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Biomedical subjects

Steven T Boyd

Publications and source records attributed to Steven T Boyd.

6 recordsLinked to original sources
PubMed2006

Outcomes of pharmacist-managed diabetes care services in a community health center.

PURPOSE: The outcomes of pharmacist-managed diabetes care services in a community health center were studied. METHODS: Eligible patients were over age 18 years and had a diagnosis of type 2 diabetes mellitus. Patients were randomly assigned by the clinical pharmacist and nurse to the intervention group (n = 76) or control group (n = 73). Patients in the intervention group were enrolled in a pharmacist-managed diabetes care program. Patients in the control group received the standard diabetes care. The primary endpoint was reduction in glycosylated hemoglobin (HbA(1c)); secondary outcome measures included weight loss, an improved body mass index, decreased blood pressure, and an improved lipid panel. Quality-of-life measures (health level, satisfaction, impact, worry about disease, and worry about social and vocational issues) were also assessed. RESULTS: Demographic differences between groups were not remarkable. Mean HbA(1c) levels fell significantly (p < 0.05) from baseline to nine months in both groups. A difference of 1.0 was reported between the groups' HbA(1c) levels (95% confidence interval, 0.08-1.78; p < 0.05). Satisfaction level improved from 63.7 to 77.4 in the intervention group, which was significant when compared with the control group, whose satisfaction score improved from 57.0 to 63.4 (p < 0.05). CONCLUSION: Patients with type 2 diabetes mellitus who received pharmacist-managed diabetes care demonstrated improved HbA(1c), systolic blood pressure, and low-density-lipoprotein cholesterol levels and quality-of-life measures and met treatment goals more often than patients receiving standard care.

Adolescent↗
PubMed2006

The endocannabinoid system.

The endocannabinoid system is a complex physiologic system. One of the most important discoveries related to the endocannabinoid system is that cannabinoid-1 receptors are present throughout the body and that they are linked to obesity and cardiometabolic risk. Adipose tissue was historically thought to be an inert, passive storage vehicle. However, recent findings prove that adipose tissue is a complex endocrine organ that releases adipokines, which influence cardiometabolic risk factors. Elevated endocannabinoid system activity is associated with obesity and coupled with excessive food intake and fat accumulation. Strong evidence suggests that the endocannabinoid system affects the surrogate cardiometabolic end points that greatly influence morbidity and mortality.

Animals↗
PubMedDate not supplied

Exercise for low-income patients with diabetes: a continuous quality improvement project.

PURPOSE: The specific aim of this project was to form a partnership between a community health center (CHC) to improve access to exercise for low-income patients with type 2 diabetes. METHODS: Eligible participants were members of the Siouxland Community Health Center (SCHC), 19 years of age or older, with a diagnosis of type 2 diabetes. Patients were medically waived and received an invitation to exercise at the Siouxland YMCA. An exercise coach (pharmacist, registered nurse, or medical assistant) met with each patient and scheduled and conducted exercise visits for participating patients 2 times each week. Patients' baseline clinical variables were taken and assessed quarterly over a 12-month period. RESULTS: This collaboration established an ongoing exercise program with a total of 1297 exercise encounters in a 12-month period. Forty-eight of 130 eligible patients (36.9%) visited the YMCA on at least 1 occasion. Patients were categorized as experimental (56.3%), involved (25%), and regular (18.8%) exercisers. Nine (18.8%) of the 48 patients attended supplementary YMCA exercise encounters. Five (11%) of the 48 patients renewed and purchased a membership at the YMCA and adopted a self-management approach to regular exercise. CONCLUSION: The creation of a partnership between a community health center and an exercise organization permitted disadvantaged patients with diabetes an affordable exercise program and contributed to improved clinical measurements. The exercise program can be used as a model for other community health centers and health professionals who desire to improve the implementation of an exercise program for patients with diabetes.

Adult↗
PubMedDate not supplied

Medication therapy management survey of the prescription drug plans.

OBJECTIVE: To evaluate the preliminary development and implementation plans for medication therapy management (MTM) services across plan sponsors for the Medicare Part D Prescription Drug Plans (PDPs) and provide pharmacists with insights for MTM development. DESIGN: Cross-sectional survey. SETTING: United States. PARTICIPANTS: 307 individual contacts from Medicare Advantage or stand-alone PDPs. INTERVENTION: A survey comprising questions about the PDP demographics, plans and implementation, beneficiary eligibility criteria, scope of services, providers of services, and payment structure for MTM services was e-mailed and mailed in November 2005. MAIN OUTCOME MEASURES: Descriptive and bivariate analysis of survey items. RESULTS: A total of 97 usable surveys were completed, a 31.5% response rate. Almost all respondents had a plan in place for MTM services. The majority of PDPs perceived that MTM would have a moderate benefit to their organization. Most PDPs planned to focus efforts on diabetes, heart failure, and other forms of cardiovascular disease. Overwhelmingly, PDPs planned to follow the Centers for Medicare & Medicaid Services (CMS) mandate for criteria regarding beneficiary eligibility. Only 8.2% of respondents planned to use a "traditional" pharmacist, such as a community, long-term care, hospital, or clinic pharmacist. The majority of PDPs (53.6%) planned to employ managed care pharmacists to administer MTM services. CONCLUSION: Pharmacists are eager to implement MTM services and are looking for PDPs to provide a path of implementation and reimbursement. Many PDPs were planning to deliver MTM services internally using health professional staff, thereby limiting the extent of participation of community, long-term care, hospital and health-system, and clinic-based pharmacists. Further research and advocacy are required to ensure that MTM services accomplish the true intent of the congressional and CMS mandates.

Cross-Sectional Studies↗