Browsing by Subject "Pharmaceutical care"

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    The medication experience of people living with HIV: From the understanding of the meanings of medication to the development of a conceptual framework of medication experience.
    (2012-06) Alves, Mateus Rodrigues
    This is a study investigating the medication experience of people living with HIV/AIDS and the influences on the patient's relationship with medications. The study was conducted from April 2011 to April 2012. The methodology of investigation was Grounded Theory. The methods included one-to-one in-depth interviews, journaling, and observations. The participants in the study were nine people living with HIV. The results suggest that there are two dimensions of experiences associated with HIV drug therapy. One is the life disruption and the other is the meaning that the patient ascribes to medications. The results of this study are presented as a theoretical visual model. The model intends to show the complexities of living with HIV and the factors influencing the patient's relationship with medications in HIV drug therapy. The author recommends the use of narratives in patient care as a standard practice to understand the patient's medication experience. In addition, the proposed model can be used as a pedagogical tool to teach students in the health care disciplines as it portrays the complexities involved in HIV medication taking in a relatively simple manner. The findings of this study contribute to the illness experience as well as medication experience literature. Lastly, the proposed model can be applied to other illness contexts in which the use of medications is a key strategy for improving the patient's quality of life.
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    Medication therapy management (MTM): a tool for optimizing clinical and economic outcomes in the management of chronic diseases
    (2013-04) Soliman, Ahmed Mohamed Ahmed
    Medication Therapy Management (MTM) is an innovative pharmacist-led and delivered pharmacy service that aims to resolve drug therapy problems, improve patient education and increase medication adherence. This dissertation sought to evaluate the impact of receiving MTM services on clinical, economic and behavioral outcomes. The first manuscript showed that diabetes patients exposed to MTM were more likely to meet the glycosylated hemoglobin clinically defined goal compared to a control group of diabetes patients. The second manuscript showed that diabetes patients who took insulin or had diabetes complications were more likely to receive a higher number of MTM visits. The third manuscript showed that patients who took four or more chronic medications had a significant cost reduction seven months after the first MTM encounter compared to a matched cohort of patients who were never exposed to MTM services. Similar results were observed in the fourth manuscript which examined the economic outcomes in diabetes patients who were taking insulin. The last manuscript showed that MTM services resulted in improvement in medication adherence (measured by proportion of days covered (PDC)) across five different classes of chronic disease medications. Taken together, this body of work shows that MTM services is a potential tool that could be used by policy makers and health plan administrators to improve patient outcomes across multiple dimensions of care.