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Issues in treating the geriatric patient with diabetes. 老年糖尿病患者的治疗问题。
Pharmacy practice management quarterly Pub Date : 1997-10-01
G A Ireland
{"title":"Issues in treating the geriatric patient with diabetes.","authors":"G A Ireland","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diabetes, a disease commonly seen in the young, is more frequently seen in the geriatric age group (older than 65 years of age). This frequency has been estimated at 30 to 50 percent, although because of underdiagnosis, reported cases have approximately a 20 percent occurrence, the majority of which is Type II or non-insulin-dependent diabetes (NIDDM). Although the presentation in older adults is similar to that in younger patients, there are considerations for both evaluation and therapy that are unique to the geriatric patient.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 3","pages":"55-64"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systematic approach to the management of the Type II diabetic patient: case presentation. 2型糖尿病患者的系统管理方法:病例报告。
Pharmacy practice management quarterly Pub Date : 1997-10-01
L T Coleman
{"title":"Systematic approach to the management of the Type II diabetic patient: case presentation.","authors":"L T Coleman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recently there has been a trend toward more aggressive management of people with diabetes. This stems from the conclusive clinical data that substantiate the benefit of tight glycemic control. It is clear that achieving near normoglycemia in people with diabetes will prevent and slow the progression of the microvascular complications and reduce the risk of the macrovascular complications. Clinicians now have multiple agents with differing mechanisms and sites of action allowing them to individualize the medication regimen and move toward normalizing the blood glucose levels. The following case is representative of a typical patient with Type II diabetes. This patient presents with multiple disease states and various treatment issues that must be addressed. An in-depth evaluation of the patient case is presented along with recommendations for drug therapy modifications.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 3","pages":"65-75"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21044554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of methodological and drug development issues on the use of economic data generated by clinical trials. 方法和药物开发问题对临床试验产生的经济数据使用的影响。
Pharmacy practice management quarterly Pub Date : 1997-07-01
D W Miller
{"title":"The impact of methodological and drug development issues on the use of economic data generated by clinical trials.","authors":"D W Miller","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 2","pages":"75-86"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21040348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Approach to the treatment of diabetic nephropathy. 糖尿病肾病的治疗方法。
Pharmacy practice management quarterly Pub Date : 1997-07-01
J M Burke
{"title":"Approach to the treatment of diabetic nephropathy.","authors":"J M Burke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Renal failure is a common long-term complication of diabetes mellitus. Stages of diabetic nephropathy have been described that characterize its clinical course. Diabetic nephropathy develops secondary to long-standing hyperglycemia and hemodynamic changes that damage the glomerulus. Therapy that focuses on the control of glomerular pressures and systemic hypertension can slow the progression of proteinuria and deterioration of renal function. Angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers have been demonstrated to be effective in the management of diabetic nephropathy. A systematic approach to the patient with diabetes with annual screening for proteinuria will help identify those individuals early in the course of disease when proper therapy may be most helpful.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 2","pages":"26-35"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21040461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Important aspects of self-management education in patients with diabetes. 糖尿病患者自我管理教育的重要方面。
Pharmacy practice management quarterly Pub Date : 1997-07-01
D M Stam, J P Graham
{"title":"Important aspects of self-management education in patients with diabetes.","authors":"D M Stam,&nbsp;J P Graham","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Diabetes Control and Complications Trial has shown that the long-term complication of diabetes can be decreased with intensive glycemic control. However, comprehensive patient education is required to provide the patient with the self-management skills necessary to achieve this level of glycemic control. Epidemiologic data indicate that large numbers of patients do not receive the proper care or education necessary to develop such self-management abilities. In order to convey the importance of patient education, the American Diabetes Association (ADA) has labeled self-management education as a cornerstone of therapy for patients with diabetes. Standards of care have also been defined by the ADA. Within the current U.S. health care system, however, limitations are present that may affect the quality of care and ability to provide adequate patient education. Therefore, it is the responsibility of the health care provider to improve the education process in an attempt to maintain standards of care outlined by the ADA. When developing a diabetes self-management training program, the ADA national standards can be used as a guideline.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 2","pages":"12-25"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21040460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of the clinical specialist in reengineered pharmacy departments. 临床专科医生在药剂科再造中的作用。
Pharmacy practice management quarterly Pub Date : 1997-07-01
R M Guerrero
{"title":"The role of the clinical specialist in reengineered pharmacy departments.","authors":"R M Guerrero","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 2","pages":"54-63"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21040346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of scheduling patients for refills on the process of providing pharmaceutical care and prescription revenue. 安排病人补药对提供药物服务和处方收入的影响。
Pharmacy practice management quarterly Pub Date : 1997-07-01
K F Martin, R K Lewis
{"title":"The impact of scheduling patients for refills on the process of providing pharmaceutical care and prescription revenue.","authors":"K F Martin,&nbsp;R K Lewis","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 2","pages":"64-74"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21040347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Strategies of the treatment of type II diabetes mellitus. 2型糖尿病的治疗策略。
Pharmacy practice management quarterly Pub Date : 1997-07-01
I V Mehra
{"title":"Strategies of the treatment of type II diabetes mellitus.","authors":"I V Mehra","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Type Diabetes mellitus (DM), the two primary defects that occur are insulin resistance and impaired insulin secretion. Currently, no data exist showing improved outcomes or reduced macrovascular complications with tight glycemic control in Type II DM, and only minimal data shows a reduction of microvascular complications. Still, the current standard of practice is to attempt to attain glycemic goals in patients with Type II DM. As an attempt to resolve this issue, the United Kingdom Prospective Diabetes Study (UKPDS) was initiated. This 11-year study is comparing conventional therapy to intensive therapy in patients with Type II DM. The American Diabetes Association's (ADA) guidelines state that either sulfonylureas, metformin, acarbose, or insulin can be used as first-line treatment for Type II DM; however, oral agents can be attempted first in most patients. Until results from the ongoing UKPDS trials are available, the guidelines for glycemic control from the ADA should be followed.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 2","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21040459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Applying the principles of pharmaceutical care to the patient with diabetes. 将药学护理原则应用于糖尿病患者。
Pharmacy practice management quarterly Pub Date : 1997-07-01
R Segal
{"title":"Applying the principles of pharmaceutical care to the patient with diabetes.","authors":"R Segal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Current medical care for patients with diabetes neither meets the guidelines from the American Diabetes Association (ADA) nor approaches the levels of intensive care in the Diabetes Control and Complications Trial (DCCT). The drug-use process for patients with diabetes could be enhanced by improving the way in which drug therapy is monitored and managed. The concept of pharmaceutical care strategically redefines the drug-use process into a pharmaceutical care system in which the pharmacist takes responsibility for monitoring the effects of drugs and acts to resolve drug-related problems before they become a drug-related morbidity. A method for implementing a pharmaceutical care service using practice guidelines to help a pharmacist provide consistent care to all patients with diabetes is discussed.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 2","pages":"47-53"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21040345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Managing the care of the diabetic transplant patient. 糖尿病移植患者的护理管理。
Pharmacy practice management quarterly Pub Date : 1997-07-01
J Siegel, V S DeVore, S M Bosley
{"title":"Managing the care of the diabetic transplant patient.","authors":"J Siegel,&nbsp;V S DeVore,&nbsp;S M Bosley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Care of the diabetic transplant patient presents many challenges for therapeutic management. Complications of diabetes such as retinopathy, neuropathy, hyperglycemia, and hypertension add to the already difficult management of nondiabetic transplant patients. The role of the pharmacist as an educator, counselor, and interaction and profile manager is an essential part of a successful transplant program. Understanding the purpose of the medications and their side effects is vital for the patient to comply with a demanding medication regimen. This depth of understanding cannot be conveyed without repetitive educational efforts that are reinforced by all of the health care practitioners and supportive family members. Although kidney transplantation offers freedom from dialysis, it does not offer freedom from insulin dependence. Kidney-pancreas, pancreas, or islet cell transplantation may provide insulin independence and are the only curative interventions available. Evaluation of the research literature compares the advantages and complications of these surgical modalities. Early intervention with transplantation may offer insulin-dependent diabetics a new opportunity to improve their quality of life; however, intensive educational efforts and assurance of compliance are essential for successful outcomes.</p>","PeriodicalId":80126,"journal":{"name":"Pharmacy practice management quarterly","volume":"17 2","pages":"36-46"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21040462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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