Journal of evaluation in clinical practice
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The effect of an integrated syndromic respiratory disease guideline in primary health care settings.
The use of integrated syndromic guidelines (ISG) aims to improve the quality of care for patients with respiratory diseases. The impact of such ISG in clinical practice can be potentially significant in primary health care (PHC) settings. We report the impact of the use by general practitioners (GPs) of a Tunisian ISG for respiratory diseases in management of respiratory patients in PHC. ⋯ Training on ISG for respiratory diseases improved the diagnosis of CRD and tuberculosis, and lead to a more rational use of drugs for ARIs in PHCs.
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Smartphone and mobile application technology have in recent years furthered the development of novel learning and assessment resources. 'MBChB Mobile' is a pioneering mobile learning (M-Learning) programme at University of Leeds, United Kingdom and provides all senior medical students with iPhone handsets complete with academic applications, assessment software and a virtual reflective environment. This study aimed to evaluate the impact of MBChB Mobile on student learning. ⋯ As one of the largest evaluative and only quantitative study of smartphone-assisted M-Learning in undergraduate medical education, MBChB Mobile suggests that smartphone and application technology enhances students' learning experience. Barriers to implementation may be addressed through the provision of tailored learning resources, along with user-defined support systems, and appropriate means of ensuring acceptability to patients.
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In rheumatic disorders, one of the treatment objectives is to improve the patient's quality of life (QoL). Similar to other chronic conditions, drug compliance is poor, but necessary for successful treatment. The relationship between drug compliance and QoL has never been tested. The aim of this study was to elucidate the relationship between drug compliance and QoL in patients with different rheumatic disorders. ⋯ Doctors caring for rheumatic patients should focus their efforts on strengthening drug compliance in patients with higher QoL where it seems that lower compliance is more likely.
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Medication adherence is essential in kidney transplant recipients to reduce the risk of rejection and subsequent allograft loss. The aim of this study was to delineate what 'usual care' entails, in relation to medication management, for adult kidney transplant recipients. ⋯ This study highlighted that nephrologists took an active approach in the medication management of kidney transplant recipients, which may assist with facilitating long-term graft survival. Ultimately, promoting medication adherence needs to be patient centred, involving an interdisciplinary team of nephrologists, pharmacists and renal transplant nurse coordinators, working together with the patient to establish optimal adherence.
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Biologics are substantially more expensive than their conventional counterparts but it is unclear whether extra costs deliver better health outcomes. We compare clinical and economic outcomes between teriparatide (monthly costs $1120) and bisphosphonates (monthly costs $14) among postmenopausal women with osteoporosis. ⋯ The biological agent, teriparatide, is more expensive yet less effective than conventional treatment, bisphosphonates.