A Matter of Substance, May 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, June 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, July 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, August 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, September 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, October 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, November 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, December 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, January 2012

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, February 2012

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

Diabetic patients who report receiving processes of diabetic care do not express a better quality of life

Background: Chronic disease management initiatives emphasize patient-centered care, and quality of life (QoL) is increasingly considered a representative outcome in that context. In this study we evaluated the association between receipt of processes of diabetic care and QoL. Methods: This cross-sectional population-based study (2011) used self-reported data from non-institutionalized, adult diabetics, recruited from randomly selected community pharmacies in Vaud. Outcomes included the physical and mental composites of the SF-36 (PCS, MCS) and the disease-specific Audit of Diabetes-Dependent QoL (ADDQoL). Main exposure variables were receipt of six diabetes processes-of care in the past 12 months. We also evaluated whether the association between care received and QoL was congruent with the chronic care model, when assessed by the Patient Assessment of Chronic Illness Care (PACIC). We used linear regressions to examine the association between process measures and the three composites of health-related QoL. Analyses were adjusted for age, gender, socioeconomic status, living companion, BMI, alcohol, smoking, physical activity, co-morbidities and diabetes mellitus (DM) characteristics (type, insulin use, complications, duration). Results: Mean age of the 519 diabetic patients was 64.4 years (SD 11.3), 60% were male and 73% had a living companion; 87% reported type 2 DM, half of respondents required insulin treatment, 48% had at least one DM complication, and 48% had DM over 10 years. Crude overall mean QoL scores were PCS: 43.4 (SD 10.5), MCS: 47.0 (SD 11.2) and ADDQoL: -1.56 (SD 1.6). In bivariate analyses, patients who received the influenza vaccine versus those who did not, had lower ADDQoL and PCS scores; there were no other indicator differences. In adjusted models including all processes, receipt of influenza vaccine was associated with lower ADDQoL (β= - 0.41, p=.01); there were no other associations between process indicators and QoL composites. There was no process association even when these were reported as combined measures of processes of care. PACIC score was associated only with the MCS (β= 1.57, p=.004). Conclusions: Process indicators for diabetes care did not show an association with QoL. This may represent an effect lag time between time of process received and quality of life; or that treatment may be related with inconvenience and patient worry. Further research is needed to explore these unexpected findings.

A Matter of Substance, March 2012

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

Community pharmacist intervention in depressed primary care patients (PRODEFAR study): randomized controlled trial protocol.

Background: Treatment of depression, the most prevalent and costly mental disorder, needs to be improved. Non-concordance with clinical guidelines and non-adherence can limit the efficacy of pharmacological treatment of depression. Through pharmaceutical care, pharmacists can improve patients' compliance and wellbeing. The aim of this study is to evaluate the effectiveness and costeffectiveness of a community pharmacist intervention developed to improve adherence and outcomes of primary care patients with depression. Methods/design: A randomized controlled trial, with 6-month follow-up, comparing patients receiving a pharmaceutical care support programme in primary care with patients receiving usual care. The total sample comprises 194 patients (aged between 18 and 75) diagnosed with depressive disorder in a primary care health centre in the province of Barcelona (Spain). Subjects will be asked for written informed consent in order to participate in the study. Diagnosis will be confirmed using the SCID-I. The intervention consists of an educational programme focused on improving knowledge about medication, making patients aware of the importance of compliance, reducing stigma, reassuring patients about side-effects and stressing the importance of carrying out general practitioners' advice. Measurements will take place at baseline, and after 3 and 6 months. Main outcome measure is compliance with antidepressants. Secondary outcomes include; clinical severity of depression (PHQ-9), anxiety (STAI-S), health-related quality of life (EuroQol-5D), satisfaction with the treatment received, side-effects, chronic physical conditions and sociodemographics. The use of healthcare and social care services will be assessed with an adapted version of the Client Service Receipt Inventory (CSRI). Discussion: This trial will provide valuable information for health professionals and policy makers on the effectiveness and cost-effectiveness of a pharmaceutical intervention programme in the context of primary care. Trial registration: NCT00794196

A Matter of Substance, April 2012

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, May 2012

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.