Journal of evaluation in clinical practice
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In the context of adjusting to life with a permanent colostomy, this study explored how perceived social support from family, friends and others influences patients' self-efficacy in managing their stoma and engaging with their social lives. ⋯ Stronger perceived social support was linked to higher stoma self-efficacy in permanent colostomy patients.
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Throughout the twentieth century and beyond, a global trend of declining mortality rates and an increase in life expectancies was noted until the onset of the coronavirus disease 2019 (COVID-19) pandemic. A reduction in life expectancies was observed in most countries, including South Asia, during 2020 and 2021 due to the excess mortality caused by the pandemic. ⋯ These findings highlight the pandemic's profound impact on mortality dynamics, emphasising the need for targeted interventions to mitigate its long-term effects on population health and longevity.
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The Drug Burden Index (DBI) measures exposure to anticholinergic and sedative drugs, which are associated with harm in older adults. To facilitate deprescribing in older Australian inpatients, we piloted an intervention bundle integrating the DBI in Electronic Medical Records, clinician deprescribing guides, consumer information leaflets and a stewardship pharmacist. ⋯ The intervention was well accepted by hospital clinicians. The bundle requires further integration into workflows for sustainability and assessment of generalisability in other health services. Given patients, carers and GPs reported poor medication-related communication, future interventions may target this.
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Chronic pelvic pain syndrome (CPPS) is prevalent and a complex multifactorial condition. The incidence is rising. CPPS patients may benefit from multidisciplinary care in a structured care pathway. ⋯ Stakeholder focus groups using the nominal group technique was a pivotal step in the development of our CPPS care pathway. This step led to fundamental recommendations, of which a personalised treatment plan at an earlier stage in the patient journey might be the most impactful. This is now implemented, and we monitor the effects on outcomes, quality of life and patient's satisfaction.
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Approximately 50% of Americans report having low health insurance literacy, leading to uncertainty when choosing their insurance coverage to best meet their healthcare needs. Therefore, we aimed to evaluate the association between lack of prescription drug benefit knowledge and problems paying medical bills among Medicare beneficiaries. ⋯ Tailored programmes aimed at improving beneficiaries' knowledge of prescription drug benefits, reducing out-of-pocket costs and preventing comorbidities may be considered for the at-risk population to address the problem.