Compliance enhancing

It is critical to the success of the implementation and continued maintenance of a quality program that management commitment is constantly visible to the company s employees. Management that clearly support quality by way of leadership and adequate resource allocation is more likely to secure and retain committed and enthusiastic employees. Executive management that does not walk the talk is likely to be viewed as duplicitous and not genuinely committed to the corporate quality mission. Employees should be encouraged to become involved and take ownership of compliance enhancements and continuous improvements in their specific areas. Individual personnel efforts should be directed by the company s overall program of continuous improvement and forward quality. 

A unified program for continuous improvement and compliance enhancement... 

An assessment program is incomplete without the final step of bringing closure to the audit process. This can only be performed after all the quality and compliance enhancements have been implemented and evaluated over a predetermined period of time. This does not necessarily mean that all the action items have been completed, since some corrections may require extensive implementation and assessment. The followup assessment, however, must include a review of the previous action... 

Patient adherence to potassium replacement may be increased with compliance-enhancing regimens. 

VC patients prior experience with CRC Screening Compliance enhancer... 

Fig. 1. CTC as a compliance enhancer . Pie chart from a US hospital think tank study showing that among patients having virtual colonoscopy 60% had never had any prior colon cancer screening...

In the last several decades, physical properties of vaginal contraceptive formulations have been improved to deUver spermicide more effectively and enhance consumer compliance. The formulation that deUvers the spermicide can affect the efficacy of vaginal contraceptives (86,87). Formulations currentiy available include jeUies, creams, suppositories, aerosol foams, and foaming tablets. Each consists of a relative inert base material that serves as a carrier for the chemically active spermicide and blocks to some extent the passage of sperm. 

Studies have shown that compliance with toothbmshing would be severely impaired if the bmshing regimen did not include dentifrices. Thus, the role of dentifrices in plaque control is to enhance the toothbmshing experience and thereby enhance the results. Dentifrices have tittle direct effect on plaque removal or accumulation unless they contain agents that have specific antiplaque properties. 

As discussed previously, industiy is beginning to realize that there are profound benefits associated with pollution prevention including cost effectiveness, reduced hability, enhanced public image, and regula-toiy compliance. Nevertheless, there are barriers or disincentives identifiea with pollution prevention. This section will briefly outline both barriers and incentives that may need to be confronted or considered during the evaluation of a pollution prevention program. 

Tackifying resins enhance the adhesion of non-polar elastomers by improving wettability, increasing polarity and altering the viscoelastic properties. Dahlquist [31 ] established the first evidence of the modification of the viscoelastic properties of an elastomer by adding resins, and demonstrated that the performance of pressure-sensitive adhesives was related to the creep compliance. Later, Aubrey and Sherriff [32] demonstrated that a relationship between peel strength and viscoelasticity in natural rubber-low molecular resins blends existed. Class and Chu [33] used the dynamic mechanical measurements to demonstrate that compatible resins with an elastomer produced a decrease in the elastic modulus at room temperature and an increase in the tan <5 peak (which indicated the glass transition temperature of the resin-elastomer blend). Resins which are incompatible with an elastomer caused an increase in the elastic modulus at room temperature and showed two distinct maxima in the tan <5 curve. 

Frequent follow-up sessions are needed to determine compliance with the drug regimen. If a follow-up visit is not feasible, die nurse considers a telephone call or home visit. It is vital tiiat the nurse strive to develop a caring and nurturing relationship with the patient. Compliance is enhanced when a patient trusts the nurse and feels comfortable confiding any problem encountered during drug tiierapy. 

Allen JP, Litten RZ Techniques to enhance compliance with disulfiram. Alcohol Clin Exp Res 16 1035-1041, 1992... 

Polyethylene glycol (PEG) consists of repeating units of ethylene glycol forming linear or branched polymers with different molecular masses. Pegylation is the process by which PEG chains are covalently attached to lEN molecules. Pegylation confers a number of properties on lEN-a molecules, such as sustained blood levels that enhance antiviral effectiveness and reduce adverse reactions, as well as a longer half-life and improved patient compliance (Kozlowski et al. 2001). 

Although it has not been proven that acidification of the urine to increase PCP excretion alters the duration of the symptoms of psychosis, it appears appropriate to facilitate excretion of PCP from the adipose tissue in which it is stored in any PCP user (Done 1980). Maintaining the urine pH at an acid level for several weeks, even though the mental status is normal, is advised. It is important to test the pH of the urine to ensure compliance with the acidification. We have found that PCP becomes detectable in acidified urine for a time, even after being undetectable in alkaline urine, in previously intoxicated individuals. We have not found a change in mental status to result from such acidification treatment and resultant enhanced PCP excretion. 

In the recently released book on worldwide compliance issues (Adherence to Long-term Therapies, Evidence for Action),7 published by the World Health Organization, researchers indicate that the problem of noncompliance is worse in countries in the developing world than in countries in the industrialized world. Many parts of the United States have similar morbidity and mortality rates as countries in the Third World.8 Specific disease states may have significant additional noncompliance ramifications due to the development of drug-resistant strains of bacteria.9 Many times what is necessary is referral to specific clinicians for individualized treatment and monitoring to enhance compliance. The case histories provided in this text will allow you to follow what others have done in similar situations to optimally help patients succeed in improving compliance rates and subsequent positive health outcomes. 

Lack of patient understanding concerning optimal antidepressant drug therapy frequently leads to partial compliance or non-compliance with therapy, thus, the primary purpose of antidepressant counseling is to enhance compliance and improve outcomes. 

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