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Iman A. Basheti - One of the best experts on this subject based on the ideXlab platform.
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Assessing the impact of medication Management Review service for females diagnosed with depression and anxiety: A randomized control trial
Journal of Evaluation in Clinical Practice, 2019Co-Authors: Yasmeen Abunaba'a, Iman A. BashetiAbstract:Rationale, aims, and objectives Depression and anxiety are common mental illnesses suffered by females worldwide. Females face treatment-related problems (TRPs), including lack of adherence to their treatment. The Medication Management Review service (MMR) can be effective in identifying and resolving the TRPs. This study sought to assess the impact of the MMR service on identifying and resolving TRPs, improving adherence, depression, and anxiety scores in females diagnosed with depression and anxiety in Jordan. Design and settings Participants were recruited into this single-blind parallel randomized controlled trial and randomized into active and control groups. A clinical pharmacist identified TRPs for all participants. Adherence, depression, and anxiety scores were assessed. Active group patients received the MMR service: pharmacist-delivered counseling and a letter with recommended changes in the patient's treatment plan were sent to the patient's psychiatrist to be applied. Control group participants did not receive the intervention. Follow-up assessments were completed for all patients at 3 months from baseline. Main outcome measures were TRPs, adherence, depression, and anxiety scores. RESULTS: Study participants (n = 73; mean age = 41.8 [SD = 16.27]) had 177 TRPs identified, with 2.42(SD = 1.06) TRPs per patient. At baseline, only 54.8% of the participants reported to be adherent to their treatment, and no significant differences were found between the groups. At follow-up, a significant decline in the number of TRPs was found for the active versus control group (active: 0.58[SD = 0.64], control: 1.78[SD = 1.13], P < .001). A significantly higher proportion of adherent patients was identified in the active (88.9%) versus control group (51.4%), P < .001. Significant improvements in the depression (P < .001) and anxiety (P = .003) scores were detected for the active versus control group. CONCLUSION: The MMR service led to a significant decrease in the number of TRPs, improved adherence, depression, and anxiety scores for females diagnosed with depression and anxiety.
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Identifying treatment related problems and associated factors among hospitalized post-stroke patients through medication Management Review: A multi-center study.
Journal of The Saudi Pharmaceutical Society, 2018Co-Authors: Iman A. Basheti, Shahnaz Mohammed Ayasrah, Muayyad M. AhmadAbstract:Abstract Background Stroke is a major cause of disability and one of the leading causes of death among the elderly. Treatment related problems can lead to undesirable consequences. The Medication Management Review (MMR) service is aimed at identifying, resolving and preventing TRPs, subsiding the undesirable outcomes associated with TRPs. Objectives To explore the types, frequencies and severity of TRPs amongst post-stroke patients recruited through hospitals via conducting the MMR service by clinical pharmacists in Jordan. Associations between patient factors and the identified TRPs were explored. Methods This cross-sectional descriptive study was conducted over three months in 2017 in different geographical areas throughout Jordan. Randomly recruited patients were interviewed at the hospitals to collect their demographic data and clinical characteristics. Types/frequencies/severity of TRPs for each stroke patient were identified by a clinical pharmacist. Associations between the identified TRPs and patient’s factors were explored through multiple regression analysis. Key findings: Out of 198 stroke patients (mean age: 56.6 ± 14.2) who completed the study, 110 (55.6%) were males. Many of the patients (82 (41.6%)) were smokers and 61 (69.2%) had hypertension and/or diabetes. The mean number of TRPs per patient was 2.5 ± 1.1. The most common TRP categories involved efficacy issues (198 (40.6%)), inappropriate drug adherence (136 (27.9%)) and inappropriate patient knowledge (114 (23.4%)). More than 70.0% (342/487) of the identified TRPs were of major severity. Higher number of TRPs was found to be associated with being a male, having a lower educational level, being a current smoker, having a higher number of drugs and a poorer quality of life. Conclusion Lack of drug efficacy, inappropriate drug adherence and patient knowledge were the major TRPs identified via delivering the MMR service to post-stroke patients. The identified TRPs highlights the importance of the MMR service, and supports planning future strategies aimed at decreasing the incidence of strokes.
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Pharmacists in humanitarian crisis settings: Assessing the impact of pharmacist-delivered home medication Management Review service to Syrian refugees in Jordan
Research in Social & Administrative Pharmacy, 2018Co-Authors: Majdoleen Al Alawneh, Nabeel Nuaimi, Iman A. BashetiAbstract:Abstract Background Refugees all over the world are facing several health-related problems. Chronic diseases among Syrian refugees in Jordan are high. The Home Medication Management Review (HMMR) service could be ideal to optimize refugees' health Management. Objectives To assess the impact of the HMMR service on the type and frequency of Treatment Related Problems (TRPs) among Syrian refugees living in Jordan. Methods This prospective randomized single blinded intervention-control study was conducted in three main cities in Jordan, between May and October 2016. Syrian refugees with chronic conditions were recruited and randomized into intervention and control groups. The HMMR service was conducted for all patients to identify TRPs at baseline. Data were collected via two home visits for all study participants. Clinical pharmacist's recommendations were written in a letter format to the physicians managing the patients in the intervention group only. Physicians' approved recommendations were conveyed to the patients via the pharmacist. Interventions at the patient level were delivered by the pharmacist directly. Patients were reassessed for their TRPs and satisfaction 3 months after baseline. Results Syrian refugees (n = 106) were recruited with no significant differences between the intervention (n = 53) and control groups (n = 53). A total of 1141 TRPs were identified for both groups at baseline, with a mean number of 10.8 ± 4.2 TRPs per patient. At follow-up, there was a significant decrease in the number of TRPs among the intervention group (P Conclusion Identified TRPs are high amongst Syrian refugees living in Jordan. The HMMR service significantly reduced the number of TRPs, and was highly accepted by the physicians. Refugees reported high satisfaction with this service.
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Value of a Community-Based Medication Management Review Service in Jordan: A Prospective, Randomized, Controlled Study.
Pharmacotherapy, 2016Co-Authors: Iman A. Basheti, Odate K. I. Tadros, Salah AburuzAbstract:tudy Objective To assess the impact of a medication Management Review (MMR) service on treatment-related problems (TRPs) and certain clinical outcomes in outpatients. Design Prospective randomized controlled study. Setting Two community pharmacies in Amman, Jordan. Patients A total of 160 people who visited the two community pharmacies between September 2009 and June 2010. Intervention Patients were randomized into two groups: intervention (82 patients) and control (78 patients) groups. The clinical pharmacist conducted a baseline assessment MMR for patients in both groups to determine the prevalence and type of TRPs; however, recommendations regarding the identified TRPs were only submitted to the physicians of patients in the intervention group. Measurements and Main Results All patients were followed for an average of 3.39 months after their baseline visit to the pharmacy. The impact of the MMR service for the intervention group was assessed by evaluating the outcomes of the recommendations submitted by the clinical pharmacist to resolve the identified TRPs, physicians' acceptance of the recommended interventions, and the effect of the intervention on certain clinical outcomes: blood glucose levels, blood pressure, and triglyceride levels. Follow-up assessment of the control group included evaluating the outcomes of the identified TRPs (identified and corrected by physicians without any input from the clinical pharmacist) and comparing glucose level, blood pressure, and triglyceride-level results with baseline values. No significant differences in mean number of medical conditions (3.7 vs 3.42, p=0.134), mean number of medications (4.51 vs 4.96, p=0.135), or mean number of TRPs per patient (5.55 vs 5.17, p=0.42) were observed at baseline in the intervention group versus the control group. Follow-up results revealed a high acceptance rate of recommendations by the physicians (94%). Regarding outcomes of TRPs, almost 70% of the identified TRPs in the intervention group were resolved or improved compared with 2% in the control group (p
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Home medication Management Review in outpatients with chronic diseases in Jordan: a randomized control trial
International Journal of Clinical Pharmacy, 2016Co-Authors: Iman A. Basheti, Rajaa A. Al-qudah, Nathir M. Obeidat, Nailya BulatovaAbstract:Background Medication Management Review (MMR) is a patient-focused, structured and collaborative health care service provided in the community setting to optimize patient understanding and quality use of medicines. Objective To conduct a randomized control trial of the MMR program in Jordan, by a pharmacist identifying treatment related problems (TRPs) through home visits, assessing type and frequency of TRPs, and eventual effect of resolving TRPs identified by the pharmacist and accepted by the physician on the health status of participating patients. Setting Outpatient clinic at the Jordan University Hospital, Amman, Jordan. Method Consecutive patients from outpatient clinics who were eligible for the study were recruited and randomly distributed into two groups (control and intervention). All patients were visited at home by the pharmacist who delivered only for intervention group counseling regarding self-reported adherence, frequency of monitoring and education regarding pharmacological and non-pharmacological therapy. After identifying TRPs, the pharmacist sent a letter to the physician with certain recommendations for patients in the intervention group only. Physician ticked the approved recommendations and returned the report to the pharmacist, allowing the pharmacist to convey the approved changes to the patients. Patients were referred back to their physicians for confirmation of any changes in treatment. Both groups were reassessed after 2–3 months during their regular follow-up visits to their physicians. Main outcome measure To assess the impact of home medication Review on the number of TRPs and self-reported adherence in outpatients with chronic diseases via hospital-based clinics in Jordan. Results A total of 158 TRPs were identified in 112 patients; mean TRP number was 1.63 per patient. As a result of the pharmacist intervention, there was a significant decrease in number of TRPs in the intervention group, the change in the mean was (1.23 (±1.19), P < 0.001) versus the control group (0.29 (±1.24), P = 0.114). After 3 months, a reduction in non-adherence was observed in the intervention (−0.81 (±1.48), P < 0.001) in contrast to no change in self-reported adherence in the control (0.22 (± 1.12), P = 0.168) group. Conclusion Overall, home-based medication Review for patients with chronic conditions decreased the total number of TRPs and improved patient self-reported adherence.
Timothy F Chen - One of the best experts on this subject based on the ideXlab platform.
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pharmacist led home medicines Review and residential medication Management Review the australian model
Drugs & Aging, 2016Co-Authors: Timothy F ChenAbstract:Older people are often prescribed multiple medicines and have a high prevalence of polypharmacy. Polypharmacy is associated with an increased risk of inappropriate use of medicines and drug-related problems. As experts in pharmacotherapy, pharmacists are well placed to Review complex medication regimens and identify causes of drug-related problems and recommend solutions to prevent or resolve them. Involvement in medication Review services represents a major philosophical shift and paradigm change in the way pharmacists practice, in that the focus is shifted away from the dispensing of prescription medicines to the provision of a professional service for a patient, in collaboration with their general practitioner (GP). In Australia, there are two established medication Review programs: Home Medicines Review (HMR) and Residential Medication Management Review (RMMR). The objectives of this article were to describe the process of government-funded medication Review services in Australia and to evaluate the contribution of pharmacists to HMR and RMMR, using evidence-based measures, such as the Drug Burden Index (DBI) and the Medication Appropriateness Index (MAI). This Review found that there is good evidence to support the role of pharmacists in delivering medication Review services across different settings. Although the positive impact of such services has been demonstrated using a variety of validated measures (DBI, MAI), there remains a need to also evaluate actual clinical outcomes and/or patient-reported outcomes.
Terje Aven - One of the best experts on this subject based on the ideXlab platform.
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risk assessment and risk Management Review of recent advances on their foundation
European Journal of Operational Research, 2016Co-Authors: Terje AvenAbstract:Risk assessment and Management was established as a scientific field some 30–40 years ago. Principles and methods were developed for how to conceptualise, assess and manage risk. These principles and methods still represent to a large extent the foundation of this field today, but many advances have been made, linked to both the theoretical platform and practical models and procedures. The purpose of the present invited paper is to perform a Review of these advances, with a special focus on the fundamental ideas and thinking on which these are based. We have looked for trends in perspectives and approaches, and we also reflect on where further development of the risk field is needed and should be encouraged. The paper is written for readers with different types of background, not only for experts on risk.
Elzotbek Rustambekov - One of the best experts on this subject based on the ideXlab platform.
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enterprise risk Management Review critique and research directions
Long Range Planning, 2015Co-Authors: Philip Bromiley, Michael K Mcshane, Anil Nair, Elzotbek RustambekovAbstract:Many regulators, rating agencies, executives, and academics have responded to recent corporate scandals and business failures by advocating and embracing a new approach to risk Management: enterprise risk Management (ERM). ERM proposes the integrated Management of all the risks an organization faces, which inherently requires alignment of risk Management with corporate governance and strategy. Academic research on ERM is still in its infancy with articles largely in accounting and finance journals, but rarely in Management journals. We argue that ERM offers an important new domain of research for Management scholars. A critical Review of ERM research allows us to identify limitations and gaps that Management scholars are best equipped to address. The paper not only identifies how Management scholars can contribute to ERM research, but also points out why ERM research (and practice) needs Management research for its development.
Barry D Dickinson - One of the best experts on this subject based on the ideXlab platform.
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male breast cancer risk factors diagnosis and Management Review
Oncology Reports, 2010Co-Authors: Katherine Johansen Taber, Lee R Morisy, Albert J Osbahr, Barry D DickinsonAbstract:Male breast cancer (MBC) is extremely rare, with an incidence in the general US population of <1%. It tends to be diagnosed at later stages than breast cancer in females, likely because of low awareness on the part of the patient and low suspicion by the physician. Risk factors include genetic predisposition, alterations to the estrogen-testosterone ratio, radiation exposure, and occupational hazards. Because of the rarity of MBC, mammography in men is more often utilized as a diagnostic tool to evaluate breast symptoms rather than as a tool for widespread screening. While clinical breast examinations are effective at evaluating breast symptoms, mammography also may be beneficial in separating malignant from benign breast disease. This study Reviews MBC and its risk factors, recommendations for screening and diagnosis, the roles of mammography and genetic testing in surveillance, and Management of patients with MBC. Heightened awareness of the increased risk in certain men by both physicians and patients, and adherence to guidelines recommended for the surveillance of men at increased risk, may result in earlier detection.
