Management of myasthenia gravis in daily practice for general neurologists and healthcare professionals

Ethical dilemmas in general are characterised by a choice between two mutually excluding options neither of which is satisfactory, because there always will be a form of moral damage. Within the context of medicine several ethics support services have been developed to support healthcare professionals in dealing with ethical dilemmas, including moral case deliberation. In this article, we describe how moral case deliberation works in daily practice, illustrated with a case example from the neurology ward. The article is meant as an introduction to moral case deliberation according to the dilemma method. We show its relevance to the clinic and the context needed to put it into practice.

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The Rise of Digital Health and Potential Implications for Pharmacy Practice

Journal of Contemporary Pharmacy Practice ◽

10.37901/jcphp16-00012 ◽

2017 ◽

Vol 64 (1) ◽

pp. 32-40

Author(s):

Mickayla Clark ◽

Thomas Clark ◽

Afeefa Bhatti ◽

Timothy Aungst

Keyword(s):

Medication Adherence ◽

Healthcare Professionals ◽

Digital Health ◽

Pharmacy Practice ◽

Daily Practice ◽

Comfort Levels ◽

Technological Advances ◽

Integration Of Technology ◽

To Come ◽

The Way

The rise of technology in healthcare has led to dramatic changes in approaches to patient care by healthcare professionals. The realm of digital health has created new opportunities for pharmacists to engage patients in clinical practice. Pharmacies and industry are increasingly integrating these innovations into their businesses and practice. This article highlights areas of digital health for pharmacists to be aware of, in particular regarding areas of medication adherence and disease management. Technology plays a massive role in our individual lives; it has morphed the human experience in ways that were simply unimaginable 50 years ago. We use technology in nearly every facet of our lives. From detecting an appropriate intensity with which to brush our teeth to counting calories lost through the course of a day, technology has made a major impact on individual health. The integration of technology into our everyday lives has changed the way we communicate, how we capture and share our lives with others, how we seek answers, and how we experience life overall. Given this change in the way people operate, it is important that pharmacists adapt to these trends and incorporate technology into daily practice. The incorporation of mobile devices and technology into healthcare has been coined as mobile health (mHealth), which falls under the broader spectrum of digital health.1 –4 Digital health focuses on the integration of mobile tools (e.g., smartphones), wearable devices, and telehealth to help personalize the treatment of patients through the widespread adoption of wireless technology. The idea of involving pharmacists in mHealth has been a topic of recent interest, due in large part to the potential ramifications for the profession.4 Today, patients are using the Internet to research their health questions and help guide their personal health choices, and some of the information they find can be misleading and unreliable. It is of the utmost importance that healthcare professionals ensure there are credible sources for patients to research their questions. As pharmacists, we can research and recommend tools to patients to help solve problems related to drug information, medication adherence, and access, which includes the recent rise of novel technological devices. All of our patients will have different comfort levels with technology; despite this spectrum, there is a place for everyone to feel comfortable using digital health tools. However, there are recent technological advances coming to the field, which are already providing a benefit to patients, ranging from mobile applications to wearable technologies to ingestible medications that notify providers of patient medication adherence. We seek to help pharmacists understand the different areas of digital health, which may have substantial influence on the realm of pharmacy practice in the years to come by addressing current and upcoming digital health developments.

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Perceptions of Compensation Strategies for Gait Impairments in Parkinson’s Disease: A Survey Among 320 Healthcare Professionals

Journal of Parkinson s Disease ◽

10.3233/jpd-202176 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1775-1778

Author(s):

Anouk Tosserams ◽

Maarten J. Nijkrake ◽

Ingrid H.W.M. Sturkenboom ◽

Bastiaan R. Bloem ◽

Jorik Nonnekes

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Practice ◽

Online Survey ◽

Healthcare Professionals ◽

Daily Practice ◽

Clinical Implications ◽

Knowledge Gap ◽

Gait Impairments ◽

Specific Expertise

Compensation strategies are an essential part of managing gait impairments in people with Parkinson’s disease (PD). We conducted an online survey among 320 healthcare professionals with specific expertise in PD management, to evaluate their knowledge of compensation strategies for gait impairments in people with PD, and whether they applied these in daily practice. Only 35% of professionals was aware of all categories of compensation strategies. Importantly, just 23% actually applied all seven available categories of strategies when treating people with PD in clinical practice. We discuss the clinical implications, and provide recommendations to overcome this knowledge gap.

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Drug pollution and pharmacotherapy in psychiatry: A “platypus” in the room

European Psychiatry ◽

10.1192/j.eurpsy.2020.32 ◽

2020 ◽

Vol 63 (1) ◽

Cited By ~ 2

Author(s):

Unax Lertxundi ◽

Rafael Hernández ◽

Juan Medrano ◽

Gorka Orive

Keyword(s):

Healthcare Professionals ◽

Daily Practice ◽

New Era ◽

Pharmaceuticals In The Environment ◽

The Web ◽

Neuroendocrine Systems

Abstract Preoccupation about potential deleterious effects of pharmaceuticals in the environment is growing fast. Psychiatric pharmaceuticals have received particular attention because of their increasing use and their potential impacts on many living beings due to their effects on phylogenetically highly conserved neuroendocrine systems. Recent studies that have shown that many pharmaceuticals (including psychotropics) bioaccumulate through the web food have raised this concern into new heights. As professionals working in the field of psychiatry and academia, we believe we are about to enter a new era with regard to pharmacotherapy. We estimate drug pollution will have a major impact on our daily practice in a way we are just starting to imagine. So far, this problem has largely been ignored by healthcare professionals, who are the ones prescribing and dispensing pharmaceuticals. We are convinced that increasing awareness among these professionals will be a key element to effectively fight against drug pollution.

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Positive experiences of healthcare professionals with a mainstreaming approach of germline genetic testing for women with ovarian cancer

Familial Cancer ◽

10.1007/s10689-021-00277-7 ◽

2021 ◽

Author(s):

Kyra Bokkers ◽

Ronald P. Zweemer ◽

Marco J. Koudijs ◽

Sanne Stehouwer ◽

Mary E. Velthuizen ◽

...

Keyword(s):

Ovarian Cancer ◽

Genetic Testing ◽

Self Efficacy ◽

Healthcare Professionals ◽

Participation Rate ◽

Daily Practice ◽

Subspecialty Training ◽

Training Module ◽

Perceived Knowledge ◽

Pathogenic Variants

AbstractAccording to current guidelines, all women with epithelial ovarian cancer are eligible for genetic testing for BRCA germline pathogenic variants. Unfortunately, not all affected women are tested. We evaluated the acceptability and feasibility for non-genetic healthcare professionals to incorporate germline genetic testing into their daily practice. We developed and implemented a mainstreaming pathway, including a training module, in collaboration with various healthcare professionals and patient organizations. Healthcare professionals from 4 different hospitals were invited to participate. After completing the training module, gynecologic oncologists, gynecologists with a subspecialty training in oncology, and nurse specialists discussed and ordered genetic testing themselves. They received a questionnaire before completing the training module and 6 months after working according to the new pathway. We assessed healthcare professionals’ attitudes, perceived knowledge, and self-efficacy, along with the feasibility of this new mainstream workflow in clinical practice, and evaluated the use and content of the training module. The participation rate for completing the training module was 90% (N = 19/21). At baseline and after 6 months, healthcare professionals had a positive attitude, high perceived knowledge and high self-efficacy toward discussing and ordering genetic testing. Knowledge had increased significantly after 6 months. The training module was rated with an average of 8.1 out of 10 and was considered useful. The majority of healthcare professionals (9/15) was able to discuss a genetic test in five to 10 min. After completion of a training module, non-genetic healthcare professionals feel motivated and competent to discuss and order genetic testing themselves.

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Advance Directives Document: knowledge and experiences of healthcare professionals in Colombia

Colombian Journal of Anesthesiology ◽

10.5554/22562087.e1012 ◽

2021 ◽

Author(s):

Ana Milena Álvarez Acuña ◽

Ómar Fernando Gomezese Ribero

Keyword(s):

Healthcare Professionals ◽

Daily Practice ◽

Cross Sectional Study ◽

Cross Sectional ◽

Advanced Directives ◽

Medical Practitioners ◽

Personal Experiences ◽

Attitudes And Knowledge ◽

The Right ◽

Number Of Individuals

Introduction: The Advanced Directives Document (ADD) is a bioethical quality benchmark for healthcare and assurance of compliance with the rights of autonomy, self-determination and dignity of the patient. This document was established over the past decade and currently there is no evidence about the attitudes and knowledge of the healthcare professionals with regards to the use of this tool in clinical practice in Colombia. Objective: To describe the knowledge and experiences of healthcare professionals members of six Colombian Scientific Societies regarding the right to sign an ADD and explore the barriers to its applicability in clinical daily practice. Methods: Descriptive, cross-sectional study conducted using an anonymous and voluntary e-survey with the participation of six Colombian Medical Societies. A questionnaire was designed comprising five groups of variables: general, ADD knowledge, medical experiences and personal experiences regarding advanced directives and potential obstacles to its implementation. Results: 533 professionals participated in the survey. 54 % (n = 286) expressed their lack of awareness about the fact that there is law governing the ADD in Colombia; 34.33 % (n = 183) said they were familiar with the requirements of the document. Over the last year, 24 % of the professionals received one or more ADDs from their patients. Only 11.7 % of healthcare practitioners had themselves completed an ADD. 77.1 % of the professionals surveyed believe that the number of individuals with an ADD has not changed after the approval and regulation of the right to an advanced directives document. 86.6 % of the practitioners said they respected the ADD, notwithstanding the fact that the patient could benefit otherwise. Conclusions: The overall perception of healthcare professionals with regards to the number of ADDs signed by patients is that the number has not changed after the approval of the Law in Colombia. This study evidenced that medical practitioners have a poor knowledge about the ADD and that there is a need to educate healthcare professionals about the ADD and to promptly implement institutional programs about Planning of Advanced Directives (PAD). Both strategies are challenging for the applicability of AD in Colombia.

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Digital and innovation skills in health care professionals in Europe

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.027 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

G Fornes-Romero ◽

A Doñate-Martinez ◽

J Garces-Ferrer ◽

T U Fredskild ◽

H Hansen ◽

...

Keyword(s):

Health Care Professionals ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Daily Practice ◽

Educational Institutions ◽

Ageing Population ◽

Healthcare Staff ◽

Close Collaboration ◽

European Healthcare ◽

Digital Skills

Abstract Background Rising life expectancy and ageing population are current phenomena that European society is facing and these are challenges for the European healthcare systems. To face them, several e-health solutions are already designed to optimize resources of the healthcare provider system. However, most of them are not being implemented or deployed. Some of the reasons are the lack of digital skills and innovation readiness in staff, and existing barriers to changing organizational practices. Objectives The DISH project (601008-EPP-1-2018-1-DK-EPPKA2-SSA) will develop 3 concepts to improve the digitalization of healthcare staff to help them in the use of e-health solutions already developed: 1)Learning Innovation Units, where healthcare staff, SMEs and educational institutions work together for improving the e-health solutions development and implementation; 2)On the job training, where healthcare staff will be trained in e-health and digital competences; 3)Assessment, where competences accomplished by healthcare staff will be recognized. All these concepts will be tested in 6 EU countries. Results The development of the 3 concepts is based on a needs analysis on present and future competences required to support the implementation of e-health solutions in Denmark, Norway, UK, Germany, Spain and Poland. Also, each country will test the 3 concepts and train 100 healthcare staff in the use of an e-solution/innovation already developed but not being fully implemented. An evaluation of the achieved skills/competences by the staff will be also conducted. Conclusions Healthcare workers and SMEs show willingness and motivation in contributing to the digitalization but there is a clear lack of digital skills (although this is different from country to country) to make easier the adoption in daily practice of such solutions. The project looks for promoting close collaboration between the interested parties to work together in overcoming the stated deficiency. Key messages The DISH concepts will facilitate a training framework for healthcare professionals in the use of digital solutions. The DISH project will promote the use of several innovations already available in the market.

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Mobile health in cardiac patients: an overview on experiences and challenges of stakeholders involved in daily use and development

BMJ Innovations ◽

10.1136/bmjinnov-2019-000418 ◽

2020 ◽

Vol 6 (4) ◽

pp. 184-191 ◽

Cited By ~ 1

Author(s):

Dirkjan Kauw ◽

Piter R Huisma ◽

Stephanie K Medlock ◽

Maarten A C Koole ◽

Eric Wierda ◽

...

Keyword(s):

Mobile Health ◽

Large Scale ◽

Healthcare Professionals ◽

Daily Practice ◽

Information And Communications Technology ◽

Cardiac Patients ◽

Important Concern ◽

Device Reliability ◽

Semistructured Interviews ◽

Remote Care

BackgroundMobile health (mHealth) can improve quality of care and empower cardiac patients. However, large-scale adoption is still lacking, as several challenges continue to be encountered in daily practice. We aimed to explore the mHealth experiences and challenges in cardiac patients, healthcare professionals, healthcare managers and information and communications technology (ICT) developers.MethodsA qualitative research was employed where semistructured interviews were conducted in patients, healthcare professionals, managers and ICT developers. We aimed to enrol participants of every stakeholder group, with diversity in sex, age group and occupation. Thematic analysis was used to identify themes reflecting experiences and challenges in mHealth in cardiac patients.ResultsIn total, 24 interviews were conducted in six patients, eight healthcare professionals, five managers and five ICT developers. Monitoring/care at home was reported as important advantage of mHealth (n=20, 83%). Patients valued increase of self-care (n=6, 100%) and remote reassurance (n=6, 100%), but reported medicalisation as important concern (n=4, 67%). Healthcare professionals warned for increased data burden (n=4, 50%). Managers agreed on the importance of device reliability (n=5, 100%) and ICT developers emphasised that the goal of mHealth is to replace care, rather than being supplementary (n=4, 80%). The majority of all participants (n=22, 92%) considered future use of mHealth as promising.ConclusionsAll stakeholders foresee benefit of mHealth in cardiac patients, especially for remote care and reassurance. Frequently mentioned challenges included the need to replace care with mHealth, rather than adding more workload, and employing reliable devices and applications. If collaboration can be improved and group-specific challenges overcome, success of mHealth in cardiac patients can improve significantly.

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