The impact of a pharmacist-driven, collaborative practice on diabetes management in an Urban underserved population: a mixed method assessment.

The objective of this manuscript is to describe the results of a pharmacist-driven, Type 2 diabetes targeted, collaborative practice within an urban, underserved federally qualified health center. Pharmacists within a primary care team managed patients with chronic illnesses utilizing a collaborative practice agreement. Pharmacists, pharmacy residents, and supervised students provided care for patients with Type 2 diabetes. The first visit incorporated past medical history, medication reconciliation, determination of adherence and patient knowledge of diabetes pathophysiology, care plan, including diet and exercise, medications, and possible complications. Pharmacists had the authority to optimize medications and order laboratory tests and referrals. Diabetes, hypertension, and medication use outcomes data were collected and analyzed to assess the impact of clinical pharmacy services. Patient and provider satisfaction were assessed via surveys and focus group interviews. Ninety-nine patients were included in the evaluation. The mean A1c level was 9.8% at baseline and 8.4% at follow-up (p
Source: Journal of Interprofessional Care - Category: Health Management Tags: J Interprof Care Source Type: research

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We examined human lung tissue from COPD patients and normal control subjects, and found a substantial increase in p16-expressing alveolar cells in COPD patients. Using a transgenic mouse deficient for p16, we demonstrated that lungs of mice lacking p16 were structurally and functionally resistant to CS-induced emphysema due to activation of IGF1/Akt regenerative and protective signaling. Fat Tissue Surrounds Skeletal Muscle to Accelerate Atrophy in Aging and Obesity https://www.fightaging.org/archives/2019/09/fat-tissue-surrounds-skeletal-muscle-to-accelerate-atrophy-in-aging-and-obesity/ Researchers her...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
AbstractPurposeThe present study aimed to examine association between inflammatory and endothelial function biomarkers and indices of cardiac autonomic control in T2DM patients.Methods50 T2DM patients were recruited for this study. For cardiac autonomic function, cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV) analysis was performed. Blood samples were collected for evaluating inflammatory and endothelial function biomarkers. Multivariable linear regression analysis adjusted for diabetes duration, glycemic control, waist circumference, hypertension, dyslipidemia, metformin, and statins was pe...
Source: Journal of Diabetes and Metabolic Disorders - Category: Endocrinology Source Type: research
Authors: Mineoka Y, Ishii M, Hashimoto Y, Nakamura N, Fukui M Abstract Diabetes and malnutrition sometimes overlap. Little is known about the relationship between malnutrition and subclinical atherosclerosis in patients with type 2 diabetes. This cross-sectional study investigated this relationship in patients with type 2 diabetes. We evaluated the relationships between malnutrition assessed by controlling nutritional status (CONUT) score and subclinical atherosclerosis assessed by carotid intima-media thickness (IMT) and carotid plaque scores in 461 consecutive patients with type 2 diabetes. Nutritional assessment...
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research
Background and Aims: To study the influence of middle-dose statin therapy on endothelial function in the combined course of arterial hypertension (AH), type 2 diabetes mellitus (DM2T) and subclinical hypothyroidism (SH).
Source: Atherosclerosis - Category: Cardiology Authors: Tags: Posters 26 - 29 May, 2019 Source Type: research
This study aimed to determine whether there were significant differences in these complications in patients with T2DM with and without hypothyroidism. METHODS: This was a retrospective, cross-sectional, case-control study from a single centre specialising in diabetes in South Africa. T2DM was defined by American Diabetes Association criteria. The cases were all patients treated for hypothyroidism and the controls were clinically and biochemically confirmed euthyroid, who were under follow up between 1 January and 1 July 2016. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) of...
Source: Cardiovascular Journal of Africa - Category: Cardiology Authors: Tags: Cardiovasc J Afr Source Type: research
Conclusion: Use of RAS blockers (ACEI or ARB) in uncomplicated as well as complicated hypertensive patients with type 2 diabetes is sub-optimal. Most of the patients are on one drug and prescription of ≥3 drugs are rare. Statins are prescribed in only a half. PMID: 31321925 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
By WILLIAM H. BESTERMANN JR., MD New Scientific Breakthroughs Can Provide a Longer Healthier Life Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biol...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients aging chronic disease Denmark Diabetes William Bestermann Source Type: blogs
Conclusions: Compared with 1996, participants entering CR in 2015 were older, more overweight, and had a higher prevalence of coronary risk factors. Lipid values improved substantially concurrent with increased statin use. While the percentage of female participants increased, they continue to be underrepresented. Patients with heart valve repair/replacement now constitute 10.6% of the patients enrolled. Clinical programs need to recognize changing characteristics of attendees to best tailor interventions.
Source: Journal of Cardiopulmonary Rehabilitation - Category: Rehabilitation Tags: Cardiac Rehabilitation Source Type: research
In this study, we found that cofilin competes with tau for direct microtubule binding in vitro, in cells, and in vivo, which inhibits tau-induced microtubule assembly. Genetic reduction of cofilin mitigates tauopathy and synaptic defects in Tau-P301S mice and movement deficits in tau transgenic C. elegans. The pathogenic effects of cofilin are selectively mediated by activated cofilin, as active but not inactive cofilin selectively interacts with tubulin, destabilizes microtubules, and promotes tauopathy. These results therefore indicate that activated cofilin plays an essential intermediary role in neurotoxic signaling th...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Sarah K. Azzam1, Wael M. Osman2, Sungmun Lee1, Kinda Khalaf1, Ahsan H. Khandoker1, Wael Almahmeed3,4, Herbert F. Jelinek5 and Habiba S. Al Safar1,2* 1Biomedical Engineering Department, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates 2Khalifa University Center of Biotechnology, Abu Dhabi, United Arab Emirates 3Institute of Cardiac Science, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates 4Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates 5Australian School of Advanced Medicine, Sydney and School of Community Health, Charles Sturt University, Ma...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
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