Enhanced patient outcomes

Jensen MK, Fiscella RG, Lewis T, 2002. Successfully enhancing patient outcomes through quality improvement processes Experience using an infectious reporting database at an ambulatory eye clinic. ASHP Midyear Clinical Meeting, Atlanta, GA. 

Frank, E. (1997). Enhancing patient outcomes Treatment ndhetence. Journal of Clinical Psychiatry, 58(Suppl. 1), 11-14. 

PBMs offer aggregate reports from their prescription data archives. These data are stripped of all patient-identifying information and are disseminated to physicians or employers for the purpose of enhancing patient outcomes. PBMs offer the expertise of clinical pharmacists to assist in the interpretation of aggregate reports. Clinical pharmacists help identify trends and goals to set for maximization of patient outcomes. 

Rosenblum A, Magura S, Palij M, et al Enhanced treatment outcomes for cocaineusing methadone patients. Drug Alcohol Depend 54 207—218, 1999 Rychtarik RG, Connors GJ, Dermen KH, et al Alcoholics Anonymous and the use of medications to prevent relapse an anonymous survey of member attimdes. J Stud Alcohol 61 134-138, 2000... 

In rodent stroke models, statin pretreatment has been shown to reduce infarct volumes and improve outcomes. Similarly, several clinical studies have shown that prior statin use reduced the severity of acute ischemic stroke and myocardial infarction. Recent studies indicate that beneftt can be achieved even when treatment is initiated after the onset of symptoms. In rodents, atorvastatin and simvastatin have been shown to reduce the growth of ischemic lesions, enhance functional outcome, and induce brain plasticity when administered after stroke onset. A retrospective analysis of the population-based Northern Manhattan Stroke Study (NOMASS) showed that patients using lipid-lowering agents at the time of ischemic stroke have a lower incidence of in-hospital stroke progression and reduced 90-day mortality rates. Retrospective analysis of data of the phase III citicoline trial showed... 

Another related technique is the use of critical pathways. A critical pathway or clinical care plan is a detailed plan of care for a specific diagnosis, disease, or procedure [27], It describes the use and timing of all the care activities to try to optimize cost-effectiveness and improve patient outcomes. Critical pathways are much more specific than practice guidelines, which means they tend to take much more effort to produce. However, their comprehensive nature can enhance communication and coordination by different practitioners who are providing care to a particular patient. While critical pathways have been accepted within hospitals, their adoption for ambulatory care has been mixed. 

Leadership is an important concept that transcends all health care professions. The acceptance of this role by all health care professionals is vital to the invention of new technologies and dosage forms, changes in the delivery of health care, enhancement of patient outcomes and quality of life, and success of their specific health care organization. The opportunities for pharmacists to be leaders in their practice setting, the pharmacy profession, and the community are plentiful. Leadership is a critical component for positive change within pharmacy organizations and the profession. 

With the ongoing refinement of endovascular devices and techniques for carotid revascularization, catheter-based therapy has become technically feasible in most patients. Notwithstanding, appropriate case selection is required to ensure procedural safety, Here within we review new concepts pertaining to patient selection and technical procedural considerations that we consider crucial for enhancing clinical outcomes following carotid stenting,... 

However, does enhanced patient xmderstanding about medication use translate into improved patient outcomes A study of a physician-directed, pharmacist-managed asthma program evaluated the impact of attending a... 

Some compendial requirements have been instituted to guide packaging practices for drugs that are characterized by their route of administration. These guidelines are designed to enhance patient safety and prevent undesirable outcomes. The administrative modes discussed here include oral, parenteral, and topical. 

Although furosemide (fmsemide) is administered commonly in oliguric ARF, there is controversy over whether this drug decreases the incidence of ARF in high-risk human patients or enhances recovery (Dishart Kellum 2000). In fact, there have been few studies that have addressed this question in a prospective, blinded fashion in comparison to placebo treatment. In a recent report that compared furosemide (fmsemide, 3mg/kg i.v. four times a day for 21 days) or torasemide (another loop diuretic) with placebo treatment in 92 humans patients with ARF, the administration of a loop diuretic had a positive effect on urine output during the initial 24 h of treatment but did not shorten the dialysis times or improve the patient outcome (Shilliday et al 1997). Nevertheless, because the adverse effects associated with furosemide (fmsemide) use are few, it remains a common treatment in oliguric ARF. 

APhA has several affiliate organizations, and through the work of its Foundation and credentialing organizations, the Association has made a major commitment to research, quality measurement, and accountability. The APhA Foundation has sponsored and directed several significant research and demonstration projects to contribute to the body of evidence that pharmacists services enhance patient health-seeking behavior and improve outcomes. Research on quality measurement and the development of tools to reduce medication use problems and errors is a priority of the Foundation. 

The traditional system of providing patient care— wherein physicians initiate drug therapy, pharmacists dispense medications, and nurses administer medica-tion.s—is often run in a disjointed fashion. This results in potentially avoidable adverse drug events that contribute to poor patient outcomes and increased medical costs. Efforts aimed at modifying the current processes of care to enhance efficiency of workflow, improve patient outcomes, and reduce medication errors arc needed. 

To enhance the quality, appropriateness, and effectiveness of health care services, and access to these services the federal government in the Omnibus Budget Reconciliation Act of 1989 (Public Law 101-239) established the AHCPR. The act, sometimes referred to as the Patient Outcome Research Act, called for the establishment of a broad-based, patient-centered outcomes research program. In addition to the traditional measures of survival, clinical endpoints and disease- and treatment-specific symptoms and problems, the law mandated measures of functional status and well-being and patient satisfaction. In 1999, then President Clinton signed the Healthcare Research and Quality Act, reauthorizing AHCPR as the AHRQ until the end of fiscal year 2005. Presently, its mission is to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, broaden access to effective services, and improve the quality of health care services. 

Multiple daily dosing of systemic corticosteroids for the initial therapy of acute asthma exacerbations appears warranted because receptor-binding affinities of lung corticosteroid receptors are decreased in the face of airway inflammation. However, patients with less severe exacerbations may be treated adequately with once-daily administration. High-dose and very-high-pulse-dose corticosteroid regimens have not been shown to enhance the outcomes in severe acute asthma but are associated with a higher likelihood of side effects. ... 

B. Repeated doses of activated charcoal may be indicated to enhance elimination of some drugs if (1) more rapid elimination will benefit the patient (and the benefits outweigh the risks of repeated doses see IV.C and V.C, below), and (2) more aggressive means of removal (eg, hemodialysis orhemoperfu-sion) are not immediately indicated or available (see p 57). However, it has not been proven to improve patient outcome in clinical studies. 

The lo-tech humble cotton sheet can now be thought of as a dynamic siuface that could potentially monitor, store and transmit information relating to your immediate state of health, deliver your drugs to you, proteet you against bacterial contamination, and, as this pq)er proposes, it could also monitor and detect levels of contamination. Its very close proximity to the way we live offers an unprecedented opportunity to not only reduce delay times in du ostics, monitoring and drug delivery, but also to deliver a unique and personalised response in these aspects as the textile is next to the skin and can respond to individual needs. The opportunity for textiles to enhance patient safety, improve healthcare delivery and to improve treatment outcomes is very real. 

B. Volpe, H. Krebs, N. Hogan, L. Edelstein, C. Diels, and M. Aisen (1999), Robot training enhanced motor outcome in patients with stroke maintained over 3 years. Neurology 53 1874-1876. 

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