Sustainable Strategies
Multi-disciplinary Approach to Vigilantly Avert Drug-induced Metabolic Syndrome
Paper Presentation in a Themed Session Matilda Stelzer, Saba Rizvi, Kristine Joy Sunga Lalic, Sadaf Ahmed, Rona Margaret Relova
Several cardio-metabolic risk factors have been linked to certain antipsychotic treatments and Veterans with mental illness are at increased risk of developing cardiovascular disease. Metabolic monitoring among patients using antipsychotics has been shown to be inadequate despite the release of several guidelines designed to guide clinicians on the optimal use of antipsychotics and the consideration of cardio-metabolic risk. Recent data indicate a higher prevalence of nearly 35 percent of all adults developing metabolic syndrome. The concept of this study is to evaluate the prevalence of antipsychotic-induced metabolic syndrome and provider’s sensitivity to cardio-metabolic disorders in their selection of antipsychotic medications. We identified patients taking antipsychotic medications prescribed by providers at VAPAHCS from January 1, 2014 to December 31, 2015. We then used patient health records to collect the following clinical information: laboratory values; vital signs; medications for hypertension, dyslipidemia and diabetes; and antipsychotic medications. Patterns of providers’ prescribing practices (like timeliness of medication changes) given abnormal lab values and physical measurements were analyzed. As preparatory for research, the proponents of this study collected 1,529 charts to review. An interdisciplinary approach to improve health outcomes involving psychiatrists, pharmacists, nutritionists, physical therapists, case managers working together to vigilantly monitor patients who are on anti-psychotic medications may prove to be the most effective preventive model. A team of diverse specialties coordinating toward a common goal to avert well-documented and modifiable risk factors such as poor diet, physical inactivity, and obesity would be most beneficial for patients.
Patients' Satisfaction with Services at the Polytechnic Ibadan Health Center
Paper Presentation in a Themed Session Olalere Adegboyega Adeagbo
The objective of this study was to determine the level of patients' satisfaction with services at the Health Center of The Polytechnic Ibadan. A cross-sectional survey was conducted 400 staff and students selected by systematic random sampling. Majority were satisfied in interaction with personnel. There was no significant association between gender, age, level of education and occupation with the overall level of satisfaction with services. However, there were significant associations between level of education, accessibility (P<0.05), and waiting time (P<0.05). Though patients were generally satisfied with services offered, dissatisfaction was expressed regarding inadequacy of drugs and toilet facilities. Recommended for the center were: drug revolving fund, periodic seminars for personnel, improved electricity supply and toilet facility while recognizing patients' feedback in evaluating health services at the center.
Designing a Law to Promote the Sharing of Medical and Health Records: Striking a Balance Between Protection of Personal Information and Promotion of Healthcare
Paper Presentation in a Themed Session Shinto Teramoto
The digitalized medical and health records (HR) of citizens are stored in Electronic Health Records (EHR) and Personal Healthcare Records (PHR). The quality of medical care will be improved if physicians can access the past HR of patients. Also, redundant medical examinations will be avoided, which will result in medical cost savings. A user-friendly service that enables citizens to share their HR with their physicians is essential to achieve the aforementioned purpose. The involvement of private businesses is expected to make such service available to citizens. However, recently, many citizens have been frustrated with the collection and control of personal data by the giants of ICT industries, and, in response, governments are establishing rules to regulate collection and handling of personal data. In contrast, sharing HR on the infrastructure provided by private businesses presupposes that these private providers handle medical and health records that fall within the most delicate types of personal data. We have to design and implement laws that promote the sharing of HR while ensuring the protection of personal data. There are a number of issues that need the intervention of laws, to ensure the confidentiality, integrity, availability and portability of HR, compatibility between EHR and PHR, and between multiple PHRs, and to ensure the portability of records between a PHR service provided by one company and a PHR service provided by a different company. The author discusses and proposes the requirements of such laws and proposes a practicable legal design to promote the sharing of HR.
Transgender Persons’ Health Care Experiences: The Role of Stigma, Societal Norms, and Knowledge
Paper Presentation in a Themed Session Sarah E Ratcliffe
Transgender individuals experience an extensive range and degree of disadvantages that can be attributed to stigmatization. This project set out to explore how transgender individuals in the Netherlands experience stigma using a general inductive approach. The project aimed to understand the contexts, manifestations, and consequences of stigmatizing experiences of transgender individuals. Inductive thematic analysis of semi-structured interviews and one focus group volunteer transgender individuals (n=26) living in the Netherlands found health care to be one context where stigma is experienced. Structural, interpersonal, and intrapersonal stigma was reflected upon and reported to negatively impact help-seeking and to prolong suffering. Societal gender norms, transgender stereotypes, and poor understanding of transgender identities were identified to influence experiences. Identification on the gender spectrum (e.g., gender non-binary compared to binary) was found to be associated with differences in experiences. Positive experiences were also found and provide insight into approaches for improving health care for transgender individuals. This research suggests that research investigating transgender individual’s experiences in health care should pay attention to knowledge and societal constructs. Overall, stigma clearly impacts the lives of transgender individuals and should be a target for intervention.
