***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: OBJECTIVE To determine the effectiveness of structured adherence counseling by pharmacists on the eradication of Helicobacter pylori when using a st and ard drug treatment regimen . DESIGN R and omized controlled clinical trial . SETTING Nonprofit group- practice health maintenance organization ( HMO ) . PARTICIPANTS HMO primary care providers referred 1,393 adult dyspeptic patients for carbon 14 urea breath testing ( UBT ) . INTERVENTIONS Those whose tests were positive for H pylori ( 23.3 % ) were provided a st and ard antibiotic regimen and r and omly assigned to receive either usual-care counseling from a pharmacist or a longer adherence counseling session and a follow-up phone call from the pharmacist during drug treatment . All subjects were given the same 7-day course of omeprazole , bismuth subsalicylate , metronidazole , and tetracycline hydrochloride ( OBMT ) . Dyspepsia symptoms were recorded at baseline and following therapy . OUTCOMES The main outcome was eradication of H pylori as measured by UBT at 3-month follow-up . Secondary outcomes were patient satisfaction and dyspepsia symptoms at 3-month follow-up . RESULTS Of the 333 participants r and omly assigned to treatment , 90.7 % completed the 3-month follow-up UBT and question naires . Overall eradication rate with the OBMT regimen was 80.5 % with no significant difference in eradication rates between the 2 groups ( P=0.98 ) . Conclusions In this study , additional counseling by pharmacists did not affect self-reported adherence to the treatment regimen , eradication rates , or dyspepsia symptoms but did increase patient satisfaction BACKGROUND Hospitalization and subsequent discharge home often involve discontinuity of care , multiple changes in medication regimens , and inadequate patient education , which can lead to adverse drug events ( ADEs ) and avoidable health care utilization . Our objectives were to identify drug-related problems during and after hospitalization and to determine the effect of patient counseling and follow-up by pharmacists on preventable ADEs . METHODS We conducted a r and omized trial of 178 patients being discharged home from the general medicine service at a large teaching hospital . Patients in the intervention group received pharmacist counseling at discharge and a follow-up telephone call 3 to 5 days later . Interventions focused on clarifying medication regimens ; review ing indications , directions , and potential side effects of medications ; screening for barriers to adherence and early side effects ; and providing patient counseling and /or physician feedback when appropriate . The primary outcome was rate of preventable ADEs . RESULTS Pharmacists observed the following drug-related problems in the intervention group : unexplained discrepancies between patients ' preadmission medication regimens and discharge medication orders in 49 % of patients , unexplained discrepancies between discharge medication lists and postdischarge regimens in 29 % of patients , and medication nonadherence in 23 % . Comparing trial outcomes 30 days after discharge , preventable ADEs were detected in 11 % of patients in the control group and 1 % of patients in the intervention group ( P = .01 ) . No differences were found between groups in total ADEs or total health care utilization . CONCLUSIONS Pharmacist medication review , patient counseling , and telephone follow-up were associated with a lower rate of preventable ADEs 30 days after hospital discharge . Medication discrepancies before and after discharge were common targets of intervention OBJECTIVE To evaluate a training workshop for community pharmacy personnel  to improve their counselling in smoking cessation based on the stage-of-change model . DESIGN A r and omised controlled trial of community pharmacies and pharmacy customers . SETTING All 76 non-city community pharmacies registered in Grampian , Scotl and , were invited to participate . Sixty-two pharmacies ( 82 % ) were recruited . SUBJECTS All the intervention pharmacy personnel were invited to attend the training ; 40 pharmacists and 54 assistants attended . A total of 492 customers who smoked ( 224 intervention , 268 controls ) were recruited during the 12-month recruitment period ( overall recruitment rate 63 % ) . MAIN OUTCOME MEASURES The perceptions of customers and pharmacy personnel of the pharmacy support and self-reported smoking cessation rates for the two groups of customers at one , four , and nine months . RESULTS The intervention customer respondents were significantly more likely to have discussed stopping smoking with pharmacy personnel , 85 % ( 113 ) compared with 62 % ( 99 ) of the controls ( p<0.001 ) . The former also rated their discussion more highly ; 34 % ( 45 ) of the intervention customers compared with 16 % ( 25 ) of the controls rated it as “ very useful ” ( p = 0.048 ) . Assuming non-responders had lapsed , one-month point prevalence of abstinence was cl aim ed by 30 % of intervention customers and 24 % of controls ( p = 0.12 ) ; four months ’ continuous abstinence was cl aim ed by 16 % of intervention customers and 11 % of controls ( p = 0.094 ) ; and nine months ’ continuous abstinence was cl aim ed by 12 % of intervention customers and 7 % of controls ( p = 0.089 ) . These trends in outcome were not affected by potential confounders ( sex , age , socioeconomic status , nicotine dependence , and type of nicotine replacement product used ) or adjustment for clustering . CONCLUSIONS The intervention was associated with increased and more highly rated counselling , and a trend toward higher smoking cessation rates , indicating that community pharmacy personnel have the potential to make a significant contribution to national smoking cessation targets OBJECTIVE To measure the effect of nurse practitioner and pharmacist consultations on the appropriate use of medications by patients . DESIGN We studied patients in the intervention arm of a r and omized controlled trial . The main trial intervention was provision of multidisciplinary team care and the main outcome was quality and processes of care for chronic disease management . SETTING Patients were recruited from a single publicly funded family health network practice of 8 family physicians and associated staff serving 10 000 patients in a rural area near Ottawa , Ont . PARTICIPANTS A total of 120 patients 50 years of age or older who were on the practice roster and who were considered by their family physicians to be at risk of experiencing adverse health outcomes . INTERVENTION A pharmacist and 1 of 3 nurse practitioners visited each patient at his or her home , conducted a comprehensive medication review , and developed a tailored plan to optimize medication use . The plan was developed in consultation with the patient and the patient 's doctor . We assessed medication appropriateness at the study baseline and again 12 to 18 months later . MAIN OUTCOME MEASURES We used the medication appropriateness index to assess medication use . We examined associations between personal characteristics and inappropriate use at baseline and with improvements in medication use at the follow-up assessment . We recorded all drug problems encountered during the trial . RESULTS At baseline , 27.2 % of medications were inappropriate in some way and 77.7 % of patients were receiving at least 1 medication that was inappropriate in some way . At the follow-up assessment s these percentages had dropped to 8.9 % and 38.6 % , respectively ( P < .001 ) . Patient characteristics that were associated with receiving inappropriate medication at baseline were being older than 80 years of age ( odds ratio [ OR ] = 5.00 , 95 % CI 1.19 to 20.50 ) , receiving more than 4 medications ( OR = 6.64 , 95 % CI 2.54 to 17.4 ) , and not having a university-level education ( OR = 4.55 , 95 % CI 1.69 to 12.50 ) . CONCLUSION We observed large improvements in the appropriate use of medications during this trial . This might provide a mechanism to explain some of the reductions in mortality and morbidity observed in other trials of counseling and advice provided by pharmacists and nurses . TRIAL REGISTRATION NUMBER NCT00238836 ( Clinical Trials.gov ) Abstract Objective To investigate the effects of compliance and periodic telephone counselling by a pharmacist on mortality in patients receiving polypharmacy . Design Two year r and omised controlled trial . Setting Hospital medical clinic . Participants 502 of 1011 patients receiving five or more drugs for chronic disease found to be non-compliant at the screening visit were invited for r and omisation to either the telephone counselling group ( n = 219 ) or control group ( n = 223 ) at enrolment 12 - 16 weeks later . Main outcome measures Primary outcome was all cause mortality  in r and omised patients . Associations between compliance and mortality in the entire cohort of 1011 patients were also examined . Patients were defined as compliant with a drug if they took 80 - 120 % of the prescribed daily dose . To calculate a compliance score for the whole treatment regimen , the number of drugs that the patient was fully compliant with was divided by the total number of prescribed drugs and expressed as a percentage . Only patients who complied with all recommended drugs were considered compliant ( 100 % score ) . Results 60 of the 502 eligible patients defaulted and only 442 patients were r and omised . After two years , 31 ( 52 % ) of the defaulters had died , 38 ( 17 % ) of the control group had died , and 25 ( 11 % ) of the intervention group had died . After adjustment for confounders , telephone counselling was associated with a 41 % reduction in the risk of death ( relative risk 0.59 , 95 % confidence interval 0.35 to 0.97 ; P = 0.039 ) . The number needed to treat to prevent one death at two years was 16 . Other predictors included old age , living alone , rate of admission to hospital , compliance score , number of drugs for chronic disease , and non-treatment with lipid lowering drugs at screening visit . In the cohort of 1011 patients , the adjusted relative risk for death was 1.61 ( 1.05 to 2.48 ; P = 0.029 ) and 2.87 ( 1.80 to 2.57 ; P < 0.001 ) in patients with compliance scores of 34 - 66 % and 0 - 33 % , respectively , compared with those who had a compliance score of 67 % or more . Conclusion In patients receiving polypharmacy , poor compliance was associated with increased mortality .  Periodic telephone counselling by a pharmacist improved compliance and reduced mortality . Trial registration International St and ard R and omised Controlled Trial Number Register : S RCT N48076318 BACKGROUND type 2 diabetes mellitus continues to increase in prevalence worldwide . Many factors have been cited as contributing to compliance , such as family and social support , education , number of tablets per dose , frequency of administration and health care provider communication . Toward these goals , the present study was developed to measure the effect offactors on glycemic control such as diabetes education by pharmacists , a diabetes disease booklet and special medication containers . MATERIAL AND METHOD A total of 360 volunteers with type 2 DM patients were recruited , participants were simple r and omized to control 180 and intervention 180 patients . Which intervention categorized to 4 groups ; all intervention groups received diabetes drug counseling by a pharmacist , one group received plus a diabetes booklet , one received plus special medical containers and the last group received all of them . The interventions were done at the 1st time of visit . Both the control and intervention groups were monitored for fasting plasma glucose and HbA1c at 0 , 3 , 6 months and glycemic level in both groups was compared . RESULTS After 3 months , mean fasting plasma glucose and HbA1c decreased wiih the intervention group vs. control group ( 152.36 + /- 39.73 to 131.52 + /- 35.22 mg% ) and ( 150.16 + /- 41.78 to 153.98 + /- 47.95 mg% ) respectively ; ( p < 0.001 ) . HbA1c level 8.16 + /- 1.44 to 7.72 + /- 1.26 vs 8.01 + /- 1.51 to 8.38 + /- 1.46 respectively ; ( p < 0.001 ) . After 6 months , mean fasting plasma glucose and HbA1c decreased with the intervention group vs. control group ( 152.36 + /- 39.73 to 145.20 + /- 46.07 mg% ) and ( 150.16 + /- 41.78 to 159.16 + /- 54.90 mg% ) respectively ; ( p < 0.013 ) . HbA1c level 8.16 + /- 1.44 to 7.91 + /- 1.27 vs. 8.01 + /- 1.51 to 8.80 + /- 1 
    Output:
    
Conclusion Pharmacist counseling is an intervention directed to patients ’ health-related needs that improve inter-professional and inter-institutional communication , by collaborating to integrate health services .