Nicole D. Gillespie

Transdermal Patch Drug Delivery Interactions with Exercise

Transdermal drug delivery systems, such as the transdermal patch, continue to be a popular and convenient way to administer medications. There are currently several medications that use a transdermal patch drug delivery system. This article describes the potential untoward side effects of increased drug absorption through the use of a transdermal patch in individuals who exercise or participate in sporting events. Four studies have been reported that demonstrate a significant increase in the plasma concentration of nitroglycerin when individuals exercise compared with rest. Likewise, several case reports and two studies have been conducted that demonstrate nicotine toxicity and increased plasma nicotine while wearing a nicotine patch in individuals who exercise or participate in sporting events compared with rest. Healthcare providers, trainers and coaches should be aware of proper transdermal patch use, especially while exercising, in order to provide needed information to their respective patients and athletes to avoid potential untoward side effects. Particular caution should be given to individuals who participate in an extreme sporting event of long duration. Further research that includes more medications is needed in this area.

Implementation of a Tool to Modify Behavior in a Chronic Disease Management Program

Chronic diseases like diabetes, hypertension, and dyslipidemia continue to be a significant burden on the US health care system. As a result, many healthcare providers are implementing strategies to prevent the incidence of heart disease and other chronic conditions. Among these strategies are proper drug therapy and lifestyle modifications. Behavior change is often the rate-limiting step in the prevention and maintenance of lifestyle modifications. The purpose of this paper is to describe a tool used to guide the progression and assess the effectiveness of a cardiovascular risk reduction program. The tool uses the Transtheoretical Model of Behavior Change to determine the readiness and confidence to change specific lifestyle behaviors pertinent to cardiovascular health. The tool aids the practitioner in developing a patient-centered plan to implement and maintain lifestyle changes and can be tailored to use in any situation requiring a behavior change on the part of the patient.

Development of a Composite Lifestyle Index and Its Relationship to Quality of Life Improvement: The CLI Pilot Study.

An important component to optimal health is quality of life (QOL). Several healthy lifestyle behaviors have independently shown to improve QOL. The simultaneous implementation of multiple lifestyle behaviors is thought to be difficult, and the current literature lacks the assessment of multiple lifestyle behaviors simultaneously with respect to the effect on QOL. This current pilot study sought to develop a method to quantify multiple lifestyle behaviors into a single index value. This value was then measured with QOL for a possible correlation. The results showed that it is possible to convert multiple raw healthy lifestyle data points into a composite value and that an improvement in this value correlates to an improved QOL. After 12 months of participation in a cardiovascular risk reduction program, study participants (N = 35) demonstrated a 37.4% (P < 0.001) improvement in the composite lifestyle index (CLI). The improved CLI demonstrated a correlation with a statistically significant improvement in how participants rated their overall health in 12 months (r = 0.701, P < 0.001) as well as the number of self-reported unhealthy days per month in 12 months (r = −0.480, P = 0.004).

Using employee experts to offer an interprofessional diabetes risk reduction program to fellow employees.

A recent increase in the incidence of diabetes and pre-diabetes is causing many employers to spend more of their healthcare benefit budgets to manage the conditions. A self-insured university in the USA has implemented an interprofessional diabetes mellitus risk reduction program using its own employee faculty and staff experts to help fellow employees manage their diabetes and pre-diabetes. The interprofessional team consists of five pharmacists, a dietitian, an exercise physiologist, a health educator and a licensed mental health practitioner. In addition, the participants physician serves as a consultant to the program, as does a human resources healthcare benefits specialist and a wellness coordinator. The volunteer program takes place at the worksite during regular business hours and is free of charge to the employees. The faculty and staff delivering the program justify the cost of their time through an interprofessional educational model that the program will soon provide to university students.

Resveratrol: Potential Benefits on Aging and Heart Disease

Resveratrol is a polyphenolic compound found in many products commonly consumed in the American diet. The reported benefits of resveratrol are broad and include antiaging effects, antioxidant effects, anticancer effects, neuroprotective effects, and an array of cardiovascular benefits such as improved cholesterol profiles, reduced atherosclerosis, improved glucose homeostasis, decreased blood pressure, and reduced ischemia– reperfusion injury. The current article discusses the literature relating the dosing, safety, and effectiveness of resveratrol for extended life span and improved cardiovascular health. Additionally, recommendations for use in clinical practice are discussed.

Reducing Inflammation: Statins or Lifestyle?

An elevated C-reactive protein level is an inflammatory marker associated with an increased risk in cardiovascular disease. Regular long-term exercise, a cholesterol-lowering diet (a diet low in saturated fat and high in viscous fiber and plant sterols), and statin pharmacotherapy have all been shown to reduce C-reactive protein levels. The purpose of this article is to describe the research available regarding lowering of C-reactive protein levels and reducing incidence of cardiovascular disease. Specifically, the article will compare the use of statin therapy, regular physical activity, and a cholesterol-lowering diet. The effectiveness of each intervention will be evaluated along with the risks and benefits associated with treatment.