Author: Mathilde Devos
Publisher:
ISBN:
Category :
Languages : fr
Pages : 280
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Book Description
L'arrêté RETEX définit les personnes âgées comme à risque d'évènements indésirables médicamenteux (EIM). La conciliation médicamenteuse participe à la réduction de la iatrogénie. Au cours de son évaluation, l'équipe mobile de gériatrie (EMG) réalise un bilan médicamenteux. L'objectif de notre étude a été d'évaluer l'impact d'un pharmacien au sein de l'EMG afin d'optimiser le bilan médicamenteux, l'analyse des traitements et leurs adaptations. Notre étude observationnelle, prospective, monocentrique, de 10 semaines, a inclus les patients de l'EMG de 75 ans ou plus, polymédiqués et hospitalisés en chirurgie ou présentant un critère de risque d'EIM. Pour chaque patient, le pharmacien a réalisé la conciliation médicamenteuse, l'analyse pharmaceutique et la revue de pertinence qui ont été comparées aux propositions du gériatre. Au total, 66 sujets ont été inclus. Soixante-treize divergences ont été identifiées, dont 41 non relevées par l'EMG parmi lesquelles 20 avec une gravité potentiellement significative. Soixante-dix interventions pharmaceutiques ont été émises, dont 53 uniquement par le pharmacien. Lors de sa revue de pertinence, le pharmacien a formulé 298 remarques, dont 200 communes et 72 non relevées mais jugées pertinentes par le gériatre. La présence du pharmacien au sein de l'EMG permettrait un bilan médicamenteux mieux optimisé et des propositions d'adaptations thérapeutiques complémentaires. Cette étude a permis une démarche pluridisciplinaire grâce à une collaboration entre les services, l'EMG et la pharmacie afin d'améliorer les thérapeutiques, et de diminuer la iatrogénie au bénéfice du patient.
Author: Jean-Xavier Peyronnet
Publisher:
ISBN:
Category :
Languages : fr
Pages : 296
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Book Description
L'augmentation de l'espérance de vie s'accompagne d'un nombre croissant de patients âgés, dont la fragilité de certains nécessite des soins pluridisciplinaires par des professionnels de santé qualifiés. La polymédication et la iatrogénie médicamenteuse sont des problématiques retrouvées fréquemment dans la littérature. Ces problématiques peuvent être abordées par le pharmacien clinicien. Son intégration au sein de l'équipe mobile de gériatrie pourrait apporter des solutions à travers une évaluation pharmaco-thérapeutique globale. L'objectif serait d'améliorer la prise en charge médicamenteuse de plusieurs façons : réduction de la prescription de médicaments potentiellement inappropriés chez la personne âgée, de la iatrogénie, de la sur-prescription (traitement sans indication), de la sous-prescription (indication sans traitement), et de l'inefficacité thérapeutique. Au Centre Hospitalier du Pays d'Apt, ce projet est en cours d'investigation. Une méthode standardisée est employée. D'abord, le médecin sollicite le pharmacien pour évaluer un patient qui présente au moins une des problématiques précédentes. Ensuite, le pharmacien s'entretient avec le patient, le médecin qui l'a sollicité, et éventuellement avec un autre membre de l'équipe mobile si ses compétences sont nécessaires à l'évaluation. Une recherche employant divers outils (liste STOPP-START, recommandations savantes, publications scientifiques) est effectuée en lien avec les informations cliniques recueillies. Enfin, un plan pharmaceutique personnalisé est établi avec des recommandations de modification de traitement, ou de suivi clinico-biologique. L'indicateur utilisé pour mesurer l'efficience du projet est le taux de suivi des recommandations, qui sera décisif dans sa pérennisation.
Author: Anne-Laure Debruyne
Publisher:
ISBN:
Category :
Languages : fr
Pages : 304
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Book Description
Author: Alberto Pilotto
Publisher: Springer
ISBN: 3319625039
Category : Medical
Languages : en
Pages : 182
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Book Description
This book offers an up-to-date review on the principles and practice of multidimensional assessment and management of the older individual, which represents the cornerstone of modern clinical practice in the elderly. The early chapters cover the main elements and scope of the comprehensive geriatric approach and explain the pathways of care from screening and case finding through to in-depth assessment and treatment planning. Subsequent chapters review the evidence of how best to apply the multidimensional assessment and management approach in defined healthcare settings and within specific clinical areas, such as cancer and surgery. Finally, the education and training challenges are reviewed and the prospects for future clinical service and research in this important field are examined. The book is very timely given the recent advances in application of this approach, which reflect the growing international realization that older people are “core business” in many clinical areas where the role of specialist geriatric medicine has hitherto been limited. Accordingly, the book will be relevant to a wide range of clinicians. The authorship comprises many of the best known and widely published experts in their respective fields.
Author: Corinne Grenier
Publisher: John Wiley & Sons
ISBN: 1786307073
Category : Business & Economics
Languages : en
Pages : 72
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Book Description
How can healthcare systems be transformed by reimagining their multiple silos to favor processes and practices that are more responsive to local, horizontal initiatives? Altering Frontiers analyzes numerous experiences, using a multidisciplinary approach, paying attention to certain actors, collectives and organizational arrangements. Through this work, levers are identified that promote lasting transformation: recognizing the legitimacy of the practices of many who are often "invisible"; trusting those who know their intervention territory; investing in methodological support; taking advantage of tools and procedures such as instruments for strategic and managerial discussion; and developing the capacity to absorb innovative ideas and experiences that circulate within the environment.
Author: Marie-Pascale Pomey
Publisher: Springer Nature
ISBN: 3030141012
Category : Medical
Languages : en
Pages : 317
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Book Description
Patient-oriented approaches to healthcare management have been brought to the fore in recent years, yet this book underlines how even further change is needed in order to fully mobilise the experiential knowledge of patients, and ultimately improve our healthcare systems. With contributions from scholars and patients across the globe, this collection brings together a comprehensive overview of major achievements in patient engagement, analysing political, organizational and clinical contexts. By understanding the concept of care partnership, the authors explore how this patient revolution could transform, improve and innovate the ways in which care services are organized and delivered. Looking closely at the role of new technologies, this timely book will undoubtedly be of use to patients, managers and professionals within the healthcare industry, as well as those researching health policy and organization.
Author: May Friedman
Publisher: Routledge
ISBN: 0429017634
Category : Social Science
Languages : en
Pages : 264
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Book Description
Thickening Fat: Fat Bodies, Intersectionality, and Social Justice seeks to explore the multiple, variable, and embodied experiences of fat oppression and fat activisms. Moving beyond an analysis of fat oppression as singular, this book will aim to unpack the volatility of fat—the mutability of fat embodiments as they correlate with other embodied subjectivities, and the threshold where fat begins to be reviled, celebrated, or amended. In addition, Thickening Fat explores the full range of intersectional and liminal analyses that push beyond the simple addition of two or more subjectivities, looking instead at the complex alchemy of layered and unstable markers of difference and privilege. Cognizant that the concept of intersectionality has been filled out in a plurality of ways, Thickening Fat poses critical questions around how to render analysis of fatness intersectional and to thicken up intersectionality, where intersectionality is attenuated to the shifting and composite and material dimensions to identity, rather than reduced to an “add difference and stir” approach. The chapters in this collection ask what happens when we operationalize intersectionality in fat scholarship and politics, and we position difference at the centre and start of inquiry.
Author: Eric Topol
Publisher: Basic Books
ISBN: 0465094473
Category : Medical
Languages : en
Pages : 386
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Book Description
The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation's top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result-better, cheaper, and more human health care-will be worth it. Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.
Author: M. David Rudd
Publisher: Guilford Press
ISBN: 9781593851002
Category : Psychology
Languages : en
Pages : 292
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Book Description
This manual provides an empirically supported approach to treating suicidality that is specifically tailored to todays managed care environment. Structured yet flexible, the model is fully compatible with current best practice standards. The authors establish the empirical and theoretical foundations for time-limited treatment and describe the specific tasks involved in assessment and intervention. The book then details effective ways to conduct a rapid case conceptualization and outpatient risk assessment, determine and implement individualized treatment targets, and monitor treatment outcomes. Outlined are clear-cut intervention techniques that focus on symptom management, restructuring the patients suicidal belief system, and building such key skills as interpersonal assertiveness, distress tolerance, and problem solving. Other topics covered include the role of the therapeutic relationship, applications to group work and longer-term therapy, the use of medications, patient selection, and termination of treatment. Illustrated with helpful clinical examples, the book features numerous table, figures, and sample handouts and forms, some of which may be reproduced for professional use.
Author: Jason Tetro
Publisher: Doubleday Canada
ISBN: 0385678533
Category : Science
Languages : en
Pages : 274
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Book Description
Since the dawn of the human race, germs have been making us sick. Whether the ailment is a cold, the flu, diabetes, obesity or certain cancers, the likely cause is germs. Our ancient enemies have four families - bacteria, viruses, fungi, and protozoa - and many names: Ebola, E. coli, salmonella, norovirus, gonorrhea. . . Human beings are engaged in a "war on germs," in which we develop ever-more sophisticated weapons and defensive strategies. But it is a war we can never win. Our best plan for staying as healthy is to choose our battles carefully, and try to co-exist with germs as best we can. The Germ Code is a wise, witty and wonderfully readable guide to our relationship with these infinitesimal but infinitely powerful creatures. Microbiologist Jason Tetro takes us outside the lab and shows the enormous influence of germs upon humanity's past, present and future. He unlocks the mysteries of "the germ code" to reveal how these organisms have exploited our every activity and colonized every corner of the earth. From his own research and personal experience, Tetro relates how the most recent flu pandemic happened, how others may have been averted and how more may come about if we aren't careful. He also explains that not every germ is our foe, and offers advice on harnessing the power of good germs to stay healthy and make our planet a better place. The Germ Code is a fascinating journey through an unseen world, an essential manual to living in harmony with germs and a life-enhancing (as well as life-saving!) good read.
