Medicines For Chronic Diseases Research Articles

Reading Difficulty of Consumer Medicine Information (CMI) Leaflets for Five Chronic Ailments in Ghana

Purpose: This study examined the reading difficulty of Consumer Medicine Information leaflets of five chronic-disease medicines. Design/ Methodology/ Approach: In this descriptive, cross-sectional study, 192 leaflets were randomly downloaded from the World Wide Web: Asthma (35), Cancer (42), Diabetes (41), HIV (29), and Hypertension (45). Text from each ‘leaflet’ was analysed using the Simple Measure of Gobbledygook (SMOG), Flesch Reading Ease, and Gunning Fog indexes. Findings: Consistently, the difficulty of the texts exceeded the recommended difficulty levels. A comparison of mean scores showed leaflets for HIV medication were the most difficult to read because they were written at grade levels too high for the average literate adult. Research Limitations: Readability indexes are suited to only prose. They neither measure how well-organised the text is, nor indicate the suitability of typographical features, such as illustrations, typeface, appeal of presentation, and use of white space. Readability scores do not account for readers’ backgrounds, exposure, and motivation. Practical implication: Developing user-friendly consumer medicine information leaflets can reduce the need for extensive explanations, allowing healthcare providers to allocate their time more efficiently. Social Implication: Improving the readability of Consumer Medicine Information leaflets can enhance health literacy, leading to better health outcomes and reduced healthcare costs associated with medication errors. Originality/Value: While readability indices have been widely used, their application specifically to Consumer Medicine Information leaflets for chronic ailments such as diabetes, hypertension, asthma, arthritis, and heart disease in Ghana is novel. Chronic ailments require continuous and often complex medication regimens, making readability particularly crucial.

The Application of Knowledge-Based Clinical Decision Support Systems to Enhance Adherence to Evidence-Based Medicine in Chronic Disease.

Among the technology-based solutions, clinical decision support systems (CDSSs) have the ability to keep up with clinicians with the latest evidence in a smart way. Hence, the main objective of our study was to investigate the applicability and characteristics of CDSSs regarding chronic disease. The Web of Science, Scopus, OVID, and PubMed databases were searched using keywords from January 2000 to February 2023. The review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Then, an analysis was done to determine the characteristics and applicability of CDSSs. The quality of the appraisal was assessed using the Mixed Methods Appraisal Tool checklist (MMAT). A systematic database search yielded 206 citations. Eventually, 38 articles from sixteen countries met the inclusion criteria and were accepted for final analysis. The main approaches of all studies can be classified into adherence to evidence-based medicine (84.2%), early and accurate diagnosis (81.6%), identifying high-risk patients (50%), preventing medical errors (47.4%), providing up-to-date information to healthcare providers (36.8%), providing patient care remotely (21.1%), and standardizing care (71.1%). The most common features among the knowledge-based CDSSs included providing guidance and advice for physicians (92.11%), generating patient-specific recommendations (84.21%), integrating into electronic medical records (60.53%), and using alerts or reminders (60.53%). Among thirteen different methods to translate the knowledge of evidence into machine-interpretable knowledge, 34.21% of studies utilized the rule-based logic technique while 26.32% of studies used rule-based decision tree modeling. For CDSS development and translating knowledge, diverse methods and techniques were applied. Therefore, the development of a standard framework for the development of knowledge-based decision support systems should be considered by informaticians.

The knock-on effects of COVID-19 pandemic on the supply and availability of generic medicines in Ethiopia: mixed methods study

BackgroundCOVID-19 pandemic posed a major impact on the availability and affordability of essential medicines. This study aimed to assess the knock-on effects of the COVID-19 pandemic on the supply availability of non-communicable chronic disease (NCD) medicines and paracetamol products in Ethiopia.MethodsA mixed methods study was conducted to assess the supply and availability of twenty-four NCD drugs and four paracetamol products listed on the national essential medicines list for hospitals. Data were collected from twenty-six hospitals located in seven zones of Oromia region in the southwestern part of Ethiopia. We extracted data on drug availability, cost and stock out for these drugs between May 2019 and December 2020. The quantitative data were entered into Microsoft Excel and exported to statistical package software for social science (SPSS) version 22 (IBM Corporation, Armonk, NY, USA) software for analysis.ResultsThe overall mean availability of selected basket medicines was 63.4% (range 16.7% to 80.3%) during the pre-COVID-19 time. It was 46.3% (range 2.8% to 88.7) during the pandemic. There was a relative increase in the availability of two paracetamol products [paracetamol 500 mg tablet (67.5% versus 88.7%) and suppository (74.5% versus 88%)] during the pandemic. The average monthly orders fill rates for the selected products range from 43 to 85%. Pre-COVID-19, the average order fill rate was greater or equal to 70%. However, immediately after the COVID-19 case notification, the percentage of order(s) filled correctly in items and quantities began decreasing. Political instability, shortage of trained human resources, currency inflation, and limited drug financing were considered as the major challenges to medicine supply.ConclusionThe overall stock out situation in the study area has worsened during COVID-19 compared to pre-COVID-19 time. None of the surveyed chronic disease basket medicines met the ideal availability benchmark of 80% in health facilities. However, availability of paracetamol 500 mg tablet surprisingly improved during the pandemic. A range of policy frameworks and options targeting inevitable outbreaks should exist to enable governments to ensure that medicines for chronic diseases are consistently available and affordable.

The Role of Chinese Medicine in Chronic Diseases

The course of chronic disease is long and the etiology is complex. With the development of society, the occurrence of chronic disease is gradually becoming younger and the incidence is getting higher and higher. At present, the prevention and control of chronic diseases are mainly palliatives, intervention lags behind other disadvantages. Society is paying more and more attention to the prevention and control of chronic diseases. Due to various factors, the quality of life of many chronic disease patients is significantly different. TCM has diversified ways, precise diagnosis, and treatment of syndrome differentiation thought and means of diagnosis and treatment, TCM technology and operability, has a unique role in health management, health care, and other aspects so TCM has an important significance in the prevention and control of chronic diseases. From the Angle of TCM prevention of chronic diseases, this paper expounds on the theory of TCM prevention of chronic diseases, the key points of attention, and the methods of TCM treatment of chronic diseases. It can be concluded from the literature that the combination of evidence-based treatment of TCM and modern medical technology can improve the condition of patients to some extent. If the theory of "treatment before treatment" of TCM is applied to public health management.

Effect of cassava flour on the lipidic and redox profile of Wistar rats with dyslipidemia.

One of the major risk factors for cardiovascular disease is high total cholesterol. It is known that some foods can reduce plasma cholesterol, such as oats. Cassava flour has a similar amount of fiber when compared to oats. The objective of this study was to evaluate the hypocholesterolemic potential of cassava flour. Thirty Wistar rats (eight weeks old) were divided into three groups: control, high-cholesterol diet, high-cholesterol diet+cassava flour, and were treated for 8weeks. The weight and food consumption of the animals were evaluated weekly. After euthanasia, analyzes of biochemical and oxidative stress profiles were performed, besides the histological analysis of the liver. Cassava flour protected animals from lipoperoxidation, according to thiobarbituric acid-reactive substances results and improved superoxide dismutase activity and thiol content; however, failed to improve the lipid profile and catalase. Cassava flour was possibly able to slow the progression of NASH according to liver histology. PRACTICAL APPLICATIONS: Lifestyle and nutritional habits have been considered important factors associated with the development of dyslipidemia and other chronic diseases. Medicines for chronic diseases are often expensive and have present side effects, and therefore, it is preferable to prevent them through food. Cassava flour is a food widely consumed by Brazilians, which is inexpensive and contains no gluten. Understanding more about one of the most used foods in Brazil is important for health professionals to be able to prescribe it for the correct purposes.

Exercise as medicine in chronic diseases during childhood and adolescence

Physical activity (PA) and exercise improve the overall quality of life, as well as prevent the onset of diseases in healthy children and adolescents, and as an aid to treat prevalent chronic diseases in childhood. PA and exercise are like medicine, but sedentary lifestyle and inactivity cause disease. In this article, the existing scientific evidence in this field is reviewed and recommendations for professionals involved in child health are updated. A good knowledge of how to prescribe exercise and PA in paediatrics in different diseases is necessary. Interventions to avoid inactivity of children and adolescents must be supported by the appropriate increase in the level of PA, through integration and training programs, which achieve both an overall improvement of the neuromuscular physical condition and also physical, cognitive, and psychosocial performance. The Health Promotion Committee of Spanish Paediatric Association proposes strategies that help to obtain this objective, aiming to improve the health of our patients through the practice of exercise and the increase in PA.

Exercise as medicine in chronic diseases during childhood and adolescence

Physical activity (PA) and exercise improve the overall quality of life, as well as prevent the onset of diseases in healthy children and adolescents, and is an aid to treat prevalent chronic diseases in childhood. PA and exercise are like medicine, while sedentary lifestyle and inactivity cause disease. In this article, the existing scientific evidence in this field is reviewed and recommendations for professionals involved in child health are updated. A good knowledge of how to prescribe exercise and PA in paediatrics in different diseases is necessary. Interventions to avoid inactivity of children and adolescents must be supported by the appropriate increase in the level of PA, through integration and training programs, which achieve both an overall improvement of the neuromuscular physical condition and also physical, cognitive, and psychosocial performance. The Health Promotion Committee of Spanish Paediatric Association proposes strategies that help to obtain this objective, aiming to improve the health of our patients through the practice of exercise and the increase in PA.

Consensus among healthcare stakeholders on a collaborative medication therapy management model for chronic diseases in Malaysia; A Delphi study.

BackgroundThe general problem is lack of inter-professional collaboration and the way private primary care responds to manage chronic diseases in Malaysia. Absence of prescription review, inadequate patient education, the highest percentage of prescribing errors and half of the chronic disease patients are nonadherent. Medicines are the most common and life long used interventions in chronic diseases. Hence, the need to manage medicine in chronic diseases becomes obligatory. As both general practitioner and community pharmacist can dispense medications, this has resulted in a business rivalry. There is a need to build consensus among various healthcare stakeholders for a collaborative medication therapy management model (CMTM) where community pharmacist has an active role in chronic care.MethodThis study utilized modified e-Delphi method to build consensus. A validated e-Delphi survey was administered to a purposive sample of 29 experts. Consensus was pre-defined to be the point where >85% of the experts fall in either agree or strongly agree category for each statement. The inter-expert agreement was computed in both rounds using Intra-class correlation coefficient and Kendall's W. Delphi operates in an iterative fashion till there comes stability in responses. At the end of each round, experts were provided aggregate response, their own response and choice to change their response in the light of aggregate response.ResultsResponse rate was 70.73% and 100% in 1st and 2nd round, respectively. Consensus was achieved on 119/132 statements which mainly referred to the need, structural and regulatory aspects of CMTM model in Malaysia. However, there were some flashpoints on dispensing separation and means to finance this model. Stability in response of experts was achieved after 2nd round; hence, no next round was executed.ConclusionOverall, the study findings witnessed the expert panel’s support for the CMTM model. Study helped to sketch CMTM model and facilitated development of some recommendations to the authorities which may help to formulate a policy to bring CPs under a working relationship with GPs. Hence, this study should be taken as a call for redefining of the roles of CPs and GPs in Malaysia.

Young Muslim Women Living with Asthma in Denmark: A Link between Religion and Self-Efficacy

Asthma is a chronic respiratory disease that can be controlled with appropriate medicinal treatment. Adherence to pharmacological treatment is therefore critical. Self-efficacy plays a key role in adherence to medicine in chronic diseases, including asthma. Additionally, ethnic minorities have poor adherence to medicines. However, the impact of religion on self-efficacy and adherence is understudied. Therefore, the aim of this study was to explore the role of self-efficacy in adherence to asthma medicine treatment and the influence of religion on self-efficacy among young, Muslim minority women. A focus group and individual interviews with 10 Muslim minority women (14–24 years of age) living in Denmark were conducted. Data analysis was deductive using Bandura’s theory of self-efficacy and modes of agency. Overall, religion was shown to affect self-efficacy. The women reported changes in self-perceived self-efficacy during the holy month of Ramadan. In addition, praying was used as an alternative to medicine for controlling asthma symptoms. However, the women did not perceive religion and treating asthma with medicine as mutually exclusive, but rather as coexisting for the shared goal of controlling asthma symptoms. It is important for healthcare professionals (HCPs) to be aware of the link between self-efficacy, religion and adherence to asthma medicine treatment. This awareness can aid HCPs in giving advice regarding adherence to asthma treatment, and when monitoring treatment to improve the quality of asthma care for young Muslim minority women.

Medication wasted – Contents and costs of medicines ending up in household garbage

Despite potentially considerable implications for public health, the environment and public funds, medicine waste is an under-researched topic. This study aims to analyse medicines drawn from household garbage in Vienna (Austria) and to assess possible financial implications for public payers. Four pharmaceutical waste samples collected by the Vienna Municipal Waste Department between April 2015 and January 2016 were investigated with regard to their content. The value of medicines was assessed at ex-factory, reimbursement and pharmacy retail price levels, and the portion of costs attributable to the social health insurance was determined. Data were extrapolated for Vienna and Austria. The waste sample contained 1089 items, of which 42% were excluded (non-pharmaceuticals, non-Austrian origin and non-attributable medicines). A total of 637 items were further analysed. Approximately 18% of these medicines were full packs. 36% of the medicines wasted had not yet expired. Nearly two out of three medicines wasted were prescription-only medicines. The majority were medicines related to the 'alimentary tract and metabolism' (ATC code A), the 'nervous system' (ATC code N) and the 'respiratory system' (ATC code R). The medicines wasted had a total value of € 1965, € 2987 and € 4207, expressed at ex-factory, reimbursement and pharmacy retail price levels, respectively. Extrapolated for Vienna, at least € 37.65 million in terms of expenditure for public payers were wasted in household garbage, corresponding to € 21 per inhabitant. This study showed that in Vienna some medicines end up partially used or even completely unused in household garbage, including prescription-only medicines, non-expired medicines and medicines for chronic diseases. While there might be different reasons for medicines being wasted, the findings suggest possible adherence challenges as one issue to be addressed.

Food: a new form of personalised (gut microbiome) medicine for chronic diseases?

Filling in the knowledge gaps between what we eat and the diseases we develop may lie in our guts, literally. The human large intestine houses the largest reservoir of microorganisms in or on the human body. With a 100-fold greater gene count than humans, the gut microbiome has huge potential to place a large metabolic burden (or advantage) on its host. The number of diverse gut microbial species is diminished in nearly all modern chronic conditions studied. The 'Western diet', rich in animal protein, fats and artificial additives, and lacking in fibre, beneficial microbes, plant phytochemicals, vitamins and minerals, is thought to drive these conditions by encouraging gut dysbiosis. Evidence from recent dietary intervention studies suggest adopting a plant-based, minimally processed high-fibre diet may rapidly reverse the effects of meat-based diets on the gut microbiome. However, recent work has shown that individual diet responses may be complicated by host genetics and the wide variation in the gut microbiome. Now that we measure genes and microbes more accurately, we are embarking on an exciting era of using both food and microbes as potential therapies.

Availability and prices of essential medicines for chronic diseases in older people in the Asia Pacific Region

Background Little is known about the prices and availability of medicines for chronic diseases used by older people in the Asia Pacific Region. The objective of this study was to assess the availability and prices of essential medicines for chronic diseases in 11 countries, namely China, Fiji, India, Indonesia, Lao, Malaysia, Mongolia, the Philippines, Sri Lanka, Thailand and Vietnam. The study was carried out at an international level.

The Emergence of Retailing of Generic Medicines: An Awareness Study at Kakinada, Andhra Pradesh

Using lower price generic medicines for chronic diseases provides efficacy similar to branded medicines. However, previous studies showed that disadvantaged people, who may particularly benefit from cost savings, have low trust on generics and showed increased reluctance to switch to generics. The rural areas include areas of high poverty and minority communities whose members are at high risk for poor health outcomes. However, whether such beliefs exist in these communities has not been reported. We sought to obtain qualitative insights about awareness and usage of generic medication among the people in urban and rural areas of Kakinada city. This survey showed that there is a gap in consumers' awareness and availability of generic medicines in urban and rural areas of Kakinada. The findings of the study suggest that awareness needs to be spread among the customers about generic medicines. Besides, it is an emerging business opportunity for local medical retailers.

University of Craiova, Faculty of Physical education, Sports & Kinesiology

Lecture 26University of Craiova is one of the most important universities in Romania. It includes also Faculty of Physical Education, Sport and Kinesiology that prepare the future specialists in sport...

Partnerships To Provide Care And Medicine For Chronic Diseases: A Model For Emerging Markets

The challenge of expanding access to treatment and medicine for chronic diseases in emerging markets is both a public health imperative and a commercial opportunity. Cross-sector partnerships-involving a pharmaceutical manufacturer; a local health care provider; and other private, public, and nonprofit entities-could address this challenge. Such partnerships would provide integrated, comprehensive care and medicines for a specific chronic disease, with medicines directly supplied to the partnership at preferential prices by the manufacturer. The model discussed here requires additional specification, using real numbers and specific contexts, to assess its feasibility. Still, we believe that this model has the potential for public health and private business to cooperate in addressing the rising problem of chronic diseases in emerging markets.