Journal of The American Academy of Nurse Practitioners 

About: Journal of The American Academy of Nurse Practitioners is an academic journal. The journal publishes majorly in the area(s): Health care & Population. It has an ISSN identifier of 1041-2972. Over the lifetime, 1516 publications have been published receiving 30348 citations.

Treating tobacco use and dependence.

Abstract: This month, the Clinical Practice Guideline (CPG) column reviews the recently published guideline, Treating Tobacco Use and Dependence. This set of recommendations is available in a quick reference format and a more comprehensive clinician's guide that includes detailed information on the methodology and references used to develop the guidelines. Both are available in electronic and hard copy versions through a variety of sources, including the National Guidelines Clearinghouse, the Centers for Disease Control and Prevention, and the National Cancer Institute.

Caregiver burden among dementia patient caregivers: a review of the literature.

Abstract: Purpose: To identify current evidence of factors influencing dementia-related caregiver burden (CB), describe patient and caregiver characteristics associated with CB, and describe evidence-based interventions designed to lessen the burden of caregiving. Data sources: Comprehensive literature review of Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Psych Info was performed for the years 1996–2006 of peer-reviewed journals using keywords CB and dementia. Conclusion: Dementia caregiving has been associated with negative effects on caregiver health and early nursing home placement for dementia patients. Many factors influence the impact of the caregiving experience such as gender, relationship to the patient, culture, and personal characteristics. Although various interventions have been developed with the goal of alleviating CB, evidence suggests that individually developed multicomponent interventions including a diversity of services will decrease burden, improve quality of life, and enable caregivers to provide at-home care for longer periods prior to institutionalization. Implications for practice: The ability to properly assess the dementia patient–caregiver dyad related to CB is critical to decreasing its negative physical and psychological health outcomes. Appropriately tailored interventions can improve the health and well-being of both caregiver and patient.

Guidelines for the Management of Rheumatoid Arthritis 2002 Update

Abstract: Rheumatoid arthritis (RA) is a progressive polyarthritis that is responsible for over nine million office visits annually. It is likely that most nurse practitioners will care for one or more patients with RA because approximately 1% of the adult population is affected by this disabling disorder. The guideline reviewed in this month's column describes the recommended care of patients who have been previously diagnosed with RA.

Patient-centered care and adherence: Definitions and applications to improve outcomes

Abstract: Purpose: The implementation of patient-centered care (PCC) has been hampered by the lack of a clear definition and method of measurement. The purpose of this review is to identify the fundamental characteristics of PCC to clarify its definition, propose a method for measurement of PCC, and recommend effective PCC practices. Data sources: Review of literature related to PCC, adherence and communication from Cinahl, PubMed Academic Search Premier, and Cochrane Library databases. Conclusions: Research has shown that patient-centered interactions promote adherence and lead to improved health outcomes. The fundamental characteristics of PCC were identified as (a) patient involvement in care and (b) the individualization of patient care. The use of a numeric rating scale to measure the presence of these characteristics allows quantification from the patient perspective. Effective PCC practices were related to communication, shared decision making, and patient education. Implications for practice: PCC is a measure of the quality of health care. Understanding the characteristics of PCC facilitates its implementation and measurement. Promoting PCC activities will improve adherence and encourage patient responsibility for health status.

Polypharmacy in the elderly: A literature review

Abstract: Purpose To review the body of literature addressing polypharmacy in individuals aged 60 years and older to (a) determine primary care providers’ definition of polypharmacy, (b) explore how polypharmacy was assessed in primary care, and (c) seek tested interventions that address polypharmacy. Data sources A systematic review of electronic bibliographic databases (e.g. EBSCOHost, InfoTrac, OVID, FirstSearch, and FirstSearch Deluxe) utilizing the search terms “polypharmacy,”“polypharmacy and elderly,”“polypharmacy and research,” and “multiple medications” for the period January 1991 to October 2003 was completed. The search was supplemented with online site searches of relevant journals and review of reference lists of each article. Conclusions Results of the literature review revealed that polypharmacy continues to be a significant issue and little research has been conducted regarding the methods primary care providers utilize to assess polypharmacy. Also, there is a gap in the literature regarding the interventions implemented by primary care providers to address polypharmacy. Implications for practice The following definition of polypharmacy in clinical practice might be more practical: the use of medications that are not clinically indicated. Selecting appropriate limits for numbers of medications may be counterproductive in populations with multiple comorbidities.