Background: Acute coronary syndrome is a major global disease burden with high morbidity and mortality. This study aims to assess the impact of clinical pharmacy interventions on improving the quality use of medicines and drug-related problems in acute coronary syndrome patients.
Methods: An open, prospective, controlled, nonrandomised clinical trial was conducted at the Teaching Hospital, Peradeniya, Sri Lanka. Consenting patients were recruited and divided into control and intervention groups. Medication history, medication adherence and drug-related problems were assessed. The intervention group received clinical pharmacy interventions for six months. Improvements in medication adherence, discharge medication appropriateness, reduction of hospital readmissions for six months, and responses from the healthcare team's awareness and perception on clinical pharmacy services were recorded.
Results: Both groups (control - 180 patients, intervention - 185 patients) showed poor medication adherence at baseline. Medication adherence improved significantly after 6-months post-discharge in the intervention group compared to the control group (49.3% vs 18.8%). The clinical pharmacists successfully identified drug-related problems and provided suggestions for resolving them. The treating team accepted the majority (60%) of these suggestions. Discharge medication appropriateness in the intervention group was significantly higher compared to the control group. There was no significant difference in hospital readmissions related to cardiovascular disorders between the groups. Most doctors and nurses were aware of clinical pharmacists but none of them had previously worked with one.
Conclusion: Clinical pharmacist-led interventions significantly improved medication adherence and appropriateness, underscoring the added value of clinical pharmacists in a multidisciplinary healthcare team. While most doctors and nurses were aware of clinical pharmacists, none of them had prior experience working with them, emphasising an opportunity to foster greater multidisciplinary integration for improved health outcomes. Overall findings highlight the potential role of clinical pharmacists in enhancing good patient outcomes and improving real-world patient care.
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http://dx.doi.org/10.1080/20523211.2025.2468782 | DOI Listing |
Gac Sanit
March 2025
Financial Economics and Accounting Department, University of Alicante, Alicante, Spain.
Objective: To review several behavioral economics-based interventions ("healthy nudges") aimed at mitigating the overuse and underuse of healthcare resources -phenomena associated with poorer health outcomes and increased costs.
Method: A comparative case study approach is used to assess the effectiveness of ten studies designed to improve treatment adherence and prevent underuse, as well as those focused on improving prescribing practices to address overuse.
Results: First, healthy nudges are generally effective, although there is considerable variability in their outcomes.
Diabetes Metab J
March 2025
Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Backgruound: Diabetes in older adults is becoming a significant public burden to South Korea. However, a comprehensive understanding of epidemiologic trends and the detailed clinical characteristics of older adults with diabetes is lacking. Therefore, we evaluated epidemiologic trends and the metabolic and lifestyle characteristics of diabetes in Korean older adults.
View Article and Find Full Text PDFNeurology
April 2025
School of Law, University of Virginia, Charlottesville.
This consensus position statement of the American Academy of Neurology, American Epilepsy Society, and Epilepsy Foundation of America updates prior 1994 and 2007 position statements on seizures, driver licensure, and medical reporting. Key consensus positions include the following: (1) in the United States, national driving standards promulgated through a system such as the Uniform Law Commission would reduce confusion and improve adherence with state driving standards; (2) state licensing criteria for medical conditions should be promulgated by regulations and guidelines based on enabling legislation rather than in statutes themselves and should be developed by medical advisory boards working in collaboration with departments of motor vehicles; (3) licensing criteria should be equitable, nondiscriminatory, objective, and compatible with comparable risks in other populations; (4) a minimum seizure-free interval of 3 months should ordinarily be required before driving in all cases and should be extended in individual cases based on review of favorable and unfavorable features by medical advisory boards; (5) individuals with exclusively provoked seizures attributable to provoking factors that are unlikely to reoccur in the future may not require a seizure-free interval before resuming driving; (6) individuals with previously well-controlled epilepsy who experience seizures due to short-term interruptions of antiseizure medications in the setting of hospitalization or practitioner-directed medication-titration may not require a seizure-free interval before driving once previously effective levels of antiseizure medications have been resumed; (7) patients and practitioners should pause driving during tapering and following discontinuation of an antiseizure medication if another such medication is not introduced; (8) individuals whose cognition or coordination is impaired due to medications used to prevent seizures should refrain from driving; (9) health care practitioners should be allowed but not mandated to report drivers who pose an elevated risk; but (10) neither a decision to report a patient suspected of being at elevated risk nor a decision declining to report a patient suspected of being at elevated risk should be subject to legal liability; (11) nations, states, and municipalities should provide alternative methods of transportation and accommodations for individuals whose driving privileges are restricted due to medical conditions.
View Article and Find Full Text PDFJ Immunol
January 2025
Division of Infectious Diseases, Center for Inflammation and Tolerance, Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Organ transplant recipients require continual immune-suppressive therapies to sustain allograft acceptance. Although medication nonadherence is a major cause of rejection, the mechanisms responsible for graft loss in this clinically relevant context among individuals with preceding graft acceptance remain uncertain. Here, we demonstrate that skin allograft acceptance in mice maintained with clinically relevant immune-suppressive therapies, tacrolimus and mycophenolate, sensitizes hypofunctional PD1hi graft-specific CD8+ T cells.
View Article and Find Full Text PDFFront Psychiatry
February 2025
Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysore, Karnataka, India.
Background: Depression is a common but severe mental health disorder affecting individuals globally. Medication non-adherence and low health-related quality of life (HRQoL) are the major challenges associated with the treatment of patients with depression.
Materials And Methods: A prospective Randomized Controlled Trial (RCT) was conducted in the psychiatry outpatient department of a tertiary care hospital for six months.
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