Notice bibliographique
Résumé
OVER THE PAST 10 YEARS I HAVE GIVEN A NUMBER OF TALKS TO pharmacists about gastroesophageal reflux disease (GERD). During that time, I have wondered how well pharmacists have been able to take that knowledge and apply it to making a difference in the care of their patients. I am very much a neophyte when it comes to theoretical and formal education on the topic of knowledge translation. Rather, I am more of an old goat who teaches by experience and knowledge of the literature. My friends who know this area much better have provided me with some references on the science of knowledge translation to guide me. As defined by the Canadian Institutes of Health Research, knowledge translation is “the exchange synthesis and ethically sound application of knowledge — within a complex system of interactions among researchers and users....”1 Those of us who provide education, formally or informally, try to transfer knowledge in such a way that those receiving the information can implement it in their practice. Knowledge translation implies that there is a personal relationship between the information provider and the person targeted to apply that knowledge. This relationship is based on trust. Knowledge translation is more than just continuing education — it focuses on health outcomes and changing behaviours. So why have I chosen to digress down the path of knowledge translation for these guidelines on GERD? Well, my biggest fear is that all the information in this supplement may not be put into practice by the pharmacists who receive it. Ask yourself, do you know patients on chronic acid suppression therapy who sound like good candidates for intermittent or on-demand therapy?2 Everyone dispensing these agents should be able to think of a number of patients who sound like good candidates. Are you going to call the prescribers or talk to the patients to get them to try different therapy? You may run the risk of unhappy physicians or upset patients if you suggest this. My sense of the ambulatory care setting is that physicians may consider on-demand therapy an acceptable option but very few are advising patients to pursue it. It is an excellent area for pharmacists to take a proactive role in optimizing GERD therapy. In order to do that, most pharmacists will need to feel comfortable with the benefits and risks associated with making an active intervention. As knowledge providers, we hope that this supplement and the additional resources we cite will give you sufficient information regarding these benefits and risks, as well as inspire you enough that you will recommend these changes. Besides on-demand therapy, in what other key areas of GERD management can pharmacists take a more proactive role in patient care? First, pharmacists should ensure that patients with signs of serious gastrointestinal pathology obtain timely medical care. How? By talking to the patient and, on occasion, the prescriber. There are many other areas of GERD management (some controversial) that you might also want to ponder, such as: • When can patients on a twice-a-day proton pump inhibitor (PPI) be stepped down to a once-a-day PPI? • Should pharmacists recommend that patients with long-standing GERD talk to their physician about getting an endoscopy to look for Barrett’s esophagus? • Should pharmacists recommend that patients talk to a physician about acid suppressive therapy for asthma, chronic cough or other potential respiratory manifestations of GERD? • What advice should pharmacists give to patients asking about the risk of pneumonia or osteoporosis with PPI use? More than anything, I hope this supplement will inspire you to make an effort to acquire additional knowledge in key areas of GERD management. Hopefully, it will lead to more inspired and confident pharmacists contributing to patient care. ■
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,074 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,004 |
| Communication savante | 0,009 | 0,015 |
| Science ouverte | 0,001 | 0,005 |
| Intégrité de la recherche | 0,009 | 0,016 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,037 | 0,026 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».