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Which interventions improve the safety and effectiveness of medicines use?
Strategies that appeared to improve medicines use included medicines self-monitoring and self-management programmes, while simplified dosing regimens and directly involving pharmacists in medicines management (eg, medicines reviews) appeared promising. Other strategies, such as delayed antibiotic prescriptions; practical management tools (eg, reminders, packaging); education or information combined with other strategies (eg, self-management skills training, counselling); and financial incentives, might also have had some positive effects, but their effects were less consistent. Some strategies (eg, directly observed therapy) might have been ineffective. Other strategies, such as providing information or education alone, had variable effects, being ineffective to change some outcomes (eg, medicines adherence) but improving others (eg, knowledge, which is key for informed medicines choices).
No single strategy improved all medicines use outcomes across all diseases, populations or settings. Reviews often had methodological limitations at study level, review level or both.
Medicines are a cornerstone of treatment for many health problems. Many strategies exist to help people use medicines safely and effectively, but research in the area is poorly organised across diseases, populations and settings.
Ryan R et al. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews. Cochrane Reviews. 2014, Issue 4. Art. No.: CD007768.DOI: 10.1002/14651858.CD007768.pub3. This review contains 75 systematic reviews.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
Otolaryngologist, head and neck surgeon Francis T. Hall discusses the evaluation of thyroid nodules, which primarily aims to determine the likelihood of malignancy. He then reviews the treatment of thyroid nodules and thyroid cancer, including recent advances in management
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