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H Herborg

Publications and source records attributed to H Herborg.

6 recordsLinked to original sources
PubMed2001

Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care: a multicentre study in seven European countries.

OBJECTIVE: This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients (> or =65 years of age) by community pharmacists in a multicentre international study performed in 7 European countries. DESIGN AND SETTING: The study was a randomised, controlled, longitudinal, clinical trial with repeated measures performed over an 18-month period. A total of 104 intervention and 86 control pharmacy sites participated in the research and 1290 intervention patients and 1164 control patients were recruited into the study. MAIN OUTCOME MEASURES AND RESULTS: A general decline in health-related quality of life over time was observed in the pooled data; however, significant improvements were achieved in patients involved in the pharmaceutical care programme in some countries. Intervention patients reported better control of their medical conditions as a result of the study and cost savings associated with pharmaceutical care provision were observed in most countries. The new structured service was well accepted by intervention patients and patient satisfaction with the services improved during the study. The pharmacists involved in providing pharmaceutical care had a positive opinion on the new approach, as did the majority of general practitioners surveyed. The positive effects appear to have been achieved via social and psychosocial aspects of the intervention, such as the increased support provided by community pharmacists, rather than via biomedical mechanisms. CONCLUSIONS: This study is the first large-scale, multicentre study to investigate the effects of pharmaceutical care provision by community pharmacists to elderly patients. Future research methodology and implementation will be informed by the experience gained from this challenging trial.

Aged↗
PubMed2000

[Quality assurance of drug therapy for patients with asthma. Health economic analysis].

The cost-effectiveness of a community pharmacy based programme for therapeutic outcomes monitoring of asthma patients' drug therapy is evaluated. Five hundred asthma patients, aged 16-60 and treated in primary care, with moderate to severe asthma, 31 community pharmacies and 139 general practitioners participated in the study. The total programme costs, costs of drugs, health care resource costs and indirect costs were evaluated together with the effects of the programme on: asthma symptoms status, days of sickness, quality of life, satisfaction with health care, peak-flow (PEF), inhalation technique and knowledge. The evaluation of the programme shows it to be cost-effective with cost-effectiveness ratios between 0.18 and 0.56. The pay off time for the programme is 23 months (range 9-64 months in the sensitivity analysis). It is concluded that the community pharmacist can contribute to identify and solve drug-related problems in a cost-effective way with positive impact on asthma patients health, clinical and psycho-social outcomes, even though the program is time consuming and intensive.

Adolescent↗
PubMed1999

[Dietary guidelines on obesity at Danish pharmacies. Results of a 12-week course with a 1-year follow-up. Research Group on Human Nutrition, Frederiksberg].

The increasing prevalence of obesity has created a need for alternative counselling sites. This retrospective study evaluates the results of a 12 week slimming course for obese subjects held at Danish pharmacies at one year follow-up. Two hundred and sixty-nine obese (BMI > 25 kg/m2, 32 +/- 4.5 [mean +/- SD]) paid 550 Dkr each for a 12 weeks slimming course held at 19 Danish pharmacies with groups of 8-20 subjects each. The age was between 18 to 81 years, 259 were females. The course included eight sessions of 1 1/2 hour education in nutrition and physiology aiming for a dietary change toward a low-fat, high carbohydrate diet. Self-reported body weight was assessed on at the pharmacy scale before and after the course and again after three, six and 12 months follow-up. One hundred and ninety-one or 71% of subjects completed the 12 week slimming programme. The average weight loss was 5.3 and 6.2 kg among females and males, respectively. The weight loss maintenance was assessed at one year follow-up in 122 (45%) of the subjects who entered the course and was 4.0 and 6.7 kg in 118 females and four males, respectively. At one year follow-up 40 subjects (20%) of the subjects who completed the course had maintained a weight loss > 5 kg. In conclusion, the initial weight loss, and maintenance and drop-out rate are comparable with results from general practitioners and hospital out-patient clinics, but the costs are substantially lower.

Adolescent↗
PubMedDate not supplied

Improving drug therapy for patients with asthma--part 1: Patient outcomes.

OBJECTIVE: To evaluate the effects of a therapeutic outcomes monitoring (TOM) program on selected process and outcome measures. DESIGN: Prospective, controlled, multicenter study. SETTING: Community pharmacies throughout Denmark (16 intervention, 15 control). PATIENTS: Five hundred patients with asthma aged 16 to 60 years and treated in primary care. INTERVENTION: TOM is a community-based program for pharmaceutical care. Using a structured, seven-step, cyclical outcome improvement process, TOM pharmacists identify and resolve (or refer) problems with drug therapy that, if not addressed, might result in therapeutic failure or adverse effects. Equal emphasis is placed on the patient's perspective (e.g., coping, control, and empowerment) and the professional's perspective (e.g., adherence, patient knowledge, and therapeutic problems). TOM requires cooperation among pharmacists, patients, and physicians. MAIN OUTCOME MEASURES: Asthma symptom status, days of sickness, health-related and asthma-specific quality of life, use of health care services and resources, and satisfaction with health care and pharmacy. INTERMEDIATE OUTCOME AND PROCESS MEASURES: Peak expiratory flow rate (PEFR), knowledge of asthma and asthma medications, inhalation errors, and drug therapy problems in the TOM group. RESULTS: The mean individual differences for TOM and control patients were tested. Beneficial effects were found for the following outcome measures: asthma symptom status, days of sickness, and health-related and asthma-related quality of life. Satisfaction with health care and pharmacy varied throughout the course of the project, with no significant difference between groups at the final evaluation. Although not statistically significant, differences in use of services were considered to be clinically significant and encouraging. Beneficial effects were found for knowledge of asthma and medications, inhalation errors, drug use and drug therapy problems. No significant differences were found for PEFR. CONCLUSION: The project demonstrated that therapeutic outcomes monitoring by community pharmacists is an effective strategy for improving the quality of drug therapy for asthma patients in primary health care.

Adolescent↗
PubMedDate not supplied

Improving drug therapy for patients with asthma-part 2: Use of antiasthma medications.

OBJECTIVES: To describe the use of antiasthma drugs among the study patients and to evaluate whether therapeutic outcomes monitoring (TOM) is associated with improved quality of drug therapy. DESIGN: Prospective, controlled, multicenter study. Consumption of antiasthma medications was measured as the number of defined daily doses (DDDs) purchased. Data were collected from the pharmacies' computer systems for a period beginning 6 months before the start of the study (period 1) and during its first and second half-years (periods 2 and 3). Treatment changes for TOM patients were classified on the basis of drug regimens at periods 1 and 3. SETTING: Community pharmacies in Denmark (16 intervention, 15 control). PATIENTS: Five hundred patients with asthma aged 16 to 60 years who were being treated in primary health care; this study used data from 350 patients from this sample. INTERVENTION: TOM. MAIN OUTCOME MEASURES: Changes in the use of individual drugs and changes in therapeutic patterns--distribution of purchased drugs; proportion of corticosteroid users; frequency of drug regimens used; treatment changes for TOM patients. RESULTS: TOM patients' consumption of beta2-agonists decreased by 12% overall from period 1 through period 3, while control patients' consumption of these medications decreased by only 1%. TOM patients' use of inhaled corticosteroids increased by more than 50% compared with 9% among controls. In both groups, about one-half of all purchased DDDs were for inhaled beta2-agonists. The proportion of inhaled corticosteroids increased from 27% to 42% of total DDDs for the TOM group and remained constant for controls. Of patients using beta2-agonists, 68% also used inhaled steroids initially in both the TOM and control groups. The proportion of inhaled steroid users in the TOM group increased to 84%, and to 70% among controls. The most common regimen was inhaled short-acting beta2-agonists and corticosteroids in combination, and the second most common regimen was monotherapy with short-acting beta2-agonists. With time, the regimens changed more toward consensus guidelines among TOM patients. Changes in drug therapy totaled 451, averaging 2.4 changes per TOM patient. The largest number of changes (49%) involved inhaled corticosteroids. CONCLUSION: Changes in medication use among TOM patients were toward improved asthma treatment. Our results show that community pharmacists, physicians, and patients, working together, can improve prescribing, solve drug therapy problems, and improve outcomes for patients with moderate-to-severe asthma.

Administration, Inhalation↗