BackgroundInhaled antibiotics (ABs) are recommended for use in the therapy of chronic Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF). The aim of this systematic literature review was to identify level of adherence to inhaled ABs and to determine predictors and consequences of nonadherence in CF.MethodsA systematic literature search of English-language articles was conducted in April 2015 using Medline and Embase. No publication date limit was applied. The literature screening was conducted by two independent reviewers. All of the included studies were assessed for quality.ResultsThe search yielded 193 publications, of which ten met the inclusion criteria and underwent data extraction. Seven studies focused on inhaled tobramycin, one on inhaled colistimethate, one on inhaled levofloxacin, and one on inhaled aztreonam lysine. Medication adherence to inhaled ABs was analyzed by pharmacy refill history, daily phone diary, parent and child self-reports, vials counting, or electronic monitoring. In randomized controlled trials (n=3), proportion of adherent patients (>75%–80% of required doses taken) ranged from 86% to 97%; in prospective cohort studies (n=3), adherence rates ranged between 36% and 92%, and in retrospective studies (n=4) it ranged between 60% and 70%. The adherence to inhaled ABs in CF was found to be associated with the complexity of treatment, time of drug administration, age of patients, treatment burden (adverse events, taste), and patient satisfaction.ConclusionThe high diversity of adherence data was because of the different study designs (randomized controlled trials vs real-world studies) and the lack of a commonly accepted consensus on the definition of adherence in the reviewed articles. Routine adherence monitoring during CF care, discussing the possible reasons of suboptimal adherence with the patient, and changing treatment regimens on the basis of patient burden can individualize CF therapy for patients and may improve the level of adherence.
Chronic obstructive pulmonary disease (COPD) is a severe respiratory disorder that poses a tremendous burden on healthcare and economic resources. The prevalence of COPD has been steadily rising globally (1) and COPD-associated mortality is predicted to be the third-leading cause of death by 2020 (2). While smoking is one of the major risk factors for developing COPD, other triggers include age, genetic predisposition, and history of bronchial asthma and recurrent respiratory infections (3). Age and COPD prevalence appears to have a positive correlation and approximately 9.0-10.0% of the >40-years population presents with COPD (4). The main goal of COPD management is to maintain stable lung function and prevent acute exacerbations. The pharmacotherapy of COPD includes bronchodilators such as fl2-adrenergic agonists (BAs) and muscarinic antagonists (MAs), and inhaled corticosteroids (5). The preferred route of administration of these agents is via the inhalation due to its advantages GENERAL
Introduction: COPD is a debilitating disease and a major death cause by 2020. Our current knowledge of the opportunities of patient education in the community pharmacy is growing, though yet limited.
Objectives: (1) To assess the potential of a patient education programme in a Hungarian pharmacy, (2) to understand patient attitudes and gather insight for the development of an education project, (3) to create a sustainable local good practice.
Methods: We invited patients with a confirmed COPD diagnosis to take part in an in-depth interview, and to assess their symptoms. Later on, we offered them tailor-made education to learn about their attitudes to create the guidelines for optimal content.
Results: Key elements of the education content should focus on the desire of active life, improve poor adherence, teach about reliever and maintenance therapy and emphasise the chronic component of the disease. Smoking cessation should be fostered, whilst patients would benefit from proper breathing techniques and posture.
Conclusion: Hungarian patients may prefer to get fast and basic education in the community pharmacies. The ideal education content should include pathophysiology, signs and symptoms, treatment options, explanation of medication, inhaler use, smoking cessation and breathing techniques.
In 1996 the Hungarian Research Student Association (HRSA) was founded. Since then more than 6000 young, talented researchers have belonged to the Association. The founders set two principal aims: (1) to support the gifted and the most promising high school students and (2) to establish an active community. The movement has grown through the work of enthusiastic high school teachers and 800 excellent mentors, providing different facilities to enhance talent (a conference of lectures, posters and an essay competition), and fostering international student exchange. The HRSA organizes science camps and conferences to contribute to self-development of research student networks.
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