853 resultados para Helenius, Päivi


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Kirjallisuusarvostelu

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Liite 1. Kysely apteekin farmaseuttiselle henkilökunnalle s. 45-47.

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Kirjallisuusarvostelu

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Kirjallisuusarvostelu

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Statins are indicated for preventing cardiovascular disease events. Patients with diabetes have a risk of major cardiovascular events double the risk of their peers without diabetes. Thus, clinical treatment guidelines recommend statins for the management of diabetic dyslipidemia. The evidence base for statin use in cardiovascular disease derives from the randomized controlled statin trials designed to prove statin efficacy under ideal conditions, among a homogenous study population meeting strict trial eligibility criteria. This thesis was implemented as four pharmacoepidemiological statin studies using register data on realworld statin users. The overall purpose was to evaluate the trends, patterns and effectiveness of statin use in everyday life. More specifically, nationwide secular trends in statin use in Finland were analysed, especially among patient groups which had been underrepresented in the statin trials. Furthermore, the benchmarking statin trials in diabetes, the Heart Protection Study and the Collaborative Atorvastatin Diabetes Study, were evaluated for their representativeness for real-world diabetes care with the emphasis placed on adherence to statin use. The association between good adherence and the incidence of major cardiovascular events in the real-world was further investigated in diabetes. These studies demonstrate that statin initiations increased from 1995 to 2005 in Finland. The increase was most pronounced among those aged at least 75 years and was observed already before the publication of rigorous trial data conducted in elderly subjects. Thus, statins seem to have been initiated in clinical practice also going beyond the strict trial eligibility criteria. Nonetheless, low adherence to statin use among the real-world patients with diabetes was found not only to limit the representativeness of the trials for clinical care but also to attenuate in all likelihood their benefits in the real-world. In fact, good adherence to statin use was found to associate with a decreased risk for major cardiovascular events in patients with diabetes. In conclusion, these studies highlight the importance of good adherence to statin use in clinical practice in order to obtain the full therapeutic value demonstrated in the statin trials. Simply increasing the number of statin users will not alone suffice in sharing our common resources appropriately.

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1/2014 on lehden EU-erikoisnumero.

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Kirjallisuusarvostelu

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The aim of this thesis was to create a process for all multi-site ramp-up (MSRU) projects in the case company in order to have simultaneous ramp-ups early in the market. The research was done through case study in one company and semi-structured interviews. There are already processes, which are now in use in MSRU-cases. Interviews of 20 ramp-up specialists revealed topics to be improved. Those were project team set up, roles and responsibilities and recommended project organization, communication, product change management practices, competence and know how transfer practices and support model. More R&D support and involvement is needed in MSRU-projects. DCM’s role is very important in the MSRU-projects among PMT-team; he should be the business owner of the project. Recommendation is that product programs could take care of the product and repair training of new products in volume factories. R&D’s participation in competence transfers is essential important in MSRU-projects. Communication in projects could be shared through special intranet commune. Blogging and tweeting could be considered in the communication plan. If hundreds of change notes are open in ramp-up phase, it should be considered not to approve the product into volume ramp-up. PMTs’ supports are also important and MSRU-projects should be planned, budgeted and executed together. Finally a new MSRU-process is presented in this thesis to be used in all MSRU-projects.

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