Journal of evaluation in clinical practice
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Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real-world evaluation. ⋯ This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale-up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases.
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The prevalence of polypharmacy in residential aged care facilities (RACFs) is high and increasing. Although not necessarily inappropriate, polypharmacy has been associated with drug interactions, adverse drug events, geriatric syndromes and hospital admissions. The aim of this study was to identify and prioritize factors contributing to the increasing prevalence of polypharmacy in RACFs. ⋯ Reasons for the increase in polypharmacy are multifactorial. Understanding the factors contributing to polypharmacy may help to guide future research and develop interventions to manage polypharmacy in RACFs.
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Few studies have investigated the quality of pre-hospital care by ethnicity. We aimed to investigate ethnic differences in pre-hospital ambulance care of patients with suspected cardiac pain. ⋯ There were significant differences in pre-hospital ambulance care for non-White compared with White patients with suspected cardiac pain. These differences could be due to differences in clinical condition or case-mix, language and cultural barriers, limited understanding of appropriate use of health care services, recording bias or true differences in provider management. Further analysis should involve larger and more complete data sets to explore ethnic differences in greater detail.
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Lack of familiarity with proper medication disposal options among patients can lead to personal and environmental safety concerns, besides signalling non-adherence. Given that community pharmacists are in a position to educate patients, this study assessed community pharmacists' knowledge on medication disposal and examined the utility of the theory of planned behaviour (TPB) in predicting their intention to provide medication disposal education to their patients. ⋯ Pharmacists showed favourable attitude, subjective norm, perceived behaviour control and intention in providing such education. However, their knowledge in this area may be lacking and they are not consistently providing this information to their patients.
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Explicit criteria have been used worldwide to identify suboptimal prescribing such as potentially inappropriate prescriptions (PIPs). The objective of our study was to determine prevalence, types and factors associated with PIPs in older people discharged from an Albanian hospital. ⋯ Our study found that between one and two out of three older patients has at least one PIP among the treatment prescribed at hospital discharge, depending on the tool used for detection. The high frequency of PIPs suggests the urgent need for interventions to reduce them.