Device inalatori nella BPCO:

Size: px
Start display at page:

Download "Device inalatori nella BPCO:"

Transcription

1 Device inalatori nella BPCO: d uso, counseling, aderenza alla terapia Fulvio Braido

2 COPD OUTCOMES Cazzola M et al. ERJ 2008

3 15.1%

4 Total medicare spending Simoni-Wastila, Am J Geriatr Pharmacother, 2012

5 Efficacia: outcomes effettivamente raggiunti / outcomes attesi Efficienza : rapporto output input

6 Drug Disease Cognition Patient Satisfaction Effectiveness = Efficacy X Adherence Treatment Schedule Inhaler Clinical effects Side effects Patient Behaviour Patient-Physician Relationship Drug delivering

7 The tough math of evidence based health care ROI = E x KT2 ROI = return on investment. E = efficacy of treatment. KT2*: Physician Patient *knowledge translation type 2 Haynes, ACP Journal Club 2009

8 The tough math of evidence based health care: asthma and ICS 25% therapeutic efficacy. 37% for patient adherence. 78% Physician adherence..25 x.37 x.78 = % the overall effectiveness Haynes ACP, Journal Club 2009

9

10 PAP Respiratory diseases management Perception and experience of the disease, adherence and attitudes towards the device PUBLIC PERCEPTION EXTENSIVE SURVEY

11 The methodology used Type of investigation: ad hoc quantitative Detection mode: Reference population: Sample: personal interv iews (C.A.P.I. system) 30 minutes structured questionnaire men and women aged 15 years and ov er resident in the whole national territory interviews representative of the sample according to the main socio-demographic parameters Survey: from May 22 nd to June 7 th, 2012

12 PAP Sample demographic characteristics N of patients: 2008 AGE < >64 TOWN SIZE LITTLE < inhab. 59 MEDIUM inhab. 16 BIG > inhab. 25

13 Socio-economic condition EDUCATION JOB DIPLOMA WORKING EMPLOYEE 18 DEGREE 9 50 ELEMENTARY- SECONDARY TRADER, CRAFSTMAN 8 TECHNICIAN 6 WORKER 5 ENTREPRENEUR, FREELANCE PROFESSIONAL 5 TEACHER 2 SOCIO-ECONOMIC CATEGORY MIDDLE MANAGER 2 EXECUTIVE MANAGER 1 Medium-high High Low Medium FARMER 1 NOT WORKING 53 RETIRED HOUSEWIFE 12 Medium-low STUDENT 10 UNEMPLOYED 6 N of patients: 2008

14 AWARENESS OF RESPIRATORY DISEASES diabetes Have you recently heard of any of the following diseases? 61 migraine artrosis hypertension ASTHMA osteoporosis 48 colitis hepatitis ASMA celiac disease BPCO 38 glaucoma BPCO PAP

15 La conoscenza delle malattie respiratorie Di recente Le è capitato di sentir parlare di qualcuna delle seguenti malattie? LIVELLO DI AWARENESS diabete emicrania artrosi ipertensione asma osteoporosi colite epatite celiachia glaucoma BPCO Rispondenti (totale campione): % Presso il general public la conoscenza delle malattie respiratorie croniche presenta consistenti discontinuità. Da un lato si è sentito parlare molto di asma, mentre la BPCO rimane un patologia ancora misconosciuta. Awareness per classi di età ASMA BPCO

16 USE OF THE INHALER DEVICE Respondents: suffer from asthma/copd USE OF THE INHALER DEVICE (%) 65 Patients currently using it % The use of device is less extended than we might expect. The percentage of abandoners is significant Patients who never used it Patients who used it in the past It should be noticed an intermittent use of the device: in most cases it is used as needed. PAP

17 Attitudes towards the device OVERALL OPINION If you had to give your overall opinion on the treatment with drugs taken by means of an inhaler device, which would be your judgment? % They use the inhaler device A relative uses the inhaler device A person they know uses the inhaler device They have heard about the inhaler device They don t know the inhaler device Positivo Positive judgement 83 Quite positive Quite negative + negative Respondents: total sample The resistance to the device is limited to people who can not rely on knowledge of the device. Where there is direct or indirect experience, there is an attitude of frank openness.

18 I believe that all device are more or less the same, that one is as good as another INDIFFERENCE 70 65,5 59, ,8 18,4 18,7 Under 64 Over I agree I disagree I don't know 2 = p<0.0130

19 The device is just a device, it does not contribute to the effectiveness of treatment INDIFFERENCE 60 51, , ,4 35,6 30 Under 64 Over ,1 17, I agree I disagree I don't know 2 = p<0.0293

20 I would be willing to use the device only for a short period of time, for therapies of a few days AVAILABILITY 60 58,2 53, ,2 27,1 30 Under 64 Over ,8 11, I agree I disagree I don't know 2 = p<0.0021

21

22

23

24 The Genuair inhaler: first multidose dry powder inhaler containing a LAMA Novel, multidose breath-actuated DPI with 1 month s supply Ready-to-use device from the package Handihaler Breezehaler Respimat Chrystyn and Niederlaender, Int J Clin Pract 2012 DPI, dry powder inhaler

25 The Genuair inhaler: inhalation is a simple two-step process Turbohaler 5 Diskus 4 Nexthaler 3

26 The Genuair inhaler: inbuilt safety measures Dose indicator Indicates when patient is close to last dose Empty inhaler prevention system Button is locked and cannot be depressed after last dose has been taken Over-dosing prevention system Only one dose released prior to inhalation, irrespective of how many times button is pressed

27 Genuair Tecnologia

28 Drug deposition (% metered dose) Lung deposition Whole-lung deposition: 30.1% of metered dose 34.0% of delivered dose Whole lungs Oropharynx Inhaler Exhaled air Newman et al, Respiration 2009 Reproduced w ith permission of S Karger AG, Basel

29

30 % dose predeterminata Genuair Pattern di distribuzione intrapolmonare 16 Interno Esterno Regioni polmonari CV = 24% CV, coefficiente di variazione; dati ottenuti da 12 adulti maschi sani dopo l inalazione di una singola dose di aclidinium 200 μg radiomarcato con 99mTc New man SP, Sutton DJ, Segarra R et al. Respiration 2009;78(3):

31

32 Highest PIF (L/min) Patients achieved highest peak inspiratory flow (PIF) with Genuair ** ** Genuair inhaler HandiHaler (slow, deep inhale) HandiHaler (fast, forceful inhale) ** All patients Moderate COPD Severe COPD Magnussen et al, Respir Med 2009 **p<0.001 vs HandiHaler Reproduced w ith permission of Elsevier

33

34

35 Correct inhalations with Genuair and HandiHaler 97.2% of inhalations through Genuair were successful (activation of trigger mechanism) and optimal (PIF 45 L/min) 73.6% of inhalations through HandiHaler (slow, deep inhalation) resulted in capsule vibration heard and no powder remaining in the centre chamber Magnussen et al, Respir Med 2009

36 % participants who succeeded Overall inhaler success is higher with Genuair compared with other inhalers Genuair HandiHaler * Respimat * Diskus % 67% 40 35% 20 23% 0 Overall inhaler success *HandiHaler blister pack manipulation and Respimat cartridge loading were not tested Hass et al, CHEST 2010

37 Average rating* Patients are more satisfied with Genuair compared with other inhalers 5 Genuair HandiHaler Respimat Diskus Overall satisfaction measures Hass et al, CHEST 2010 *Rating 1 5 (worst best)

38 Patients prefer Genuair compared with other inhalers Most preferred Least preferred Genuair Diskus HandiHaler Respimat Average cm from 0; max is 100 Hass et al, CHEST 2010

39 COSTS ADHERENCE Implementation Strategies Media Campaigns MD students Education Interactions HCS CME-Meetings Opinion Leaders Scientific Societies HC Blogs Blogs Internet Social Networks Patient Organizations EFFECTIVENESS patient/physician partnership Patient Education

40

41

42 The tough math of evidence based health care ROI = E x KT2 ROI = return on investment. E = efficacy of treatment. KT2*: Physician Patient *knowledge translation type 2 Haynes, ACP Journal Club 2009

43 Assist and motivate patients to enact optimal guided self-management Patient s expertise, experience, knowledge and attitude Tools and resources supporting patient s selfmanagement Phy sician s behavioural and/or practice change supporting patient s guided selfmanagement Guidelines, knowledge production and dissemination and expert opinion Optimal practice Workplace culture and peer influence and support Phy sician s education, expertise and knowledge Phy sician s attitude and efforts with regards to optimal practice Support physicians to achieve optimal practice Offer effective and efficient services Interprofessional patient management Reorganisation of care and organizational change management Resources and tools supporting phy sician s decision making and optimal practice

44 Device inalatori nella BPCO: d uso, counseling, aderenza alla terapia Fulvio Braido

TECHNIQUE TRAINING ON INHALERS

TECHNIQUE TRAINING ON INHALERS TECHNIQUE TRAINING ON INHALERS Donna Huynh, PharmD, BCPS, MA Assistant Professor University of Maryland School of Pharmacy Optimizing Medication Safety in Maryland Assisted Living Facilities March 17,

More information

Common Mistakes with inhaler Technique

Common Mistakes with inhaler Technique Common Mistakes with inhaler Technique Inhaling medication into the lungs can be very effective - but frequently it is not. The most common reasons for patients not responding to treatment are:- Being

More information

Greater Manchester COPD Management Plan

Greater Manchester COPD Management Plan Greater Manchester COPD Management Plan Inhaler therapy options for patients with COPD Non-pharmacological options for ALL patients, consider at all stages (please see page 3): Inhaler technique Encourage

More information

Before prescribing for COPD management, the patient should have had appropriate assessment, including spirometry, as per NICE guidelines.

Before prescribing for COPD management, the patient should have had appropriate assessment, including spirometry, as per NICE guidelines. Formulary Guidance for Management of COPD patients Before prescribing for COPD management, the patient should have had appropriate assessment, including spirometry, as per NICE guidelines. For inhaler

More information

New inhaled drugs for asthma & COPD: integration into UK practice

New inhaled drugs for asthma & COPD: integration into UK practice New inhaled drugs for asthma & COPD: integration into UK practice Hasanin Khachi Lead Pharmacist - Respiratory Medicine Joint Chair UKCPA Respiratory Group Barts Health NHS Trust 30 th September 2014 Outline

More information

Laboratorios Almirall, S.A. and Forest Laboratories, Inc. complete Phase III Studies in COPD

Laboratorios Almirall, S.A. and Forest Laboratories, Inc. complete Phase III Studies in COPD Laboratorios Almirall, S.A. and Forest Laboratories, Inc. complete Phase III Studies in COPD BARCELONA, July 7th: Laboratorios Almirall, S.A. and Forest Laboratories, Inc. (NYSE: FRX) have announced that

More information

Prevention of Acute COPD exacerbations

Prevention of Acute COPD exacerbations December 3, 2015 Prevention of Acute COPD exacerbations George Pyrgos MD 1 Disclosures No funding received for this presentation I have previously conducted clinical trials with Boehringer Ingelheim. Principal

More information

GSK Medicine: Study Number: Title: Rationale: Study Period: Objectives Indication: Study Investigators/Centers: Research Methods Data Source:

GSK Medicine: Study Number: Title: Rationale: Study Period: Objectives Indication: Study Investigators/Centers: Research Methods Data Source: GSK Medicine: Study Number: 08257 Title: OCSIGEN study Longitudinal follow-up of a cohort of patients with asthma treated with inhaled corticosteroids in primary care Rationale: In the Post-Licensing File

More information

Concept Series Paper on Disease Management

Concept Series Paper on Disease Management Concept Series Paper on Disease Management Disease management is the concept of reducing health care costs and improving quality of life for individuals with chronic conditions by preventing or minimizing

More information

Yul D. Ejnes, MD, MACP Clinical Associate Professor of Medicine Warren Alpert Medical School of Brown University Chair-Emeritus, Board of Regents

Yul D. Ejnes, MD, MACP Clinical Associate Professor of Medicine Warren Alpert Medical School of Brown University Chair-Emeritus, Board of Regents Yul D. Ejnes, MD, MACP Clinical Associate Professor of Medicine Warren Alpert Medical School of Brown University Chair-Emeritus, Board of Regents American College of Physicians Yul D. Ejnes, MD, MACP Has

More information

Respiratory Inhalers. Identification Guide Version 2

Respiratory Inhalers. Identification Guide Version 2 Respiratory Inhalers Identification Guide Version 2 230801 This booklet has been produced by NHS Greater Glasgow and Clyde together with the following companies, Almirall, AstraZeneca, Boehringer Ingelheim

More information

Asthma Intervention. An Independent Licensee of the Blue Cross and Blue Shield Association.

Asthma Intervention. An Independent Licensee of the Blue Cross and Blue Shield Association. Asthma Intervention 1. Primary disease education Member will have an increased understanding of asthma and the classification by severity, the risks and the complications. Define asthma Explain how lungs

More information

Care Planning and Goal setting in Diabetes management

Care Planning and Goal setting in Diabetes management Care Planning and Goal setting in Diabetes management How can we provide self-management support to people with chronic conditions? Professor Malcolm Battersby Flinders University Flinders Human Behaviour

More information

Sponsor Novartis Pharmaceuticals

Sponsor Novartis Pharmaceuticals Clinical Trial Results Database Page 1 Sponsor Novartis Pharmaceuticals Generic Drug Name Indacaterol Therapeutic Area of Trial Chronic Obstructive Pulmonary Disease (COPD) Indication studied: COPD Study

More information

Understanding the Risks and Benefits of Stepping Down Asthma MedicaDons

Understanding the Risks and Benefits of Stepping Down Asthma MedicaDons Understanding the Risks and Benefits of Stepping Down Asthma MedicaDons 4813 Workshop: Stepping Down Asthma MedicaDons: Benefits and Risks Monday March 3, 2014 4:45 pm to 6:00 pm AAAAI 2014 John B. Hagan,

More information

Medicare Respiratory Therapist Access Act - 2013

Medicare Respiratory Therapist Access Act - 2013 Medicare Respiratory Therapist Access Act - 2013 These Frequently Asked Questions (FAQs) are designed to provide insight into developing a legislative initiative, to discuss why AARC is taking a different

More information

Integrated Approach to Build Patient Adherence: Helping Pharmaceutical Companies to Enhance Growth

Integrated Approach to Build Patient Adherence: Helping Pharmaceutical Companies to Enhance Growth Cognizant White Paper Integrated Approach to Build Patient Adherence: Helping Pharmaceutical Companies to Enhance Growth Executive Summary Pharmaceutical companies have traditionally considered various

More information

Inhaler Technique Check

Inhaler Technique Check Protocol October 2015 Version 1.3 Table of Contents Service Information... 2 Service objective... 2 Clinical service overview... 2 Documentation... 3 Staff Roles... 3 Facilities to support the program...

More information

ONCE-DAILY TIOTROPIUM RESPIMAT ADD-ON TO ICS ± LABA IMPROVES CONTROL ACROSS ASTHMA SEVERITIES

ONCE-DAILY TIOTROPIUM RESPIMAT ADD-ON TO ICS ± LABA IMPROVES CONTROL ACROSS ASTHMA SEVERITIES SPIRIVA Respimat is approved for use in asthma in the EU, Japan, the USA and many other countries. The label varies by country. Please refer to the local product information ONCE-DAILY TIOTROPIUM RESPIMAT

More information

A Comprehensive Survey of Managed Care Organization (MCO) Medication Adherence Intervention Programs Part I: Patient and Intervention Targeting

A Comprehensive Survey of Managed Care Organization (MCO) Medication Adherence Intervention Programs Part I: Patient and Intervention Targeting A Comprehensive Survey of Managed Care Organization (MCO) Medication Adherence Intervention Programs Part I: Patient and Intervention Targeting August 2014 1 of 14 Executive Summary Additional annual healthcare

More information

Bronchodilators in COPD

Bronchodilators in COPD TSANZSRS Gold Coast 2015 Can average outcomes in COPD clinical trials guide treatment strategies? Long live the FEV1? Christine McDonald Dept of Respiratory and Sleep Medicine Austin Health Institute for

More information

Medication and Devices for Chronic Obstructive Pulmonary Disease (COPD)

Medication and Devices for Chronic Obstructive Pulmonary Disease (COPD) Medication and Devices for Chronic Obstructive Pulmonary Disease (COPD) Patients with COPD take a wide variety of medicines to manage their symptoms these include: Inhaled Short Acting Bronchodilators

More information

Breathing Easier In Tennessee: Employers Mitigate Health and Economic Costs of Chronic Obstructive Pulmonary Disease

Breathing Easier In Tennessee: Employers Mitigate Health and Economic Costs of Chronic Obstructive Pulmonary Disease Breathing Easier In Tennessee: Employers Mitigate Health and Economic Costs of Chronic Obstructive Pulmonary Disease By John W. Walsh, Co-Founder and President of the COPD Foundation Breathing Easier In

More information

Population Health Management Program

Population Health Management Program Population Health Management Program Program (formerly Disease Management) is dedicated to improving our members health and quality of life. Our Population Health Management Programs aim to improve care

More information

Core therapeutic areas

Core therapeutic areas Core therapeutic areas Platforms for growth Luke Miels, Executive Vice President, Global Portfolio & Product Strategy and Corporate Affairs Current business is led by core therapeutic areas Sales 9M 2014

More information

Spirometry and Flow Volume Measurements

Spirometry and Flow Volume Measurements Spirometry and Flow Volume Measurements Standards & Guidelines April 2006 To serve the public and guide the medical profession Revision Dates: April 2006 December 1998 Approval Date: June 1998 Originating

More information

This clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.

This clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data. abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical

More information

Insight Into Evolving Payment and Delivery Models

Insight Into Evolving Payment and Delivery Models Insight Into Evolving Payment and Delivery Models Overview Objectives Provide an overview of Accountable Care Organization (ACO)-like payment and delivery models Demonstrate Genentech s commitment to patient

More information

Programme Specification and Curriculum Map for the Advanced Diploma in Long Term Conditions

Programme Specification and Curriculum Map for the Advanced Diploma in Long Term Conditions Programme Specification and Curriculum Map for the Advanced Diploma in Long Term Conditions 1. Programme title Advanced Diploma in Long Term Conditions 2. Awarding institution Middlesex University 3. Teaching

More information

Trends in Technology based Health Investments (A USA view)

Trends in Technology based Health Investments (A USA view) Trends in Technology based Health Investments (A USA view) Second UPM innovatech International Workshop Investing in High Technology for Success Center for Support of Technological Innovation CAIT Technical

More information

Samer El Rayess, M.D. Internal Medicine, PGY3 29 January 2016

Samer El Rayess, M.D. Internal Medicine, PGY3 29 January 2016 Samer El Rayess, M.D. Internal Medicine, PGY3 29 January 2016 Case Scenario Mr. X., a 50 year old man heavy smoker 80 pack / year known to have -COPD on spiriva at home last exacerbation 9 months ago -Hypertension

More information

Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida

Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Medicare Quality Management Program Overview Quality Improvement (QI) Overview At Coventry, we

More information

Pulmonary Rehabilitation. Use it or lose it??? By John R. Goodman BS RRT

Pulmonary Rehabilitation. Use it or lose it??? By John R. Goodman BS RRT Pulmonary Rehabilitation Use it or lose it??? By John R. Goodman BS RRT Of all the forms of Rehabilitation that are available in medicine, pulmonary rehabilitation is a relative newcomer. For example Cardiac

More information

Severe asthma Definition, epidemiology and risk factors. Mina Gaga Athens Chest Hospital

Severe asthma Definition, epidemiology and risk factors. Mina Gaga Athens Chest Hospital Severe asthma Definition, epidemiology and risk factors Mina Gaga Athens Chest Hospital Difficult asthma Defined as asthma, poorly controlled in terms of chronic symptoms, with episodic exacerbations,

More information

Skill Levels for Delivering High Quality Asthma and COPD Respiratory Care by Nurses in Primary Care

Skill Levels for Delivering High Quality Asthma and COPD Respiratory Care by Nurses in Primary Care Skill Levels for Delivering High Quality Asthma and COPD Respiratory Care by Nurses in Primary Care September 2007 Revised December 2009, April 2014 Author: Ruth McArthur In conjunction with the PCRS-UK

More information

Inhaled Insulin: A Truth or a Fallacy?

Inhaled Insulin: A Truth or a Fallacy? Bahrain Medical Bulletin, Vol. 27, No. 1, March 2005 Family Physician Corner Inhaled Insulin: A Truth or a Fallacy? Abeer Al-Saweer, MD* Injectable Insulin therapy has revolutionized the management and

More information

Asthma Prescribing Guidelines Adults and Children over 12 years

Asthma Prescribing Guidelines Adults and Children over 12 years South Staffordshire Area Prescribing Group Asthma Prescribing Guidelines Adults and Children over 12 years Inhaler choices in this guideline are different from previous versions produced by the APG. It

More information

U.S. Bureau of Labor Statistics

U.S. Bureau of Labor Statistics U.S. Bureau of Labor Statistics Psychologists Summary Psychologists diagnose and evaluate mental and emotional disorders. 2012 Median Pay Entry-Level Education Quick Facts: Psychologists Work Experience

More information

Conducting studies on the Internet and mobile phones

Conducting studies on the Internet and mobile phones Conducting studies on the Internet and mobile phones Jean-François ETTER, PhD Associate Professor IMSP, Faculty of Medicine, University of Geneva, Switzerland Jean-Francois.Etter@unige.ch HUG Colloque

More information

Inhaled Corticosteroids and the Risks

Inhaled Corticosteroids and the Risks Inhaled Corticosteroids and the Risks of Diabetes Onset and Progression Journal Club October 13, 2010 By Anya Litvak, Kik Keiko Greenberg, and Jonathan Chrispin Background Inhaled corticosteroids are commonly

More information

User Centric Product Design for Greater End-User Adherence. Primary Data on a 360 o Analysis

User Centric Product Design for Greater End-User Adherence. Primary Data on a 360 o Analysis User Centric Product Design for Greater End-User Adherence Primary Data on a 360 o Analysis Panel Discussion Gary Hall, Jr. 10 time Olympic Medalist & Diabetes Patient Russell Rothman, MD, MPP Assistant

More information

c. determine the factors that will facilitate/limit physician utilization of pharmacists for medication management services.

c. determine the factors that will facilitate/limit physician utilization of pharmacists for medication management services. Consumer, Physician, and Payer Perspectives on Primary Care Medication Management Services with a Shared Resource Pharmacists Network Marie Smith, PharmD and Michlle Breland, PhD University of Connecticut,

More information

Treatment Approaches for Drug Addiction

Treatment Approaches for Drug Addiction Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call 1-800-662-HELP(4357)

More information

An Introduction to Medication Adherence

An Introduction to Medication Adherence An Introduction to Medication Adherence Medication Adherence Project (MAP) A project of the Cardiovascular Prevention & Control Program and the Fund for Public Health in New York Drugs don t work in patients

More information

COPD and Asthma Differential Diagnosis

COPD and Asthma Differential Diagnosis COPD and Asthma Differential Diagnosis Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in America. Learning Objectives Use tools to effectively diagnose chronic obstructive

More information

Nonin Medical COPD STEP Readmission Reduction Plan. A Patient-Centered Disease Management Plan to Improving COPD Outcomes

Nonin Medical COPD STEP Readmission Reduction Plan. A Patient-Centered Disease Management Plan to Improving COPD Outcomes Nonin Medical COPD STEP Readmission Reduction Plan A Patient-Centered Disease Management Plan to Improving COPD Outcomes THE PROBLEM: Most hospitals have programs in place to treat the acute aspects of

More information

Predicting Medication Compliance and Persistency

Predicting Medication Compliance and Persistency Predicting Medication Compliance and Persistency By: Jay Bigelow, President Amanda Rhodes, M.P.H., C.H.E.S., Vice President Behavioral Solutions MicroMass Communications, Inc. Introduction A widely recognized

More information

The use of alcohol and drugs and HIV treatment compliance in Brazil

The use of alcohol and drugs and HIV treatment compliance in Brazil The use of alcohol and drugs and HIV treatment compliance in Brazil André Malbergier, MD, PhD Hospital das Clínicas Medical School University of São Paulo Brasil The Casa da AIDS offers specialized integral

More information

Health Management Survey Findings: Employers in Brazil, with Some Comparisons with US Employers August 2011

Health Management Survey Findings: Employers in Brazil, with Some Comparisons with US Employers August 2011 Health Management Survey Findings: Employers in Brazil, with Some Comparisons with US Employers August 2011 2011 The Benfield Group, LLC 2 Background Survey designed by Benfield and CPH Health Fielded

More information

British Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Medication Adherence Services

British Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Medication Adherence Services British Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Introduction Medication adherence can be generally defined as the extent to which a patient takes medication as prescribed by his

More information

GSK Respiratory Committed to a brighter future for people with respiratory disease

GSK Respiratory Committed to a brighter future for people with respiratory disease GSK Respiratory Committed to a brighter future for people with respiratory disease First Mission Improve Alliance Leadership Community Medicines Impact Healthcare Patients Professional Partnerships Initiative

More information

Proving Respiratory Therapy value in the Affordable Care Pay Structure

Proving Respiratory Therapy value in the Affordable Care Pay Structure Proving Respiratory Therapy value in the Affordable Care Pay Structure The Curve 2 2 No Margin No Mission (FFS) Outcomes 3 * 2001 study in five states found that medical debt contributed to 46.2% of all

More information

Midwest ESOP Conference. September 11, 2015

Midwest ESOP Conference. September 11, 2015 Midwest ESOP Conference September 11, 2015 Why are you here today? I want to fix my company s healthcare problem Rising healthcare costs are: Negatively affecting my bottom line, EBITDA, stock price, etc

More information

Guidance to support the stepwise review of combination inhaled corticosteroid therapy for adults ( 18yrs) in asthma

Guidance to support the stepwise review of combination inhaled corticosteroid therapy for adults ( 18yrs) in asthma Guidance to support the stepwise review of combination inhaled corticosteroid therapy for adults ( 18yrs) in asthma Important Complete asthma control needs to be achieved for at least 12 weeks before attempting

More information

Treatment Approaches for Drug Addiction

Treatment Approaches for Drug Addiction Treatment Approaches for Drug Addiction [NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call

More information

Prof. Dr. med. Roland Bingisser Head of Clinical Emergency Medicine University Hospital Basel. making?

Prof. Dr. med. Roland Bingisser Head of Clinical Emergency Medicine University Hospital Basel. making? Pathway decision making Prof. Dr. med. Roland Bingisser Head of Clinical Emergency Medicine University Hospital Basel What s published in decision making? Huge body of evidence: Adherence to guideline-

More information

Kaiser Permanente: Health Education. Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center

Kaiser Permanente: Health Education. Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center Kaiser Permanente: Health Education Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center Who Is Kaiser Permanente? Founded in 1945, Kaiser Permanente

More information

Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Frequency of visit as recommended by PCP

Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Frequency of visit as recommended by PCP SCREENING EXAMINATION & COUNSELING UPMC Health Plan Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Annually Physical Exam and Counseling 1 Blood Pressure 2 At each visit. At least

More information

PATIENT GROUP DIRECTION (PGD) ADMINISTRATION OF INHALED SALBUTAMOL FOR THE EMERGENCY TREATMENT OF ACUTE ASTHMA OR COPD EXACERBATION AT HMP FORD

PATIENT GROUP DIRECTION (PGD) ADMINISTRATION OF INHALED SALBUTAMOL FOR THE EMERGENCY TREATMENT OF ACUTE ASTHMA OR COPD EXACERBATION AT HMP FORD PATIENT GROUP DIRECTION (PGD) ADMINISTRATION OF INHALED SALBUTAMOL FOR THE EMERGENCY TREATMENT OF ACUTE ASTHMA OR COPD EXACERBATION AT HMP FORD Version Number: 01HMP Patient Group Direction originally

More information

Continuous Nebulized Bronchodilator Therapy (Large and Medium Volume Continuous Nebulizer)

Continuous Nebulized Bronchodilator Therapy (Large and Medium Volume Continuous Nebulizer) Page 1 of 6 Purpose Scope (Large and Medium Volume Continuous Nebulizer) Physician's Order To standardize the use of continuous aerosol therapy as a modality used for the rescue of patients with severe

More information

Understanding the New Digital Healthcare Consumer:

Understanding the New Digital Healthcare Consumer: Understanding the New Digital Healthcare Consumer: Top Trends for DTC Marketers Meredith Ressi President, Manhattan Research mressi@manhattanresearch.com Unauthorized use, redistribution and reproduction

More information

Restoring a good night s sleep

Restoring a good night s sleep Restoring a good night s sleep Products for diagnosing, treating, and monitoring sleep apnea Sleep apnea solutions A good night s sleep is an essential part of healthy living, but for patients diagnosed

More information

TORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013)

TORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013) Objective: To enhance system-wide performance and outcomes for persons with stroke in Toronto. Goals: Timely access to geographically located acute stroke unit care with a dedicated interprofessional team

More information

Disease Management Identifications and Stratification Health Risk Assessment Level 1: Level 2: Level 3: Stratification

Disease Management Identifications and Stratification Health Risk Assessment Level 1: Level 2: Level 3: Stratification Disease Management UnitedHealthcare Disease Management (DM) programs are part of our innovative Care Management Program. Our Disease Management (DM) program is guided by the principles of the UnitedHealthcare

More information

Care Coordination. The Embedded Care Manager. Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed

Care Coordination. The Embedded Care Manager. Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed Care Coordination The Embedded Care Manager Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed Goals of Care Management The goals of care Management are consistent with the Triple Aim: Improve population

More information

Healthy workplaces and productivity

Healthy workplaces and productivity Making the healthy workplace business case and leading change Graham S. Lowe, Ph.D. Presentation at The European Network of Enterprise for Health, Mondragón, Spain, 14 October 2003. www.grahamlowe.ca Copyright

More information

Asthma in Older Adults: overcoming the challenges of diagnosis and management

Asthma in Older Adults: overcoming the challenges of diagnosis and management Asthma in Older Adults: overcoming the challenges of diagnosis and management Jennifer Gonzalez McComb, MD, MPH, FACP Section Chief, Pulmonary and Critical Care Medicine UPMC Shadyside Hospital April 9,

More information

Critical Care Resident Respiratory Education Series. Respiratory Care Department Alfred I. dupont Hospital for Children Wilmington, DE.

Critical Care Resident Respiratory Education Series. Respiratory Care Department Alfred I. dupont Hospital for Children Wilmington, DE. Critical Care Resident Respiratory Education Series Respiratory Care Department Alfred I. dupont Hospital for Children Wilmington, DE. Objectives: Oscillator a. Theory of operation b. Care of the patient

More information

The German system of rehabilitation of addiction

The German system of rehabilitation of addiction The German system of rehabilitation of addiction Meeting of Addiction Researchers from Germany and from the Netherlands 8 th and 9 th of October 2008 in Münster Dr. Joachim Köhler German Pension Insurance

More information

COPD - Education for Patients and Carers Integrated Care Pathway

COPD - Education for Patients and Carers Integrated Care Pathway Patient NHS COPD - Education for Patients and Carers Integrated Care Pathway Date ICP completed:. Is the patient following another Integrated Care Pathway[s].. / If yes, record which other Integrated Care

More information

Course Prospectus. Elevate your practice to the next level of patient care.

Course Prospectus. Elevate your practice to the next level of patient care. Course Prospectus Elevate your practice to the next level of patient care. Description Transform your ability to manage your patients medication therapy with ADAPT, an innovative, application-based, skills

More information

PUBLIC SUMMARY DOCUMENT

PUBLIC SUMMARY DOCUMENT PUBLIC SUMMARY DOCUMENT Product: Budesonide with eformoterol fumarate dihydrate, powder for oral inhalation, fixed dose combination, 400 micrograms-12 micrograms per dose, Symbicort Turbuhaler 400/12 Sponsor:

More information

Bridging treatment gaps for the elderly and the disabled

Bridging treatment gaps for the elderly and the disabled Bridging treatment gaps for the elderly and the disabled Issues unique to the elderly and the disabled Identifying Treatment Gaps Introduce Home and Community Services and their programs How to create

More information

West Virginia University School of Pharmacy Educational Outcomes Professional Curriculum Approved by the Faculty: October 11, 2013

West Virginia University School of Pharmacy Educational Outcomes Professional Curriculum Approved by the Faculty: October 11, 2013 West Virginia University School of Pharmacy Educational Outcomes Professional Curriculum Approved by the Faculty: October 11, 2013 1 Preamble The School of Pharmacy s educational outcomes (EOs) are designed

More information

People centred research for people centred health system: translating preventive evidence into practice

People centred research for people centred health system: translating preventive evidence into practice People centred research for people centred health system: translating preventive evidence into practice Mark Harris, UNSW Outline Using three examples from our own work: An approach to working with practitioners

More information

10 questions to consider. before you smoke your next joint.

10 questions to consider. before you smoke your next joint. 10 questions to consider before you smoke your next joint. 1 2 You ve probably heard conflicting opinions about marijuana and its risks. The statistics and health information included here are not opinions.

More information

Atrial Fibrillation 2014 How to Treat How to Anticoagulate. Allan Anderson, MD, FACC, FAHA Division of Cardiology

Atrial Fibrillation 2014 How to Treat How to Anticoagulate. Allan Anderson, MD, FACC, FAHA Division of Cardiology Atrial Fibrillation 2014 How to Treat How to Anticoagulate Allan Anderson, MD, FACC, FAHA Division of Cardiology Projection for Prevalence of Atrial Fibrillation: 5.6 Million by 2050 Projected number of

More information

FINAL REPORT 2005 08 RESEARCH GRADE 7 TO 12 PROGRAMS. Frontier College would like to thank the Ontario Ministry of Education for their support.

FINAL REPORT 2005 08 RESEARCH GRADE 7 TO 12 PROGRAMS. Frontier College would like to thank the Ontario Ministry of Education for their support. FINAL REPORT 2005 08 RESEARCH GRADE 7 TO 12 PROGRAMS Frontier College would like to thank the Ontario Ministry of Education for their support. 1 Introduction For the past three years, Frontier College

More information

School Nurse Training Series

School Nurse Training Series May 2014 Southern NH Area Health Education Center A Public Health Training Center 128 Route 27, Raymond, NH 03077 www.snhahec.org Upcoming Conferences, Workshops, and Programs Conferences and Workshops

More information

National Council Against Drug Abuse Youth Perception Survey 2013

National Council Against Drug Abuse Youth Perception Survey 2013 Part 6 Articles of Interest National Council Against Drug Abuse Youth Perception Survey 2013 Introduction The National Council Against Drug Abuse (NCADA) was formed in January 1995 as an advisory council

More information

Breathe With Ease. Asthma Disease Management Program

Breathe With Ease. Asthma Disease Management Program Breathe With Ease Asthma Disease Management Program MOLINA Breathe With Ease Pediatric and Adult Asthma Disease Management Program Background According to the National Asthma Education and Prevention Program

More information

Magnet Recognition and the Role of the Wound, Ostomy and Continence Nurse FACT SHEET

Magnet Recognition and the Role of the Wound, Ostomy and Continence Nurse FACT SHEET Magnet Recognition and the Role of the Wound, Ostomy and Continence Nurse Originated By: WOCN Professional Practice Committee Date Completed: May 4, 2012 FACT SHEET The Wound, Ostomy and Continence Nurses

More information

Coding Guidelines for Certain Respiratory Care Services July 2014

Coding Guidelines for Certain Respiratory Care Services July 2014 Coding Guidelines for Certain Respiratory Care Services Overview From time to time the AARC receives inquiries about respiratory-related coding and coverage issues through its Help Line or Coding Listserv.

More information

PG Certificate / PG Diploma / MSc in Clinical Pharmacy

PG Certificate / PG Diploma / MSc in Clinical Pharmacy PG Certificate / PG Diploma / MSc in Clinical Pharmacy Programme Information September 2014 Entry School of Pharmacy Queen s University Belfast Queen s University Belfast - Clinical Pharmacy programme

More information

Title: High Healthcare Utilization in a Severe Asthma Population Despite Use of High Dose ICS/LABA

Title: High Healthcare Utilization in a Severe Asthma Population Despite Use of High Dose ICS/LABA Title: High Healthcare Utilization in a Severe Asthma Population Despite Use of High Dose ICS/LABA M Castro 1, N Reaven 2, S Funk 2 and N Jarjour 3. 1 Washington University, MO, United States; 2 Strategic

More information

Insulin Delivery Options: Inhale, Inject, and Infuse. Traci Evans, A.N.P., B.C.-A.D.M. Nurse Practitioner The Diabetes Center Ocean Springs, MS

Insulin Delivery Options: Inhale, Inject, and Infuse. Traci Evans, A.N.P., B.C.-A.D.M. Nurse Practitioner The Diabetes Center Ocean Springs, MS Insulin Delivery Options: Inhale, Inject, and Infuse Traci Evans, A.N.P., B.C.-A.D.M. Nurse Practitioner The Diabetes Center Ocean Springs, MS Objectives Identify three ways patients are able to utilize

More information

High Desert Medical Group Connections for Life Program Description

High Desert Medical Group Connections for Life Program Description High Desert Medical Group Connections for Life Program Description POLICY: High Desert Medical Group ("HDMG") promotes patient health and wellbeing by actively coordinating services for members with multiple

More information

This way to better breathing

This way to better breathing STRIVERDI RESPIMAT (olodaterol) Inhalation Spray is a long-term, once-daily prescription medicine for adults that controls symptoms of chronic obstructive pulmonary disease (COPD) and can help you breathe

More information

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic

More information

Improving end of life care in nursing homes

Improving end of life care in nursing homes Improving end of life care in nursing homes Nele Van Den Noortgate, MD, PhD Dept of Geriatric Medicine University Hospital Ghent EAPC RN, Ghent, October 19 th, 2012 Objectives Introduction Methods and

More information

Formulating Research Questions. School of Health Sciences and Social Work

Formulating Research Questions. School of Health Sciences and Social Work Formulating Research Questions EBP steps Formulate a clinically relevant and answerable question Find the best evidence Evaluate the evidence Integrate with clinical expertise and patient values and apply

More information

One COPD. Philips patient care solutions

One COPD. Philips patient care solutions COPD patient care solutions One COPD Philips patient care solutions TREATING patients with advanced technology devices EMPOWERING clinicians and patients with education MONITORING patients with connected

More information

COPD RESOURCE PACK SECTION 11. Fife Integrated COPD Care Pathways

COPD RESOURCE PACK SECTION 11. Fife Integrated COPD Care Pathways COPD RESOURCE PCK SECTION 11 Fife Integrated COPD Care Pathways In this section: 1. COPD Guidance treatment at each stage of the disease 2. Overview of Respiratory (COPD) Integrated Pathway 3. Chronic

More information

Resource Guide. Antidepressant Medication Management. A helpful resource for primary care physicians

Resource Guide. Antidepressant Medication Management. A helpful resource for primary care physicians Resource Guide Antidepressant Medication Management A helpful resource for primary care physicians August 2015 Depression Management Managing your patients with depression This booklet provides an overview

More information

PULMONARY FUNCTION TESTS A Workshop on Simple Spirometry & Flow Volume Loops

PULMONARY FUNCTION TESTS A Workshop on Simple Spirometry & Flow Volume Loops PULMONARY FUNCTION TESTS A Workshop on Simple Spirometry & Flow Volume Loops YOU SHOULD READ THE FOLLOWING MATERIAL BEFORE Tuesday March 30 Interpretation of PFTs Learning Objectives 1. Specify the indications

More information

Preventive Services Explained

Preventive Services Explained Preventive Services Explained Medicare covers many preventive care services without charge. Most of these services have been recommended by the U.S. Preventive Services Task Force. However, which beneficiaries

More information

COPD PROTOCOL CELLO. Leiden

COPD PROTOCOL CELLO. Leiden COPD PROTOCOL CELLO Leiden May 2011 1 Introduction This protocol includes an explanation of the clinical picture, diagnosis, objectives and medication of COPD. The Cello way of working can be viewed on

More information

An Analysis of Economic Value & Health System Benefits for Pharmacy Professional Services

An Analysis of Economic Value & Health System Benefits for Pharmacy Professional Services An Analysis of Economic Value & Health System Benefits for Pharmacy Professional Services Ontario Pharmacists Association September 1, 2009 REFERENCES Bibliography: Report Sources Report Bibliography Canadian

More information

Medicines Management of Chronic Obstructive Pulmonary Disease (COPD)

Medicines Management of Chronic Obstructive Pulmonary Disease (COPD) Medicines Management of Chronic Obstructive Pulmonary Disease (COPD) (Chronic & Acute) Guidelines for Primary Care Guideline Authors: Shaneez Dhanji (Wandsworth CCG) Samantha Prigmore (St George s Hospital)

More information

Exploring the Value of Continuing Education Mandates

Exploring the Value of Continuing Education Mandates VOLUME 6 SEPTEMBER 2003 NCSBN Research Brief Report of Findings Exploring the Value of Continuing Education Mandates June Smith, PhD, RN National Council of State Boards of Nursing, Inc. (NCSBN) i Report

More information