Electronic monitoring of compliance to lipid-lowering therapy in clinical practice

Nonadherence to treatment is a common problem in the clinical management of hypercholesterolemic patients. This study was carried out with the aim of monitoring the daily compliance to a 6-month course of lipid-lowering therapy, using a microelectronic device, the Medication Event Monitoring System (MEMS), versus pill count. Forty men with primary hypercholesterolemia were prescribed fluvastatin 1 x 40 mg daily, provided in a MEMS package to record the date and time of each opening of the pillbox. Thirty-nine of 40 patients (98%) completed the study. Total cholesterol and LDL cholesterol levels decreased significantly (18% and 25%, p < 0.001) during the 6-month therapy period. A high mean rate of compliance was achieved by MEMS using the following three indexes--compliance to total prescribed dose (88.8% +/- 13.5%), compliance to prescribed days (82.4% +/- 19.5%), and compliance to prescribed time of day (81.86% +/- 19.5%)--and by pill count (93.4% +/- 9.5%). In addition, the MEMS provided some patterns of nonadherence to medication, undetectable by pill count alone, such as a drug holiday in 38% of cases, a drug omission for more than 7 consecutive days in 9% of cases, and, conversely, use of more than the one prescribed daily dose in 47% of cases. A significant correlation between the rate of compliance and the decrease in LDL cholesterol was observed only when the compliance was assessed by MEMS. The results indicate that MEMS is a useful tool for monitoring compliance in clinical practice and may possibly increase adherence to long-term lipid-lowering therapy.

A Delphi study to identify research priorities for the therapy professions in Northern Ireland

A study by the University of Ulster, funded by Health and Social Care Research and Development Division of the Public Health Agency, enabled members of six Allied Health Professions (AHPs) to express opinions on research needs within their areas of expertise.The respondents to 'A Delphi Study to Identify Research Priorities for the Therapy Professions in Northern Ireland', were selected from professionals based in clinical and academic settings in the areas of physiotherapy, occupational therapy, speech and language therapy, podiatry, nutrition and dietetics and orthoptics. The views of a group of key stakeholders in health and social care and a separate panel of service users were also gathered. A copy of this report, and an Executive Summary,�can be downloaded below.

Speech, language and communication therapy action plan

This is the first update newsletter of the Speech, language and communication therapy action plan. The action plan was developed by the Department of Health, Social Services and Public Safety (DHSSPS) with the aim that all children and young people at risk of or presenting with speech, language or communication needs will be able to benefit from timely support and integrated services that best meet their requirements.The Public Health Agency (PHA), in partnership with the Health and Social Care Board (HSCB), has been tasked with implementing the action plan.The update includes news on the publication of the Healthy child, health future framework and highlights other points of progress so far, including the development of the Family Support NI website. There is also an invite for parents to join a focus group to influence and assist with the implementation of the action plan.�

Antiretroviral treatment during pregnancy.

OBJECTIVE: Virologic failure of HIV-positive patients is of special concern during pregnancy. We compared virologic failure and the frequency of treatment changes in pregnant and non-pregnant women of the Swiss HIV Cohort Study. METHODS: Using data on 372 pregnancies in 324 women we describe antiretroviral therapy during pregnancy. Pregnant women on HAART at conception (n = 131) were matched to 228 non-pregnant women (interindividual comparison) and to a time period of equal length before and after pregnancy (intraindividual comparison). Women starting HAART during pregnancy (n = 145) were compared with 578 non-pregnant women starting HAART. FINDINGS: The median age at conception was 31 years, 16% (n = 50) were infected through injecting drug use and the median CD4 cell count was 489 cells/microl. In the majority of pregnancies (n = 220, 59%), women had started ART before conception. When ART was started during pregnancy (n = 145, 39%), it was mainly during the second trimester (n = 100, 69%). Two thirds (n = 26) of 35 women starting in the third trimester were diagnosed with HIV during pregnancy. The risk of virologic failure tended to be lower in pregnant than in non-pregnant women [adjusted odds ratio 0.52 (95% confidence interval 0.25-1.09, P = 0.08)], but was similar in the intraindividual comparison (adjusted odds ratio 1.04, 95% confidence interval 0.48-2.28). Women starting HAART during pregnancy changed the treatment less often than non-pregnant women. CONCLUSION: Despite the physiological changes occurring during pregnancy, HIV infected pregnant women are not at higher risk of virologic failure.

Healthy child, healthy future - Speech and language therapy: Factsheet for parents 3. Talk to your child in your own language

This factsheet encourages non-English speaking parents to talk to their children in their own language.