Patient Awareness Research Articles

Thyroid Malignancy and Cutaneous Lichen Amyloidosis: Key Points Amid RET Pathogenic Variants in Medullary Thyroid Cancer/Multiple Endocrine Neoplasia Type 2 (MEN2).

We aimed to provide an updated narrative review with respect to the RET pathogenic variants and their implications at the clinical and molecular level in the diagnosis of medullary thyroid cancer (MTC)/multiple endocrine neoplasia (MEN) type 2, particularly with respect to the presence of cutaneous lichen amyloidosis (CLA). We searched English-language, in extenso original articles with no timeline nor study design restriction that were published on PubMed. A traditional interplay stands for CLA and MTC in MEN2 (not MEN3) confirmation. While the connection has been reported for more than three decades, there is still a large gap in understanding and addressing it. The majority of patients with MEN2A-CLA have RET pathogenic variants at codon 634; hence, it suggests an involvement of this specific cysteine residue in both disorders (most data agree that one-third of C634-positive subjects have CLA, but the ranges are between 9% and 50%). Females seem more prone to MEN2-CLA than males. Non-C634 germline RET pathogenic variants included (at a low level of statistical evidence) the following: RET V804M mutation in exon 14 for MTC-CLA (CLA at upper back); RET S891A mutation in exon 15 binding OSMR variant G513D (familial MTC and CLA comprising the lower legs to thighs, upper back, shoulders, arms, and forearms); and C611Y (CLA at interscapular region), respectively. Typically, CLA is detected at an early age (from childhood until young adulthood) before the actual MTC identification unless RET screening protocols are already applied. The time frame between CLA diagnosis and the identification of RET pathogenic variants was between 5 and 60 years according to one study. The same RET mutation in one family is not necessarily associated with the same CLA presentation. In MTC/MEN2 subjects, the most affected CLA area was the scapular region of the upper back. Alternatively, another hypothesis highlighted the fact that CLA is secondary to long-term prurit/notalgia paresthetica (NP) in MTC/MEN2. OSMR p. G513D may play a role in modifying the evolutionary processes of CLA in subjects co-harboring RET mutations (further studies are necessary to sustain this aspect). Awareness in CLA-positive patients is essential, including the decision of RET testing in selected cases.

Family member reported symptom burden, predictors of caregiver burden and treatment effects in a goal-oriented community-based randomized controlled trial in the chronic phase of traumatic brain injury

BackgroundFamily members are often affected by the long-term consequences of traumatic brain injury, but are rarely involved in rehabilitation programs in the chronic phase. We thus do not know what family members´ main concerns are in the chronic phase, what factors are associated with perceived caregiver burden, and whether family members´ health and functioning improves due to rehabilitation efforts received by the patients. This study explored family-members` functioning, predictors of caregiver burden and effect for family members of a goal-oriented intervention in the chronic phase of traumatic brain injury.MethodsFamily members self-reported data measuring their caregiver burden, depression, general health, loneliness, and their evaluation of patient competency in everyday life, patient awareness levels, main problem areas (target outcomes) for the patient related to the brain injury, and demographic data were collected. Regression models were used to explore predictors of caregiver burden, and mixed models analysis was used to explore treatment effects.ResultsIn total, 73 family members were included, 39 in the intervention group and 34 in the control group. Moderate to high caregiver burden was reported by 40% of family members, and 16% experienced clinical levels of depression. Family member loneliness and their evaluation of the patient`s level of functional competency explained 57% of the variability in caregiver burden. There were no treatment-related changes in caregiver burden, family member depression or general health. At T2 there was however a significant reduction in how family members rated severity of target outcomes that the family members had nominated at baseline (-0.38, 95% CI, -0.75 to -0.02, p = 0.04), but not for the target outcomes the patients had nominated.ConclusionsA significant proportion of family members to patients in the chronic phase of TBI continue to experience challenging caregiver burden and emotional symptoms. Both family member-related and patient factors contribute to caregiver burden. Interventions targeting patient complaints do not automatically alleviate family members´ burden. It is important to address social support for family members early after injury, and there is a need for more interventions specifically targeting family members´ needs.Trial registrationThe trial was registered at ClinicalTrials.gov, NCT03545594 on the 4th of June 2018.

Examining the Hypertension Control Cascade in Adults With Uncontrolled Hypertension in the US

Uncontrolled hypertension is a major contributor to cardiovascular disease (CVD) in the US. To determine the prevalence of hypertension control cascade outcomes (hypertension awareness, treatment recommendations, and medication use) among individuals with uncontrolled hypertension to inform action across cascade levels. This weighted cross-sectional study used January 2017 to March 2020 National Health and Nutrition Examination Survey (NHANES) data from noninstitutionalized adults aged 18 years or older in the US with uncontrolled hypertension. Data analysis occurred from January to February 2024. Calendar year of response to the NHANES survey. Mean blood pressure (BP) was computed using up to 3 measurements. Uncontrolled hypertension was defined as systolic BP of 130 mm Hg or greater or diastolic BP of 80 mm Hg or greater, regardless of medication use. Outcomes included patient awareness of hypertension, treatment recommendations, and medication use. To estimate population totals by subgroup, the age-standardized proportion of each outcome was multiplied by the estimated number of adults with uncontrolled hypertension. The study included 3129 US adults with uncontrolled hypertension (1675 male [weighted percentage, 52.3%]; 775 aged 18 to 44 years [weighted percentage, 29.4%]; 1306 aged 45 to 64 years [weighted percentage, 41.4%]; 1048 aged 65 years or older [weighted percentage, 29.2%]), resulting in a population estimate of 100.4 million adults (weighted percentage, 83.7%) with uncontrolled hypertension. More than one-half of study participants (57.8 million adults [weighted percentage, 57.6%]) were unaware that they had hypertension, and of the 35.0 million who were aware and met criteria for antihypertensive medication, 24.8 million (weighted percentage, 70.8%) took the medication but had hypertension that remained uncontrolled. These negative outcomes in the hypertension control cascade occurred across demographic groups, with notably high prevalence among younger adults and individuals engaged in health care. Among an estimated 30.1 million adults aged 18 to 44 years with hypertension, 10.4 of 11.3 million females (weighted percentage, 91.8%) and 17.7 million of 18.8 million males (weighted percentage, 94.3%) had uncontrolled hypertension. Of the 10.4 million females, 7.2 million (weighted percentage, 68.8%) were unaware of their hypertension status, and of the 17.7 million males, 12.0 million (weighted percentage, 68.1%) were unaware. Additionally, 9.9 of 13.0 million adults with uncontrolled hypertension (weighted percentage, 75.7%) reported no health care visits in the past year and were unaware. Conversely, among 70.6 million adults with uncontrolled hypertension reporting 2 or more health care visits, approximately one-half (36.6 million [weighted percentage, 51.8%]) were unaware. In this cross-sectional study, more than 50% of adults with uncontrolled hypertension in the US were unaware of their hypertension and were untreated, and 70.8% of those who were treated had hypertension that remained uncontrolled. These findings have serious implications for the nation's overall health given the association of hypertension with increased risk for CVD.

Analysis of Pharmaceutical Sciences and Public Health Applications

Growing in frequency in both rural and urban parts of India, growing percentage of people at risk of diabetes, Indian population's genetic susceptibility to diabetes risk factors related to the environment, Globalisation causing a decline in physical exercise Some of the challenges that the disease poses in India are low patient awareness of hypertension, undiagnosed hypertension due to a variety of factors such as low healthcare facilities and economic status, inadequate disease control, and an increasing incidence of complications related to hypertension. Although there are solutions, the healthcare team will need to work in tandem with the clinician who is battling the illness on an individual basis. This will prevent the patient from receiving the proper care, the clinician from being able to listen to the patient's problems and find solutions, the patient from receiving the psychological support they need for a chronic illness, and the nation from suffering from economic hardship after the patient's illness. The purpose of this study was to identify the services provided by pharmaceutical care and evaluate the barriers to pharmaceutical care in various settings in order to provide relevant recommendations.

Insights into patient awareness and preferences in medical imaging procedures involving ionizing radiation

Abstract Introduction: Advancements in technology have revolutionized the landscape of medical imaging, offering a multitude of modalities. However, this progress is not always fully traceable to patients, necessitating studies in this area to bridge the gap between technological advancements and patients’ insights. This study delves into patient awareness, preferences, and understanding concerning radiation risk in medical imaging procedures using ionizing radiation. Material and methods: An anonymous survey was conducted among 152 patients in Bulgaria who underwent X-ray procedures to gauge their insights into medical imaging. Data analysis utilized SPSS version 20.0, computing frequencies and percentages for categorical variables like gender, age, and education. Results: Significant correlations were found between gender and the need for knowledge related to radiation risks (χ2 = 4.622, p = 0.032), as well as patient understanding of radiation dose information and decision-making preferences (χ2 = 10.800; p = 0.020). Female participants showed higher awareness levels in these areas compared to male participants. Younger patients, notably aged 36-50 (52.6%), comprised a significant portion undergoing X-ray imaging, diverging from global trends. Age correlated with the frequency of X-ray examinations (χ2 = 171.256; p = 0.000) and decision-making preferences (χ2 = 8.324; p = 0.016), with older patients favoring informed decisions with physician input. Education levels significantly influenced radiation risk awareness (χ2 = 7.084, p = 0.008) and understanding of radiation dose information (χ2 = 14.752, p = 0.001). Patients with higher education levels demonstrated a significantly better understanding of absorbed radiation doses compared to those with secondary education. These findings highlight the influence of demographic factors such as gender, age, and education on patient awareness, knowledge acquisition, and decision-making processes regarding medical imaging and radiation risks. Conclusions: Tailored communication strategies, informed consent practices, and ongoing specialist education are crucial to enhancing patient awareness, optimizing decision-making processes, and ensuring radiation safety in medical imaging. Implementation of electronic health records can further improve radiation exposure monitoring, aligning with evolving technological standards and patient needs.

Experts' Opinion in Fabry Disease Management and the Unmet Medical Need: The Saudi Perspective.

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by α-galactosidase A gene mutations. Its global incidence ranges from 1:40,000 to 1:170,000. This expert review evaluates the available guidelines, the status of diagnosed but untreated patients with FD, and the challenges in diagnosing and managing FD in the Kingdom of Saudi Arabia (KSA). An advisory board meeting (ABM) was conducted in two phases, with a survey that aimed to receive insights on the current unmet needs in the management of patients with FD in November 2022, and a second, offline meeting in February 2023. The goal of this ABM was to discuss current unmet needs in the management of Fabry patients in the Kingdom of Saudi Arabia. In the first ABM, experts opined on the best practices in the diagnosis, screening, and management of FD for healthcare professionals. These opinions on the management of FD relied on data from research and expert clinical judgments. In the second ABM, the same panel discussed different aspects of FD diagnosis, treatment, and management in the member countries of the Gulf Cooperation Council. The experts discussed the stigma associated with FD, patient awareness and knowledge, genetic screening, biomarkers, and home infusion therapy. They reviewed international guidelines and clinical criteria for enzyme replacement therapy (ERT). Furthermore, they also discussed the diagnosis of FD in men and women, the current guidelines followed for monitoring patients with FD, monitoring untreated patients with FD, Fabry Stabilization IndeX (FASTEX) as an assessment tool for the diagnosis of FD, FD management in KSA, challenges encountered while prescribing ERT in patients with FD, and the clinical criteria for starting ERT. The discussions led to the conclusion that currently, ERT is the only available therapy to manage FD and research should be focused on the early diagnosis and management of FD.

The role of oculoplastic surgeons in minimally invasive cosmetic injectables.

In recent years, the field of aesthetic medicine has witnessed a paradigm shift with an increasing demand for minimally invasive cosmetic procedures, including cosmetic injectables. This review aims to delineate the distinctive role played by oculoplastic surgeons in the administration of cosmetic injectables, comparing their expertise to that of nonphysician practitioners. Complications arising from cosmetic injections are discussed, including skin discoloration, inflammation, necrosis, vision loss, retinal pathology, and central nervous system adverse effects. Injector expertise, patient factors, type of filler, location of injection, and management strategies are reviewed. Findings highlight diverse practitioner involvement, common adverse effects like skin necrosis and vision loss, with hyaluronic acid fillers being prominent. Areas at the highest risk for ocular complication include the glabella and nose with potential management involving dissolving fillers and reducing pressure. Emphasis is placed on expert injector selection and patient awareness. The administration of cosmetic injectables requires a profound understanding of facial anatomy, vasculature, and potential complications. In contrast to nonphysician practitioners, oculoplastic and aesthetic surgeons bring a level of anatomical precision and clinical acumen that is essential for navigating the complexities of cosmetic injectables. Emphasis on training and collaboration among practitioners will be essential in advancing the field while prioritizing patient safety and satisfaction.

Assessment of Nutritional Status and Food Awareness for Hyperthyroid and Hypothyroid Patients

Assessment of Nutritional Status and Food Awareness for Hyperthyroid and Hypothyroid Patients

Awareness of Current Surgical Practice for Congenital Scoliosis and Optimal Timing of Treatment Among Physicians and Patients' Families in Saudi Arabia.

Congenital scoliosis (CS) is a developmental spinal deformity characterized by an abnormal curvature of the spine, affecting one in 1,000 births. The mainstay of treatment involves either observation or surgery in significant curve progression. The optimal timing of surgical intervention is debated, with early intervention preferred. Therefore, understanding physicians' and patients' families' perspectives is crucial for optimizing surgical outcomes in CS. To assess the awareness and knowledge of physicians and patients' families regarding current, as well as new surgical practices and the optimal timing of treatment for CS. A cross-sectional study was conducted in Saudi Arabia using an online self-administered questionnaire distributed through social media platforms and neurosurgery clinics. Levels of awareness were assessed by a knowledge-scoring system. The study involved 403 participants, primarily patients' families (85.1%, N = 343) and physicians (14.9%, N = 60). The results show that physicians had a significantly higher correct response than patients' families regarding the ideal age for surgical correction of CS, the timing of surgical intervention whether before or after maturity, and the role of conservative management, as evident from statistically significant p-values of <0.001, 0.031, and <0.001, respectively. On the contrary, patients' families excelled in understanding interventions irrespective of symptomatic status if Cobb's angle is 40 degrees or above, with a statistically significant p-value of 0.031. Both groups exhibited a good level of overall knowledge, as evidenced by mean awareness scores of 12.18 and 11.64, respectively. Additionally, physicians had a statistically significanthigher level of awareness compared to patients' families, with a p-value of (0.014). However, both groups demonstrated poor knowledge of the latest techniques, including distraction-based magnetically controlled growing rods (MCGRs), growth-guided modern Luque trolleys, and posterior dynamic deformity correction (ApiFix). The mean awareness score of both physicians and patients' families indicates a good level of knowledge. However, both groups exhibited poor knowledge in relation to the optimal timing of treatment and new surgical techniques.

Early Identification and Management of Patients with Rash on Apalutamide.

Apalutamide is a selective androgen receptor signalling inhibitor that is used in the treatment of prostate cancer. Skin rash is one of the most common adverse events with apalutamide. Although the majority of rash events are grade 1 and 2, the appearance of skin rash during treatment can lead to dose reduction, a pause in treatment or even treatment discontinuation, especially if patients present late when the rash has become severe. This in turn can result in a significant delay or even a permanent discontinuation in the patient's treatment of prostate cancer. As apalutamide is a generally well tolerated and an effective treatment for many men with advanced prostate cancer, it is extremely important to make attempts to prevent skin problems or to manage them at the earliest stage possible. We therefore have developed practical guidance for the management of apalutamide-related rash, including an infographic with recommendations for rash management by grade. Central to this approach is patient education and awareness. Encouraging patients to proactively care for their skin from the start of treatment and informing them of the risk of rash with apalutamide therapy are essential. If the patient observes any skin changes, they should be advised to report it straight away to their cancer care team. Adopting this simple, proactive approach of patient education and increased vigilance from the care team is expected to lead to early identification of rash and subsequent intervention to allow for quicker resolution and enable patients to continue their cancer treatment with a drug that can delay disease progression and increase survival in patients with prostate cancer.

Proportion of Patients in the United States Who Fill Their Nirmatrelvir/Ritonavir Prescriptions.

Although real-world studies demonstrate that those prescribed nirmatrelvir/ritonavir (and particularly within 5days of symptom onset) are less likely to experience severe COVID-19 outcomes, prior studies show that only a small fraction of patients with COVID-19 who are eligible for nirmatrelvir/ritonavir receive a prescription. Studies calculating the proportion of nirmatrelvir/ritonavir prescriptions filled and identifying individual- and pharmacy-level correlates of filling nirmatrelvir/ritonavir are lacking. This retrospective cohort study included individuals aged ≥ 12years with a nirmatrelvir/ritonavir prescription ordered at a large national retail pharmacy (December 22, 2021-August 12, 2023). Those taking contraindicated medications were excluded. For those with only one nirmatrelvir/ritonavir prescription ordered, the outcome was whether the prescription was filled (yes/no). In a subanalysis of these individuals, the outcome was whether the prescription was filled within 5days of symptom onset (yes/no). For those with multiple prescriptions ordered, the outcome was whether > 1 (vs. 0 or 1) prescriptions were filled. A log-binomial regression with generalized estimating equations was used to identify individual (clinical and demographic) and pharmacy-level (percentage of trade area that is non-Hispanic white, urbanicity, US Census region, and tract-level area deprivation index) correlates. A total of 2,103,570 unique nirmatrelvir/ritonavir prescriptions were ordered for 1,985,990 individuals. Among the 95% of individuals prescribed only one nirmatrelvir/ritonavir course, 88% filled their prescription. Among those with > 1 prescription ordered, 77% (82,993/108,411) filled one and 13% (13,662/108,411) filled > 1. Patients ≥ 50years of age and those with documented high-risk conditions were slightly more likely to fill prescriptions, regardless of whether one or multiple courses were ordered. Individuals with cancer, asthma, or taking corticosteroids or immunosuppressive medications were more likely to fill multiple prescriptions. Most patients filled their nirmatrelvir/ritonavir prescriptions. Interventions to improve uptake should focus on increasing patient and provider awareness, reducing nirmatrelvir/ritonavir prescribing disparities, and ensuring treatment initiation within 5days.

Scale consistance in cognitive status awareness of patients with Parkinson’s disease

Objectives: This study aimed to investigate the relationship between patients’ awareness of their cognitive symptoms and the presence of cognitive involvement according to neuropsychological tests. Patients and methods: In this cross-sectional study, 539 patients (276 males, 263 females; mean age: 64.3±11.0 years; range, 19 to 88 years) were assessed between September 2020 and June 2023. The Mini-Mental Status Examination (MMSE) scores were recorded in addition to age, sex, education level, and chronic diseases. Patients were classified as having cognitive disorders if their MMSE scores were &lt;26, while those with scores ≥26 were classified as cognitively healthy. The relationship between the frequency of cognitive involvement according to a related question from the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and the frequency of cognitive disorders according to the MMSE scores was evaluated. Results: No relationship was detected between the frequency of cognitive disorders according to the MMSE scores and the frequency of cognitive involvement according to the corresponding question in the nonmotor component of the MDS-UPDRS (p&lt;0.001). Conclusion: The findings indicate that the cognitive impairment inquiry in the nonmotor section of the MDS-UPDRS is not an effective method for detecting cognitive involvement in Parkinson’s disease.

Impact of shared decision-making in Taiwanese patients with atrial fibrillation eligible for novel oral anticoagulant therapy

Background/PurposeShared decision-making (SDM) promotes patient awareness about medical conditions and treatments, facilitating patient involvement in care decisions. This two-stage multicenter study evaluated impacts of SDM in Taiwanese adults with atrial fibrillation (AF) eligible for novel oral anticoagulant (NOAC) therapy. MethodsParticipants were NOAC-naïve (part I) or dabigatran-experienced (part II). During Stage I, part I participants (n = 124) completed a semi-structured survey (understanding evaluation sections only) before and after viewing SDM materials on stroke prevention for AF. Surveys collected data on anxiety about AF, confidence in healthcare professionals, usefulness of the SDM materials, and perception of different NOACs. During Stage II, part I participants after being prescribed NOACs, and part II participants completed another survey to compare impacts of SDM. ResultsDuring Stage I, dabigatran was the preferred NOAC after viewing the SDM materials among 90% of part I participants. During Stage II, both part I (n = 87) and part II participants (n = 104) completed another survey. Fewer part I participants were anxious about AF (p < 0.01), and more had confidence in healthcare professionals (p < 0.01) after viewing SDM materials than before. Most part I participants (≥90%) rated the SDM materials as “very helpful”. In Stage II, participants viewing SDM before initiating dabigatran had lower anxiety (part I, 43%; part II, 53%; p < 0.01) and a higher trust (part I, 92%; part II, 84%; p < 0.01). ConclusionIn conclusion, SDM reduced anxiety and improved trust in healthcare professionals among NOAC-naïve participants with AF.

Recent and forecasted increases in coccidioidomycosis incidence in California linked to hydroclimatic swings.

Coccidioidomycosis, or Valley fever, is an infectious disease caused by inhalation of Coccidioides spp., fungi found primarily in soils of the southwestern United States. Prior work showed that coccidioidomycosis cases in California sharply increase by nearly 2-fold following wet winters that occur one- and two-years following drought. Statewide drought between 2020-2022 followed by heavy precipitation during the 2022-2023 winter raised concerns over potential increases in coccidioidomycosis cases in the fall of 2023, prompting California Department of Public Health (CDPH) to issue public health alerts. As anticipated, California saw a near record number of cases in 2023, with 9,054 provisional cases reported. During the 2023-2024 California wet season, precipitation was 115% the long-term average, furthering concerns about continued high coccidioidomycosis risk. We developed an ensemble model to forecast coccidioidomycosis cases in California in 2024-2025. Using this model, we predicted a total of 11,846 cases (90% PI: 10,056-14,094) in California between April 1, 2023, and March 31, 2024, encompassing the preliminary state report of 10,593. Our model forecasted 12,244 cases statewide between April 1, 2024, and March 31, 2025 - a 62% increase over the cases reported during the same period two years prior, and on par with the high incidence seen in 2023. The Southern San Joaquin Valley (5,398 cases, 90% PI: 4,556-6,442), Southern Coast (3,322, 90% PI: 2,694-3,961), and Central Coast (1,207 cases, 90% PI: 867-1,585) regions are expected to see the largest number of infections. Our model forecasts that disease incidence will exhibit pronounced seasonality, particularly in endemic regions, with cases rising in June and peaking in November at 1,411 (90% PI: 815-2,172) cases statewide - 98% higher than the peak two years prior (714) and nearly as high as the peak in 2023 (1,462). Near-term forecasts have the potential to inform public health messaging to enhance provider and patient awareness, encourage risk reduction practices, and improve recognition and management of coccidioidomycosis.

Patient awareness and practices regarding antimicrobial use and drug resistance.

Drug-resistant bacterial infections have become a substantial problem in various communities. Appropriate antimicrobial use is required because reducing antimicrobial use could reduce the number of resistant bacteria. The inappropriate use of antimicrobials can be prevented by improving the knowledge of patients, physicians, and other healthcare professionals; however, no antimicrobial awareness survey specifically aimed at patients has been conducted yet. Therefore, to promote proper antimicrobial use, mainly by patients, we conducted a survey on the attitudes of patients who brought their antimicrobial prescriptions from insurance pharmacies. The results were based on 858 responses. Awareness of the terms "bacteria, viruses, and antimicrobials" was > 80%, whereas that of "drug-resistant bacteria" was only 37.2%. Only 26.5% of respondents understood what the efficacy of antimicrobial drugs meant. Additionally, 31.5% of the respondents had experienced discontinuation antimicrobials, and approximately 70% of the reasons for discontinuation were self-judged symptom improvement. Furthermore, those who had experienced discontinuation were less aware of the various aspects of antimicrobial use than those who had not. In antimicrobial treatment, avoiding the emergence of drug-resistant bacteria is difficult, is detrimental to patients consuming treatment, and presents a major problem in society. Therefore, healthcare professionals should strive to optimize infectious disease treatment by providing appropriate guidance on the proper use of antimicrobials, significance of taking them, and harmful effects of their discontinuation to patients.

An Evaluation of Oral Anticoagulant Safety Indicators by England's Community Pharmacies.

Anticoagulants are life-saving medicines that can prevent strokes for patients diagnosed with atrial fibrillation (AF) as well as treating patients with venous thromboembolism (VTE), but when used incorrectly, they are frequently associated with patient harm. To evaluate the impact of community pharmacy teams on optimising patient knowledge and awareness and improving medication safety from the use of anticoagulants. Two national audits, consisting of 17 questions assessing and improving patients' understanding of anticoagulant therapy, identifying high-risk patients, and contacting prescribers when clinically appropriate were incentivised for England's community pharmacies in 2021-2022 and 2023-2024 using the Pharmacy Quality Scheme (PQS) commissioned by NHS England. Approximately 11,000 community pharmacies audited just under a quarter of a million patients in total, whilst making almost 150,000 interventions for patients taking oral anticoagulants, i.e., identifying and addressing medication issues which could increase the risk of bleeding/harm. Out of the 111,195 patients audited in 2021-2022, only 24,545 (23%) patients were prescribed vitamin K antagonists. The remaining patients were prescribed direct oral anticoagulants (DOACs). By 2023-2024, this decreased to 17,043 (16%) patients. Most patients knew that they were prescribed an anticoagulant (95.6%, 106,255 in 2021-2022 and 96.5%, 101,006 in 2023-2024, p < 0.001). The audits resulted in a statistically significant increase in patients with a standard yellow anticoagulant alert card, as identified in audit 2 (73,901 66.5% in 2021-2022 to 76,735, 73.3% in 2023-2024, p < 0.001). Furthermore, fewer patients were prescribed concurrent antiplatelets with an anticoagulant (6021; 4.6% in 2021-2022 to 4975; 4% in 2023-2024, p < 0.001). Although there was an increase in the number of patients prescribed NSAIDs with anticoagulants, more of these patients were also prescribed gastroprotection concurrently (927 77.2% in 2021-2022 to 1457 84.1% in 2023-2024, p < 0.05). The majority of patients on warfarin had their blood checked within 12 weeks. Further there was an increase for these patients in the percentage of people prescribed VKAs who knew dietary changes can affect their anticoagulant medicine (16,764 67.4% in 2021-2022 to 12,594 73.9% in 2023-2024 p < 0.001). Community pharmacy teams are well placed in educating and counselling patients on the safe use of anticoagulants and ensuring that all patients are correctly monitored.

The moderating effect of self-efficacy in the risk awareness and treatment compliance of hypertensive patients.

The WHO reported that 46% of adults with HT in the global statistics were unaware of the disease.The aim of this study was to examine the moderating role of self-efficacy in risk awareness and treatment compliance of hypertensive patients. Data for this descriptive and correlational study were collected between 22.08.2023 and 22.02.2024. A personal information form was used for data collection together with a risk awareness scale, self-efficacy scale, and antihypertensive treatment compliance scale. The data were collected from 169 patients in face-to-face intterviews. Multiple linear regression and PROCESS macro-Model vn.3.5 were used in the analyses. The STROBE control list was followed in the study. A moderate level of risk awareness (40.03 ± 7.98) and self-awareness (56.11 ± 10.18) of the study participants was determined, and there was seen to be treatment compliance (6.53 ± 2.34). Risk awareness was seen to be positively correlated with both treatment compliance and self-efficacy (p < 0.05). The moderating effect of the treatment points between risk awareness and self-efficacy was analyzed and the model formed was found to be statistically significant (F = 1.942, p = 0.006). Independent variables in the model explained 28% of the change in the dependent variable. Self-efficacy points were not found to have a moderating effect on the effect of cardiovascular risk awareness on antihypertensive treatment compliance (p = 0.144). Treatment compliance can increase with an increase in the self-efficacy and risk awareness of an individual. Increased self-efficacy may affect the moderating role.

Influence of Seamless Patient-Centered Care on Efficiency, Satisfaction, and Patient Awareness in Imaging Departments: A Prospective Cohort Study.

This prospective cohort study included 300 patients undergoing imaging examinations from January 2019 to January 2022. Subjects were divided into control and observation groups (n=150 each) based on different nursing methods. The control group received routine care, and the observation group received seamless care. The following outcome measures were assessed using validated questionnaires: patient satisfaction (measured using a 5-point Likert scale), medical staff satisfaction with patient examination cooperation (measured using a 5-point Likert scale), nursing quality compliance rate (percentage of nursing tasks performed according to established guidelines), dissatisfaction rate (percentage expressing dissatisfaction with examination cooperation), and effect evaluation [measured using a knowledge test validated in previous studies (Chung et al., 2020) with a total score range of 0-20]. Average imaging examination and nursing times were significantly lower in the observation group compared to the control group (P&#60;0.05). The examination cooperation dissatisfaction rate was significantly lower in the observation group (P&#60;0.05). There were significant differences in examination precautions, procedures, breathing training methods, and injection comparisons between the groups (all P&#60;0.05). The application of seamless nursing care may be associated with improved patient satisfaction, nursing service quality, imaging examination efficiency, and patient awareness of imaging examinations. However, further research is needed to establish causal relationships.

Promoting Patient Engagement in Adverse Drug Reaction Reporting: A Novel Approach Utilizing Set Induction-Based Skill Questionnaires.

All stakeholders must address the global health concern of an increasing frequency of adverse drug reactions (ADRs), regardless of the practice settings. Adverse drug reactions have been found to be a significant cause of morbidity and death across all age groups, hospital admissions, and a significant financial burden on society and healthcare systems. The main objective of this study was to measure patients' awareness and knowledge of reporting adverse drug reactions using a questionnaire and then to help patients become more aware of and sensitive to reporting ADRs. The current investigation was carried out in the OPD Block of the All India Institute of Medical Sciences in Deoghar using a pre-experimental study with one group pre-test post-test design. One hundred and ninety-nine patients who were visiting different OPDs and IPDs participated in this study. The average age of the 199 study participants was 34.6 years. The majority of participants were male, illiterate and belonged to rural areas. We found a statistically significant difference [-11.90(0.000*)] in the pre-test and post-test knowledge questionnaire scores of the participants, indicating the efficacy of awareness and sensitization for patients on ADR reporting. This survey aims to inform patients about the pharmacovigilance Program in India. The questions are structured in a way that allows patients to reflect and become more selfaware while reading them. They also function as a set introduction to ADR (Adverse Drug Reaction) monitoring centers and increase patient awareness of reporting ADRs.

“Determinants of antibiotic use/misuse from patients' and health providers’ perspective – A descriptive analysis from coastal Karnataka, India”

ObjectivesTo evaluate the awareness and practices of patient's antibiotic usage and assess the perception of health providers with regard to antibiotic use and misuse in a tertiary hospital. MethodsA cross sectional study was conducted in a tertiary care hospital in coastal Karnataka, India. The study participants included consenting volunteers of either gender, aged >18 years, including 384 patients, 25 nurses and 25 physicians. ResultsKnowledge about indications for antibiotic usage was found to be poor as 85.9 % believed that antibiotics were effective against viral diseases as well. It was found that about 71.6 % patients had self-medicated themselves for minor illnesses, but majority preferred tertiary health care facilities for major illnesses. Practice of the patients was found to be good with 78.1 % patients consulting a physician before consuming antibiotics and 96 % completing the course as advised. Among the 25 nurses interviewed, 92 % reported discussion with patients regarding their antibiotic prescription. About 21.4 % nurses reported to have prescribed antibiotics to other friends, neighbours and patients, on the basis of their clinical exposure. The causes of emerging Antimicrobial Resistance (AMR) as reported by the doctors were-inappropriate prescription, self-medication, and non-adherence to the course as prescribed. ConclusionBetter doctor patient communication, educating both doctors and patients, antibiotic sensitivity-based prescription and practicing evidence-based medicine are required to combat antimicrobial resistance.