Physicians’ and pharmacists’ information provision and patients’ psychological distress

Providing information related to medication has many benefits for patients. However, patients’ conflicting perceptions about medical information provided by physicians and pharmacists may be associated with their psychological distress regarding treatment and medication. This study investigated associations between patients’ perceptions of agreement between physicians and pharmacists about medical information and improvements in their psychological distress. It also clarified the specific relationships of their perceptions with psychological distress. A cross-sectional survey was conducted in Japanese community pharmacy settings. Pharmacists approached 1,500 patients visiting community pharmacies and provided them with questionnaire packages. Patients completed the questionnaires at home and returned them to the researchers by mail. Multivariate logistic regression analysis and signal detection analysis were conducted to examine associations of patients’ perceptions of information agreement with improvement in psychological distress. Measures of improvement in worry and anxiety about disease, improvement in worry and anxiety about medication, and improvement in depressive mood were used to assess alleviation of psychological distress. A total of 645 patients returned the questionnaires; 628 contributed to the data. Multivariate logistic regression analyses clarified that patients’ perceptions of agreement in information regarding need for medication, methods for adverse drug reaction reduction, adverse drug reaction symptoms, coping with forgetting to take medication, and advice for daily life were significantly associated with improvements in psychological distress. Furthermore, signal detection analysis showed that several combinations of patients’ perceptions of agreement between physicians and pharmacists about specific medical information were also significantly associated with improvement in psychological distress. Consistent information provision by physicians and pharmacists could contribute to decreased psychological distress in patients, and consequently to adherence to treatment and taking medication.     

Les effets pharmacologiques d’extraits d’Epilobium

Résumé  Depuis les premiers travaux montrant en 1988 qu’Epilobium parviflorum agissait sur le tissu prostatique en améliorant la symptomatologie de l’hypertrophie bénigne de la prostate, les études se sont faites rares. Après des travaux sur la prolifération du tissu prostatique, l’auteuir a voulu vérifié cet effet pour différentes épilobes, comme pour des épilobes d’origine géographique différente. Il semble que les plus actifs sont E. angustifolia et E. rosmarinifolia. Parmi les constituants chimiques il semble par ailleurs que ce soit avant tout l’oenothéine B qui est active, mais son activité n’explique pas toute l’activité du totum de la plante.      

Travelers’ diarrhea

Travelers’ diarrhea is common. Between 8% and 50% of travelers develop diarrhea; incidence depends on the country visited. The attack rate is highest for travelers from a developed country who visit a developing country. Children are at particular risk. Travelers’ diarrhea is usually acquired through ingestion of fecally contaminated food and water. Most cases are due to a bacterial pathogen, commonly,Escherichia coli, and occur within the first few days after arrival in a foreign country. More than 90% of episodes develop within the first 2 wk of initiation of travel. Dehydration is the most common complication. Water and electrolyte replenishment is important and can usually be accomplished with an oral rehydration solution. Judicious use of an antimotility agent and antimicrobial therapy reduces the duration and severity of diarrhea. Pretravel education on hygiene and on the safe selection of food items is important in minimizing episodes. Dukoral™ (Aventis Pharma Ltd., Auckland, New Zealand) vaccine should be considered for travelers who are 2 y of age or older and who will be visiting an area associated with risk of infection due to enterotoxigenicE coli orVibrio cholerae. Typhoid vaccine is recommended for travelers who will be visiting areas with poor sanitation and hygiene.     

‘Sorted’

Each year in Accident and Emergency an increasing number of young people present with acute problems related to social drugs. These problems range from mild symptoms to life-threatening conditions, many of which can be extremely difficult and time consuming for staff to manage. It has become apparent that as with sex the experimental age for taking drugs is getting younger as youths are now far more ‘streetwise’ than their predecessors. This is one of the main reasons for this paper being written; it is imperative that staff are equipped with the appropriate knowledge to deal with the challenge and are educated about the problems associated with current drug trends. This potentially improves the quality of care and, in turn, good communication improves relationships. Ecstacy is once again becoming increasingly popular within mainstream clubs, as recently highlighted in the media, and with it reappear its problems. This article discusses the historical aspects of Ecstasy and aims to educate staff about its use and effects and provides health promotion advice for those who are involved in the care of people who take Ecstasy.     

L’éducation thérapeutique : ce qu’elle est et ce qu’elle n’est pas

Patient therapeutic education (PTE) first began in Switzerland in 1975. From it outset, it was part of the care provided in the diabetic unit of Professor J.-P. Assal, its designer, in Geneva hospital. It is based on a constructivist pedagogy to help patients suffering from any chronic illness to acquire new skills and become actors of their own treatment; thus, they would be able to live the life they want. Far from being a simple transfer of knowledge from the care giver to the patient and making him/her become his/her own doctor, it is a new medicine (third medicine) integrating biologic, psychologic, and social component. Each time a chronic illness diagnostic is made, it means, for the patient, loss of his or her former good health status and concern about future life as a different person. PTE must consider patients’ representations, beliefs, and knowledge about their chronic disease, and help them move toward a more suitable (from a health status point of view) relationship with it. These goals cannot be achieved without providing specific training to the care givers, to promote a truly therapeutic link (tutor’s resilience), within which medical decisions will be shared by both parties, in full regard of the patient.