How can pharmacists can contribute to safety by improving health outcomes and reducing health inequalities for people with intellectual disabilities?
Source: Pharmacy | Free Full-Text
Author: Bernadette Flood
How can pharmacists can contribute to safety by improving health outcomes and reducing health inequalities for people with intellectual disabilities?
Source: Pharmacy | Free Full-Text
Author: Bernadette Flood
Source: 2017 – British Journal of Learning Disabilities – Wiley Online Library
Authors: Owen Doody, Maria E. Bailey
Abstract
Accessible summary
Pain is difficult to identify when people cannot communicate. If pain is not identified, it cannot be managed and causes stress. Pain assessment is essential in order to identify pain. Pain assessment requires a combination of knowledge, health assessments and observations.
Abstract
Background Individuals with intellectual disability experience the same chronic diseases and conditions as the general population, but are more likely to have physical and psychological co-morbidities, resulting in a higher risk of experiencing pain and having more frequent or severe pain.
Method This position paper aims to highlight the importance of pain assessment for people with intellectual disability. Results As people with intellectual disability live within the community and/or remain in the family home, they are accessing a wide range of healthcare services. This necessitates that nurses across all care settings are knowledgeable regarding appropriate/alternative pain assessment methods for people with intellectual disability. While many pain assessment tools are available for use with the intellectual disability population, they are often not well established or infrequently used to establish their validity.
Conclusion Although self-report is the gold standard in pain assessment, pain assessment for people with intellectual disability is often challenging as they may be unable to self-report their pain due to their levels of communication or cognitive ability. Assessment requires a combination of approaches amalgamating: pain assessment, health assessment and observation of behaviours.
Fifty-eight people completed the questionnaire. Many of them said they did not get enough information about their medicine. Most people wanted easy-read leaflets and pictures.
Authors: Rebecca Fish, Chris Hatton, Umesh Chauhan
Source: British Journal of Learning Disabilities – 2017 – Wiley Online Library
Abstract
Accessible summary
We gave a questionnaire to self-advocates who were attending a conference. The questionnaire asked them how they felt about the information they get with their medicine. Fifty-eight people completed the questionnaire. Many of them said they did not get enough information about their medicine. Most people wanted easy-read leaflets and pictures. There are many different places to find easy-read information on the internet. We think they should be collected and checked. We also think that doctors and chemists need to spend more time with people to explain about medicines.
Abstract
Background Previous research has found that people with learning disabilities are not given prescription information that is tailored to their needs. We wanted to find out people’s information requirements.
Materials and Methods A questionnaire was co-produced by the authors and consultants with learning disabilities. It asked what information people received from their GP and pharmacist about medications. The questionnaire was circulated at a self-advocacy conference in the North of England. Fifty-eight self-advocates completed the questionnaire.
Results Information from GPs and pharmacists was mainly instructional, referring to when and how to take the medicine and dosage. Most respondents struggled to read the leaflets and remember verbal information. Many wanted the information in easy-read format, and some wanted pictures or diagrams as well. A key theme was that health professionals often talked only to carers or support workers rather than involving the patient directly, and some respondents disclosed that they were not informed about side effects or alternative medications.
Conclusions Health professionals should take time to discuss health issues and medication with the individual rather than only with carers. This could be facilitated by providing information in an accessible format.
Source: Opioid Prescribing: Where you live matters
The amount of opioids prescribed in the US peaked in 2010 and then decreased each year through 2015. However, prescribing remains high and vary widely from county to county. Healthcare providers began using opioids in the late 1990s to treat chronic pain (not related to cancer), such as arthritis and back pain. As this continued, more opioid prescriptions were written, for more days per prescription, in higher doses. Taking opioids for longer periods of time or in higher doses increases the risk of addiction, overdose, and death. In 2015, six times more opioids per resident were dispensed in the highest-prescribing counties than in the lowest-prescribing counties. County-level characteristics, such as rural versus urban, income level, and demographics, only explained about a third of the differences. This suggests that people receive different care depending on where they live. Healthcare providers have an important role in offering safer and more effective pain treatment.
Healthcare providers can:
To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.
In this study, we investigated intellectual disability support professionals’ knowledge and expectations towards effects of psychotropic drug use on behaviour and drug use in their clients, because shortcomings may lead to misinterpretations of behavioural symptoms and inappropriate drug use.
Two self-designed questionnaires were used to measure the knowledge and expectations of 194 support professionals in 14 residential facilities regarding psychotropic drug use and effects of antipsychotics on behavioural, cognitive and mental functioning of people with intellectual disability. The psychometric properties of both questionnaires were adequate.
A majority of the professionals had unrealistic expectations regarding the positive effects of antipsychotics on cognitive and behavioural functioning, and 94% scored below the cut-off scores regarding knowledge; 60% indicated they needed education and training.
To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.
Source: Study finds $200 billion in avoidable health care costs | American Pharmacists Association
Health care costs caused by improper and unnecessary use of medications exceeded $200 billion in 2012, amounting to an estimated 10 million hospital admissions, 78 million outpatient treatments, 246 million prescriptions, and 4 million emergency department visits annually, according to a new report from the IMS Institute for Healthcare Informatics.
This amount, representing 8% of the nation’s health care spending that year, “could pay for the health care of more than 24 million currently uninsured U.S. citizens,” said Murray Aitken, IMS Executive Director, in a news release announcing the report, Avoidable Costs in U.S. Healthcare: The $200 Billion Opportunity from Using Medicines More Responsibly.
These avoidable costs arose when patients failed to receive the right medications at the right time or in the right way, or received them but failed to take them, according to the report. Improvement is necessary in six areas: medication nonadherence, lag in adoption of evidence-based treatment practice, misuse of antibiotics, medication errors, suboptimal use of generics, and mismanaged polypharmacy in older adults.
Health Access for Independent Living (HAIL): Developing a Health Promotion Assistance Tool To learn more, see the HAIL feature story. This project is one of five interventions designed to improve community living opportunities for people with disabilities.
Source: RTC Projects: R7 | Research & Training Center on Independent Living