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Telehealth Comes of Age
Published in Tom Lawry, Hacking Healthcare, 2022
New systems using AI can detect errors in a consumer's self-medication administration which is especially important for those with chronic conditions. For example, research suggests that up to 70% of diabetic patients do not take their insulin as prescribed. One such system developed at MIT uses AI to scour sensor data. When it detects an error in the patient's self-administration of insulin, it can alert the patient, provider, or family member.11
More Complex Patients
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
Patient-controlled analgesia (PCA) should not be withheld from older patients simply because of their age. If there are no contraindications to the use of PCA (see Chapter 8) and as long as the patient is able to comprehend the technique, PCA is a safe and effective form of pain relief. Although the proportion of older patients who can effectively use PCA may be less than in younger age groups, age by itself does not limit the ability to use PCA successfully. Older patients should be followed closely to ensure that they understand the concept of self-administration and to confirm that they are obtaining adequate pain relief.
Medicare Set-Asides
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
Jennifer C. Jordan, Leslie Schumacher
The biggest benefit of professional administration over self-administration is the protection afforded all parties in the fact the administrator is an unrelated third party contractually bound to pay only related medical expenses otherwise covered by Medicare. There are no mistaken payments or possibility of borrowing from the account for unrelated expenses. Unfortunately, these services do not come for free. Because CMS will not count the cost of administration against proper exhaustion, the cost must be borne outside the MSA. Accordingly, the cost must be negotiated as a term of settlement, otherwise claimant would be left to pay for such services after realizing that it is harder than contemplated.
Self-administration of gender-affirming hormones: a systematic review of effectiveness, cost, and values and preferences of end-users and health workers
Published in Sexual and Reproductive Health Matters, 2022
Caitlin E. Kennedy, Ping Teresa Yeh, Jack Byrne, L. Leigh Ann van der Merwe, Laura Ferguson, Tonia Poteat, Manjulaa Narasimhan
This review addressed the following question: Should self-administration of gender-affirming hormones be made available in addition to health worker-administration? We defined self-administration according to the WHO self-care guideline definition as “the process of people administering pharmacological substances or biomedical interventions to themselves”.14 For self-administration of gender-affirming hormones, we considered either self-prescription of oral or topical hormones or self-injection of injectable hormones (either self-prescribed or health worker-prescribed hormones). We recognise that this definition includes a wide range of practices that are not comparable on many aspects. However, we decided a broad approach would capture a breadth of information for the purposes of the review.
Self-administration of omalizumab: why not? A literature review and expert opinion
Published in Expert Opinion on Biological Therapy, 2021
Francesco Menzella, Emanuele Ferrari, Silvia Mariel Ferrucci, Enrico Lombardi, Silvio Alfano, Ornella Bonavita, Paolo Morini, Andrea Rizzi, Andrea Matucci
Self-administration of biologics can be considered as a valid alternative to traditional injections in a clinical setting, and the evidence has shown that there appear to be no major obstacles to overcome in terms of safety or efficacy. Self-administration has benefits not only for patients but also for health-care providers. Patient education must be considered as a fundamental component of rendering the patient autonomous, and patients must feel confident in their ability to self-administer. A feeling of empowerment will likely be associated with good adherence to therapy, and there are many tools that can help to monitor adherence. Moreover, patients must feel that they still have a valid support network in place with less frequent clinical visits, and involving pharmacists and general practitioners can help fill the gap in this regard.
Safety and effectiveness of adalimumab in Japanese patients with juvenile idiopathic arthritis: Results from a real-world postmarketing study
Published in Modern Rheumatology, 2021
Syuji Takei, Naomi Iwata, Ichiro Kobayashi, Toru Igarashi, Yoko Yoshinaga, Naoko Matsubara, Naomi Sunaga, Ayumi Ito, Shumpei Yokota
Fifteen serious ADRs were reported in 12 patients (3.4%), most frequently within the System Organ Class (SOCs) of infections and infestations (1.7%) and musculoskeletal and connective tissue disorders (1.1%). All but 2 patients with serious ADRs recovered; 1 patient had optic disc vasculitis that remained unresolved, and the second patient experienced temporomandibular joint syndrome with an unknown outcome. Among ADRs of interest, infections, administration site reactions, and TB were reported in 41 (11.5%), 14 (3.9%), and 1 (0.3%) patient(s), respectively (Table 2). One case of disseminated and pulmonary TB was reported in a teenager who weighed 40 kg and had enthesitis-related arthritis (ERA). At baseline TB screening, this patient tested negative by immunologic test. The patient received adalimumab 40 mg q2w for 71 days and had moderate disease activity when he discontinued adalimumab because of the onset of TB. The patient reportedly improved after 1 year. No cases of autoimmune disease, pancytopenia, demyelinating disease, CHF, or interstitial pneumonia were reported. Self-administration errors were reported in 2 patients (0.8%), both in the age group of ≥11–<16 years. No malignancy was reported during the follow-up period. Overall, 239 (67.1%) AEs and 27 (7.6%) SAEs were reported.