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R J Botelho

Publications and source records attributed to R J Botelho.

27 records · Page 2Linked to original sources
PubMed1992

Home assessment of adherence to long-term medication in the elderly.

BACKGROUND: Drug nonadherence to long-term medication is a common and poorly understood problem in the elderly. A study was conducted to assess whether elderly patients would accept a research assistant conducting pill counts in their homes, and to examine how nonadherence was associated with patient variables. METHODS: A letter and a telephone follow-up call were used to identify eligible patients (aged 65 years and over, with two or more chronic diseases). RESULTS: A total of 98 eligible patients were identified. Fifty-nine agreed to participate in the study. Of the 59 participants, 54.7% were nonadherent to their medication regimen. Nonadherence was defined as an overall mean level of compliance of less than 80%. Drug regimen nonadherence was associated with the inability to read medication labels (P less than .01), but not with impaired visual acuity, the number of prescribed medications, the type of medication container lid, depression, cognitive impairment, perceived health status, or the cost of medications. Frequency of drug administration affected patient adherence to the medication regimen. Mean adherence of patients to prescriptions for drugs to be taken once or twice daily was 72%, whereas drugs to be taken three or four times daily had a mean adherence rate of 54% (P less than .01). CONCLUSIONS: Using the simple pill count method on home visits, rates of nonadherence to long-term medication were comparable to those found in studies using electronic pill-counting devices. Larger studies are needed to clarify how other variables, in addition to patient inability to read medication labels, are associated with noncompliance with medication regimens for chronic diseases in elderly patients.

Aged↗
PubMed1988

Right upper lobe obstruction with right-sided double-lumen endobronchial tubes: a comparison of two tube types.

Twenty-nine patients undergoing left thoracotomy consecutively were intubated with right-sided double-lumen endotracheal tubes in the conventional "blind" fashion. The first 20 received Leyland red-rubber double-lumen tubes, and the subsequent nine received Mallinckrodt polyvinylchloride double-lumen tubes. The patency of the right upper lobe bronchial orifice was then assessed by flexible fiberoptic bronchoscopy. Right upper lobe obstruction occurred in 89% of the polyvinylchloride tube intubations and in 10% of the red-rubber tube intubations.

Bronchoscopy↗
PubMedDate not supplied

The Town Forum debate?

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Decision Making↗
PubMedDate not supplied

Using a family systems approach in a balint-style group: an innovative course for continuing medical education.

Primary care physicians provide access and continuity of care to difficult patients and their families. Optimal medical management may be jeopardized by the emotional responses of physicians caring for such patients. These responses may pose moral dilemmas for the physician, who may be reluctant to treat these patients. Even though physicians have the right to dismiss such patients, the ethos of primary care engenders a sense of obligation to provide access to care. Traditional continuing medical education (CME) overemphasizes content and avoids emotional issues common in problematic physician-patient relationships. This CME demonstration project for community based physicians addressed this issue through a longitudinal course which was learner-centered and process-oriented. This article reports the successes and difficulties in organizing this innovative course.

Curriculum↗