PharmD,Nicole D. Gillespie, PharmD,Jessica J. Skradski, PharmD
INNOVATIONS in Pharmacy , 2012,
Abstract: Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization’s outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM), lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC) and the Medication Possession Ratio (MPR). Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01). The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence) for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01). The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence) pre enrollment versus post enrollment (+10%, P=0.086). The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for at least one year and was shown to be better when compared to a matched cohort of similar age, condition and region.
Lifestyle Medicine-Related Cardiovascular Risk Factor Changes in Employees Participating in a Pharmacist-Run Risk Reduction Program  [PDF]
Thomas L. Lenz, PharmD,Nicole D. Gillespie, PharmD,Michele A. Faulkner, PharmD,Maryann Z. Skrabal, PharmD
INNOVATIONS in Pharmacy , 2012,
Abstract: Cardiovascular disease (CVD) remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001), fruit and vegetable consumption (p < 0.001), and decrease self-reported stress level (p = 0.006). The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting.
Dental caries in children participating in a Dentistry for infants program  [PDF]
Letícia Vargas Freire Martins Lemos,Angela Cristina Cilense Zuanon,Silvio Issáo Myaki,Luiz Reynaldo de Figueiredo Walter
Einstein (S?o Paulo) , 2011,
Abstract: Objective: To assess the impact of the “Dentistry for Infants” early dental care program run by Jacareí County (SP) by comparing the caries of individuals participating and not participating in this program. Methods: In total, 300 children between 0 and 48 months old were assessed in the following two groups: infants not participating in the program (G1, n = 100) and infants participating in the program (G2, n = 200). Each group was further divided according to age in subgroups of 0 to 24 months and 25 to 48 months. All children were clinically assessed for carious lesions using the visual-tactile method. The data were statistically analyzed using a paired Student’s t-test, Mann-Whitney test, and c2 test at a 5% significance level. Results: There was a significant difference in the prevalence (P) and mean index of deciduous teeth (deft) (C) that were decayed, indicated for extraction and filled, and the highest values were observed in G1 (p < 0.0001). The values were as follows: PG1, 73%; PG2, 22%; CG1, 3.45 ± 3.84; and CG2, 0.66 ± 1.57. Conclusion: Participating in the program positively impacted the infants’ oral health.
Pharmacist intervention in home care program for diabetes patients  [PDF]
Syed Wasif Gillani, Syed Azhar Syed Sulaiman, Mirza Baig, Yelly Oktavia Sari, Siti Maisharah Sheikh Ghadzi, Sabariah Noor Haroon, Nur Hafzan Md Hanafiah
Journal of Diabetes Mellitus (JDM) , 2012, DOI: 10.4236/jdm.2012.23045
Abstract: Majority of research reports identified moderate reduction in glycated haemoglobin with education interventions regardless of age group. Our study objective was to evaluate the pharmacist interventions in providing patient home care. A 24-week longitudinal quasi-experimental—pre-test/post-test study design was used to assess the effectiveness of a diabetes education program to enhance self-care practices. A double-blinded randomized study design was considered but was not feasible as the investigator was responsible for implementing the intervention and collecting data on outcomes. Since this was a longitudinal study a 25% attrition rate was included in the calculation of sample size. Hence the sample size for the proposed study was 106 subjects with 53 subjects in each group. All analyses were done using SPSS version 18?. The level of significance was set at 0.05. The Research Ethics Committee of hospital and the Malaysian Medical Research and Ethics Committee approved the study. Of the 109 subject who met the study-entry criteria, 3 subjects declined to participate due to lack of time and interest. There was no significant relationship between the demographic and clinical characteristic of participants who completed the study. No significant relationship between the intervention and control groups who completed the study in demographic, clinical and psychosocial contexts. Of the 47 subjects from the intervention group who reported adherent to their daily medication intake after the education intervention, 51 subjects (31.9%) reported taking their medication at the wrong time. The recommended times for oral anti-hyperglycemic medication (OAM) are: sulphonylureas 30 minutes before food, acarbose with food, metformin with or within 30 minutes after food. This research has shown a brief structured education program that incorporated behavior science specifically self-efficacy was effective in enhancing self-care practices (SMBG and medication adherence) and improving glycaemic control in the intervention group.
Initiation of health-behaviour change among employees participating in a web-based health risk assessment with tailored feedback
Ersen B Colkesen, Maurice AJ Niessen, Niels Peek, Sandra Vosbergen, Roderik A Kraaijenhagen, Coenraad K van Kalken, Jan GP Tijssen, Ron JG Peters
Journal of Occupational Medicine and Toxicology , 2011, DOI: 10.1186/1745-6673-6-5
Abstract: We conducted a questionnaire survey among 2289 employees who voluntarily participated in a HRA program at seven Dutch worksites between 2007 and 2009. The HRA included a web-based questionnaire, biometric measurements, laboratory evaluation, and tailored feedback. The survey questionnaire assessed initial self-reported health-behaviour change and satisfaction with the web-based HRA, and was e-mailed four weeks after employees completed the HRA.Response was received from 638 (28%) employees. Of all, 86% rated the program as positive, 74% recommended it to others, and 58% reported to have initiated overall health-behaviour change. Compared with employees at low CVD risk, those at high risk more often reported to have increased physical activity (OR 3.36, 95% CI 1.52-7.45). Obese employees more frequently reported to have increased physical activity (OR 3.35, 95% CI 1.72-6.54) and improved diet (OR 3.38, 95% CI 1.50-7.60). Being satisfied with the HRA program in general was associated with more frequent self-reported initiation of overall health-behaviour change (OR 2.77, 95% CI 1.73-4.44), increased physical activity (OR 1.89, 95% CI 1.06-3.39), and improved diet (OR 2.89, 95% CI 1.61-5.17).More than half of the employees who voluntarily participated in a web-based HRA with tailored feedback, reported to have initiated health-behaviour change. Self-reported initiation of health-behaviour change was more frequent among those at high CVD risk and BMI levels. In general employees reported to be satisfied with the HRA, which was also positively associated with initiation of health-behaviour change. These findings indicate that among voluntary participating employees a web-based HRA with tailored feedback may motivate those in greatest need of health-behaviour change and may be a valuable component of workplace health promotion programs.Cardiovascular diseases (CVD) are the leading cause of disability and death[1]. Much of the CVD burden could be eliminated by addressing p
Fatigue in patients with COPD participating in a pulmonary rehabilitation program
Cindy J Wong, Donna Goodridge, Darcy D Marciniuk, et al
International Journal of Chronic Obstructive Pulmonary Disease , 2010, DOI: http://dx.doi.org/10.2147/COPD.S12321
Abstract: tigue in patients with COPD participating in a pulmonary rehabilitation program Short Report (8175) Total Article Views Authors: Cindy J Wong, Donna Goodridge, Darcy D Marciniuk, et al Published Date September 2010 Volume 2010:5 Pages 319 - 326 DOI: http://dx.doi.org/10.2147/COPD.S12321 Cindy J Wong1, Donna Goodridge1, Darcy D Marciniuk2, Donna Rennie1,3 1College of Nursing, 2College of Medicine, 3Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada Background: Fatigue is a distressing, complex, multidimensional sensation common in individuals with chronic obstructive pulmonary disease (COPD). While fatigue negatively impacts functional performance and quality of life, there has been little study of the fatigue that affects participants in pulmonary rehabilitation programs. The purpose of this study was to examine the emotional, behavioral, cognitive, and physical dimensions of fatigue and their relationships to dyspnea, mental health, sleep, and physiologic factors. Patients and methods: A convenience sample of 42 pulmonary rehabilitation participants with COPD completed self-report questionnaires which measured dimensions of fatigue using the Multidimensional Fatigue Inventory, anxiety and depression using the Hospital Anxiety and Depression Scale, and sleep quality using the Pittsburgh Sleep Quality Index. Data on other clinical variables were abstracted from pulmonary rehabilitation program health records. Results: Almost all (95.3%) participants experienced high levels of physical fatigue. High levels of fatigue were also reported for the dimensions of reduced activity (88.1%), reduced motivation (83.3%), mental fatigue (69.9%), and general fatigue (54.5%). Close to half (42.9%) of participants reported symptoms of anxiety, while almost one quarter (21.4%) reported depressive symptoms. Age was related to the fatigue dimensions of reduced activity (ρ = 0.43, P < 0.01) and reduced motivation (ρ = 0.31, P < 0.05). Anxiety was related to reduced motivation (ρ = -0.47, P < 0.01). Fatigue was not associated with symptoms of depression, sleep quality, gender, supplemental oxygen use, smoking status, or Medical Research Council dyspnea scores. Conclusions: Fatigue (particularly the physical and reduced motivation dimensions of fatigue) was experienced by almost all participants with COPD attending this pulmonary rehabilitation program. Fatigue affected greater proportions of participants than either anxiety or depression. The high prevalence of fatigue may impact on enrolment, participation, and attrition in pulmonary rehabilitation programs. Further investigation of the nature, correlates, and impact of fatigue in this population is required.
A Study of Influential Factors on Employees’ Motivation for Participating in the In-Service Training Courses Based on Modified Expectancy Theory  [cached]
Farhad Ebrahim Abadi,Mohammad Reza Jalilvand,Mostafa Sharif,Ghorban Ali Salimi
International Business and Management , 2011,
Abstract: By training we can foster human resources in harmonizing with inside and outside organizational changes. Participation of active and motivated employee in training courses can facilitate acquisition of courses goals and prevent cost-wasting in this section of human resources. The purpose of current study is to identity influential factors on motivation based on revisited expectancy theory. Statistical population was formal and temporary employees of National Iranian Oil Products Distribution Company in Isfahan and Kurdistan. Finding reveals that situation, expectancy, intrinsic instrumentally, and intrinsic valence have affected employees’ motivation to participate in the in-service training courses, and utilization level of influential factors could not satisfy employees’ expectations. Key words: In-service training; Modified expectancy theory; Motivation; Situation; Employee
A Study of Influential Factors on Employees’ Motivation for Participating in the In-Service Training Courses Based on Modified Expectancy Theory
Farhad Ebrahim Abadi,Mohammad Reza Jalilvand,Mostafa Sharif,Ghorban Ali Salimi
International Business and Management , 2010,
Abstract: By training we can foster human resources in harmonizing with inside and outside organizational changes. Participation of active and motivated employee in training courses can facilitate acquisition of courses goals and prevent cost-wasting in this section of human resources. The purpose of current study is to identity influential factors on motivation based on revisited expectancy theory. Statistical population was formal and temporary employees of National Iranian Oil Products Distribution Company in Isfahan and Kurdistan. Finding reveals that situation, expectancy, intrinsic instrumentally, and intrinsic valence have affected employees’ motivation to participate in the in-service training courses, and utilization level of influential factors could not satisfy employees’ expectations. Key words: In-service training; Modified expectancy theory; Motivation; Situation; Employee
Promotion Strategy Specific to Organizations Participating in “Back to School” Program  [PDF]
Irina SUSANU,Nicoleta CRISTACHE,Sofia DAVID,Liljana ELMAZI
Annals of Dun?rea de Jos University. Fascicle I : Economics and Applied Informatics , 2009,
Abstract: Romania’s stationery market records a growth rhythm of about 10-15percent per year. For the beginning of school year 2007-2008, organizations ofthe type forecast a growth of 25%. During the top period, stationery sales growgenerally with about 800-1000 % in comparison with a habitual period of theyear. For distributors, the season of school stationery lasts from July toSeptember, a period where it is accomplished 20-25% of the entire yearturnover. All these events unfold rapidly in a relatively short period of time, 2-3months for distributors and a month for retailers, producing a real storm in theframe of their management. In order to deal with “shopping fury” specific to thetime before the school beginning, organizations of the field are in the positionof applying a series of communication strategies. The purpose of this work is tohighlight a practical example of communication plan specific to organizationsinvolved in “back to school” program.
Fatigue in patients with COPD participating in a pulmonary rehabilitation program  [cached]
Cindy J Wong,Donna Goodridge,Darcy D Marciniuk,et al
International Journal of COPD , 2010,
Abstract: Cindy J Wong1, Donna Goodridge1, Darcy D Marciniuk2, Donna Rennie1,31College of Nursing, 2College of Medicine, 3Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, CanadaBackground: Fatigue is a distressing, complex, multidimensional sensation common in individuals with chronic obstructive pulmonary disease (COPD). While fatigue negatively impacts functional performance and quality of life, there has been little study of the fatigue that affects participants in pulmonary rehabilitation programs. The purpose of this study was to examine the emotional, behavioral, cognitive, and physical dimensions of fatigue and their relationships to dyspnea, mental health, sleep, and physiologic factors.Patients and methods: A convenience sample of 42 pulmonary rehabilitation participants with COPD completed self-report questionnaires which measured dimensions of fatigue using the Multidimensional Fatigue Inventory, anxiety and depression using the Hospital Anxiety and Depression Scale, and sleep quality using the Pittsburgh Sleep Quality Index. Data on other clinical variables were abstracted from pulmonary rehabilitation program health records.Results: Almost all (95.3%) participants experienced high levels of physical fatigue. High levels of fatigue were also reported for the dimensions of reduced activity (88.1%), reduced motivation (83.3%), mental fatigue (69.9%), and general fatigue (54.5%). Close to half (42.9%) of participants reported symptoms of anxiety, while almost one quarter (21.4%) reported depressive symptoms. Age was related to the fatigue dimensions of reduced activity (ρ = 0.43, P < 0.01) and reduced motivation (ρ = 0.31, P < 0.05). Anxiety was related to reduced motivation (ρ = -0.47, P < 0.01). Fatigue was not associated with symptoms of depression, sleep quality, gender, supplemental oxygen use, smoking status, or Medical Research Council dyspnea scores.Conclusions: Fatigue (particularly the physical and reduced motivation dimensions of fatigue) was experienced by almost all participants with COPD attending this pulmonary rehabilitation program. Fatigue affected greater proportions of participants than either anxiety or depression. The high prevalence of fatigue may impact on enrolment, participation, and attrition in pulmonary rehabilitation programs. Further investigation of the nature, correlates, and impact of fatigue in this population is required.Keywords: COPD, fatigue, pulmonary rehabilitation, anxiety, depression, sleep quality
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