1.
The "10 keys" to healthy aging: 24-month follow-up results from an innovative community-based prevention program.
Robare, JF, Bayles, CM, Newman, AB, Williams, K, Milas, C, Boudreau, R, McTigue, K, Albert, SM, Taylor, C, Kuller, LH
Health education & behavior : the official publication of the Society for Public Health Education. 2011;(4):379-88
Abstract
The purpose of this report was to evaluate a prevention program to reduce risk factors for common diseases among older individuals in a lower income community. This randomized community-based study enrolled older adults into a Brief Education and Counseling Intervention or a Brief Education and Counseling Intervention plus a physical activity and (for those with hypertension) a dietary sodium intervention. Outcomes were collected on 389 adults with a mean age of 73.9 years over 24 months. Adherence to the "10 Keys" improved significantly in the proportion meeting goals for low-density lipoprotein cholesterol (+14%), bone mineral density testing (+11%), pneumonia vaccination (+11%), colonoscopy (+14%), and adherence to antihypertensive medication (+9%). This program resulted in significant reductions in key risk factors, increases in immunizations, and adherence to established prevention guidelines over 2 years. Further research is needed to refine the use of community health counselors for translating prevention knowledge into community settings. A major limitation of these studies is the low participation percentage.
2.
Tacrolimus: review of pharmacokinetics, pharmacodynamics, and pharmacogenetics to facilitate practitioners' understanding and offer strategies for educating patients and promoting adherence.
Vicari-Christensen, M, Repper, S, Basile, S, Young, D
Progress in transplantation (Aliso Viejo, Calif.). 2009;(3):277-84
Abstract
Kidney transplantation requires lifelong immunosuppression with agents that prevent allograft rejection. Immunosuppressive regimens typically include a steroid, an immune modulator (eg, azathioprine, mycophenolate mofetil, or mycophenolate sodium), and a calcineurin inhibitor, either cyclosporine or tacrolimus. Tacrolimus is metabolized by cytochrome P450 3A4 in both the liver and small intestine. Drugs that are substrates of cytochrome P450 3A4, as well as inhibitors and inducers of cytochrome P450 3A4, can cause significant interactions with tacrolimus. A review of the pharmacodynamics and pharmacokinetics of tacrolimus is important to enhance practitioners' understanding when using tacrolimus after kidney transplantation. It is also important to educate patients and their families about tacrolimus. Patients' adherence to this medication regimen is pivotal for allograft survival. A consistent and comprehensive approach to education and discharge teaching is a key component of adherence and the attainment of therapeutic drug levels. At Shands Jacksonville Transplant Center, discharge education and teaching tools aid the transplant professionals and facilitate patients' adherence. This in turn supports the goals of maintaining therapeutic serum levels of tacrolimus and improving renal allograft survival.
3.
Hepatitis C: are you confused?: Issues related to patient education.
Kerbleski, M
Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates. 2005;(3 Suppl):S19-23
Abstract
More than 4 million Americans are infected with the hepatitis C virus. Although overshadowed by acquired immune deficiency syndrome, the hepatitis C epidemic is now recognized as a major health problem. Prevalence is estimated to be anywhere from 1.2% to 10% in specific populations. Nurses continue to express confusion in understanding the disease process; therefore, many opportunities are missed to counsel patients and families who may be at risk or who have hepatitis C. Many patient questions go unanswered because nurses mistakenly assume the medical provider will educate these patients and families. However, nurses have more contact with patients, and one of the nurse's roles is to provide health education. The Society of Gastroenterology Nurses and Associates and the Joint Commission on Accreditation of Healthcare Organizations agree it is the nurse's role to educate patients. Accurate hepatitis C virus information helps nurses guide patients and families in understanding this disease process.
4.
Patient acceptance of educational voice messages: a review of controlled clinical studies.
Krishna, S, Balas, EA, Boren, SA, Maglaveras, N
Methods of information in medicine. 2002;(5):360-9
Abstract
OBJECTIVES The objective of this study was to evaluate controlled evidence on the impact of automated computer-based telephone messaging technology upon health outcomes, cost savings and acceptance by patients, caregivers and care providers. METHODS Systematic searches of electronic databases were conducted to find controlled clinical studies of automated phone messaging used in patient care. Studies were selected based on the three criteria: 1) randomized controlled trials or controlled trials; 2) patients receiving health care related education, information, advice or reminder for a specific action to be taken in their home setting; and 3) use of automated computer-based phone technology to deliver the messages. Information abstracted from studies included information about the institution, persons targeted, intervention and its effect on health outcomes, costs and acceptance by patients and caregivers. RESULTS A total of nineteen studies were identified for review. Sixteen studies were randomized controlled trials and three were controlled studies with no randomization. Studies were placed in two categories, preventive care education and chronic care studies. Preventive care education studies covered childhood immunizations, medication compliance, influenza vaccinations, tuberculosis and health prevention activities and chronic care studies were related to cholesterol, diabetes, hypertension and congestive heart failure. More than 80% of studies showed significant impact upon measurable health outcomes. CONCLUSIONS Controlled evidence substantiates the efficacy of automated telephone communication in improving the quality of care. Educational voice messages are acceptable in patients and represent an important opportunity to enhance telemedicine and telehealth applications.