Return to work after occupational and non-occupational lower extremity amputation.

BACKGROUND: Factors impacting on return to work (RTW) after lower extremity amputation are important in occupational rehabilitation. AIMS: Our objective was to compare RTW in patients who had traumatic work-related amputation with amputations from other causes. METHODS: A retrospective cohort study was conducted with participants employed at the time of amputation and at least 1 year post-discharge from amputee rehabilitation. The primary outcome measure was RTW. RESULTS: One hundred and forty-seven amputees were included with 69% returning to work. Amputation reason did not impact on RTW (odds ratio [OR] 1.83, P = non-significant). Trans-femoral amputees were less likely to RTW (OR 0.22, P < 0.05). Years since amputation (OR 1.20, P = 0.001) and Reintegration to Normal Living Index (OR 1.05, P < 0.001) were predictive of RTW after adjusting for other covariates. CONCLUSIONS: Amputation aetiology did not impact on RTW. Years since amputation, level of amputation and Return to Normal Living Index were associated with RTW which may be important to consider in RTW prognosis and planning.

Physical assessment in the community pharmacy.

As pharmacists continue to define their role in the health care system of the future and implement pharmaceutical care, they will need new or enhanced skills in managing patient care cost-effectively. Their ability to perform basic physical assessments will be a vital tool in managing their patients' health status. By using the SOAP method of evaluation and plan development and by using a systematic approach to obtaining physical data, pharmacists can properly perform initial assessment and monitor the patients they now serve. This enhanced level of care will be well accepted by patients and other health care team members when pharmacists provide them in a professional manner and serve as partners with these practitioners in developing and managing appropriate care plans.

Pharmacist-managed, physician-directed asthma management program reduces emergency department visits.

OBJECTIVE: To determine whether the number of emergency department (ED) visits for acute asthma exacerbations could be decreased by providing patients with a comprehensive program of asthma management delivered by a pharmacist and a physician. DESIGN: Patients were selected from the ED and asked to attend a special asthma clinic that provided education about asthma and proper use of asthma medications, regular telephone contact between the pharmacist and patient, and an open-door clinic policy. SETTING: A university-affiliated urban teaching hospital. PARTICIPANTS: The study population consisted of 25 asthmatic patients who were at least 18 years of age and who were seen in the ED a minimum of 3 times in a 12-month period. MAIN OUTCOME MEASURES: The number of visits to the ED for acute exacerbations of asthma was measured. Patients served as their own controls. The number of ED visits for asthma during the 6-month study period was compared with two 6-month periods prior to the study period for each patient. RESULTS: The total number of ED visits for the 25 enrolled patients six months prior to their enrollment into the study was 92; the number of ED visits during the same months of the study in the prior year was 47. During the study period, there were only 6 ED visits for asthma exacerbations. CONCLUSIONS: The comprehensive asthma management program reduced the number of ED visits for acute exacerbations of asthma.