Improper Administration Research Articles

Mexiletine-Induced Esophageal Ulceration: Two Case Reports and a Review of the Literature

Background and Clinical Significance: Mexiletine is a class 1B antiarrhythmic drug commonly prescribed for ventricular arrhythmias and neuropathic pain. It works as a blocker of the sodium channel that modulates cardiac conduction and reduces aberrant nerve signaling. While it is generally well tolerated, gastrointestinal side effects, such as nausea, vomiting, and abdominal pain, are relatively common. Esophagitis and esophageal ulcerations have been described as rare side effects; however, they are poorly documented in the literature. Esophageal ulceration induced by oral medications, termed pill esophagitis, occurs due to prolonged contact between the medication and the esophageal mucosa. Factors contributing to this phenomenon include improper administration, such as swallowing without sufficient water, taking medication before lying down, or inherent irritant properties of the drug itself. Mexiletine-induced esophageal ulceration has not been extensively reported, making such cases clinically significant and worth investigating. In particular, the prompt diagnosis of mexiletine-induced esophageal injury is essential for timely treatment initiation or the discontinuation of the drug, preventing complications such as bleeding, strictures, or perforation. Altogether, these actions are important to prevent the onset of potentially serious complications, such as bleeding, strictures, and the perforation of the esophagus. Case Presentation: Two different patients were included in this case report on mexiletine-induced esophageal ulceration: a 78-year-old woman affected by primary dilated cardiomyopathy and atrial fibrillation with high ventricular response and a 19-year-old man affected by dilated cardiomyopathy and systemic sclerosis. Conclusions: This case report underscores the importance of recognizing mexiletine-induced esophageal ulceration, and it advocates for timely diagnosis and management to optimize patient outcomes.

An ayurvedic approach to the management of Fissure-in-ano: A case Study

Background: In today's sedentary lifestyle, coupled with unhealthy dietary habits and stress, digestive disorders such as Fissure-in-ano have become prevalent. Fissure-in-ano is a longitudinal tear in the anal canal, most commonly occurring in the posterior midline, characterized by severe pain, burning sensation, and occasional bleeding. In Ayurveda, this condition aligns with Parikartika, often caused by improper administration of therapies like Basti (enema) or Virechana (purgative). Case Study: It explores the efficacy of per rectal Administration of Kaseesadi Taila for the management of Parikartika in a 35-year-old female patient presenting with anal pain, burning, and rectal bleeding post-defecation. Materials & Methods: It involved daily rectal Administration of Kaseesadi Taila (10ml) for 7 days. Results: It showed significant improvement by day 3, with complete relief of symptoms and healing of the fissure by day 7. The therapeutic benefits of Kaseesadi Taila are attributed to its Lekhana (scraping), Shodhana (cleansing), and Ropana (healing) properties, which promote wound healing, reduce inflammation, and facilitate easier bowel movements. Conclusion: Kaseesadi Taila is an effective, cost-efficient treatment for fissure-in-ano, providing significant symptom relief without the drawbacks of conventional surgical interventions.

Modelling an Integrated Fuzzy Based Decision Support System for an Anaesthetist during Pre-Operative Clinical Assessment

Pre-operative clinical assessment is a crucial responsibility for every anaesthetist before any major medical procedure. This assessment evaluates a patient’s suitability for anaesthesia and their overall physical condition to endure the stresses of surgery. This is especially vital given recent data linking many surgical deaths to improper anaesthesia administration, with a mortality rate of 20 deaths per 10,000 anaesthetics in developed countries. This paper proposes an integrated fuzzy-based decision support system to assist anaesthetists during pre-operative clinical assessments. The approach combines neural network algorithms to classify and normalize input data, which then feeds into a fuzzy logic system for multi-variable decision-making analysis. To evaluate this decision support system, patient anaesthesia assessment datasheets were sourced from Ibom Multi Specialist Hospital in Akwa Ibom State, along with an online dataset from electronic anaesthesia records (MetaVision, 1MDsoft) of adult patients undergoing surgery at a major academic medical center. The study focused on patients over 18 years old undergoing non-cardiac surgeries, taking into account factors such as urgency and type of anaesthesia. The next step involves a decision-making process that assesses patient suitability for surgical anaesthesia based on established rules and membership functions developed through the fuzzy inference system. The results from this integrated decision support system were found to be reliable and consistent with anaesthetists’ assessments. The system achieved an accuracy of 91.46%, as indicated by a ROC curve comparing sensitivity and specificity, demonstrating its effectiveness in evaluating patients for medical procedures. To enhance the training of future anaesthesiologists, the introduction of artificial intelligence into the curriculum is recommended, along with the application of evolutionary algorithms like genetic algorithms and programming. These strategies aim to significantly enrich the decision-making processes employed by anaesthetists. Keywords: Fuzzy logic, neural network, anaesthesia, artificial intelligence

Impact of Traditional Chinese Medicine Antioxidants on Oxidative Stress and Drug-Induced Liver Injury: A Review.

The liver serves as a crucial organ for detoxification and exhibits a robust regenerative capacity. The improper administration of pharmaceuticals frequently results in drug-induced liver injury (DILI), a condition closely associated with the overproduction of reactive oxygen species (ROS). In addressing DILI, Traditional Chinese Medicine (TCM) often employs plant-based remedies, which have demonstrated favorable therapeutic outcomes. These plant-based treatments are typically rich in antioxidants capable of neutralizing ROS. However, there is a notable lack of comprehensive reviews that synthesize the therapeutic effects of antioxidants derived from medicinal plants on DILI. The present review starts by exploring ROS generation and clearance in human health, then outlines DILI characteristics and treatments, emphasizing its strong link to oxidative stress. Furthermore, we discuss the properties and classification of antioxidants found in plant-based pharmaceuticals, with a particular emphasis on the synergistic effects of these antioxidants and their mechanisms for repairing DILI. Finally, we provide a summary of commonly utilized medicinal plants from TCM for the treatment of DILI. In conclusion, this article explores the future prospects and potential solutions for treating DILI using antioxidants found in plant-based drugs derived from TCM. The objective of this review is to examine the role of antioxidants in TCM and their impact on DILI.

Evaluating the Antidote Action of Nimbuk Swarasa and Peya in Jayapala Toxicity: A Critical Review

Jayapala (Myristica fragrans), a plant-based toxin, is recognized for its therapeutic importance despite its toxic properties. Improper administration or insufficient purification can lead to adverse effects, including gastrointestinal irritation, salivation, and even death. The management of Jayapala poisoning is well-documented in classical Ayurvedic texts, with specific antidotes such as Nimbuk Swarasa (lemon juice) and Peya (rice water) being highlighted. This review critically evaluates the mode of action of Nimbuk Swarasa and Peya in Jayapala poisoning, to establish their therapeutic efficacy and practical applicability as antidotes. The study highlights the antidotal potential of Nimbuk Swarasa and Peya in enhancing digestive function, alleviating symptoms, and providing a cost-effective solution for managing Jayapala toxicity. The findings indicate that these preparations not only mitigate harmful effects but also embody a practical approach to addressing accidental poisoning

Combining Mesoporous Bioactive Glass Nanoparticles (MBGNs) with Essential Oils to Tackle Bacterial Infection and Oxidative Stress for Bone Regeneration Applications.

Bacterial infectious diseases remain one of the significant challenges in the field of bone regeneration applications. Despite the development of new antibiotics, their improper administration has led to the development of multiresistant bacterial strains. In this study, we proposed a novel approach to tackle this problem by loading clove oil (CLV), a natural antibacterial compound, into amino-functionalized mesoporous bioactive glass nanoparticles (MBGNs). The scanning electron microscopy images (SEM) revealed that amino-functionalization and CLV loading did not affect the shape and size of the MBGNs. The successful grafting of the amino groups on the MBGNs' surface and the presence of CLV in the material were confirmed by attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy and zeta potential measurements. The increased CLV concentration led to a higher loading capacity, encapsulation efficiency, and antioxidant activity. The in vitro CLV release profile exhibited an initial burst release, followed by a controlled release over 14 days. The loading of CLV into MBGNs led to a stronger antibacterial effect against E. coli and S. aureus, while MG-63 osteoblast-like cell viability was enhanced with no morphological changes compared to the control group. In conclusion, the CLV-MBGNs nanocarriers showed promising properties in vitro as novel drug delivery systems, exploiting essential oils for treating bone infections and oxidative stress.

8752 The Ethical Concerns Of Improper Semaglutide Administration After Acquisition From A Compounded Pharmacy

8752 The Ethical Concerns Of Improper Semaglutide Administration After Acquisition From A Compounded Pharmacy

Evaluation of Proper Treatment Delivery and Time of Initiation of Treatment After Hospitalization by Nursing Staff in Kuwait Teaching Hospital Peshawar

Background: Medication errors are a pressing public health concern, leading to adverse outcomes and substantial healthcare costs. This study examines the incidence of drug administration errors, emphasizing the critical importance of timely treatment initiation. Delays in treatment pose significant risks to patient safety, highlighting the need for improved medication delivery protocols and enhanced patient care practices in hospitals. Methods: A prospective cross-sectional study in a Kuwait teaching hospital's paediatrics unit, involving 120 participants, utilized non-probability convenient sampling. Data collection from patient files and attendants utilized a specially designed form. Data was collected by observing one patient for 24 hours. Participants were instructed to retain medication vials. Permission was obtained from the department head, and oral informed consent was secured. No personal identifiers were recorded. Interventions included workshops and performance evaluations, leading to observed improvement. Data analysis was conducted using SPSS version 22. Results: Baseline data showed variations in dose administration across departments, with notable discrepancies in proper drug administration alignment with prescriptions. Treatment initiation delays were significant, and patient satisfaction was moderate. Post-intervention, improvements were observed in dose administration, although treatment initiation delays persisted. However, patient satisfaction notably increased following interventions. Conclusion: Our study highlighted several critical issues in medication administration, such as delays in treatment initiation, improper dose administration, and missed doses. Implementing training sessions and workshops for nursing staff will ensure the best practices and they can manage their responsibilities more effectively.

Deep learning classification of drug-related problems from pharmaceutical interventions issued by hospital clinical pharmacists during medication prescription review: a large-scale descriptive retrospective study in a French university hospital

ObjectivesPharmaceutical interventions are proposals made by hospital clinical pharmacists to address sub-optimal uses of medications during prescription review. Pharmaceutical interventions include the identification of drug-related problems, their prevention and resolution....

Antibiotic Prescribing Practices for Upper Respiratory Tract Infection Among Clinical Officers at Kiambu County

Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.

Examining antibiotic use in Kenya: farmers’ knowledge and practices in addressing antibiotic resistance

BackgroundAntibiotics hold the promise of mitigating the spread of livestock diseases while enhancing productivity. However, there is global concerns surrounding the improper handling and administration of antibiotics, which has led to an alarming rise in antimicrobial resistance (AMR). Kenya is currently listed as an AMR hotspot. This study assesses farmers’ knowledge and practices on antibiotics in livestock production, knowledge on AMR as well as factors influencing farmers’ knowledge of antibiotic safety and resistance, and antibiotics use.MethodsA across-sectional, quantitative survey was employed with 319 farming households in five counties in Kenya. Multivariate regression analysis was used to identify explanatory factors.ResultsAbout 80% of households use antibiotics in their livestock, and 58% administer the antibiotics themselves. The vast majority of farmers buy antibiotics without a prescription. Antibiotics are used for both therapeutic and non-therapeutic purposes, the latter mainly in form of growth promoters and feed enhancers in poultry. The withdrawal periods reported by farmers are shorter than the officially recommended periods. Although the majority of farmers reported risky antibiotic practices, most (76%) were well aware of bacterial AMR. Nineteen of 21 knowledge statements on AMR and safe use of antibiotics were answered correctly by 55–89% of respondents, indicating considerable farmer knowledge on different aspects of antibiotics risk, while certain knowledge gaps remain. Number of livestock owned was the factor most positively influencing farmers’ knowledge on AMR and safe use.ConclusionKenya has made notable progress towards creating knowledge and awareness of farming communities on the risks and requirements associated with antibiotic use in livestock. Nonetheless, farmers’ antibiotics practices continue to constitute considerable risk of further AMR development. This shows that knowledge is not enough to ensure fundamental behavioral change. There needs to be an enabling environment driven by (1) effective policy interventions and enforcement to ensure compliance with set guidelines for antibiotic use; (2) research on and deployment of alternatives, such as probiotics, vaccinations and disease prevention measures, (3) continued public awareness raising and education using multiple channels to reach farmers and, (4) strengthened cross-sector, multi-stakeholder collaboration to address the multi-dimensional complexities of AMR.

Septicemic salmonellosis in suckling piglets resulting from improper intramuscular administration of an oral vaccine.

We describe an unusual outbreak of mortality in suckling piglets following the misadministration of an oral vaccine against Salmonella Typhimurium and Salmonella Choleraesuis. Within 3-48 h of vaccination of a batch of ~700 piglets, ~300 developed marked swelling in the dorsal neck region, respiratory distress, fever, recumbency, and apathy. In total, ~100 died, and 4 were submitted for autopsy. Gross and microscopic lesions consisted of focally extensive areas of purple discoloration in the skin of the cervical region, associated with edema and hemorrhage in the subcutis and muscles. Additionally, there was interstitial pneumonia with marked interlobular edema and mild fibrinous pleuritis. Aerobic bacterial culture identified Salmonella Typhimurium (3 cases) and Salmonella Choleraesuis (1 case) in samples of skeletal muscle and lung and from pleural swab samples. Marked immunostaining against Salmonella spp. was observed in the skeletal muscle of the cervical region, as well as in blood vessels and macrophages from the lung, liver, spleen, and kidney. We concluded that inappropriate intramuscular administration of an oral vaccine against Salmonella resulted in septicemia and death in a batch of piglets.

The lived experiences of mother's caring for children with uncontrolled asthma: A qualitative study.

Childhood-onset asthma is a chronic respiratory disease that profoundly impacts patients, their families, and healthcare systems. This study explores the lived experiences, challenges, and perceptions of mothers in managing asthma, controlling symptoms, and maintaining the quality of life for their children with asthma in Palestine. A qualitative descriptive design through semi-structured interviews was used in this study. Purposive sampling was used to identify mothers who have children with severe uncontrolled asthma in the four public hospitals with pediatric units in the West Bank, Palestine. Mothers of children with scored below 15 on the asthma control test were included in the study. The data were analyzed using an analytical framework following a thematic analysis through the NVivo 11. A total of 20 mothers participated in interviews wherein they delineated the most important challenges negatively affecting asthma management from mothers' perspectives. These challenges encompassed frequent emergency room visits, improper medication administration practices, and limitations in physical activity. The mothers expressed concerns regarding asthma control, including anxieties concerning the chronicity of the illness, adverse effects of medications, and susceptibility to weather fluctuations. The main themes that emerged from the data included reduced quality of life for the child, parental responsibility for monitoring triggers, symptoms, and medications, challenges in asthma management, apprehensions regarding asthma control, and strategies for enhancing asthma management. This study emphasizes the pressing need for targeted interventions to address asthma management, environmental triggers, and psychosocial disruptions related to asthma in children with asthma to enhance the quality of life and asthma control. This study highlights the importance of developing strategies that provide mothers with the appropriate information and tools to navigate the complexities of caring for a child with asthma.

Evaluasi penggunaan antibiotik pada neonatus di NICU rumah sakit umum milik pemerintah daerah Banyumas

Infection is one of the leading causes of death in neonatal patients. One of the causes of these infectious diseases is bacteria, so antibiotics are the primary therapy in treating infections. The harmful effects of improper administration of antibiotics are pathogenic bacterial resistance, unwanted drug reactions, and inefficient treatment costs. The purpose of this study was to evaluate the quality of antibiotic use in neonatal patients treated in the Banyumas District Government Hospital NICU from December 2019 to March 2020 by using the Gyssens flow criteria and knowing the outcome of antibiotic use. This research is descriptive and observational. Data obtained from medical records and patient monitoring data with prospective data collection techniques. The inclusion criteria of this study were neonatal patients who were admitted to the NICU and received antibiotics for prophylactic and curative treatment. Total respondent for this study is 56 patients. The Gyssens flow criteria evaluation results were obtained from 53 medical records (94%)tegorized in category 0. There is one medical record each categorized in categories IV D (2%), IV B (2%), and III A (2%). Most of the use of antibiotics is rational. Antibiotics are not a determining factor for the outcome of patients with the same diagnosis and laboratory test results.

Role of Oxacillin Susceptibility Testing Strategy in Changing Scenario of mecA Positive Staphylococcus aureus Isolates (OS-MRSA) Detection

Staphylococcus aureus strains that are mecA and PBP2a positive but phenotypically susceptible to oxacillin are becoming more and more abundant, according to research from all around the world. The oxacillin susceptibility of Staphylococcus aureus (OS-MRSA) contributes to consequent treatment-failure due to misidentification by conventional susceptibility tests. Therefore, the objective of the current study was to ascertain the prevalence of OSMRSA in a tertiary care facility located in Mysore, South India. 395 MRSA isolates collected from diverse clinical samples were included in this lab-based prospective investigation. These isolates were tested using an oxacillin 1μg disc phenotypically by standard disc diffusion test, and simultaneously MIC to Oxacillin was determined from Vitek2 systems. Additionally, MRSA specific mecA gene detection was applied to these isolates in order to confirm their MRSA status genotypically. PCR findings demonstrate that 65% of the isolates were MRSA. The vitek2 system detected 4.06% OS-MRSA isolates with an oxacillin MIC of ≤2µg/ml. The disc diffusion method identified a total of 13.75% isolates as oxacillin sensitive and 10% isolates were oxacillin intermediately sensitive. Oxacillin sensitivity was shown for 1.87% of the mecA-positive MRSA isolates using the VITEK2 and disc diffusion techniques. This analysis found isolates with lower oxacillin MICs but relatively reduced OS-MRSA incidence. Using an oxacillin disc for routine laboratory MRSA detection might occasionally produce false negative results, which can result in improper antibiotic administration and treatment failure. In order to distinguish OS-MRSA from MRSA, it is crucial to combine phenotypic and genotypic techniques.

Adhesive Capsulitis Secondary to COVID-19 Vaccination - A Case Series.

Shoulder injury related to vaccine administration (SIRVA) is a group of pathologies defined by pain and stiffness after intramuscular administration of vaccine to the upper arm and has been reported after COVID-19 vaccination. We aim to discuss its pathophysiology, clinical presentation, treatment and outcomes. We retrospectively identified patients presenting with adhesive capsulitis within four weeks of administration of COVID-19 vaccine to the affected arm at our tertiary institution from March 2021 to December 2022. Based on the above criteria, we identified seven cases of adhesive capsulitis, comprising one male and six female patients, with average age of 60 years. We present initial symptoms, signs and the duration from when the vaccine was administered. We have highlighted our treatment strategies as well as the clinical and functional outcomes reported by these patients after treatment. We have reported improvement in both Visual Analogue Scale (VAS) and range of motion (ROM) in all our patients after non-surgical management which included physiotherapy and, in some cases, hydrodilatation. SIRVA related adhesive capsulitis is rare and under-reported with limited information in current literature. This study highlights that adhesive capsulitis is a potential complication arising from improper COVID-19 vaccine administration and reinforces traditional wisdom of administering vaccinations on the non-dominant arm. Conservative treatment strategies appear to be effective, particularly hydrodilatation combined with physiotherapy, and patients are expected to have a good return of function.

Double vision due to lateral rectus injury after cosmetic botulinum toxin injections.

Facial intramuscular injections of Botulinum toxin (BoNT) injections are among the most common cosmetic procedures in dermatology. Rarely, serious adverse reactions such as blepharoptosis, diplopia and periorbital hematoma may occur with improper administration technique. Here we report a case of painless diplopia 5 weeks post-BoNT injection for 'crow's feet' likely due to inadvertent BoNT diffusion into the lateral rectus muscle causing a temporary palsy. This case aims to raise awareness of proper cosmetic BoNT injection techniques in the periorbital area to avoid ophthalmic complications.

ARGs Detection in Listeria Monocytogenes Strains Isolated from the Atlantic Salmon (Salmo salar) Food Industry: A Retrospective Study.

Among bacterial foodborne pathogens, Listeria monocytogenes represents one of the most important public health concerns in seafood industries. This study was designed as a retrospective study which aimed to investigate the trend of antibiotic resistance genes (ARGs) circulation in L. monocytogenes isolates identified (in the last 15 years) from Atlantic salmon (Salmo salar) fresh and smoked fillets and environmental samples. For these purposes, biomolecular assays were performed on 120 L. monocytogenes strains collected in certain years and compared to the contemporary scientific literature. A total of 52.50% (95% CI: 43.57-61.43%) of these samples were resistant to at least one antibiotic class, and 20.83% (95% CI: 13.57-28.09%) were classified as multidrug resistant. Concerning ARGs circulation, tetracycline (tetC, tetD, tetK, tetL, tetS), aminoglycoside (aadA, strA, aacC2, aphA1, aphA2), macrolide (cmlA1, catI, catII), and oxazolidinone (cfr, optrA, poxtA) gene determinants were majorly amplified. This study highlights the consistent ARGs circulation from fresh and processed finfish products and environmental samples, discovering resistance to the so-called critical important antimicrobials (CIA) since 2007. The obtained ARGs circulation data highlight the consistent increase in their diffusion when compared to similar contemporary investigations. This scenario emerges as the result of decades of improper antimicrobial administration in human and veterinary medicine.

Identifying a list of healthcare ‘never events’ to effect system change: a systematic review and narrative synthesis

BackgroundNever events (NEs) are patient safety incidents that are preventable and so serious they should never happen. To reduce NEs, several frameworks have been introduced over the past two decades;...

Best Practices for FACE-Q Aesthetics Research: A Systematic Review of Study Methodology.

The FACE-Q Aesthetics module is a validated patient-reported outcome measure (PROM) that evaluates perspectives on facial aesthetic treatments. Improper administration and poor study methodology can compromise the validity and interpretation of this PROM. This systematic review sought to evaluate the administration and scoring of the FACE-Q Aesthetics scales within the literature. A search of Ovid Medline, Embase, Cochrane, and Web of Science was performed on December 20, 2022 with the assistance of a health-research librarian (CRD42022383676). Studies that examined facial aesthetic interventions using the FACE-Q Aesthetics module as a primary or secondary outcome measure were included for analysis. There were 114 studies included. The Face Overall (n=52, 45.6%), Psychological (n=45, 39.4%), and Social (n=43, 37.7%) scales were most frequently reported. Errors in FACE-Q administration were identified in 30 (26.3%) studies. The most common error was the presentation of raw ordinal scores rather than the converted Q score (n=23). Most studies reported a time horizon for their primary analysis (n=76, 66.7%); however, only four studies provided a rationale for this selection. Sample size calculations for the primary outcome were rarely performed (n=9, 7.9%). There continues to be limitations in PROM administration and the quality of articles that report FACE-Q Aesthetic scale data. The authors suggest that future investigators using the FACE-Q refer to the User's Guide regarding administration and scoring of this scale, report a rationale for the study time horizon and provide an a priori sample size calculation for the primary outcome of interest.