| 1. |
- Cachim, Afonso, et al.
(author)
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Measuring adherence to inhaled control medication in patients with asthma : Comparison among an asthma app, patient self-report and physician assessment
- 2023
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In: Clinical and Translational Allergy. - : John Wiley & Sons. - 2045-7022. ; 13:2
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Journal article (peer-reviewed)abstract
- BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment.MethodsThis study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100).ResultsA total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001).ConclusionsAdherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
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| 2. |
- Kassolik, Krzysztof, et al.
(author)
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Recommendations of the Polish Society of Physiotherapy, the Polish Society of Family Medicine, the College of Family Physicians in Poland and the European Rural and Isolated Practitioners Association regarding the use of simple forms of Physiotherapy, including massage and self-massage in primary care, endorsed by the Polish Society of Physiotherapy Specialists
- 2019
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In: Family Medicine and Primary Care Review. - 1734-3402. ; 21:3, s. 277-288
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Research review (peer-reviewed)abstract
- Background. In general practice, dysfunctions within the locomotor system are a recurring health issue. Most frequently, diagnoses and treatments relate to pain syndromes of the backbone, the shoulder girdle or the pelvic girdle. The authors believe that physiotherapy, along with other clinical disciplines, should be regarded as an important factor which influences the effectiveness of the therapeutic process in this area. In primary care, treatment of musculoskeletal disorders – especially at the stage of early clinical symptoms – should incorporate basic physiotherapy methods, e.g., massage, physical procedures, kinesiotherapy and the underrated education of the patient. Restoring appropriate spatial arrangement of tissues provides the right conditions for the regeneration and repair of muscles, ligaments and tendons, although it is a process that requires a long time. Therefore, it can be very important to introduce self-therapy in the form of systematically repeated, easy-to-replicate procedures in the scope of self-massage and self-kinesiotherapy. Objectives. This paper presents the impact of physiotherapy in treating selected disorders and pain syndromes of the locomotor system with particular attention to the role of massage. Emphasis is placed on the meaning of self-massage in the process of restoring structural balance of tissues. The model of active inclusion of the patient in the treatment process as preparation for self-therapy is presented. This paper aims to justify the need to reorganize health services provided through general practicioners within the National Health Fund network by incorporating physiotherapy in primary care.
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| 3. |
- Kurpas, Donata, et al.
(author)
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The pros and cons of the implementation of a chronic care model in European rural primary care : the points of view of European rural general practitioners
- 2021
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In: Rural and Remote Health. - 1445-6354. ; 21:3
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Journal article (peer-reviewed)abstract
- INTRODUCTION: This article describes the views of European rural general practitioners regarding the strengths, weaknesses, opportunities and threats (SWOT) of the implementation of a chronic care model (CCM) in European rural primary care. METHODS: This was a mixed-methods online survey. Data were collected from 227 general practitioners between May and December 2017. Categorical data were analysed using descriptive methods while free-text responses were analysed using qualitative methods. The setting was rural primary care in nine European countries (including Central and Eastern Europe). Main outcomes measures were respondents' evaluations of a chronic care model in their rural healthcare settings in terms of SWOT. RESULTS: The SWOT analysis showed that the expertise of healthcare professionals and the strength of relationships and communications between professionals, caregivers and patients are positive components of the CCM system. However, ensuring adequate staffing levels and staff competency are issues that would need to be addressed. Opportunities included the need to enable patients to participate in decision making by ensuring adequate health literacy. CONCLUSION: The CCM could certainly have benefits for health care in rural settings but staffing levels and staff competency would need to be addressed before implementation of CCM in such settings. Improving health literacy among patients and their carers will be essential to ensure their full participation in the implementation of a successful CCM.
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| 4. |
- Müller Kratz, Jadel, et al.
(author)
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Anti-HSV-1 and anti-HIV-1 activity of gallic acid and pentyl gallate.
- 2008
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In: Memórias do Instituto Oswaldo Cruz. - 1678-8060. ; 103:5, s. 437-42
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Journal article (peer-reviewed)abstract
- The synthetic n-alkyl esters of gallic acid (GA), also known as gallates, especially propyl, octyl and dodecyl gallates, are widely employed as antioxidants by food and pharmaceutical industries. The inhibitory effects of GA and 15 gallates on Herpes Simplex Virus type 1 (HSV-1) and Human Immunodeficiency Virus (HIV-1) replication were investigated here. After a preliminary screening of these compounds, GA and pentyl gallate (PG) seemed to be the most active compounds against HSV-1 replication and their mode of action was characterized through a set of assays, which attempted to localize the step of the viral multiplication cycle where impairment occurred. The detected anti-HSV-1 activity was mediated by the inhibition of virus attachment to and penetration into cells, and by virucidal properties. Furthermore, an anti-HIV-1 activity was also found, to different degrees. In summary, our results suggest that both compounds could be regarded as promising candidates for the development of topical anti-HSV-1 agents, and further studies concerning the anti-HIV-1 activity of this group of molecules are merited.
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| 5. |
- Müller Kratz, Jadel, et al.
(author)
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Evaluation of anti-HSV-2 activity of gallic acid and pentyl gallate.
- 2008
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In: Biological & pharmaceutical bulletin. - 0918-6158. ; 31:5, s. 903-7
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Journal article (peer-reviewed)abstract
- The synthetic n-alkyl esters of gallic acid, also known as gallates, are widely employed as antioxidants by food and pharmaceutical industries. Besides the antioxidant activity, other biological activities have been described for this group of molecules, mainly anticancer, antibacterial and antifungal properties. In the present study, the anti-herpes simplex virus (HSV)-2 activity of gallic acid and pentyl gallate was evaluated followed by the determination of the site of antiviral activity of these compounds. Our results demonstrated that both compounds reduced HSV-2 replication in a concentration-dependent manner when either incubated with the virus prior to the addition of the mixture to cells, or added to and incubated with cells after their infection. In summary, the anti-HSV-2 activity of gallic acid and pentyl gallate was ascribed to their virucidal effect on virus particles, a change that was likely accompanied by partial inhibition of the virus attachment to cells and its subsequent cell-to-cell spread activity. This suggests that these compounds can be regarded as promising candidates for development as topical anti-HSV-2 agents.
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