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1.
Pharmacy (Basel) ; 12(1)2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38392934

RESUMO

(1) Background: This study aims to examine pharmacy students' perceptions of their knowledge and competencies in human resource management (HRM) while also investigating their attitudes toward the educational content provided in a didactic HRM course. (2) Methods: A survey evaluating both course knowledge (pre and post) and attitudes was administered to students enrolled in an HRM class. Data were analyzed using descriptive statistics and measures of associations. (3) Results: All 98 course enrollees completed the survey (N = 98), revealing statistically significant knowledge growth across HRM topics from pre- to post-survey (p < 0.05). Notably, emotional intelligence, workforce diversity, conflict resolution, and recruitment strategies exhibited the most substantial increases. The expert panel session proved highly effective, with 71% reporting it as the most knowledge-enhancing activity. "Global and cultural effectiveness" emerged as the most valued competency, reflecting a positive overall attitude towards HRM. (4) Conclusions: HRM competency is one of the most fundamental skills for pharmacists, as many problems faced by pharmacy organizations and their solutions stem from the workforce. Pharmacy schools should therefore assess their curriculum to ensure that HRM is adequately addressed to meet accreditation standards and to prepare students to navigate HRM challenges in their workplaces post-graduation.

2.
Cancers (Basel) ; 16(3)2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38339293

RESUMO

PURPOSE: To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against the backdrop of socio-economic and regional healthcare disparities. METHODS: An innovative theoretical framework was developed to integrate individual- and census tract-level social determinants of health (SDOH) with sociodemographic factors. A comparative analysis of the ML models was conducted using key performance metrics such as AUC-ROC to evaluate their predictive accuracy. Spatio-temporal analysis was used to identify disparities in late-stage CRC diagnosis probabilities. RESULTS: Gradient boosting emerged as the superior model, with the top predictors for late-stage CRC diagnosis being anatomic site, year of diagnosis, age, proximity to superfund sites, and primary payer. Spatio-temporal clusters highlighted geographic areas with a statistically significant high probability of late-stage diagnoses, emphasizing the need for targeted healthcare interventions. CONCLUSIONS: This research underlines the potential of ML in enhancing the prognostic predictions in oncology, particularly in CRC. The gradient boosting model, with its robust performance, holds promise for deployment in healthcare systems to aid early detection and formulate localized cancer prevention strategies. The study's methodology demonstrates a significant step toward utilizing AI in public health to mitigate disparities and improve cancer care outcomes.

3.
Healthcare (Basel) ; 11(22)2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-37998415

RESUMO

(1) Background: Continuous growth in pharmaceutical expenditure indicates the need for more advanced pharmacoeconomics evaluations to optimize healthcare outcomes and resource allocation. This study assesses the extent to which accredited pharmacy colleges in the United States cover pharmacoeconomics content within the didactic curriculum of their Doctor of Pharmacy (PharmD) programs. (2) Methods: We conducted a systematic search of the websites of accredited professional-degree programs in pharmacy schools located in the United States to identify pertinent content related to pharmacoeconomics. (3) Results: Out of 141 pharmacy programs, a total of 111 programs of varying sizes were found to have publicly accessible information regarding the content of their pharmacoeconomic curricula on their websites. All these programs required the inclusion of pharmacoeconomics content in their curricula. An examination of course syllabi revealed that the goals and descriptions were broad, aiming to provide students with an introductory understanding of the principles of pharmacoeconomics. The number of credit hours allocated to pharmacoeconomics education ranged from one to seven across the programs. The approach to delivering pharmacoeconomics content varied among the programs. (4) Conclusions: Advanced knowledge of the principles of pharmacoeconomics must be an integral component of all PharmD curricula to prepare pharmacists to assess the rational use of pharmacy products and services, improve clinical outcomes, and mitigate healthcare expenditures.

4.
Community Health Equity Res Policy ; 44(1): 65-76, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37724032

RESUMO

BACKGROUND: Low-income women (LIW) are underrepresented in physician-provided cervical cancer screening. Providing women with an option for Human Papillomavirus (HPV) self-sampling would increase cervical cancer screening. However, little is known about LIW's attitude towards self-sampling for cervical cancer. We determined the associations between the Theory of Planned Behavior (TPB) constructs and LIW intention for participation in the HPV self-sampling. METHODS: A 44-item survey was administered among women receiving food from a food pantry in central Texas. Independent variables included TPB constructs (i.e., attitudes, subjective norms, and perceived control). The outcome variables were intentions and preference for self-sampling. Both variables were measured on a 5-point scale. Hierarchical linear regression models were used to analyze the data. RESULTS: A sample of 241 participants (age 50.13 ± 9.60 years) comprising non-Hispanic White (40%), Black/African American (27%), and Hispanic (30%) participated in the study. The participants were current with a pap test (54.8%) and preferred self-sampling (42%). The participant's attitudes and subjective norms were significantly associated with their intention for self-sampling, accounting for 38.7% of the variance (p < .001). Women who were overdue for pap testing versus current with pap testing had increased odds of preferring self-sampling (OR = 1.72, 95% CI: 1.27, 6.04). CONCLUSIONS: The key predictors for LIW's intention for self-sampling included attitudes and subjective norms. Future research should use the TPB as a framework to examine whether intention predicts self-sampling behavior among LIW.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/diagnóstico , Detecção Precoce de Câncer , Infecções por Papillomavirus/diagnóstico , Teoria do Comportamento Planejado , Papillomavirus Humano
5.
Healthcare (Basel) ; 11(5)2023 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-36900745

RESUMO

How impactful is the use of Sertraline, Fluoxetine, and Escitalopram monotherapy on psychological distress among adults with depression in the real world? Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. Medical Expenditure Panel Survey (MEPS) longitudinal data files from 1 January 2012 to 31 December 2019 (panel 17-23) were used to assess the effects of Sertraline, Fluoxetine and Escitalopram on psychological distress among adult outpatients diagnosed with a major depressive disorder. Participants aged 20-80 years without comorbidities, who initiated antidepressants only at rounds 2 and 3 of each panel, were included. The impact of the medicines on psychological distress was assessed using changes in Kessler Index (K6) scores, which were measured only in rounds 2 and 4 of each panel. Multinomial logistic regression was conducted using the changes in the K6 scores as a dependent variable. A total of 589 participants were included in the study. Overall, 90.79% of the study participants on monotherapy antidepressants reported improved levels of psychological distress. Fluoxetine had the highest improvement rate of 91.87%, followed by Escitalopram (90.38%) and Sertraline (90.27%). The findings on the comparative effectiveness of the three medications were statistically insignificant. Sertraline, Fluoxetine, and Escitalopram were shown to be effective among adult patients suffering from major depressive disorders without comorbid conditions.

6.
Ann Pharmacother ; 57(3): 292-299, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35850551

RESUMO

INTRODUCTION: Approximately 30% to 50% of hospital discharge antimicrobials are inappropriate. Limited data exist on approaches to improve antimicrobial prescribing practices at the time of discharge from a community hospital. Objective: To assess the impact of a comprehensive pharmacist-led antimicrobial stewardship intervention at discharge. METHODS: We conducted a quasi-experimental, pre-post study. A biphasic intervention took place on 2 medicine units from November 2019 to May 2020 at a community hospital. Baseline data were collected, followed by prescriber education on antimicrobial stewardship to both units (education phase). Next, a pharmacist-led intervention took place on one unit (intervention phase). The primary outcome was composite appropriateness of an oral antimicrobial prescribed to an adult at the time of discharge, defined by narrow spectrum of activity, dosing, and duration of therapy. The primary outcome was assessed using Fisher exact test. RESULTS: Baseline composite appropriateness was 30% (n = 12) on the control unit and 30.8% (n = 20) on the intervention unit. From baseline to posteducation, no significant change in composite appropriateness was found on the control (30% to 26.7%, P = 0.256) or intervention (30.8% to 19.4%, P = 0.09) unit. There was no significant difference between the education to intervention phase (26.7% vs 35%, P = 0.254) on the control unit. On the intervention unit, a significant difference in composite appropriateness was found from the education to intervention phase (19.4% vs 47.8%, P = 0.017). CONCLUSION AND RELEVANCE: A pharmacist-led intervention improved appropriateness of oral antimicrobials prescribed at discharge. One-time education was insufficient for improving antimicrobial stewardship.


Assuntos
Anti-Infecciosos , Gestão de Antimicrobianos , Adulto , Humanos , Alta do Paciente , Farmacêuticos , Anti-Infecciosos/uso terapêutico , Hospitais Comunitários , Antibacterianos/uso terapêutico
7.
Innov Pharm ; 13(1)2022.
Artigo em Inglês | MEDLINE | ID: mdl-36304689

RESUMO

Introduction: A multidisciplinary team (MDT) approach within cancer care settings is increasingly being adopted to improve patient outcomes due to the rising complexity of diagnosis and treatment. This study aims to explore the perspective of pharmacists on the structure, decision-making process, and communication practices of cancer MDTs. Methods: A 25-item online questionnaire was distributed to oncology-related clinical pharmacists in Alabama. Data were analyzed using descriptive statistics. Results: A total of 15 pharmacists completed the survey. More than half of the respondents reported that MDT meetings were held mostly in person on a set schedule. While physicians primarily facilitated the meetings, patients and/or their caregivers were largely not invited to participate in them. The treating physician oversaw delivering and update to the patient and/or their caregivers after the MDT meetings. Most respondents indicated that positron emission and computed tomography were the most common sources of information available at initial case presentations. Overall, respondents strongly agreed that they felt comfortable sharing their opinions with others health professionals during MDT meetings. Conclusions: This study provides evidence that oncology pharmacists are involved in MDT decision-making processes and communications but suggests the need to promote conditions to further their participation.

8.
Healthcare (Basel) ; 10(4)2022 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-35455859

RESUMO

(1) Background: Pharmacy-related financial management training and education are an integral part of the pharmacy curriculum. This study aims to evaluate pharmacy students' perceptions toward financial management education, their attitudes on its clinical relevance, and their ability to use financial management knowledge in introductory and advanced pharmacy practice experiences. (2) Methods: An online survey was sent to third- and fourth-year pharmacy students. The survey assessed the following three themes: perceptions toward financial management education; attitudes toward the clinical relevance of financial management education; and the student's ability to use knowledge of financial management in practice. Descriptive statistics were used to summarize the data. (3) Results: The overall response rate for the survey was 60% (139/233). Overall, the study showed a positive perception and attitude toward financial management education. Results indicate that pharmacy students were confident in their ability to use financial management knowledge in pharmacy practice. (4) Conclusions: This survey found an overall optimism in financial management education's role in pharmacy practice and the ability to obtain financial management competencies in professional pharmacy training. With the evolving practice requirements, pharmacy schools should adapt their financial management curricula with relevant skills to prepare students to become effective entrepreneurs, innovators, and practice leaders.

9.
Healthcare (Basel) ; 10(4)2022 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-35455892

RESUMO

Patient outcomes are improved when healthcare professionals work collaboratively. In order for future professionals to have these entry-level skills, students from different disciplines must work together in scenarios simulating patient care. This paper provides an overview of a large-scale, acute care simulation involving students of different disciplines, including nursing and pharmacy. A survey using the validated Student Perceptions of Interprofessional Clinical Education Revised (SPICE-R2) tool was administered to students participating in the simulation prior to and within 1 week of the simulation. There were between-group statistically significant differences on two items on the pre-simulation survey and two items on the post-simulation survey. Student participants reported more positive perceptions after the simulation on every item except for "During their education, health professional students should be involved in teamwork with students from other health professions to understand their perspective roles". The authors concluded that an interprofessional acute care simulation allowed students in both professions to recognize the value of a team approach to patient care.

10.
Cancer Epidemiol ; 72: 101911, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33662693

RESUMO

BACKGROUND: There is an increasing trend of colorectal cancer (CRC) incidence and mortality in individuals under the age of 50. The impact of age on the outcomes of CRC remains controversial. This study examined the characteristics and treatment trends of young-onset CRC by comparing patients < 50 years of age to those ≥50. METHODS: Data were retrospectively obtained from one of the largest hospital systems in Virginia. The sample included patients diagnosed with CRC from 2008 to 2016. Bivariate analyses were used to describe patients' characteristics. Stratified and multivariate analyses were used to evaluate the association between treatments and age groups in different stages at diagnosis. RESULTS: Approximately 11.6 % (n = 522) of the cohort were younger than 50 years old at diagnosis with a mean age of 42.7 (SD = 5.9) years. Compared to their older counterpart (50 and older), young-onset patients were more likely to be African American (28.7 % (n = 150) vs. 23.7 % (n = 944)), to own private insurance (68.5 % (n = 313) vs. 27.6 % (n = 1032)), to have never used tobacco products (50.4 % (n = 237) vs. 43.8 % (n = 1616)), and to be late stage at diagnosis (68.6 % (n = 358) vs. 52.5 % (n = 2090)) (all p < 0.05). For early stage diagnosis, over 98 % of the young-onset treatments were surgery. For late stage diagnosis, the cancer treatment for young onset patients were a combination of surgery (89.4 %), radiation (82.5 %), and chemotherapy (86.3 %). The results of the analyses also demonstrated that patients with young-onset CRC have higher odds for surgery [OR = 1.76, 95 %CI (1.26, 2.47)], radiation [OR = 1.31, 95 %CI (1.17, 1.47)], and chemotherapy [OR = 3.34, 95 %CI (2.62, 4.25)]. CONCLUSIONS: Findings confirmed late-stage prevalence among young-onset as well as significant demographic differences with patients' age ≥50. This study is one of few to explore the characteristics and assess treatment of young patients with CRC using U.S hospital data. Moreover, further studies need to clarify the effects of biological properties like genetic influences and environmental factors between races on cancer patient outcomes.


Assuntos
Neoplasias Colorretais/etnologia , Neoplasias Colorretais/terapia , Disparidades nos Níveis de Saúde , Adolescente , Adulto , Idade de Início , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Estudos Retrospectivos , Virginia , Adulto Jovem
11.
J Pharm Pract ; 34(3): 480-492, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32067555

RESUMO

OBJECTIVE: Pharmacists are ideally positioned to promote optimal use and assess the adherence of prescription medications in patients with chronic diseases. This systematic review of randomized controlled trials (RCTs) ascertains the effectiveness of pharmacist interventions to improve blood pressure (BP) control and medication adherence in patients with hypertension. DATA SOURCES: Electronic databases were searched for studies in English published between January 1, 1995, and January 31, 2018. Eligibility criteria included patients with a diagnosis of hypertension tested with RCT where pharmacist-led interventions occurred. The primary outcome was BP control and the secondary outcome was adherence to hypertensive medication. Quality of studies was assessed using the Cochrane Risk of Bias Tool. DATA SYNTHESIS: Thirty-five studies met the inclusion-exclusion criteria and were included in this study. Major themes included pharmacist-led interventions with medication counseling, patient education, distribution of interventions materials, individualized care plans, and check-in meetings. The vast majority of trials (n = 29) showed statistically significant improvement in BP in the intervention groups at follow-up. Of the 35 studies, most (n = 20) assessed medication adherence; several trials (n = 9) showed statistically significant improvement in medication adherence in patients receiving additional pharmaceutical care services. None of the RCTs was considered to have a high risk of bias. CONCLUSION: Pharmacist-led interventions improved BP control and medication adherence through education, counseling, or a combination of both. Future research is needed to determine the most effective pharmacists' interventions in managing hypertension and to assess the cost-effectiveness of these interventions.


Assuntos
Assistência Farmacêutica , Farmacêuticos , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Humanos , Adesão à Medicação , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Complement Ther Med ; 50: 102362, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32444043

RESUMO

Diabetes is an increasingly problematic health concern in the United States. Moringa oleifera (M. oleifera) has been suggested as medication in the prevention or treatment of diabetes, but there is no convincing evidence of a causal relation between moringa and decreased blood sugar levels in humans. The purpose of this scoping review is to examine the effects of Moringa oleifera on blood glucose levels in rats and humans. A search of Scopus, Ovid Medline, Ovid Embase, IPA, and Web of Science and manual searching of bibliographies were performed for peer-reviewed English articles published between May 1, 2008 and May 1, 2018. This review included thirty studies. Out of seven human studies, five found that M. oleifera significantly reduced blood glucose levels in diabetic patients. Out of twenty-three animal studies, twenty-one found that administration of M. oleifera led to a statistically significant decrease in animal blood glucose levels. In human studies, moringa was mostly administered in a powdered leaf form, while in animal studies it was frequently administered to as an aqueous or ethanol-based extract. The review found statistical evidence that moringa decreased blood glucose; the evidence is not strong enough to recommend it as the default treatment for people with diabetes.


Assuntos
Glicemia/metabolismo , Moringa oleifera/química , Extratos Vegetais/farmacologia , Animais , Humanos , Folhas de Planta/química , Ratos
14.
Health Commun ; 35(10): 1289-1294, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31167572

RESUMO

We examined whether the patient-provider relationship (PPR) is associated with Black survivors' health outcomes and whether this association was mediated by the quality of care. The outcome variables were survivors' quality of care and health outcome, and the predictor variable was PPR (communication, emotional support, time spent, and survivors' shared-decision making). A sample of 223 Black cancer survivors (age 63.0 ± 14.0 years) provided evaluable data. The most common cancer types reported by the participants were: gynecologic (32.7%), genitourinary (21.5%), and gastrointestinal cancers (11.2%). After controlling for covariates. A Structural Equation Model (SEM) showed that PPR was significantly associated with both health outcome (p = .015) and quality of care (p = .002). When PPR and quality of care were tested in the mediation model, the direct association between PPR and health outcome was attenuated, and it was no longer significant (b = -0.05, SE = 0.11, p = .65). However, indirectly, there was a strong association between PPR and health outcome through the quality of care (b = 0.22, SE = 0.08, p = .003), indicating full mediation. Providers' interpersonal relationships had a significant influence on the health of Black survivors, and this influence may be due to the increased positive perception of the quality of care. The implications of these findings for further research are discussed.


Assuntos
Negro ou Afro-Americano , Neoplasias , Idoso , Comunicação , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias/terapia , Avaliação de Resultados em Cuidados de Saúde , Relações Profissional-Paciente , Qualidade da Assistência à Saúde
15.
Pharmacy (Basel) ; 7(3)2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31480454

RESUMO

This study assesses the effectiveness of a pharmacy-led transition of care (TOC) service on increasing patients' understanding of, and reported adherence to, medication post hospital discharge. A cross-sectional survey was administered to patients who were discharged from the hospital with at least one medication received via bedside delivery from the TOC service. Adherence was assessed by asking the patient if they had taken their discharge medications as instructed by the prescriber. Satisfaction with the discharge medication counseling service was assessed through a five-point Likert scale. Descriptive statistics were conducted for all questionnaire items and qualitative data was examined using content analysis. The majority of patients (73%) were counseled on their medication(s) before leaving the hospital. Among those who received counseling, 76 patients had a better understanding of their medication(s). Ninety-five percent of the patients reported adherence, and all six of the patients reporting non-adherence claimed they were not counseled on their medications prior to discharge. Many patients had questions regarding their medication during the follow-up phone call, substantiating the need for further follow-up with patients once they have left the hospital environment. The implementation of medication bedside delivery and counseling services, followed by outpatient adherence monitoring via a transitional care management service, can result in higher levels of reported medication adherence.

17.
J Manag Care Spec Pharm ; 25(5): 578-586, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31039059

RESUMO

BACKGROUND: Adjuvant endocrine therapy (AET) is a critical therapy in that it improves survival in women with hormone receptor-positive (HR+) breast cancer (BC), but adherence to AET is suboptimal. The purpose of this study was to fill scientific gaps about predictors of adherence to AET among black and white women diagnosed with BC. OBJECTIVE: To assess AET adherence in black and white insured women using multiple measures, including one that uses an innovative statistical approach. METHODS: Black and white women newly diagnosed with HR+ BC were identified from 2 health maintenance organizations. Pharmacy records captured the type of oral AET prescriptions and all fill dates. Multivariable logistic regression was used to identify predictors of adherence defined in terms of proportion of days covered (PDC; ≥ 80%) and medication gap of ≤ 10 days. A zero-inflated negative binomial (ZINB) regression model was used to identify variables associated with the total number of days of medication gaps. RESULTS: 1,925 women met inclusion criteria. 80% were PDC adherent (> 80%); 44% had a medication gap of ≤ 10 days; and 24% had no medication gap days. Race and age were significant in all multivariable models. Black women were less likely to be adherent based on PDC than white women (OR = 0.72, 95% CI = 0.57-0.90, P < 0.01), and they were less likely to have a medication gap of ≤ 10 days (OR = 0.65, 95% CI = 0.54-0.79, P < 0.001). Women aged 25-49 years were less likely to be PDC adherent than women aged 65-93 years (OR = 0.65, 95% CI = 0.48-0.87, P < 0.001). In the ZINB model, women were without their medication for an average of 37 days (SD = 50.5). CONCLUSIONS: Racial disparities in adherence to AET in the study highlight a need for interventions among insured women. Using various measures of adherence may help better understand this multidimensional concept. There might be benefits from using both more common dichotomous measures (e.g., PDC) and integrating novel statistical approaches to allow tailoring adherence to patterns within a specific sample. DISCLOSURES: This research was funded by the National Institutes of Health (R01CA154848). It was also supported in part by the NIH-NCI Cancer Center Support Grant P30 CA016059, the Laboratory of Telomere Health P30 CA51008, and the TSA Award No. UL1TR002649 from the National Center for Advancing Translational Sciences. The contents of this study are solely the responsibility of the authors and do not necessarily represent official views of the National Center for Advancing Translational Sciences or the National Institutes of Health. Bosworth reports grants from Sanofi, Otsuka, Johnson & Johnson, and Blue Cross/Blue Shield of NC and consulting fees from Sanofi and Otsuka. The other authors have nothing to disclose. The datasets generated during and/or analyzed during the current study are not publicly available due to privacy reasons but are available from the corresponding author on reasonable request. The author does not own these data. Data use was granted to the author as part of a data use agreement between specific agencies and organizations.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/terapia , Sobreviventes de Câncer/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Adesão à Medicação/estatística & dados numéricos , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante/estatística & dados numéricos , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Receptores de Estrogênio/antagonistas & inibidores , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/antagonistas & inibidores , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Análise de Sobrevida , Estados Unidos , População Branca/estatística & dados numéricos
18.
J Immigr Minor Health ; 21(3): 606-658, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30117005

RESUMO

To summarize the literature on barriers and facilitators to breast and cervical cancer screening among immigrants to the US. A literature review was conducted for studies on breast and cervical cancer screening among immigrant populations. A thematic analysis of 180 studies identified a variety of barriers and facilitators to screening at the personal and system levels. Personal barriers included lack of knowledge and insurance coverage, high cost of care, and immigration status. System barriers included poor access to services, lack of interpreter services, and insensitivity to patient needs. Facilitators to screening included knowledge of disease, access to information sources, physician recommendation, and social networks. Cultural norms and resource availability at the individual and system levels influence screening among immigrants. Health insurance coverage was found to be an important predictor of preventative screening use. Future research should seek to identify the best way to address this and other barriers to cancer screening among immigrants groups.


Assuntos
Neoplasias da Mama/etnologia , Detecção Precoce de Câncer/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Neoplasias do Colo do Útero/etnologia , Atitude do Pessoal de Saúde , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Acessibilidade aos Serviços de Saúde , Humanos , Cobertura do Seguro/estatística & dados numéricos , Tradução , Estados Unidos
19.
Innov Pharm ; 10(3)2019.
Artigo em Inglês | MEDLINE | ID: mdl-34007558

RESUMO

PURPOSE: Approximately 15% of patients with hypothyroidism are dissatisfied with their treatment due to persistence of residual symptoms associated with hypothyroidism. The purpose of this study was to compare thyroid symptoms using the hypothyroid symptom scale (HSS) in patients receiving stable thyroid therapy for 6 months to patients without hypothyroidism. The HSS was used to identify the percentage of levothyroxine-treated hypothyroid patients with residual or persistent hypothyroid symptoms. METHODS: Patients included in the study had hypothyroidism and were receiving a stable/maintenance dose of levothyroxine sodium therapy, unchanged for at least 6 months. A control group of patients were included if they did not have an active prescription for thyroid hormone therapy. The HSS was administered via phone or face-to-face interactions. Patients were asked to score 10 symptoms over the past month on a scale of 0 to 4 (e.g., 0, absence of, to 4, severe symptoms). Results were analyzed using descriptive and inferential statistics. T-tests and chi-squared analysis were used to assess differences in continuous and categorical variables. RESULTS: A total of 68% of the contacted patients responded to the survey. A total of 302 patients were in the intervention group and 273 were in the control group. The mean total HSS scores between groups were significantly higher in the treatment compared to the control group (13.92 ± 10.91 vs.10.07 ± 7.85; P < 0.001). CONCLUSION: Significantly more patients receiving thyroid hormone therapy experienced residual thyroid symptoms compared to control patients. Attempts should be made to offer alternatives for hypothyroid patients with persistent symptoms.

20.
Innov Pharm ; 10(3)2019.
Artigo em Inglês | MEDLINE | ID: mdl-34007565

RESUMO

Significant progress has taken place in the field of cancer immunotherapy in recent years. Cancer immunotherapy, particularly immune checkpoint inhibitors, have shown rather dramatic results and are believed to have completely transformed the field of oncology. However, these transformational therapies are more expensive than previous cancer therapies. As more cancer immunotherapy agents are being developed, with some already being marketed, it is important to consider how economic constraints will shape health policy and value assessment related to these agents. A number of strategies have been suggested to alleviate the price burden and the ensuing concerns about the sustainability of publicly funded healthcare systems. Among these strategies, value-based pricing (VBP) for innovative drugs dominates the headlines in the field of oncology. The specifics of how VBP may be implemented in the United States is still unclear. Nonetheless, policy reform and economic considerations will have to be incorporated into the planning of VBP. The objective of this paper is multifold: (i) to identify the factors affecting the impact of cancer immunotherapy on healthcare cost; (ii) to critically appraise current approaches used to assess the value of novel cancer therapies; (iii) to assess the methodological challenges associated with the economic evaluation of cancer immunotherapy. As the health care system in the U.S transitions toward a value-based model, the need for a formal value assessment framework is warranted in cancer immunotherapy.

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