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Faurie C, Alvergne A, Cheng D, Duflos C, Elstgeest L, Ferreira R, Raat H, Valsecchi V, Pilotto A, Baker G, Pisano MM, Pers YM. Can pain be self-managed? Pain change in vulnerable participants to a health education programme. Int J Health Plann Manage 2024; 39:1313-1329. [PMID: 38549189 DOI: 10.1002/hpm.3802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 02/26/2024] [Accepted: 03/14/2024] [Indexed: 09/03/2024] Open
Abstract
Chronic pain exerts a significant impact on the quality of life, giving rise to both physical and psycho-social vulnerabilities. It not only leads to direct costs associated with treatments, but also results in indirect costs due to the reduced productivity of affected individuals. Chronic conditions can be improved by reducing modifiable risk factors. Various educational programs, including the Chronic Disease Self-Management Programme (CDSMP), have demonstrated the advantages of enhancing patient empowerment and health literacy. Nevertheless, their efficacy in addressing pain symptoms has received limited attention, especially concerning vulnerable populations. This research aims to assess the effectiveness of the CDSMP in alleviating pain among socio-economically vulnerable participants with chronic conditions. By accounting for a wide range of variables, and using data from the EFFICHRONIC project (EU health programme), we investigated the changes in pain levels after the intervention, among 1070 participants from five European countries. Our analyses revealed a significant reduction in pain following the intervention. This finding supports the notion that training programs can effectively ameliorate pain and alleviate its impact on the quality of life, particularly in vulnerable populations. Younger participants, as well as those with higher education levels and individuals experiencing higher levels of pain at baseline, were more likely to experience a reduction in their pain levels. These findings underscore the importance of recognising the social determinants of health. The study was registered at ClinicalTrials.gov (ISRCTN70517103).
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Affiliation(s)
- Charlotte Faurie
- Institute for Evolutionary Sciences (ISEM), University of Montpellier, CNRS, EPHE, IRD, Montpellier, France
- Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France
| | - Alexandra Alvergne
- Institute for Evolutionary Sciences (ISEM), University of Montpellier, CNRS, EPHE, IRD, Montpellier, France
| | - Demi Cheng
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Claire Duflos
- Institut Desbrest d'Epidémiologie et de Santé Public, UMR UA11 INSERM, University of Montpellier, Montpellier, France
| | - Liset Elstgeest
- Reinier Academy, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Rosanna Ferreira
- IRMB, University of Montpellier, INSERM, Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, CHU Montpellier, Montpellier, France
| | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Verushka Valsecchi
- IRMB, University of Montpellier, INSERM, Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, CHU Montpellier, Montpellier, France
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
| | - Graham Baker
- Quality Institute for Self-Management Education and Training, Chaldon, UK
| | - Marta M Pisano
- General Direction of Care, Humanization and Social and Health Care, Ministry of Health, Biosanitary Research Institute of the Principality of Asturias, Asturias, Spain
| | - Yves-Marie Pers
- IRMB, University of Montpellier, INSERM, Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, CHU Montpellier, Montpellier, France
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Hernández RCL, Martínez JLA, Del Angel MAH, de Córdova IP, Solís VS, Salinas MEV. Outcomes of a Self-Management Program for People with Non-Communicable Diseases in the Context of COVID-19. Healthcare (Basel) 2024; 12:1668. [PMID: 39201226 PMCID: PMC11354043 DOI: 10.3390/healthcare12161668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/08/2024] [Accepted: 08/17/2024] [Indexed: 09/02/2024] Open
Abstract
OBJECTIVE To evaluate the effectiveness of the online version of the Chronic Disease Self-Management Program (CDSMP) on physical activity and depressive symptoms in individuals with non-communicable diseases (NCDs) in Mexico and Peru during the COVID-19 pandemic. MATERIALS AND METHODS Quasi-experimental study with a non-probability sample of 114 people with NCDs, recruited by invitation in Mexico and by convenience in Peru. The participants were assigned to intervention (n = 85) and control (n = 29) groups. The Personal Health Questionnaire (PHQ-8) and the Physical Activity Scale were used to assess the outcomes. Measurements were taken before and after the intervention. The CDSMP comprises six sessions that take place once per week and last 2.5 h each. RESULTS The intervention group showed a significant reduction in depressive symptoms and an increase in physical activity (PA) at the end of the program. In contrast, the control group showed no significant improvement in depression and presented a significant decrease in PA.
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Affiliation(s)
| | - Jorge Luis Arriaga Martínez
- Facultad de Enfermería Tampico, Universidad Autónoma de Tamaulipas, Centro Universitario Tampico-Madero, Tampico 89339, Mexico; (J.L.A.M.); (M.A.H.D.A.); (I.P.d.C.)
| | - Martha Arely Hernández Del Angel
- Facultad de Enfermería Tampico, Universidad Autónoma de Tamaulipas, Centro Universitario Tampico-Madero, Tampico 89339, Mexico; (J.L.A.M.); (M.A.H.D.A.); (I.P.d.C.)
| | - Isabel Peñarrieta de Córdova
- Facultad de Enfermería Tampico, Universidad Autónoma de Tamaulipas, Centro Universitario Tampico-Madero, Tampico 89339, Mexico; (J.L.A.M.); (M.A.H.D.A.); (I.P.d.C.)
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Kessler D, McCutcheon T, Rajachandrakumar R, Lees J, Deyell T, Levy M, Liddy C. Understanding barriers to participation in group chronic disease self-management (CDSM) programs: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 115:107885. [PMID: 37473604 DOI: 10.1016/j.pec.2023.107885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To identify factors that influence enrollment in and attendance of chronic disease self-management (CDSM) group programs. METHODS A scoping review of peer-reviewed publications that reported on factors of enrollment or attendance in group CDSM programs for adults with any type of chronic condition. Screening was completed by two reviewers and data extraction was checked for accuracy. Data were summarized and key themes were identified in collaboration with the study team. RESULTS Following screening, 52 of 2774 articles were included. Attendance rates that varied from 10.4-98.5% (mean =72.5%). There is considerable overlap between enrollment and attendance factors. These included Competing Commitments, Logistics, Personal characteristics, Perception of illness/health status, Health service provision, and Group dynamics. CONCLUSIONS Varied and individualized factors can facilitate or impede enrollment or attendance in group CDSM programs. Consideration of these factors and tailoring of programs is needed to facilitate patient ability to take part. Participatory co-design is a growing approach to ensure programs meet individual and community needs. More research is needed to identify the specific impact of using codesign on enrollment and attendance in group CDSM programs. PRACTICE IMPLICATIONS Including community members and service users in design and implementation may enhance CDSM program access.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada.
| | - Tess McCutcheon
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | | | - Jodie Lees
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Tracy Deyell
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada
| | - Marisa Levy
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
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Santos C, Fernandes CS, Bastos C, Cruz MA, Costa S, Lima L. Older person's experience of PT4Ageing-A programme on self-management «support» in chronic illness. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:346-352. [PMID: 37714461 DOI: 10.1016/j.enfcle.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/30/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE This study sought to describe the experience of a group of older adults who participated in a chronic illness self-management program. METHODS The study employed a qualitative phenomenological approach. Participants were eight elders and data collected using semi-structured interviews Data was analysed using thematic analysis. RESULTS Five themes emerged from the analysis: (1) Tips to improve our daily lives, (2) I was always motivated, (3) Sharing and mutual help, (4) They made us believe we were capable (5). It would be great if it did not end here. Globally, the participants of the program described their experience as very positive. They identified gains from participating in the program, such as learning strategies to help them cope with their health problems, improving their ability to manage their illnesses more autonomously and building social support, that even persisted after the conclusion of the intervention. CONCLUSION The findings of this study provide insight into how older adults experience a program for the self-management of chronic illness. For the development of future programs, support building must be considered. Older adults who participate in self-management programmes exhibit improved self-efficacy in relation to the management their chronic illnesses and greater autonomy in self-care.
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Affiliation(s)
- Célia Santos
- Escuela de Enfermería de Oporto, Porto, Portugal; lCINTESIS@RISE Research, Porto, Portugal
| | - Carla Silvia Fernandes
- Escuela de Enfermería de Oporto, Porto, Portugal; lCINTESIS@RISE Research, Porto, Portugal.
| | - Celeste Bastos
- Escuela de Enfermería de Oporto, Porto, Portugal; lCINTESIS@RISE Research, Porto, Portugal
| | | | - Sandra Costa
- lCINTESIS@RISE Research, Porto, Portugal; Instituto de Ciencias Biomédicas Abel Salazar, Universidad de Oporto, Porto, Portugal; ACES Grande Porto I - Santo Tirso/Trofa, ARS Norte Administración Sanitaria del Norte, I.P., Porto, Portugal
| | - Lígia Lima
- Escuela de Enfermería de Oporto, Porto, Portugal; lCINTESIS@RISE Research, Porto, Portugal
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Kim S. Effect of primary care-level chronic disease management policy on self-management of patients with hypertension and diabetes in Korea. Prim Care Diabetes 2022; 16:677-683. [PMID: 35985963 DOI: 10.1016/j.pcd.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 07/04/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022]
Abstract
AIMS This study aimed to evaluate the effect of introducing a regional chronic disease management project on the self-management of patients with hypertension and diabetes. METHODS This study included 174,546 patients. The relationship between introducing chronic disease management in a region and the self-awareness of disease status was analyzed using a generalized estimating equation model. Poisson regression analysis was used to evaluate the effect of policy adoption on medication adherence and risk-reduction behavior in patients with hypertension and diabetes. Finally, we used a difference-in-differences model to assess the net effectiveness of policies. RESULTS Overall, regions with policies implemented showed more condition awareness and drug adherence than those without; however, this was only significant in regions where patients and physicians were incentivized. Risk-reduction behavior for patients with diabetes was higher in regions with policies implemented than in those without. The policy had a net effect of significantly and non-significantly increasing disease awareness and medication adherence, respectively. CONCLUSION Chronic disease management policies at the primary care level that incentivized both patients and physicians improved patient self-management. However, the effects on patients with diabetes and hypertension differed. Future studies should account for additional patient outcomes, including long-term impact assessments and clinical outcomes.
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Affiliation(s)
- Seungju Kim
- Department of Nursing, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea.
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Clinical Pharmacist Intervention on Drug-Related Problems among Elderly Patients Admitted to Medical Wards of Northwest Ethiopia Comprehensive Specialized Hospitals: A Multicenter Prospective, Observational Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8742998. [PMID: 35898673 PMCID: PMC9314180 DOI: 10.1155/2022/8742998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/28/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022]
Abstract
Background: Drug therapy in the elderly needs an emphasis on age-related changes in drug pharmacokinetics and pharmacodynamics profile. Hospitalized elderly patients are at risk of more than one disease and polypharmacy associated with these; they are at risk of drug-related problems. This study aimed to assess the role of clinical pharmacy on identifying and resolution of drug-related problems among elderly patients admitted to medical ward of Northwest Ethiopia comprehensive specialized hospitals. Methods: A multicenter prospective observational study was conducted. A systematic sampling technique was used. The identified drug-related problem was recorded and classified using Cipolle, and adverse drug reaction was assessed using Naranjo algorithm of adverse drug reaction probability scale, and Medscape was used for drug-drug interaction. Data were analyzed by using STATA software version 14.1. Logistic regression was used, and results were reported as odds ratios (ORs) with 95% Confidence intervals with
statistically significant. Result: A total of 389 study participants were included in the study. About 266 (68.4%) of the participants had at least a single drug-related problem. About 503 drug-related problems were identified with a mean of 1.32 (CI: 1.27-1.36) drug-related problem per patient. The three-leading categories of drug-related problems were dose too high 108 (21.5%), nonadherence 105 (20.9%), and adverse drug reaction 96 (19.1%). Alcohol use (
, 95CI%: 1.23-3.94), source of the drug (
, 95CI%: 1.63-4.98), length of hospitalization (
, 95CI%: 1.37-3.95), number of comorbidities (
, 95CI%: 1.09-1.99), and polypharmacy (
, 95CI%: 1.72-5.46) were important risk factors for drug-related problems. From the intervention provided, 84.7% were accepted by prescribers. Among the total drug-related problems 67.4% of the problem was totally solved. Conclusion: This study revealed that DRPs were high among elderly patients admitted to medical ward of Northwest Ethiopia. Comorbidity, length of hospitalization, ploy-pharmacy, payer, and alcohol drinker were more likely to developed drug-related problems. Treatment optimizations were also done by clinical pharmacists and interventions were well accepted by prescribers.
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Pullyblank K, Brunner W, Scribani M, Krupa N, Ory MG, Smith ML. Recruitment and engagement in disease self-management programs: Special concerns for rural residents reporting depression and/or anxiety. Prev Med Rep 2022; 26:101761. [PMID: 35299592 PMCID: PMC8921301 DOI: 10.1016/j.pmedr.2022.101761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/07/2022] [Accepted: 03/06/2022] [Indexed: 11/30/2022] Open
Abstract
Poorer health outcomes are correlated with depression/anxiety in a rural population. Electronic modes of recruitment engage those reporting depression/anxiety into CDSME. CDSME increases patient activation regardless of history of depression/anxiety.
Chronic disease self-management education (CDSME) programs benefit individuals with chronic diseases, including mental health conditions, by improving health-related outcomes and increasing engagement with the health care system. Recruiting individuals with a history of mental health conditions to participate in CDSME is challenging, particularly in rural, underserved areas. Hence, it is important to understand factors associated with the presence of mental health conditions, and impacts of CDSME on patient engagement. This project identifies individual and program-level characteristics, as well as recruitment characteristics, associated with reporting a history of depression and/or anxiety. It also assesses factors related to program engagement and the relationship between completing CDSME and patient activation. Data were collected during CDSME workshops offered in 2019 in a rural region of New York. Of the 421 enrollees who completed survey instruments, 162 reported a history of depression and/or anxiety. Univariate analyses indicated that those reporting a history of depression and/or anxiety were younger, female, in poorer health, had more comorbidities, were Medicaid beneficiaries, and had lower patient activation scores. They also heard about and signed up for the workshop through the internet at higher rates than those not reporting a history of depression and/or anxiety. Multivariable logistic regression modeling indicated age, self-rated health, and number of comorbidities were independent predictors of reporting a history of depression and/or anxiety. Among CDSME completers, patient activation significantly improved regardless of history of depression and/or anxiety. Engaging individuals with mental health conditions in CDSME requires a multimodal recruitment strategy incorporating electronic marketing and registration.
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Affiliation(s)
- Kristin Pullyblank
- Center for Rural Community Health, Bassett Research Institute, Bassett Medical Center, One Atwell Road, Cooperstown, NY 13326, USA.,Decker College of Nursing and Health Sciences, Binghamton University, PO Box 6000, Binghamton, NY 13902, USA
| | - Wendy Brunner
- Center for Rural Community Health, Bassett Research Institute, Bassett Medical Center, One Atwell Road, Cooperstown, NY 13326, USA
| | - Melissa Scribani
- Center for Biostatistics, Bassett Research Institute, Bassett Medical Center, One Atwell Road, Cooperstown, NY 13326, USA
| | - Nicole Krupa
- Center for Biostatistics, Bassett Research Institute, Bassett Medical Center, One Atwell Road, Cooperstown, NY 13326, USA
| | - Marcia G Ory
- Center for Population Health and Aging, Texas A&M University, 212 Adriance Lab Rd, College Station, TX 77843-1266, USA.,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Rd, College Station, TX 77843-1266, USA
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, 212 Adriance Lab Rd, College Station, TX 77843-1266, USA.,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Rd, College Station, TX 77843-1266, USA
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Kim SK, Kim HS, Chung SS. Effects of an Individualized Educational Program for Korean Patients With Chronic Low Back Pain: A Randomized Controlled Trial. J Nurs Res 2021; 29:e177. [PMID: 34593721 DOI: 10.1097/jnr.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Most patients with low back pain prefer to ignore symptoms and avoid medical management because of incorrect perceptions about this condition. However, over 90% of patients with chronic low back pain are hardly unable to perform daily activities, with 50% reporting that their daily activities have been severely impeded. PURPOSE In this study, an individualized educational program was developed and implemented in a sample of Korean patients with chronic low back pain, and the effectiveness of this program was evaluated. METHODS This study was conducted as a randomized controlled trial with outpatients (n = 43) in an orthopedic clinic. The Analysis, Design, Development, Implementation, and Evaluation model was applied to develop the educational program. The experimental group was provided with an educational booklet and contacted via biweekly personalized telephone and face-to-face counseling sessions. The control group was provided the educational booklet only. SAS Version 9.4 was used to analyze collected data using the χ2 test, t test, Fisher's exact test, Wilcoxon test, linear regression analysis, and Spearman partial correlation analysis. RESULTS After 8 weeks, the experimental group demonstrated a significantly greater reduction in maximum, average, and current low back pain experienced within the immediately preceding 24 hours than the control group (p = .001, p = .002, and p = .014, respectively). In addition, daily living disability showed a greater reduction, and average back muscle strength showed a more significant improvement in the experimental group than in the control group (p = .001 and p = .035). The difference in medication adherence between the groups was not statistically significant (p = .089). The experimental group rated an average of 4.3 out of 5.0 points on the program satisfaction scale, indicating an 86% rate of satisfaction. CONCLUSIONS/IMPLICATIONS FOR PRACTICE In this study, the individualized educational program was shown to be effective in helping alleviate symptoms in patients with chronic low back pain, decrease daily living disability, and improve average back muscle strength. It was further demonstrated that following up with expert medical staffs can motivate patients to incorporate the recommendations of the program into their daily routine, leading to higher patient satisfaction.
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Affiliation(s)
- Seong-Kyong Kim
- PhD, RN, General Manager, Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Hee-Seung Kim
- PhD, RN, Emeritus Professor, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Soo Chung
- PhD, MD, Orthopedist, Department of Orthopedic Surgery, Bumin Hospital, Busan, Republic of Korea
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Zora S, Custodero C, Pers YM, Valsecchi V, Cella A, Ferri A, Pisano-González MM, Peñacoba Maestre D, Vazquez Alvarez R, Raat H, Baker G, Pilotto A. Impact of the chronic disease self-management program (CDSMP) on self-perceived frailty condition: the EU-EFFICHRONIC project. Ther Adv Chronic Dis 2021; 12:20406223211056722. [PMID: 34820081 PMCID: PMC8606718 DOI: 10.1177/20406223211056722] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/12/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction: The Chronic Disease Self-Management Program (CDSMP) improves self-efficacy and health outcomes in people with chronic diseases. In the context of the EFFICHRONIC project, we evaluated the efficacy of CDSMP in relieving frailty, as assessed by the self-administered version of Multidimensional Prognostic Index (SELFY-MPI), identifying also potential predictors of better response over 6-month follow-up. Methods: The SELFY-MPI explores mobility, basal and instrumental activities of daily living (Barthel mobility, ADL, IADL), cognition (Test Your Memory-TYM Test), nutrition (Mini Nutritional Assessment-Short Form-MNA-SF), comorbidities, medications, and socio-economic conditions (social-familiar evaluation scale-SFES). Participants were stratified in three groups according to the 6-month change of SELFY-MPI: those who improved after CDSMP (Δ SELFY-MPI < 0), those who remained unchanged (Δ SELFY-MPI = 0), and those who worsened (Δ SELFY-MPI > 0). Multivariable logistic regression was modeled to identify predictors of SELFY-MPI improvement. Results: Among 270 participants (mean age = 61.45 years, range = 26–93 years; females = 78.1%) a benefit from CDSMP intervention, in terms of decrease in the SELFY-MPI score, was observed in 32.6% of subjects. SELFY-MPI improvement was found in participants with higher number of comorbidities (1–2 chronic diseases: adjusted odd ratio (aOR)=2.38, 95% confidence interval (CI) =1.01, 5.58; ⩾ 3 chronic diseases: aOR = 3.34, 95% CI = 1.25, 8.90 vs no chronic disease), poorer cognitive performance (TYM ⩽ 42: aOR = 2.41, 95% CI = 1.12, 5.19 vs TYM > 42) or higher risk of malnutrition (MNA-SF ⩽ 11: aOR = 6.11, 95% CI = 3.15, 11.83 vs MNA-SF > 11). Conclusion: These findings suggest that the CDSMP intervention contributes to decreasing the self-perceived severity of frailty (SELFY-MPI score) in more vulnerable participants with several chronic diseases and lower cognitive performance and nutritional status.
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Affiliation(s)
- Sabrina Zora
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, EO Galliera Hospital, Genova, Italy
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni,” University of Bari Aldo Moro, Bari, Italy
| | - Yves-Marie Pers
- IRMB, University of Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Verushka Valsecchi
- IRMB, University of Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Alberto Cella
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, EO Galliera Hospital, Genova, Italy
| | - Alberto Ferri
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, EO Galliera Hospital, Genova, Italy
| | - Marta M. Pisano-González
- SESPA, Health Service of the Principality of Asturias, Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), Oviedo, Spain
| | - Delia Peñacoba Maestre
- SESPA, Health Service of the Principality of Asturias, Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), Oviedo, Spain
| | - Raquel Vazquez Alvarez
- SESPA, Health Service of the Principality of Asturias, Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), Oviedo, Spain
| | - Hein Raat
- Erasmus University Medical Center, Rotterdam, The Netherlands
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Medication Risk Management in Routine Dispensing in Community Pharmacies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218186. [PMID: 33167543 PMCID: PMC7663945 DOI: 10.3390/ijerph17218186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 01/01/2023]
Abstract
Community pharmacists have a duty to contribute to medication risk management in outpatient care. This study aimed to investigate the actions taken by pharmacists in routine dispensing to manage medication risks. The study was conducted as a national cross-sectional online survey targeted at all community pharmacies in Finland (n = 576) in October 2015. One pharmacist from each pharmacy was recommended to be the spokesperson for the outlet to describe their practices. Responses were received from 169 pharmacies (response rate of 29%). Pharmacists were oriented to solving poor adherence and technical problems in prescriptions, whereas responsibility for therapeutic risks was transferred to the patient to resolve them with the physician. Pharmacists have access to a wide range of electronic medication risk management tools, but they are rarely utilized in daily dispensing. Attention was paid to drug–drug interactions and the frequency of dispensing with regard to high-risk medicines. Pharmacies rarely had local agreements with other healthcare providers to solve medication-related risks. In routine dispensing, more attention needs to be given to the identification and solving of therapeutic risks in medications, especially those of older adults. Better participation of community pharmacists in medication risk management requires stronger integration and an explicit mandate to solve the therapeutic risks.
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Tan SS, Pisano MM, Boone AL, Baker G, Pers YM, Pilotto A, Valsecchi V, Zora S, Zhang X, Fierloos I, Raat H. Evaluation Design of EFFICHRONIC: The Chronic Disease Self-Management Programme (CDSMP) Intervention for Citizens with a Low Socioeconomic Position. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111883. [PMID: 31142017 PMCID: PMC6603786 DOI: 10.3390/ijerph16111883] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/14/2019] [Accepted: 05/25/2019] [Indexed: 12/21/2022]
Abstract
Background/rationale: The Chronic Disease Self-Management Programme (CDSMP) intervention is an evidence-based program that aims to encourage citizens with a chronic condition, as well as their caregivers, to better manage and maintain their own health. CDSMP intervention is expected to achieve greater health gains in citizens with a low socioeconomic position (SEP), because citizens with a low SEP have fewer opportunities to adhere to a healthy lifestyle, more adverse chronic conditions and a poorer overall health compared to citizens with a higher SEP. In the EFFICHRONIC project, CDSMP intervention is offered specifically to adults with a chronic condition and a low SEP, as well as to their caregivers (target population). Study objective: The objective of our study is to evaluate the benefits of offering CDSMP intervention to the target population. Methods: A total of 2500 participants (500 in each study site) are recruited to receive the CDSMP intervention. The evaluation study has a pre-post design. Data will be collected from participants before the start of the intervention (baseline) and six months later (follow up). Benefits of the intervention include self-management in healthy lifestyle, depression, sleep and fatigue, medication adherence and health-related quality of life, health literacy, communication with healthcare professionals, prevalence of perceived medical errors and satisfaction with the intervention. The study further includes a preliminary cost-effectiveness analysis with a time horizon of six months. Conclusion: The EFFICHRONIC project will measure the effects of the CDSMP intervention on the target population and the societal cost savings in five European settings.
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Affiliation(s)
- Siok Swan Tan
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Marta M Pisano
- Fundación para el Fomento en Asturias de la Investigación Científica Aplicada y la Tecnología (FICYT), Cabo Noval St, 11, 1ºC, 33007 Oviedo-Asturias, Spain.
| | - An Ld Boone
- Public Health General Directorate, Principality of Asturias (CSPA), C/ Ciriaco Miguel Vigil 9, 33006 Oviedo, Spain.
| | - Graham Baker
- Quality Institute for Self Management Education & Training (QISMET), Harbour Court, Compass Road, North Harbour, Portsmouth, Hampshire PO6 4ST, UK.
| | - Yves-Marie Pers
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 5, France.
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy.
| | - Verushka Valsecchi
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 5, France.
| | - Sabrina Zora
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy.
| | - Xuxi Zhang
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Irene Fierloos
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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