Advanced directives, such as Living Wills and Do Not Resuscitate (DNR) orders, provide the ability to identify, respect, and implement an individual's wishes for medical care during serious illness or end-of-life care. The aim of this study was to evaluate the prevalence of advanced directives amongst the residents of long-term care facilities in the United States. A total of 527 cases were extracted from 2018 National Study of Long-Term Care Providers, which was collected by the National Center for Health Statistics through the surveys of residential care communities and adult day services centers. Advanced directive rates were higher in patients 90 years of age and above as compared to other age groups. Nursing home residents were more likely to have advanced directives than other long term care facilities. There was no significant difference among males and females in the rate of advanced directives. Nursing home and Hospice residents had more advanced directives compared to other facilities. The Black population had the highest rate of advanced directive preparedness. Overall, the finding of this study revealed that there was a significant difference in the preparedness of DNR orders and Living Wills by patient demographics and the type of long-term care facility. Offering advanced directive services at public health/social services facilities can enhance the rate of advanced directive preparedness. Advanced directives ease the stress and anxiety of patients, family, and friends during difficult times.
Introduction: Several states provide pharmacists the authority to dispense and counsel on naloxone, but most pharmacy schools provide little to no training in opioid management for students as a part of their curriculum. The aim of this study was to assess the attitude of pharmacy students towards the opioid epidemic and overdose management. Material and Methods: The study was conducted among pharmacy students enrolled at Rosalind Franklin University of Medicine and Science (RFUMS). An anonymous Qualtrics® survey accompanied by an informed consent was distributed to students at RFUMS. Results and Discussion: A total of 162 out of 200 students (81%) enrolled in the College of Pharmacy completed the survey. Students’ attitudes varied by demographics. The majority of students were not prepared to manage opioid overdose situations and administer opioid antidotes, such as naloxone. Conclusions: Overall, the findings of the study indicate that pharmacy students are willing to receive additional education to improve preparedness in managing opioid abuse situations. Hands-on training for opioid abuse management will provide pharmacy students the necessary knowledge and tools to help patients. Pharmacy schools nationwide should incorporate opioid abuse management as a part of their didactic curriculum.
This retrospective research aimed to study the prescribing trends of antibiotics for influenza and adherence to the guidelines issued by the Infectious Diseases Society of America (IDSA) by utilizing the National Ambulatory Medical Survey (NAMCS) 2016 database. This was based on a sample of visits to non-federally employed officebased physicians who are engaged in direct patient care at community health centers. Patient sex, race, as well as the source of payment, and the provider type were among the demographic variables studied for adherence to the guidelines. The total number of ambulatory care visits were 1,753. Of those, 63.6% of patients were prescribed, inappropriate agents. General and Family Practice physicians were the most frequented providers (32.9%), followed by Nurse Practitioners (21.9%), and Pediatricians (17.1%). Family practice physicians and nurse practitioners appeared to prescribe more inappropriately as compared to the other specialties (X2 =0.001). White and black patients were prescribed more inappropriately as compared to other races (X2 =0.032). Antibiotic resistance is a public health problem of increasing magnitude, and finding effective solutions to address this problem is critical. Antibiotic resistance is also an economic healthcare burden. Adherence to guidelines minimizes antibiotic resistance and promotes patients and public health.
Background: Exercise routines, diet management, education and Medication Therapy Management (MTM) have shown to improve glycemic control, lower blood pressure and body weight. While the majority of patients are on some form of weight management, many do not receive professional guidance to create their diet plan. Objective: The aim of this study was to determine if the utilization of type 2 diabetes mellitus prevention services were impacted by patient and physician characteristics in visits to ambulatory providers in the United States. Findings: A total of 1,932 patients with a primary diagnosis of Type 2 Diabetes Mellitus were extracted from the 2017 National Ambulatory Medical Care Survey database, collected by the National Center of Health Statistics. The patients’ age, sex, race, gender, region, insurance and physician characteristics were among the demographic variables studied. The prevalence of lifestyle preventive services, including exercise therapy, nutrition therapy, patient education or counseling, were analyzed. Patients older than 61 years and white patients were offered more exercise therapy than their comparable demographics. The southern region of the U.S. and patients with Medicaid or state insured plans were offered and utilized the most exercise therapy, nutrition therapy and education. Family practice physicians and internists defined as primary care physicians offered the most exercise therapy, nutrition therapy and education services. Majority of the studied population were not offered exercise therapy, nutrition therapy, or education services, indicating the need for more preventative lifestyle services. Conclusions: Overall, the findings of this study revealed that there was a significant difference in the utilization and offering of preventive resources amongst various demographic groups and physician characteristics. This confirms the prevalence of disparities in the U.S. Healthcare System and calls for the need to narrow this gap both at the policy and community level.
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