"I will confess," admitted Marsha Nunley, MD. "I did become my own doctor." "I tried all the different ways to do hormones. I think I've tried every protocol that there is, and I finally found the one that was right for me and started down that path." "I think many physicians that get into this—that's how they get there," she added, referring to the field of functional medicine. "They don't feel well." "Or they look at their patients and they think 'I don't know what to do for these people that come in.'" "Not to put my colleagues down. They don't know. They're not trained . . . They don't know what to do with you, so they give you the antidepressants and move you down the road." * * * The effort to understand her own symptoms led
Androgens affect sexual function, bone health, muscle mass, body composition, mood, energy, and the sense of well-being. Androgen insufficiency clearly has been demonstrated in patients with hypopituitarism, adrenalectomy, oophorectomy, and in some women placed on oral estrogen therapy which increas …
What is a qualitative synthesis? | Evidence-Based Nursing
If you want to inform your practice with answers to questions such as ‘What is it like for people to suffer chronic pain?’ or ‘What are patients’ understanding and experience of hypertension and taking medication’1 or ‘What are older people's views about falling and taking part in a falls programme’2 then what might you do? You could read individual research papers, but often there are many papers and they can be difficult to track down and access. A qualitative synthesis (sometimes called a qualitative systematic review) systematically searches for research on a topic, and draws the findings from individual studies together. Although systematic …
Nasa dugo (‘It’s in the blood’): lay conceptions of hypertension in the Philippines | BMJ Global Health
Introduction Understanding explanatory models is important for hypertension, a leading risk factor for cardiovascular disease and stroke. This article aims to determine what adult patients with hypertension in the Philippines attribute their condition to, how these views might be explained and what the implications are for hypertension management. Methods This is a qualitative study drawing on 71 semistructured interviews (40 initial and 31 follow-up) and four focus group discussions with patients diagnosed with hypertension. The setting was urban and rural low-income communities in the Philippines. Results Four prominent perceived causes were identified—genetics, heat, stress and diet—for what patients refer to as ‘high blood’. We propose a ‘folk physiology’ that rests on local understandings of blood and blood flow, draws from broader cultural notions of illness causation and accounts for a dynamic, non-chronic view of hypertension that in turn informs the health behaviours of those affected. Conclusions By understanding that hypertension is frequently seen not as a chronic constant condition but rather as an episodic one triggered by external influences, although in those genetically predisposed to it, it may be possible to address patient’s beliefs and thus adherence to treatment.
Development of the Drug Adherence Work-up (DRAW) tool - Journal of the American Pharmacists Association
To develop and conduct an initial field test of the Drug Adherence Work-up (DRAW) tool, which was developed to guide pharmacists when addressing nonadherence during medication therapy management (MTM) visits.
7 Modern Strategies to Improve Medication Adherence | MobileSmith Health
The estimated cost of medication non-adherence is 290 billion dollars per year in the United States alone, according to a report by CVS Health. Keeping patients
Study: Proteus' digital pill system accurate, improved adherence among California TB patients | MobiHealthNews
The independent investigation suggests that wirelessly observed therapies using Proteus' system could be considered equivalent to in-person medication adherence programs, but much better received by
Wirelessly observed therapy compared to directly observed therapy to confirm and support tuberculosis treatment adherence: A randomized controlled trial
Author summary Why was this study done? TB is the infectious disease that kills the most people annually and is spread by droplets released into the air from persons with TB in their lungs. Multiple antibiotics taken over many months are necessary to cure this infection, and if doses are missed or full treatment is not completed, infected people can continue spreading the disease, and antibiotic resistance may occur. New methods to confirm that all the correct medication doses are taken and support patients over the long treatment course are crucial to saving lives and combatting disease spread. What did the researchers do and find? We tested a new FDA-approved technology that uses a sensor made of minerals that is swallowed with TB medication and subsequently records the ingestion on a cellphone. We tested the sensor system accuracy to identify ingestions and we also randomly assigned persons with TB to receive the new system or the standard of care currently available, directly observed therapy, for supporting and confirming medication taking during TB treatment for periods up to 29 weeks. We found the system was highly accurate and that persons using this system were confirmed as taking 93% of their daily prescribed doses as opposed to 63% using directly observed therapy. In this study, the difference observed was mainly driven by the ability of the system to confirm doses 7 days a week compared to only on working days for directly observed therapy. What do these findings mean? These findings indicate that novel sensor-based systems that use cell phones to remotely record digital data are as accurate as actually watching a person swallow their medications and can be used to confirm and support TB treatment 7 days a week, compared to 5 days a week for the current standard of care available. However, this technology still needs to be tested over the full course of TB treatment. WOT should be tested in high-burden TB settings, where it may substantially support LMIC TB programs.
Wirelessly observed therapy compared to directly observed therapy to confirm and support tuberculosis treatment adherence: A randomized controlled trial
Author summary Why was this study done? TB is the infectious disease that kills the most people annually and is spread by droplets released into the air from persons with TB in their lungs. Multiple antibiotics taken over many months are necessary to cure this infection, and if doses are missed or full treatment is not completed, infected people can continue spreading the disease, and antibiotic resistance may occur. New methods to confirm that all the correct medication doses are taken and support patients over the long treatment course are crucial to saving lives and combatting disease spread. What did the researchers do and find? We tested a new FDA-approved technology that uses a sensor made of minerals that is swallowed with TB medication and subsequently records the ingestion on a cellphone. We tested the sensor system accuracy to identify ingestions and we also randomly assigned persons with TB to receive the new system or the standard of care currently available, directly observed therapy, for supporting and confirming medication taking during TB treatment for periods up to 29 weeks. We found the system was highly accurate and that persons using this system were confirmed as taking 93% of their daily prescribed doses as opposed to 63% using directly observed therapy. In this study, the difference observed was mainly driven by the ability of the system to confirm doses 7 days a week compared to only on working days for directly observed therapy. What do these findings mean? These findings indicate that novel sensor-based systems that use cell phones to remotely record digital data are as accurate as actually watching a person swallow their medications and can be used to confirm and support TB treatment 7 days a week, compared to 5 days a week for the current standard of care available. However, this technology still needs to be tested over the full course of TB treatment. WOT should be tested in high-burden TB settings, where it may substantially support LMIC TB programs.
Wirelessly Observed Therapy to Optimize Adherence and Target Interventions for Oral Hepatitis C Treatment: Observational Pilot Study - PubMed
Conclusions: The findings of this study suggest that digital medicines can be used for wirelessly observed therapy to support adherence to antiviral HCV therapy, reduce unnecessary medication wastage and retreatment costs, and potentially optimize sustained virologic response rates, especially in po …
