Chapters authored
Pneumonia: Drug-Related Problems and Hospital Readmissions
Pneumonia is one of the most common infectious diseases and the fourth leading cause of death globally. According to US statistics in 2019, pneumonia is the most common cause of sepsis and septic shock. In the US, inpatient pneumonia hospitalizations account for the top 10 highest medical costs, totaling $9.5 billion for 960,000 hospital stays. The emergence of antibiotic resistance in the treatment of infectious diseases, including the treatment of pneumonia, is a globally alarming problem. Antibiotic resistance increases the risk of death and re-hospitalization, prolongs hospital stays, and increases treatment costs, and is one of the greatest threats in modern medicine. Drug-related problems (DRPs) in pneumonia - such as suboptimal antibiotic indications, prolonged treatment duration, and drug interactions - increase the rate of antibiotic resistance and adverse effects, thereby leading to an increased burden in treatment. In a context in which novel and effective antibiotics are scarce, mitigating DRPs in order to reduce antibiotic resistance is currently a prime concern. A variety of interventions proven useful in reducing DRPs are antibiotic stewardship programs, the use of biomarkers, computerized physician order entries and clinical decision support systems, and community-acquired pneumonia scores.
Part of the book: Pneumonia
Drug-Related Problems in Coronary Artery Diseases
Coronary artery disease (CAD) remains the leading cause of mortality among cardiovascular diseases, responsible for 16% of the world’s total deaths. According to a statistical report published in 2020, the global prevalence of CAD was estimated at 1655 per 100,000 people and is predicted to exceed 1845 by 2030. Annually, in the United States, CAD accounts for approximately 610,000 deaths and costs more than 200 billion dollars for healthcare services. Most patients with CAD need to be treated over long periods with a combination of drugs. Therefore, the inappropriate use of drugs, or drug-related problems (DRPs), can lead to many consequences that affect these patients’ health, including decreased quality of life, increased hospitalization rates, prolonged hospital stays, increased overall health care costs, and even increased risk of morbidity and mortality. DRPs are common in CAD patients, with a prevalence of over 60%. DRPs must therefore be noticed and recognized by healthcare professionals. This chapter describes common types and determinants of DRPs in CAD patients and recommends interventions to limit their prevalence.
Part of the book: Coronary Artery Bypass Grafting
Medication Adherence in Cardiovascular Diseases
Cardiovascular disease is a significant cause of death globally. While effective long-term medications that reduce the risk of morbidity and mortality related to cardiovascular disease are readily available, nonadherence to prescribed medications remains a significant reason for suboptimal management. Consequently, this might lead to increased morbidity and mortality and healthcare costs. Medication nonadherence causes are myriad and complicated, with factors at the patient, healthcare provider, and health system levels. Many clinical trials have investigated interventions to target these factors for improving medication adherence, including improving patient education, testing behavioral interventions, implementing medication reminder tools, reducing medication costs, utilizing social support, utilizing healthcare team members, and simplifying medication dosing regimens. This book chapter describes factors influencing medication adherence and highlights the impact of varying levels of adherence on patients’ clinical and economic outcomes. We also summarize interventions for improving medication adherence in cardiovascular disease.
Part of the book: Novel Pathogenesis and Treatments for Cardiovascular Disease