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medicines optimisation

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https://www.readbyqxmd.com/read/28420381/operations-research-in-global-health-a-scoping-review-with-a-focus-on-the-themes-of-health-equity-and-impact
#1
REVIEW
Beverly D Bradley, Tiffany Jung, Ananya Tandon-Verma, Bassem Khoury, Timothy C Y Chan, Yu-Ling Cheng
BACKGROUND: Operations research (OR) is a discipline that uses advanced analytical methods (e.g. simulation, optimisation, decision analysis) to better understand complex systems and aid in decision-making. Herein, we present a scoping review of the use of OR to analyse issues in global health, with an emphasis on health equity and research impact. A systematic search of five databases was designed to identify relevant published literature. A global overview of 1099 studies highlights the geographic distribution of OR and common OR methods used...
April 18, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28409203/the-role-of-infection-models-and-pk-pd-modelling-for-optimising-care-of-critically-ill-patients-with-severe-infections
#2
REVIEW
T Tängdén, V Ramos Martín, T W Felton, E I Nielsen, S Marchand, R J Brüggemann, J B Bulitta, M Bassetti, U Theuretzbacher, B T Tsuji, D W Wareham, L E Friberg, J J De Waele, V H Tam, Jason A Roberts
Critically ill patients with severe infections are at high risk of suboptimal antimicrobial dosing. The pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobials in these patients differ significantly from the patient groups from whose data the conventional dosing regimens were developed. Use of such regimens often results in inadequate antimicrobial concentrations at the site of infection and is associated with poor patient outcomes. In this article, we describe the potential of in vitro and in vivo infection models, clinical pharmacokinetic data and pharmacokinetic/pharmacodynamic models to guide the design of more effective antimicrobial dosing regimens...
April 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28408545/reducing-medical-admissions-into-hospital-through-optimising-medicines-remain-home-study-protocol-for-a-stepped-wedge-cluster-randomised-trial
#3
Holly Foot, Christopher Freeman, Karla Hemming, Ian Scott, Ian D Coombes, Ian D Williams, Luke Connelly, Jennifer A Whitty, Nancy Sturman, Sue Kirsa, Caroline Nicholson, Grant Russell, Carl Kirkpatrick, Neil Cottrell
INTRODUCTION: A model of general practitioner (GP) and pharmacist collaboration in primary care may be an effective strategy to reduce medication-related problems and provide better support to patients after discharge. The aim of this study is to investigate whether a model of structured pharmacist and GP care reduces hospital readmissions in high-risk patients. METHODS AND ANALYSIS: This protocol details a stepped-wedge, cluster-randomised trial that will recruit participants over 9 months with a 12-month follow-up...
April 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28403876/development-of-a-core-outcome-set-for-effectiveness-trials-aimed-at-optimising-prescribing-in-older-adults-in-care-homes
#4
Anna N Millar, Amrit Daffu-O'Reilly, Carmel M Hughes, David P Alldred, Garry Barton, Christine M Bond, James A Desborough, Phyo K Myint, Richard Holland, Fiona M Poland, David Wright
BACKGROUND: Prescribing medicines for older adults in care homes is known to be sub-optimal. Whilst trials testing interventions to optimise prescribing in this setting have been published, heterogeneity in outcome reporting has hindered comparison of interventions, thus limiting evidence synthesis. The aim of this study was to develop a core outcome set (COS), a list of outcomes which should be measured and reported, as a minimum, for all effectiveness trials involving optimising prescribing in care homes...
April 12, 2017: Trials
https://www.readbyqxmd.com/read/28397789/full-deflection-profile-calculation-and-young-s-modulus-optimisation-for-engineered-high-performance-materials
#5
A Farsi, A D Pullen, J P Latham, J Bowen, M Carlsson, E H Stitt, M Marigo
New engineered materials have critical applications in different fields in medicine, engineering and technology but their enhanced mechanical performances are significantly affected by the microstructural design and the sintering process used in their manufacture. This work introduces (i) a methodology for the calculation of the full deflection profile from video recordings of bending tests, (ii) an optimisation algorithm for the characterisation of Young's modulus, (iii) a quantification of the effects of optical distortions and (iv) a comparison with other standard tests...
April 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28387961/chemical-profiling-combined-with-omics-technologies-cp-omics-a-strategy-to-understand-the-compatibility-mechanisms-and-simplify-herb-formulas-in-traditional-chinese-medicines
#6
Tengfei Xu, Zifeng Pi, Shu Liu, Fengrui Song, Zhiqiang Liu
INTRODUCTION: The compatibility mechanisms of formulas in traditional Chinese medicine (TCM) are indistinct. In order to better understand the compatibility mechanisms and the quality control of the formulas, it is necessary to simplify formulas in TCM research. OBJECTIVE: Developing a novel method by multi-analysing the contents of different compounds in formula and inferred simplified formula simultaneously. METHODOLOGY: Chemical profiling combined with "omics" technologies (CP-omics) was employed in the present study...
April 7, 2017: Phytochemical Analysis: PCA
https://www.readbyqxmd.com/read/28386916/identification-of-factors-that-may-influence-the-selection-of-first-line-biologic-therapy-for-people-with-psoriasis-a-prospective-multi-centre-cohort-study
#7
N J Davison, R B Warren, K J Mason, K McElhone, B Kirby, A D Burden, C H Smith, K Payne, C E M Griffiths
BACKGROUND: The Psoriasis Stratification to Optimise Relevant Therapy (PSORT) consortium has a collective aim to develop a prescribing algorithm to help stratify eligible psoriasis patients to the most appropriate biologic treatment. To facilitate the adoption of a stratified approach, it is necessary to first understand the factors driving the choice of first-line biologic therapy. OBJECTIVES: To identify and quantify factors which influence the selection of the first-line biologic therapy for people with psoriasis...
April 7, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28378954/pre-hospital-and-retrieval-medicine-clinical-governance-and-workforce-models
#8
Marcus Kennedy, Mark Elcock, Daniel Ellis, Gary Tall
Pre-hospital and retrieval medicine (PHARM) has developed significantly in the past decade. This perspective article proposes that PHARM should develop with a clear focus on contemporary health governance principles, and that its workforce and models of care adopt modern interdisciplinary approaches. Many of the older systems of managing clinical standards, and outdated cultural approaches to professional 'turf', workforce and scope of practice have little place in high-performance organisations. This paper calls us to attention with a recommendation that best and safest systems of care, structured to optimise patient outcomes and system performance should be our goal...
April 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28346134/five-key-recommendations-for-the-implementation-of-hospital-electronic-prescribing-and-medicines-administration-systems-in-scotland
#9
Kathrin Cresswell, Ann Slee, Aziz Sheikh
NHS Scotland is about to embark on the implementation of Hospital Electronic Prescribing and Medicines Administration (HEPMA) systems. There are a number of risks associated with such ventures, thus drawing on existing experiences from other settings is crucial in informing deployment.Drawing on our previous and ongoing work in English settings as well as the international literature, we reflect on key lessons that NHS Scotland may wish to consider in going forward. These deliberations include recommendations surrounding key aspects of deployment strategy surrounding: 1) the way central coordination should be conceptualised, 2) how flexibility in can be ensured, 3) paying attention to optimising systems from the outset, 4) how expertise should be developed and centrally shared, and 5) ways in which learning from experience can be maximised...
January 24, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/28303618/australian-mental-health-consumers-and-carers-expect-more-health-management-information-from-community-pharmacy
#10
Jasmina Fejzic, Kathy Knox, Hendrika Laetitia Hattingh, Amary Mey, Denise McConnell, Amanda J Wheeler
OBJECTIVE: To identify the health management information needs of Australian mental health consumers and carers and explore the role of community pharmacy in meeting those needs. METHOD: Interviews and focus groups were conducted with a purposive convenience sample of 74 mental health consumers and carers across three Australian states, representing metropolitan, rural and remote settings, including those with culturally and linguistically diverse backgrounds. Recruitment and interviews continued until data saturation was reached...
March 16, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28292257/medical-appropriateness-of-adult-calls-to-danish-out-of-hours-primary-care-a-questionnaire-based-survey
#11
Karen Busk Nørøxe, Linda Huibers, Grete Moth, Peter Vedsted
BACKGROUND: Optimal utilisation of the out-of-hours primary care (OOH-PC) services remains a concern in public health policy. We need more knowledge on potentially avoidable contacts. This study examines the frequency of medically assessed inappropriate OOH-PC calls from adults, explores factors associated with such assessment, and examines the relation to patient-assessed severity of health problem and fulfilment of expectations. METHODS: We performed secondary analyses of data from a large cross-sectional survey on contacts to Danish OOH-PC...
March 14, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28290273/from-the-ebm-pyramid-to-the-greek-temple-a-new-conceptual-approach-to-guidelines-as-implementation-tools-in-mental-health
#12
L Salvador-Carulla, S Lukersmith, W Sullivan
Guideline methods to develop recommendations dedicate most effort around organising discovery and corroboration knowledge following the evidence-based medicine (EBM) framework. Guidelines typically use a single dimension of information, and generally discard contextual evidence and formal expert knowledge and consumer's experiences in the process. In recognition of the limitations of guidelines in complex cases, complex interventions and systems research, there has been significant effort to develop new tools, guides, resources and structures to use alongside EBM methods of guideline development...
April 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28288634/understanding-the-implementation-and-adoption-of-a-technological-intervention-to-improve-medication-safety-in-primary-care-a-realist-evaluation
#13
Mark Jeffries, Denham L Phipps, Rachel L Howard, Anthony J Avery, Sarah Rodgers, Darren M Ashcroft
BACKGROUND: Monitoring for potentially hazardous prescribing is increasingly important to improve medication safety. Healthcare information technology can be used to achieve this aim, for example by providing access to prescribing data through surveillance of patients' electronic health records. The aim of our study was to examine the implementation and adoption of an electronic medicines optimisation system that was intended to facilitate clinical audit in primary care by identifying patients at risk of an adverse drug event...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28283408/development-and-evaluation-of-an-enzyme-linked-immunosorbent-assay-for-the-detection-of-antibodies-to-a-common-urogenital-derivative-of-chlamydia-trachomatis-plasmid-encoded-pgp3
#14
Catherine E Winstanley, Kyle H Ramsey, Peter Marsh, Ian N Clarke
BACKGROUND: Urogenital infection with Chlamydia trachomatis is the most commonly diagnosed sexually transmitted infection in the developed world. Accurate measurement and therefore understanding the seroprevalence of urogenital C. trachomatis infections requires a rigorously optimised and validated ELISA. Previous ELISAs based on the C. trachomatis plasmid-encoded protein, PGP3, have been described but lack standardisation and critical controls or use a less common PGP3 as the capture antigen...
March 7, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28278664/ultra-high-performance-liquid-chromatography-with-tandem-mass-spectrometry-for-rapid-separation-and-identification-of-main-constituents-in-chinese-herbal-formula-xuan-hu-suo-san
#15
Huaqi Tang, Xinyue Zhang, Shilin Luo, Fei Shang, Jianping Chen, Jinghong Wang, Xiaojie Duan, Xiaoyan Gao, Yikun Sun
Xuan Hu Suo San (XHSS) is a traditional Chinese medicine that has been extensively applied in the treatment of osteoarthritis for many years, however, its chemical composition has not yet been elucidated. Thus, a rapid, efficient, and precise method based on ultra high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry was applied in both positive- and negative-ion modes to rapidly separate and identify the main chemical ingredients in XHSS for the first time. Finally, with the optimised separation and detection method, a total of 57 compounds were simultaneously separated within 13 min, among which 14 compounds were confirmed by comparing retention time and MS data with reference standards and others were tentatively identified by comparing with reference literatures...
February 15, 2017: Natural Product Research
https://www.readbyqxmd.com/read/28270656/raising-awareness-of-bronchiectasis-in-primary-care-overview-of-diagnosis-and-management-strategies-in-adults
#16
James D Chalmers, Sanjay Sethi
Bronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28263169/unraveling-the-gordian-knot-red-blood-cell-storage-lesion-and-transfusion-outcomes
#17
REVIEW
Vassilis L Tzounakas, Anastasios G Kriebardis, Jerard Seghatchian, Issidora S Papassideri, Marianna H Antonelou
What is following the impressive progress that has been made? During the last couple of years several tremors have shaken the field of Transfusion Medicine. The epicentres of those tremors were located on novel insights into the RBC storage lesion, on emerging connections between storage lesion and post-transfusion performance and effects, and on acknowledging that storage time is only one (rather than the most prominent) of the parameters which contribute to the progression of storage lesion in any given unit of blood...
March 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28238038/bluegenics-bioactive-natural-products-of-medicinal-relevance-and-approaches-to-their-diversification
#18
Joseph S Zarins-Tutt, Emily R Abraham, Christopher S Bailey, Rebecca J M Goss
Nature provides a valuable resource of medicinally relevant compounds, with many antimicrobial and antitumor agents entering clinical trials being derived from natural products. The generation of analogues of these bioactive natural products is important in order to gain a greater understanding of structure activity relationships; probing the mechanism of action, as well as to optimise the natural product's bioactivity and bioavailability. This chapter critically examines different approaches to generating natural products and their analogues, exploring the way in which synthetic and biosynthetic approaches may be blended together to enable expeditious access to new designer natural products...
2017: Progress in Molecular and Subcellular Biology
https://www.readbyqxmd.com/read/28228341/doctors-and-nurses-perceptions-of-military-pre-hospital-emergency-care-when-training-becomes-reality
#19
REVIEW
Sten-Ove Andersson, Lars Lundberg, Anders Jonsson, Pia Tingström, Madeleine Abrandt Dahlgren
The aim of this study was to identify physicians' and nurses' perceptions of military pre-hospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The results after pre-deployment training can be categorised as (1) learning about military medicine and (2) taking care of the casualty. The results after an international mission can be categorised as (1) collaborating with others, (2) providing general health care and (3) improving competence in military medicine...
February 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28219959/randomised-prospective-medico-economic-nationwide-french-study-of-islet-transplantation-in-patients-with-severely-unstable-type-1-diabetes-the-stabilot-study-protocol
#20
Sandrine Lablanche, Sandra David-Tchouda, Jennifer Margier, Edith Schir, Anne Wojtusciszyn, Sophie Borot, Laurence Kessler, Emmanuel Morelon, Charles Thivolet, François Pattou, Marie Christine Vantyghem, Thierry Berney, Pierre-Yves Benhamou
INTRODUCTION: Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy...
February 20, 2017: BMJ Open
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