Polypharmacy is associated with poorer health outcomes in older adults. It is challenging to minimize the harmful effects of medications while maximizing benefits of single-disease-focused recommendations. Integrating patient input can balance these factors. The objectives are to describe the goals, priorities, and preferences of participants asked about these in a structured process to polypharmacy, and to describe the extent that decision-making within the process mapped onto these, signaling a patient-centered approach. This is a single-group quasi-experimental study, nested within a feasibility randomized controlled trial. Patient goals and priorities were mapped to medication recommendations made during the intervention. Overall, there were 33 participants who reported 55 functional goals and 66 symptom priorities, and 16 participants reported unwanted medications. Overall, 154 recommendations for medication alterations occurred. Of those, 68 (44%) recommendations mapped to the individual's goals and priorities, whereas the rest were based on clinical judgment where no priorities were expressed. Our results signal this process supports a patient-centered approach: allowing conversations around goals and priorities in a structured process to polypharmacy should be integrated into subsequent medication decisions.
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http://dx.doi.org/10.1177/23743735231174762 | DOI Listing |
Disabil Rehabil
December 2024
Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
Introduction: Electrical stimulation (E-stim) can reduce the impact of complications, like spasticity, bladder dysfunction in people with spinal cord injuries (SCIs), enhancing quality of life and health outcomes. With SCI prevalence high in regional Australia and a shift towards home-based community integrated care, the perspectives of people with SCI and healthcare professionals on current and future use of E-stim home-devices are needed.
Methods: A mixed-methods concurrent triangulation approach was used.
Contemp Clin Trials
December 2024
San Francisco VA Medical Center, United States of America; Department of Medicine, University of California, San Francisco, CA, United States of America; Measurement Science Quality Enhancement Research Initiative, San Francisco VA Healthcare System, United States of America. Electronic address:
Background: Colorectal cancer (CRC) prevention is a Veterans Affairs (VA) priority. Colonoscopy quality, especially adenoma detection rate (ADR), is critical for effective screening. Our research indicates considerable variation in ADR among VA providers.
View Article and Find Full Text PDFHeliyon
December 2024
School of Management, Ocean University of China, Qingdao, People's Republic of China.
With the advancement of the United Nations Sustainable Development Goals, the trend toward sustainable and high-quality development has become prominent for tourism enterprises. Tourism small and medium-sized enterprises (SMEs), which are numerous, constitute a significant part of the global tourism market. However, existing research predominantly focuses on the pathways for high-quality development of large tourism enterprises, with many gaps in understanding the corresponding processes for tourism SMEs.
View Article and Find Full Text PDFRisk Manag Healthc Policy
December 2024
Department of International Affairs and Social Sciences, College of Humanities and Social Sciences, Zayed University, Abu Dhabi, United Arab Emirates.
The Israel military occupation, ongoing for over 75 years, has profoundly impacted the health and well-being of Palestinians. Despite longstanding calls for Universal Health Coverage (UHC) and sustainable development, the response of global health systems and organizations to crises such as the recent large-scale military assault on Gaza in October 2023 has been inadequate. There is a critical need to examine why these global health approaches have failed and how they can be restructured to address the unique challenges in Gaza effectively.
View Article and Find Full Text PDFPharmaceut Med
December 2024
Medical Affairs Department, AstraZeneca Farmacéutica Spain, C. del Puerto de Somport 21-23, Fuencarral-El Pardo, 28050, Madrid, Spain.
Introduction: The rapidly evolving healthcare landscape has prompted Medical Affairs (MA) departments within pharmaceutical companies to transition from their traditional role as information providers to becoming strategic partners in the healthcare ecosystem. Responding to the increasing complexity of patient needs and stakeholder dynamics within Spain's national health system, this shift emphasizes the importance of aligning MA functions with broader healthcare goals. Effective transformation requires in-depth assessments of stakeholder trends and expectations.
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