Long-term Use Of Medicines Research Articles

Relationship of the SITLESS intervention on medication use in community-dwelling older adults: an exploratory study.

Sedentary behavior (SB) and physical activity (PA) interventions in older adults can improve health outcomes. Problems related with aging include prevalent comorbidity, multiple non-communicable diseases, complaints, and resulting polypharmacy. This manuscript examines the relationship between an intervention aiming at reducing SB on medication patterns. This manuscript presents a local sub-analysis of the SITLESS trial data on medication use. SITLESS was an exercise referral scheme (ERS) enhanced by self-management strategies (SMS) to reduce SB in community-dwelling older adults. We analyzed data from the ERS + SMS, ERS and usual care (UC) groups. Patient medication records were available at baseline and at the end of the intervention (4-month period) and were analyzed to explore the effect of SITLESS on medication patterns of use. A sample of 75 participants was analyzed, mostly older overweight women with poor body composition scores and mobility limitations. There was a significant reduction of 1.6 medicines (SD = 2.7) in the ERS group (p < 0.01), but not in the UC or ERS + SMS groups. Differences were more evident in medicines used for short periods of time. The findings suggest that an exercise-based program enhanced by SMS to reduce SB might influence medication use for acute conditions but there is a need to further investigate effects on long-term medicine use in older adults.

Effectiveness of Semont maneuver in the treatment of benign paroxysmal positional vertigo: an institutional study

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. In this condition, the vertigo is precipitated by certain head movements. BPPV is diagnosed by Dix-Hallpike positional test. Various repositioning maneuvers and treatment modalities exist for the management of this condition. Semont maneuver is a simple procedure for the treatment of posterior semicircular canal BPPV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This non randomized controlled study was conducted in the ENT Department of a tertiary care hospital at Thiruvananthapuram over a period of one year. Hundred patients with posterior semicircular canal BPPV were included in the study. Fifty patients treated with Semont maneuver were compared with 50 patients who were treated with betahistine 16 mg three times daily. Outcomes were measured by relief of vertigo and negative Dix- Hallpike positional test during follow up examination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The most common age group affected by BPPV was 50-60 years. Right side was more affected than the left. There was a female preponderance. 84% patients treated with Semont maneuver were cured at the end of the first week and 90% at the end of the second week. The percentage of patients cured with betahistine were 48% at the end of first week and 56% at the end of second week. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The Semont maneuver was very effective in the treatment of BPPV. It helps to reduce the long-term use of medicines in our population.&lt;/p&gt;

Medication-Related Needs and Humanistic Impact of Patient-Centered Pharmaceutical Care at University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia.

PurposeTo assess patients’ medication-related needs and the humanistic impact of patient-centered pharmaceutical care.Patients and MethodsA hospital-based cross-sectional study was conducted using self-administered structured questionnaires from February 4 to 28, 2019, on patients attending ambulatory care for chronic non-communicable diseases at the University of Gondar specialized teaching hospital, North-west Ethiopia. Data were entered to SPSS version 22 for analysis. Descriptive statistics was used to describe the socio-demographic characteristics and medication-related needs of study participants. Independent sample t-test and one-way ANOVA analysis were performed to check for possible associations between dependent and independent variables.ResultsInformation about what to do if patients missed doses and the potential side-effects or abnormal conditions caused by the prescribed medicines were not explained for most of the 425 patients studied. The majority of the study participants reported that they felt worried about adverse medicine effects, drug interactions, and long-term medicine use. Patients who were older than 50 or those receiving two or more medications were less satisfied with the effect of their medicine as compared to younger ones and those on monotherapy, respectively. People who were illiterate or had attended only primary schools thought that they received less disease and medicine information from health professionals than people who attended tertiary education.Conclusion and RecommendationMost of the participants were particularly unhappy with the amount of information received about side-effects and what to do if doses were missed. Special emphasis should be given to patients with a low level of education as they were not satisfied with medicine and disease information obtained from health professionals, experienced more psychological impacts of medicine use, and had poor overall quality-of-life.

MANAGEMENT OF VITILIGO (SHVITRA) ACCORDING TO AYURVEDA: A CASE STUDY

The color of the skin is important biologically, cosmetically and socially. Vitiligo is an acquired condition where melanocytes are absent in affected area. The worldwide prevalence of Vitiligo is lesser than 1%. Though the condition is rare and non communicable, patients who are suffering from Vitiligo may experience cosmetically disfiguring and psychological problems like depression. It is not clear why the melanocytes disappear from the skin. Theories regarding the Vitiligo include an autoimmune cause because of association with other autoimmune disorders, presence of antimelanin antibodies and lymphocytic infiltrate in early lesions. In Ayurveda, all the skin diseases are described under the heading of ‘Kushta’, which are further divided in to two namely ‘Mahakushta’ and ‘Kshudra Kushta’. Shvitra has been mentioned separately. Based upon clinical features of Shvitra, it can be correlated with Vitiligo. Aacharya Charak has mentioned Shvitra under the ‘Rakta Pradoshaj Vikara’. Considering the limitations of modern medical system and side effects associated with long term use of medicines, Ayurveda has much more convincing treatment modalities for Vitiligo. In present study emphasis has been made to study efficacy of Shvitrahara Vati and Shitrahara Lepa in Shvitra (Vitiligo).

The impact of cardiovascular medication use on patients\u2019 daily lives: a cross-sectional study

Background The management of multiple long-term medicines of patients with chronic diseases creates a burden for patients. However, limited research is performed on its impact on patients’ daily lives. Objective The aim of this study was to explore the impact of cardiovascular medication on different daily life aspects and to examine differences of these aspects between adherent and non-adherent patients. Setting Two community pharmacies in the Netherlands. Method In this cross-sectional study patients (≥ 45 years) using cardiovascular medication participated. Two equally group sized samples of patients non-adherent as assessed with pharmacy refill data, and patients adherent were selected. Main outcome measure Data were collected by means of the Living with Medicines Questionnaire measuring the impact of medicines use on patients’ daily lives. Results In total, 196 patients participated, including 96 non-adherent patients. Substantial proportions of patients experienced medication-related burden on different daily life aspects. This burden was mainly related to the acceptance of long-term medicine use, medication-related concerns or dissatisfaction, the interference of medicines with social and daily lives, and the interaction and communication with health care providers. No statistically significant results were found when comparing the impact on patients’ daily lives between adherent and nonadherent patients. Conclusion Health care providers should acknowledge the impact of multiple long-term medicines on patient’s daily lives and should make an effort to diminish patients’ medication-related burden by improving patient–provider relationships and by providing adequate treatment information incorporating patients’ individual circumstances. This may facilitate the integration of long-term medicine use in patients’ daily lives.

Avaliação da satisfação dos usuários das farmácias do sistema público de saúde

Objective: To assess the access to medicines and the level of satisfaction in users of public pharmacies in the municipality of Ijui, Rio Grande do Sul. Methods: Quantitative observational and analytical cross-sectional study conducted with users of pharmacies from 14 health care centers who were randomly selected in the waiting room in January and February 2013. Data were collected using a semi-structured questionnaire on socioeconomic aspects, health conditions, and use of health services and medicines. Satisfaction was measured by a score of zero to 10. Data were analyzed using the Mann-Whitney, ANOVA and Kruskal-Wallis tests. Results: Participants were 134 users: 75.4% (n=101) of them were women and mean age was 48.95 ± 16.28 years. Most (n=89 - 66.4%) of the participants reported long term use of medicines, 54.5% (n=73) reported access to all the medicines in the pharmacy of the center, and 74.6% (100) reported buying the medicine if the pharmacy was out of them. The main problem identified was the lack of medicines (n=50 - 37.3%), followed by service and lack of human resources (n=17 - 12.6%). Mean satisfaction with the services was 8.7 ± 1.5. Greater satisfaction was found in those with lower levels of education, those who have access to medicines and those who have their doubts clarified. Conclusion: There is satisfaction with the services provided; however, the findings highlight the poor access to medicines and the need for effective qualification of the pharmaceutical services provided to ensure access to treatment with quality and problem-solving capacity.

Polypharmacy among the elderly in the Republic of Srpska: extent and implications for the future

ABSTRACTThe prescribing of medicines is a fundamental component of care for the elderly; however, there is increasing concern with polypharmacy and its impact on morbidity, mortality and costs. As a result, long-term prescription-medicine use and the prevalence of polypharmacy in the elderly in the Republic of Srpska were analyzed. The findings were subsequently used to suggest potential future measures. A retrospective study of all elderly patients during 2005–2010 stratified by age group (three groups), sex and long-term medicine use was performed. Polypharmacy (five or more medicines) increased from 1.4% of the elderly taking medicines long-term to 3.6% by 2010, with 53.6% of elderly taking two or more medicines long-term. The most prevalent diseases were cardiovascular diseases and diabetes. Most prescriptions were in accordance with recent guidelines; however, there was a concern with appreciable prescribing of digoxin and aminophylline. Whilst polypharmacy rates are low in the Republic, the increasing rate is a concern. Further studies are planned.

Hepatoprotective Role of Caesalpenia bonduc: A Histopathological and Biochemical Study.

Hepatotoxicity is one of the inevitable side effects of long term use of medicines in many different disorders, chronic use of alcohol and in certain infectious disorders. Even though there are few effective drugs to treat such hepatotoxicity, mortality due to hepatotoxicity is increasing day by day. Therefore, in search of alternative and more effective medicine we found that Caesalpenia bonduc (CB), a shrub grows in hotter places of south Asia has been effectively used to treat such hepatotoxicity in folk medicine. AIM of the study is to scientifically evaluate the hepatoprotective nature of aqueous extract of CB using Carbon tetrachloride(CCl4) induced hepatotoxic rat model. Materials and Methods and Result: Elevated levels of blood ALT, AST and ALT enzymes were found in CCl4 induced hepatotoxic rat models. Treating these animals with CB either prior or after the induction of hepatotoxicity, shows significant decrease in the levels of ALP, AST, and ALT in their blood in comparison with the untreated hepatotoxic group. Additionally, histologically, hepatotoxic rats show necrotic changes & vacuolation in their hepatocytes, altered hepatic architecture and congested hepatic sinusoids. However, such histopathological adverse changes were minimized when these animals treated with CB. Results of the present study indicate that CB acts as both preventive and curative hepatoprotector.

Evaluating medicines: let's use all the evidence

The current drug regulatory system is outdated and relies primarily on a process of premarketing evaluation, followed by periodic reviews of reported adverse events. While long-term medicine use for chronic conditions is now commonplace, current drug evaluation systems do not incorporate the comprehensive evidence accruing over time in clinical practice. Good quality, routinely collected data on medicines use are now available in some countries. Consistent with international opinion, we propose an expanded and integrated system of medicines regulation for Australia, based on a surveillance system that improves safety monitoring by complementing existing systems, making best use of routinely collected data, and leveraging the power of information technology. Australia is well placed to pilot such a model system.

Prevalence of long-term use of medicines with prolonged oral clearance in the elderly: a survey in north east England

Prevalence of long-term use of medicines with prolonged oral clearance in the elderly: a survey in north east England

Prevalence of long-term use of medicines with prolonged oral clearance in the elderly: a survey in north east England.

To determine the prevalence of long-term use by the elderly of prescribed and over-the-counter (OTC) medicines with prolonged oral clearance (POC), with regard to sugars content, dose form and therapeutic groups of medicines used. Two cross-sectional observational surveys in ten general medical practices in north-east England during 1996. Computerised patient records of all elderly patients (aged 60 years and over) were surveyed for prescribed medicines use. Within these practices, 50% of elderly patients registered with ten general medical practitioners were surveyed by postal questionnaire to assess over-the-counter (OTC) medicines use. Of 20,731 elderly patients registered, prevalence of use of prescribed prolonged oral clearance (POC) medicines was 9.8% (95% CI: 8.2%, 11.3%) and use in females aged 75 years and older was significantly more likely (P < 0.0001). Of 2,796 prescribing instances (PIs) for 143 POC medicines used long-term, 53% were gastrointestinal and 72% were sugars-free; however, 82% of 542 PIs for generic liquids were sugars-containing compared with 8% of 685 PIs for proprietary liquid oral medicines. Of 1,532 elderly respondents to a postal questionnaire, 17 were using 13 different OTC medicines with POC regularly and long-term (mean prevalence; 1.1%). Of the 17 instances of regular long-term use of OTC medicines, 59% were sugars-free. Prescribed medicines represent the bulk of regular, long-term medicines use in the elderly. Generic prescribing is more likely to result in sugars-containing medicines being dispensed. Generic medicines manufacturers must be encouraged to provide sugars-free alternatives to POC medicines used long-term, and health professionals should be vigilant when prescribing and dispensing these medicines to the increasingly dentate elderly.