Improve Patient Compliance Research Articles

Predicting skin permeation-enhancing effect of fixed oils using saturated to unsaturated fatty acid ratio content

Background: Transdermal drug delivery is non-invasive and advantageous as it improves patient compliance.
 Objective: This study evaluated the effect of varying ratios of saturated to unsaturated fatty acids in fixed oils on the permeation of ibuprofen across pig dorsal skin.
 Methods: The solubility of ibuprofen in soybean oil, theobroma oil, and shea butter (fixed oils) was evaluated and in vitro skin permeation studies were conducted using Franz diffusion cells.
 Results: A significant difference in permeability parameters, such as flux and effective skin permeability, in the different formulations was observed. Skin permeation depended on the ratio of saturated to unsaturated fatty acids. It also depended on the type and concentration of individual saturated and unsaturated fatty acids present in the fixed oils. The skin permeation of ibuprofen increased with an increasing ratio of palmitic acid (PA) to oleic acid (OA) concentrations. The highest flux was obtained in the theobroma oil formulation, with a PA:OA ratio of 0.78. The lowest flux was obtained in the shea butter formulation, with a PA:OA ratio of 0.09. The PA:OA ratio was 0.46 in the soybean oil formulation.
 Conclusion: These results suggest that the ratio of saturated to unsaturated fatty acids in fixed oils could be used as a model for predicting the rate of skin permeation of drugs in oil-based formulations. Depending on the desired rate of drug permeation, different combinations of the ratio of saturated to unsaturated fatty acids can be used in formulations for transdermal delivery.

Optimization of Pramipexole-Loaded In Situ Thermosensitive Intranasal Gel for Parkinson's Disease.

The objective of the present work was to develop and optimize an intranasal in situ gel of Pramipexole dihydrochloride for enhanced drug delivery, better patient acceptability, and possible proper treatment of Parkinson's disease. Preliminary studies were performed to select formulation components and identify key variables affecting the formulation. The optimization of the in situ gelling system of Pramipexole dihydrochloride was achieved by applying 32 full factorial design using Design-Expert® software (Stat-Ease 9.0.6 version) and taking concentrations of Poloxamer 407 (X1) and HPMC K4M (X2) as independent variables. The gelling temperature, gel strength, and percentage of drug diffused after 8 h were taken as dependent variables. The software provided an optimized formulation, with 16.50% of X1 and 0.2% of X2 with the highest desirability. An in vivo drug retention time study was performed for the optimized formulation in Wistar rats. The results of the optimization process demonstrated that the selected gel formulation exhibited desirable characteristics, including gelation near body temperature, good gel strength, suitable viscosity, and sustained drug release. The optimized formulation displayed significantly higher drug retention, lasting about 5 h, versus the plain poloxamer gel formulation. Hence, it was concluded that the optimized formulation will remain affixed at the site of application for a significant time after intranasal administration and consequently sustain the release of the drug. The optimized formulation was found to be stable during the stability studies. The developed dosage form may improve patient compliance, enhance nasal drug residence, and offer sustained drug release. However, further clinical studies are necessary to validate these findings.

Effect of Crospovidone, Croscaramellose Sodium in Combination on the Drug Release of Anti diabetic Medication in Tablet Form

Objective: The current study’s objective is to check the impact of superdisintegrants on the drug release of Vildagliptin by developing oral disintegrating tablets (ODT). Vildagliptin, new class of oral hypoglycemic agent. It acts by inhibiting dipeptidyl peptidase-4. Conventional Vildagliptin tablets are (due to its first pass effect) unsuitable where quicker onset of action is required Hence, it is necessary to develop oral disintegrating tablet, in order to obtain improved patient compliance. Methods: Using Oral disintegrating tablets of Vildagliptin were prepared using various quantities of Crospovidone & Croscaramellose sodium as Superdisintegrants by direct compression method. Nine trials were developed by varying the quantities of Crospovidone, Croscaramellose sodium such as 6 ± 1.5 mg i.e. 4.5, 6, 7.5 mg respectively. Prepared formulations were assessed for Pharmaceutical Product Performance as per official methods such as hardness, friability, weight variation, drug content, wetting time, disintegration time, and drug release studies. Results: Findings indicate that all formulations meet the acceptance criteria such as good mechanical strength (>4.3 kg/cm2), less friable (<0.65%), uniform drug content (>98%) and kinetic modeling was applied to the in-vitro dissolution profiles. Conclusion: The best formulation (F1), which is likewise identical to the marketed product (Galvus-50) (f2= 89.01, f1= 1.85), contained 7.5 mg of Crospovidone and 7.5 mg of Croscaramellose sodium. Formulation (F1) follow first order, whereas release mechanism found to be Fickian type (n= 0.323).

Incorporating surfactants into PCL microneedles for sustained release of a hydrophilic model drug

Polymeric microneedles (MNs) are widely used for sustained drug release due to their distinct advantages over other types of MNs. Poly-ε-caprolactone (PCL) stands out as a biodegradable and biocompatible hydrophobic polymer commonly employed in drug delivery applications. This study explores the impact of surfactants on the encapsulation and release rate of a model hydrophilic drug, minoxidil (MXD), from PCL MNs. Three nonionic surfactants, Tween 80, Span 60, and polyethylene glycol (PEG), were integrated into PCL MNs at varying concentrations. Compared to the other types of surfactants, PEG-containing PCL MNs exhibit enhanced insertion capabilities into a skin-simulant parafilm model and increased mechanical strength, suggesting facile penetration into the stratum corneum. Furthermore, MXD-PEG MNs show the highest encapsulation efficiency and are further characterized using FTIR, DSC and XRD. Their mechanical strength against different static forces was measured. The MNs exhibit a sustained release pattern over 20 days. Eventually, MXD-PEG MNs were subjected to penetration testing using chicken skin and required minimal insertion forces with no observed MN failure during experimentation even after compression with the maximum force applied (32 N per patch). Taken together, the present work demonstrates the feasibility of incorporating nonionic surfactants like PEG into the tips of hydrophobic PCL MNs for sustained delivery of a model hydrophilic drug. This formulation strategy can be used to improve patient compliance by allowing self-administration and achieving prolonged drug release.

The Development of an Oral Solution Containing Nirmatrelvir and Ritonavir and Assessment of Its Pharmacokinetics and Stability.

Paxlovid®, a co-packaged medication comprised of separate tablets containing two active ingredients, nirmatrelvir (NRV) and ritonavir (RTV), exhibits good effectiveness against coronavirus disease 2019 (COVID-19). However, the size of the NRV/RTV tablets makes them difficult for some patients to swallow, especially the elderly and those with dysphagia. Therefore, an oral liquid formulation that can overcome this shortcoming and improve patient compliance is required. In this study, we developed a liquid formulation containing NRV and RTV by adopting strategies that used co-solvents and surfactants to enhance the solubility and inhibit possible recrystallization. The in vitro release results showed that NRV and RTV could be maintained at high concentrations in solution for a certain period in the investigated media. In vivo studies in rats showed that the oral bioavailability of NRV/RTV solution was significantly enhanced. Compared to Paxlovid® tablets, the AUC(0-t) of NRV and RTV increased by 6.1 and 3.8 times, respectively, while the Cmax increased by 5.5 times for both. Furthermore, the promoting effect of the absorption of RTV on the bioavailability of NRV was confirmed. Experiments with a beagle showed a similar trend. Stability studies were also conducted at 4 °C, 25 °C, and 40 °C for 90 days, indicating that the oral liquid formulation was physically and chemically stable. This study can be used as a valuable resource for developing and applying oral liquid NRV/RTV formulations in a clinical context.

Comprehensive Review of Oro Dispersible Tablets and Co Processed Super disintegrants

Due to their ease of administration, self-administration, and improved patient compliance, solid dosage forms are most popular. The most normally utilized strong dose structures are tablets and capsules, which is challenging for pediatric and geriatric patients. Considering these prerequisites endeavors have been made to foster rapid dissolving Tablets. The solid dosage form of a medicine that dissolves in a matter of seconds when swallowed is known as orodispersible tablet. The utilization of Superdisintegrants improves the crumbling season of the tablet. Fast Dissolving Tablets are generally liked because of their convenience, higher bioavailability, quick disintegration and breaking down of the medication. The various technologies utilized in the formulation of Orodispersible tablets (ODT) and their evaluation are the primary focus of this review.

The efficacy and safety of acupoint catgut embedding therapy for depression: a protocol for systematic review and meta-analysis.

Depression is a common public health problem, characterized by persistent low mood, lack of pleasure and exhaustion. Conventional treatments such as antidepressants and psychotherapy have some limitations, including variable efficacy, adverse side effects and high costs. Acupoint catgut embedding (ACE) therapy, as a subtype of acupuncture, has gained increasing clinical application due to its long-term effects, higher patient compliance, and cost-effectiveness. This study aims to conduct a meta-analysis to evaluate the efficacy and safety of ACE for depression. Electronic searches will be conducted in 12 databases (both in English and Chinese databases), encompassing from inception to April 2022, without language restrictions. Randomized controlled trials (RCTs) that involve ACE for treating depression will be included. The primary outcome measures will include the response rate, Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI), and Traditional Chinese Medicine Symptom Scale (TCMSSS). The secondary outcome measure will include Quality of Life scale score (QoL) and the incidence of adverse events. Results will be presented as risk ratios for dichotomous data and mean differences for continuous data. Two reviewers will independently conduct study selection, data extraction, and quality assessment. The methodological quality of eligible studies will be evaluated according to the criteria specified by the Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Meta-analysis will be performed by RevMan 5.3 software. Due to the limitations, a safer, high-efficacy and non-pharmacological intervention with minimal side effects is required for treating depression. ACE has the advantages of longer-lasting effects, improved patient compliance, and reduced treatment costs. This protocol represents a meta-analysis and systematic review, aiming to present the current evidence regarding the efficacy and safety of ACE for depression. It seeks to provide clinicians with a theoretical basis and valuable references for complementary and alternative medicine therapies in their treatment approaches. https://www.crd.york.ac.uk/PROSPERO/#recordDetails, Identifier CRD42022325966.

Current paradigms in employing self-assembled structures: Drug delivery implications with improved therapeutic potential

Recent efforts have focused on developing improved drug delivery systems with enhanced therapeutic efficacy and minimal side effects. Micelles, self-assembled from amphiphilic block copolymers in aqueous solutions, have gained considerable attention for drug delivery. However, there is a need to further enhance their efficiency. These micelles offer benefits like biodegradability, biocompatibility, sustained drug release, and improved patient compliance. Yet, researchers must address stability issues and reduce toxicity. Nanoscale self-assembled structures have shown promise as efficient drug carriers, offering an alternative to conventional methods. Fine-tuning at the monomeric and molecular levels, along with structural modifications, is crucial for optimal drug release profiles. Various strategies, such as entrapping hydrophobic drugs and using polyethylene oxide diblock copolymer micelles to resist protein adsorption and cellular adhesion, protect the hydrophobic core from degradation. The polyethylene oxide corona also provides stealth properties, prolonging blood circulation for extended drug administration. Amphiphilic copolymers are attractive for drug delivery due to their adjustable properties, allowing control over micelle size and morphology. Emerging tools promise complex and multifunctional platforms. This article summarizes about the challenges as far as the use of micelles is concerned, including optimizing performance, rigorous pre-clinical and clinical research, and suggests further improvement for drug delivery efficacy.

The Osmolality and Hemolysis of High-Concentration Monoclonal Antibody Formulations.

Highly concentrated monoclonal antibody (mAb) formulations for subcutaneous administration are becoming increasingly preferred within the biopharmaceutical industry for ease of use and improved patient compliance. A common phenomenon observed in the industry is that osmolality detected via freezing-point depression (FPD) in high-concentration mAb formulations is much higher than the theoretical concentrations, yet the occurrence of this phenomenon and its possible safety issues have been rarely reported. The current study summarized theoretical osmolality of U.S. Food and Drug Administration approved high-concentration mAb formulations and evaluated effects of high osmolality on safety using hemolysis experiments for the first time. Two mAbs formulated at 150mg/mL were used as models and configured into two isotonic solutions: a, a theoretically calculated molarity in the isotonic range (H) and b, an osmolality value measured via the FPD in the isotonic range (I). The H and I formulations of each mAb were individually subjected to hemolysis experiments, and the hemolysis rates of the two formulations of the same mAb were compared. Besides, the effect of mAb concentration on osmolality detected by FPD was explored as well. The results indicated that the hemolysis rates were similar between the H and I formulations of mAbs at the same sample addition volume, and the osmolality values increased approximately linearly with the increase in mAb concentration. High osmolality for high-concentration mAb formulations would not affect product safety and the excipients could be added at relatively high levels to maintain product stability, especially for labile products.

Room for improvement in patient compliance during peripheral vascular interventions

BackgroundFor patients receiving procedural sedation and analgesia (PSA), patient cooperation is crucial, because patients remain continuously aware of operating room activity and can be asked to perform tasks, such as prolonged breath-holds. This survey aimed to collect information on patient compliance with on-table instructions and its relation to periprocedural outcomes from surgeons nationwide performing peripheral vascular interventions (PVIs) under PSA. MethodsA nine-question online survey was sent to 383 vascular surgeons (including both vascular surgery attendings and trainees) across the United States through REDCap from August 30 to September 21, 2021, with responses closed on October 30, 2021. The survey response was analyzed with descriptive statistics. ResultsThere were 83 (21.6%) vascular surgeons who responded to the survey, of who, 67 (80.7%) were attending vascular surgeons and 16 (19.3%) were vascular surgery trainees. Forty-one respondents (49.4%) performed 11 to 20 PVI cases under PSA every month, and 31 (41.0%) respondents performed 1 to 10 PVI cases under PSA every month. Forty-one respondents (49.4%) reported that in 1% to 10% of their cases, additional contrast and/or radiation was administered because patient moved on the table or did not cooperate with breath-holds; 25 (30.1%) reported that this occurred in 11% to 20% of their cases, 12 (14.5%) reported that this occurred in 21% to 50% of their cases, and 4 (4.8%) reported that this occurred in >50% of their cases. In such cases, the majority of respondents reported a 1% to 10% increase in contrast volume (59.0%), radiation dosage (62.7%), sedative/analgesia administration (46.3%), and procedural time (54.9%). Of cases being converted to general anesthesia owing to inadequate patient cooperation, 35 (42.2%) respondents reported between 1 and 5 cases per month and 3 (3.6%) respondents reported between 6 and 10 cases per month. Of cases being aborted owing to inadequate patient cooperation, 25 respondents (30.1%) reported between 1 and 5 cases per month, and 1 (1.2%) respondent reported between 6 and 10 cases per month. ConclusionsA significant fraction of PVI cases performed under PSA result in increased radiation and contrast exposure, sedative administration, and procedural time owing to inadequate patient cooperation. In certain cases, conversion to general anesthesia or case abortion is required. Further research should be performed to investigate strategies to minimize such adverse patient safety events.

Recent advances in the technology of effervescent tablets: lessons learned and future perspectives

Effervescent tablets are solid pharmaceutical dosage forms that are widely accepted due to their advantages. The improvement in patient compliance results from a combination of factors related both to the...

Transoral Robotic Surgery - An Inevitable Future of Oral and Maxillofacial Surgery

With the advancements in oral surgical procedures minimally invasive surgery has gained prime importance to avoid the drawbacks associated with conventional surgical procedures in the head and neck region. In 2005 robotic surgery was used in the management of head and neck tumors and various non neoplastic diseases. Transoral robotic surgery TORS demonstrated several advantages such as being minimally invasive reduced intraoperative blood loss decreased post operative hospital stay preservation of adjacent structures accurate dissection and decreased post operative tissue morbidity with improved patient compliance. The application of TORS is still in the experimental stage and requires more research to establish its wide spread use. Although its development is inevitable and proves to be a boon for the expanding future of oral and maxillofacial surgery the results seem to be promising. This review highlights the current application of roboticTORS procedure its benefits and limitations in the head and neck region.

Biopolymeric and lipid-based nanotechnological strategies for the design and development of novel mosquito repellent systems: recent advances.

Mosquitoes are the most medically important arthropod vectors of several human diseases. These diseases are known to severely incapacitate and debilitate millions of people, resulting in countless loss of lives. Over the years, several measures have been put in place to control the transmission of mosquito-borne diseases, one of which is using repellents. Repellents are one of the most effective personal protective measures against mosquito-borne diseases. However, conventional delivery systems of repellents (e.g., creams, gels, and sprays) are plagued with toxicity and short-term efficacy issues. The application of biopolymeric and lipid-based systems has been explored over the years to develop better delivery systems for active pharmaceutical ingredients including mosquito repellents. These delivery systems (e.g., solid lipid micro/nanoparticles, micro/nanoemulsions, or liposomes) possess desirable properties such as high biocompatibility, versatility, and controlled/sustained drug delivery, and thus are very important in tackling the clinical challenges of conventional repellent systems. Their capability for controlled/sustained drug release has improved patient compliance as it removes the need for consistent reapplication of repellents. They can also be engineered to reduce repellents' skin permeation, consequently improving their safety. However, despite the benefits that these systems offer very few of them have been successfully translated to the global market for commercial use, a vital challenge that previous reports have not thoroughly examined. The issue of limited clinical translation of novel repellent systems is a vital aspect to consider, as the ultimate goal is to move these systems from bench to bedside. As such, this study seeks to highlight the recent advances in the use of biopolymeric and lipid-based systems for the development of novel mosquito-repellent systems and also analyze the challenges that have limited the clinical translation of these systems while proposing possible strategies to overcome these challenges.

Evaluation of prescribing pattern of fixed-dose combinations in obstetrics and gynecology department of a tertiary care hospital of central India

Background: Improved patient compliance and cost effectiveness are two benefits of fixed-dose combination drugs. Irrational fixed-dose combinations (FDCs) raise the most urgent issue since they put patients at needless risk for negative medication responses. Aims and Objectives: The present study was done with objective of analyzing prescribing pattern of FDCs in department of fixed-dose combination in department of obstetrics and gynecology in a tertiary care hospital of central India. Materials and Methods: This study, which was both prospective and observational, was conducted at the tertiary care hospital of central India. This study comprised the prescriptions of all patients who visited the obstetrics and gynecology Outpatient Department during the study period. Results: In the present study, 1605 prescriptions were analyzed, comprising total 3016 drugs. Out of these 1262 were prescribed as FDCs and 1754 were prescribed as single drugs. On analyzing system-wise prescriptions, it was found that majority drugs were prescribed pertaining to gastrointestinal tract, that is, 1720 prescriptions, of which 722 (38.8%) were prescribed as FDCs. Four hundred and sixty-three drugs were prescribed related to hematological system, of which 97 (14.9%) were FDCs. Four hundred and thirty-three drugs were prescribed related to anti-infective class, comprising 196 (36.6%) FDCs. Among FDCs prescribed in gastrointestinal system, Vitamin D3 + Calcium carbonate was most commonly prescribed, accounting for 644 (51%) prescriptions. Clotrimazole + Clindamycin was most commonly prescribed FDC in anti-infective system comprising 118 (9.3%) patients. Ferrous ascorbate + folic acid was most commonly prescribed hematological FDC, accounting for 49 (3.8%) patients. Dextromethorphan + phenylephrine + Chlorpheniramine was most commonly prescribed FDC in respiratory segment accounting for 39 (2.9%) patients. Conclusion: The present study highlights a considerable number of drugs prescribed as FDCs. FDCs reduce pill burden and also help to improve patient compliance. However, rationality of FDCs should be thought before prescribing it to patients.

Novel Arena of Nanocosmetics: Applications and their Remarkable Contribution in the Management of Dermal Disorders, Topical Delivery, Future Trends and Challenges.

Nanocosmetics have attracted a considerable audience towards natural care due to their low cost, target-specific delivery, and reduced toxicity compared to chemical-based cosmetics. Nanofomulations, including nanoemulsions, nanotubes, and polymeric carriers, have become next-generation products explored for the multifaced applications of nanotechnology in skin care. The rise in the cosmetic industry demands innovative and personalized products designed using nanocarriers for better targeting and improving patient compliance. Furthermore, nanocosmetics increase the efficiency of skin permeation active ingredient entrapment, providing better UV protection. Moreover, it offers controlled drug release, targeting active sites and enhancing physical stability. Further, overcoming the drawback of penetration problems makes them sustainable formulations for precision medicine. Skincare nourishment with nanocosmetics using Indian spices helps to maintain, beautify, and rejuvenate human skin. Nanophytopharmaceuticals extracted from plants, including alkaloids, flavonoids, antioxidants, and volatile oils, are essential phyto-products for skin care. Nano herbals and nanocosmetics are a growing market and gift of nature that nourishes and cures skin ailments like acne, pemphigus, anti-aging, albinism, psoriasis, and fungal infections. The emerging concern is highlighted in the investigation of nanoformulation toxicity and safety concerns in skin care. Further, it helps to manifest research, development, and innovation in expanding the scope of herbal industries.

Ligand-conjugated multiwalled carbon nanotubes for cancer targeted drug delivery.

Multiwalled carbon nanotubes (MWCNTs) are at the forefront of nanotechnology-based advancements in cancer therapy, particularly in the field of targeted drug delivery. The nanotubes are characterized by their concentric graphene layers, which give them outstanding structural strength. They can deliver substantial doses of therapeutic agents, potentially reducing treatment frequency and improving patient compliance. MWCNTs' diminutive size and modifiable surface enable them to have a high drug loading capacity and penetrate biological barriers. As a result of the extensive research on these nanomaterials, they have been studied extensively as synthetic and chemically functionalized molecules, which can be combined with various ligands (such as folic acid, antibodies, peptides, mannose, galactose, polymers) and linkers, and to deliver anticancer drugs, including but not limited to paclitaxel, docetaxel, cisplatin, doxorubicin, tamoxifen, methotrexate, quercetin and others, to cancer cells. This functionalization facilitates selective targeting of cancer cells, as these ligands bind to specific receptors overexpressed in tumor cells. By sparing non-cancerous cells and delivering the therapeutic payload precisely to cancer cells, this therapeutic payload delivery ability reduces chemotherapy systemic toxicity. There is great potential for MWCNTs to be used as targeted delivery systems for drugs. In this review, we discuss techniques for functionalizing and conjugating MWCNTs to drugs using natural and biomacromolecular linkers, which can bind to the cancer cells' receptors/biomolecules. Using MWCNTs to administer cancer drugs is a transformative approach to cancer treatment that combines nanotechnology and pharmacotherapy. It is an exciting and rich field of research to explore and optimize MWCNTs for drug delivery purposes, which could result in significant benefits for cancer patients.

Sub-100 nm carriers by template polymerization for drug delivery applications.

Size-controlled drug delivery systems (DDSs) have gained significant attention in the field of pharmaceutical sciences due to their potential to enhance drug efficacy, minimize side effects, and improve patient compliance. This review provides a concise overview of the preparation method, advancements, and applications of size-controlled drug delivery systems focusing on the sub-100 nm size DDSs. The importance of tailoring the size for achieving therapeutic goals is briefly mentioned. We highlight the concept of "template polymerization", a well-established method in covalent polymerization that offers precise control over molecular weight. We demonstrate the utility of this approach in crafting a monolayer of a polymer around biomolecule templates such as DNA, RNA, and protein, achieving the generation of DDSs with sizes ranging from several tens of nanometers. A few representative examples of small-size DDSs that share a conceptual similarity to "template polymerization" are also discussed. This review concludes by briefly discussing the drug release behaviors and the future prospects of "template polymerization" for the development of innovative size-controlled drug delivery systems, which promise to optimize drug delivery precision, efficacy, and safety.

To assess the knowledge, attitude, and practice about prescribing fixed-dose combinations among medical doctors in a tertiary care hospital in Karnataka: A cross-sectional study

Background: Fixed-dose combinations (FDCs) constitute a substantial portion of prescribed medications worldwide and offer benefits such as enhanced efficacy, reduced pill burden, and improved patient compliance. However, their improper utilization can lead to inefficacies, increased costs, and adverse health outcomes. The assessment of clinicians’ understanding, attitudes, and practices regarding FDC prescription at a tertiary care teaching hospital in South India serves as a crucial step toward ensuring informed and rational medication practices. Aims and Objectives: The aim and objectives of the study are to evaluate the knowledge, attitude, and practice of prescribing FDCs among medical doctors. Materials and Methods: Following approval from the Ethics Committee at Mysore Medical College and Research Institute, as well as obtaining written informed consent from medical doctors working in the institute, a selfadministered, structured, and pre-tested questionnaire was utilized. This questionnaire had been adapted from prior studies with similarities and was adjusted to align with the specific context of the present study. Results: The study of 72 doctors highlighted high FDC awareness (91.7%). The generic name of FDC was employed by 69.4% of the participants in the study. Most advocated proper prescriptions (84.8%). 57% of them identified FDC rationality. 22.2% relied on drug indexes, among other varied sources, for FDC information. Conclusion: It is essential to emphasize gaps in knowledge, attitude, and practice as it increases the risk of irrational prescriptions. Measures aiming to educate and rectify this issue, particularly in a tertiary hospital setting, help in mitigating the irrational use of drugs and optimizing patient care.

The Effect of PDCA Circulation on Improving The Up-to-Standard Rate of Wearing Time Length in OSAHS Patients with Non-Invasive Ventilator

Purpose: To investigate the clinical effect of PDCA（Plan-Do-Check-Act） circulation mode in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) using continuous positive air way pressure (CPAP) ventilator. Methods: 83 patients with OSAHS who were treated in the department of otorhinolaryngology head and neck surgery were randomly divided into PDCA group (n = 41) and control group (n = 42). The nursing outcomes of the two groups were compared. Result: The rate of reaching the standard wearing time length of non-invasive ventilator in the PDCA group was 80.49%, which was significantly higher than that in the control group (35.71%), and the difference was statistically significant (χ2=17.005, P<0.05). The compliance rate of patients in the PDCA group (90.24%) was higher than that in the control group (73.80%), and the difference was statistically significant (Z= 2.571, P<0.05). The incidence of adverse reactions in the PDCA group was 19.51% lower than that in the control group (64.29%), and the difference was statistically significant (χ2=17.005, P<0.05). The score of fatigue in the PDCA group (4.17 ±1.223) was significantly lower than that in the control group (6.45 ±0.803). Conclusion: PDCA circulation nursing model can effectively improve the up-to-standard rate of time length of patients wearing non-invasive ventilator, reduce the incidence of adverse reactions, improve patient compliance and reduce patient fatigue, which is worthy of clinical promotion. Key words: PDCA circulation nursing model; the up-to-standard rate of time length of non-invasive ventilator; compliance; incidence of adverse reactions; fatigue degree.

Frontier and hot topics in home enteral nutrition based on CiteSpace bibliometric analysis.

The benefits of home enteral nutrition (HEN) are increasingly recognized, with more scholars focusing on this field. This study aimed to comprehensively identify collaborative networks, analyze, and track research trends, focus on current hotspots, and accurately predict the forefront and focus of home enteral nutrition. A computer search of the Web of Science Core Collection (WoSCC) was conducted for studies related to home enteral nutrition published from January 1, 2004, to December 31, 2023, and select them in compliance with the PRISMA guidelines. The CiteSpace software was used for bibliometric visualization and comparative analysis of countries, institutions, journals, references, and keywords. A total of 1,113 documents were included, showing a steady annual increase in publication volume. The United States and the Mayo Clinic were the top publishing country and institution, with 302 and 41 papers, respectively. "CLIN NUTR" had the highest number of publications, totaling 221, while "ESPEN guideline on home enteral nutrition" was the most cited reference, with 43 citations. The most prolific author was Manpreet S with 29 papers. The management of HEN is a current research hotspot. The safety of HEN and how to improve patient compliance are critical areas for researchers to consider. Future research could focus on these aspects. The blurring of boundaries between hospital and home care and how to utilize telemedicine technologies to serve more patients deserve in-depth exploration. Researchers worldwide should combine their unique characteristics and advantages to strengthen international cooperation.