Dec 2012 DOI 10.14302/issn.2324-7339.jcrhap-12-71
Rajesh RadhakrishnanCorresponding author
Radhakrishnan Rajesh M.Pharm, Asst Professor (Senior Grade), Department of Pharmacy Practice, Manipal College of pharmaceutical Sciences, Manipal University, Manipal- 576 104, Karnataka, India.
In India, interruptions to highly active antiretroviral therapy (HAART) are due to adverse drug reactions (ADRs) and no reports on the direct cost incurred in the management of ADRs to HAART are available. There is a need to study direct cost incurred with ADRs to HAART to explore the high economic cost burden imposed by ADRs to HAART in HIV/AIDS patients. This study was aimed to evaluate the direct cost incurred in the management of ADRs to HAART in Indian HIV positive patients. This prospective study was conducted at a Medicine department in a South Indian tertiary care teaching hospitals were ADRs reporting system exist. HIV-positive hospitalized in-patients were identified and intensively monitored for ADRs to HAART. The World Health Organization (WHO) probability scale was used for causality assessment of ADRs. Modified Hart wig and Siegel scale was used for severity assessment of ADRs.Pearson chi-square test identified association of mean direct cost between ADRs and without ADRs by investigating total mean direct cost. The overall direct cost per ADRs to HAART was found to be higher in the context of expenditure on health care cost in India.
Jul 2023 DOI 10.14302/issn.2574-450X.jom-23-4654
Hodges StephanieCorresponding author
Background Nearly 40% of the adult population in the United States are considered obese by current standards, which equates to approximately 93 million people. Obesity is a chronic disease that is linked to more than 40 other diseases, including hypertension, heart disease, stroke, diabetes, and at least 13 distinct types of cancers. The direct and indirect costs of obesity have been estimated at up to $210 billion annually. Local Problem In Cumberland County, North Carolina, 34% of the adult population was considered obese. The aim of this quality improvement study was to increase effective care (screening, patient engagement, and referral to treatment) in adult patients with a BMI greater than 30 kg/m2 to 75% within 90 days. Methods A rapid cycle plan-do-study-act framework was used to evaluate four focus areas concurrently over 8 weeks with a small test of change completed in each 2-week cycle. Interventions An expanded screening with a checklist, shared decision-making tools (SDMTs), and a referral to treatment checklist were implemented. Activities from the team engagement plan were initiated. Results The effective care of patients increased by 42 percentage points while engaging both the patients and the staff. Conclusions Utilizing standardized communication, SDMTs, checklists, and management plans improved effective care while motivating and enabling patients to take control of their care and make sustainable lifestyle changes that enhance overall health.