Prescription Medications Research Articles

Associations Between Hearing Loss and Health-Related Costs: A Retrospective Population-Based Cohort Study

Purpose: Hearing loss (HL) is a leading cause of disability worldwide, but its health-related costs have been incompletely studied. Our objective was to examine the association between HL and direct health care costs and identify subgroups in which costs associated with HL are especially high. Method: This was a retrospective population-based cohort study of adults treated in a universal health care system between April 2008 and March 2019. HL was identified using administrative health data. We estimate health care costs in 2023 Canadian dollars, including costs for hospitalization, provider claims, ambulatory care visits, prescription medications, and long-term care (LTC). Results: Of 4,424,632 participants, 146,644 (3.3%) had HL. Participants with HL were older ( Mdn = 55 years [interquartile range: 43–68] vs. 35 years [24–50]) and had more comorbidities (1 [0–2] vs. 0 [0–1]) at baseline than participants without, whereas the likelihood of female sex, rural residence, and material deprivation were similar between groups with and without HL. Over median follow-up of 11.0 years, total age–sex adjusted annual health costs and each of its component costs were significantly higher in participants with HL compared to those without (annual total costs: $6,871, 95% confidence interval [CI] [$6,778, $6,962] vs. $4,716, 95% CI [$4,729, $4,763]). After full adjustment (a maximum of 29 comorbidities), annual costs remained significantly higher in participants with HL overall and for certain subcomponents (provider claims, ambulatory visits, and medications), whereas adjusted costs of hospitalization and LTC were lower among people with HL. The magnitude of the incremental costs among participants with HL was most pronounced for younger participants, men, or those with less comorbidity. Total projected annual direct health costs for Alberta residents with HL were $1.01 billion in 2023, of which $125 million (95% CI [$116, $135 million]) was attributable to HL specifically. Conclusions: Compared to those without HL, health costs were markedly higher among participants with HL, partially due to a higher burden of comorbidity. The relatively high population attributable costs of HL suggest that better prevention, recognition, and management of this condition could yield substantial economic benefits. Supplemental Material: https://doi.org/10.23641/asha.27353439

Knowledge and attitudes toward over-the-counter medications among pharmacy students: insights from a cross-sectional study in Taif University, Saudi Arabia

IntroductionOver-the-counter (OTC) medications are those obtained without a medical prescription from a healthcare professional. With the increasing availability of information from various sources, including social media, pharmacy students may be exposed to unreliable or inaccurate data. Incorrect medication use is particularly concerning due to its potential risk of causing adverse health effects.” Hence, this study aims to determine students’ knowledge and attitudes at Taif University’s pharmacy college.MethodsThis research utilized a cross-sectional online questionnaire-based study, employing data from a sample of 450 pharmacy students from Taif University in Saudi Arabia. Descriptive analysis included descriptive and differential analysis. The data were analyzed using statistical package for social sciences (SPSS) Version 27.ResultsThe majority of participants, 297 (88.2%), were aware that inappropriate use of over-the-counter medications might have negative implications. A total of 233 participants (51.8%) reported having previously used an OTC medication. Also, 293 (65.1%), were aware that using OTC medications beyond their expiration date was harmful. A total of 280 participants (62.2%) had a high knowledge of OTC medication, whereas 170 respondents (37.8%) had a low level of knowledge. A significant correlation was found between age, year of study, and the use of OTC medication p-values <0.05 (0.016*, 0.003*, and 0.001* respectively) and understanding of OTC medication. Gender had no significant influence on knowledge of OTC (p > 0.05).ConclusionThe study found positive attitudes toward OTC medications. Due to increased pharmaceutical exposure and self-medication, upper-year students and OTC course graduates comprehend OTC medications better. The examination found safety protocol violations in expiration dates, prescription label interpretation, and storage. Therefore, the study provides useful information for future attempts. Also, this study may contribute to the literature and guide future research to fill knowledge gaps.

Prevalence of epilepsy: a population-based cohort study in Denmark with comparison to Global Burden of Disease (GBD) prevalence estimates

BackgroundThe Global Burden of Disease Study (GBD) produces prevalence estimates for ‘idiopathic epilepsy’ (ie, of unknown aetiology) and ‘secondary epilepsy’ (ie, with known aetiology) but does not report prevalence by...

Healthcare and Pharmacy Staffs' Experiences on Medication Management for Migrants—A Qualitative Exploratory Case Study in Primary Health Care

ABSTRACTAimTo explore what healthcare staff and staff in pharmacies experiences, as challenges, and possibilities in handling and use medications by foreign‐born persons or their relatives, and how necessary information is exchanged between different units in the healthcare chain to prevent medication errors.DesignA qualitative explorative single‐unit case study in a primary healthcare centre, with connected home care and pharmacies in an immigrant‐dense area.MethodsIndividual semi‐structured interviews with 17 respondents, including pharmacists, physicians and registered nurses, were conducted between May and December 2022, in Sweden. Inductive qualitative content analysis was applied.ResultsSix categories were identified: limited knowledge about medications, lack of knowledge about the Swedish system for medication prescriptions and pharmacy regulations, insufficient time to develop trusting relations, communication to support medication management, tools for facilitating safe use of medications and problems in exchange of information in the healthcare chain.ConclusionGood communication is both a challenge and a prerequisite for safe medication management by well‐informed patients. To ensure patient safety, it is crucial to establish ways to communicate with patients about their medications, regardless of their language skills. Improving communication within the healthcare chain is essential to prevent medication errors.Implication for the Profession and Patient CareUnderstanding the complexity of medication management and preventing medication errors requires staff to communicate effectively with patients at all steps in the healthcare chain to identify their informational and educational needs.ImpactThis study provides a comprehensive understanding of the importance of communication within the healthcare chain, including prescribing physicians, nurses, pharmacists and patients, to prevent medication errors.Reporting MethodCOREQ checklist.Patient or Public ContributionThis study focused on staff at a healthcare centre and two pharmacies.

General practice utilisation by Australian cancer patients in the last year of life

Abstract Objectives General practice plays a key role in end-of-life care, yet the extent of this remains largely unknown due to a lack of detailed clinical data. This study aims to describe the care provided by General Practitioners (GPs) for people with cancer in their last year of life. Methods Retrospective cohort study using linked routine primary care and death certificate data in Victoria, Australia. Patients were included who died from cancer between 2008 and 2017. Results In total 7025 cancer patients were included, mean age of 74.8 yrs. 95% of patients visited their GP in the last 6 months of life, with a median of 11 general practice contacts in this period. 72% of patients visited their GP in the second-last month prior to death, and 74% in the last month of life. The majority of patients (58%) were prescribed opioids, 19% anticipatory medications, 24% received a home visit, and a small proportion had imaging (6%) in the last month and pathology (6%) in the last fortnight. Patients in regional areas had more contact with general practices in the last year of life compared to metropolitan patients (median metropolitan = 16, inner regional = 25, and outer regional = 23, P < .001). The use of GP services did not differ by cancer type. Conclusions GP’s play a central role in end-of-life care provision for cancer patients, which intensifies in the last months of life. There is room for improvement, with a proportion having little or no engagement, and low rates of home visits and anticipatory medication prescribing.

Understanding the Determinants Influencing Self-Medication with Antibiotics Among Malaysian Residents: A Qualitative Study to Inform Preventive Public Health Strategies

Introduction: Self-medication with antibiotics (SMA)—the use of these drugs without a physician’s diagnosis, supervision, or a medical prescription—has emerged as a significant crisis in many societies, being a particular concern in low- and middle-income countries. SMA practices hinder global efforts to reduce antibiotic consumption in the human health sector and to control antimicrobial resistance (AMR). The aims of the study were to explore the motivations, perspectives, and personal experiences of the Malaysian population related to SMA, analyzing their subjective viewpoints, attitudes, and behaviors. Methods: The present qualitative study applied an interpretivism paradigm to explore the complex topic of SMA; the interview questions were developed and confirmed by experts in AMR and pharmacy practice. Qualitative data analysis was carried out through a thematic approach. Results: Out of twenty-seven (n = 27) eligible individuals, eleven (n = 11) agreed to participate in in-depth interviews. Three main themes and seven subthemes were identified. Participants revealed directly purchasing antibiotics from pharmacies, due to doctors prescribing similar medications for comparable illnesses in the past. Trust issues related to physicians prescribing unnecessary additional medications and suspected personal motives were revealed. Budgetary constraints, timesaving, and aspects of self-care were identified as some of the key drivers for SMA. Conclusions: The current study’s findings contribute to the understanding of the complexities surrounding SMA and provides insights into the public perceptions and behaviors regarding unregulated antibiotic use in Malaysia. Understanding these dynamics may inform targeted public health interventions to address SMA to mitigate the development of AMR.

Proton pump inhibitors in inpatients: Are we getting it right? A retrospective analysis

Background: Proton pump inhibitors (PPIs) are commonly prescribed to hospitalized patients, but many of these prescriptions may not be based on evidence-based indications. It’s important to understand that inappropriate prescribing of PPIs can lead to unnecessary medications and financial burdens. Unfortunately, there are not many recent studies exploring how often PPIs are prescribed and if they are being prescribed appropriately. Objective: The study aimed to assess the appropriateness of PPIs use among hospitalized patients. It evaluated the indications for PPIs use and determined whether the use of PPIs in hospitalized patients is justified or not. Setting: The study was conducted at Hamad General Hospital, a tertiary academic healthcare center in the state of Qatar. Methods: A retrospective observational study with 201 subjects, was conducted in general internal medicine wards at a tertiary hospital. Physician documentation and inpatient and outpatient medication prescriptions were analyzed for PPIs exposure. Main outcome measures: The appropriateness of exposure to PPIs is determined based on international recommendations. Results: Of 533 hospitalized patients who were not critically ill, 201 (37.7%) were prescribed PPIs. The study found that 65.2% of the patients had no valid indication for PPIs exposure. Furthermore, 18% of patients were inappropriately prescribed stress ulcer prophylaxis with PPIs even though they had a low risk for the development of ulcer disease. After discharge, 82.6% of patients were prescribed PPIs, with the most common indication (43%) being gastrointestinal ulcer prophylaxis. Conclusion: This study sheds light on the issue of overutilization of PPIs, specifically in non-critically ill hospitalized patients. It highlights the unnecessary continuation of PPI prescriptions at discharge and emphasizes the importance of physicians reevaluating PPI prescriptions periodically to ensure they are still necessary and discontinuing them when possible to avoid unwanted consequences.

The prevalence of suboptimal prescribing of medication in First Nations older adults in the Torres Strait

AbstractObjectivesThis study assessed the prevalence of suboptimal prescribing of medicines in First Nations older adults in the Torres Strait. Types of suboptimal prescribing included polypharmacy, over‐prescribing, under‐prescribing and anticholinergic burden. It also assessed any significant associations between suboptimal prescribing and common age‐related problems such as falls, reduced function and cognition.MethodCross‐sectional study (2015–2018) on 18 island and five mainland communities in the Torres Strait and Northern Peninsula Area of Far North Queensland, Australia. Community‐dwelling residents aged 45 years and older who identified as Torres Strait Islander and/or Aboriginal with complete medication histories were recruited in this study. Validated prescribing tools were used to identify suboptimal prescribing practises.ResultsThere were 254 participants with complete medication histories. The mean age was 65.7 (SD ± 10.9, range 45–93), with 65% female. Suboptimal prescribing in this study was 74%. Of these, 49% of participants had polypharmacy, 44% were over‐prescribed, and 36% were under‐prescribed. Anticholinergic burden was identified in 26% of participants. Polypharmacy was more prevalent in participants who were dependent on instrumental activities of daily living (iADLs).ConclusionsThe results demonstrate the importance of general practitioners, health‐care workers or pharmacists, to monitor medication prescribing in this population. Frequent review of medications to reduce suboptimal prescribing practices within these communities may help to reduce adverse outcomes because of prescribing practices.

Assessment of Errors in Handwritten Prescriptions in Zliten City- Libya

Errors in handwritten prescriptions are a major factor in medical errors and are the main cause of harm to patients due to the lack of clarity of the prescription or the lack of correct data, which leads to the prescription of the wrong medication, causing adverse events. The present study aimed to identify the common errors in handwriting prescriptions in Zliten City. To collect information about errors in handwritten prescriptions, we used two models: first, we distributed fifty-one questionnaires to fifty-one pharmacies distributed in all areas of Zliten city, and second, we collected one hundred and fifty prescriptions from different health facilities distributed in different areas within Zliten city. The questionnaires and prescriptions then analysed to identify medical errors. In the first model of the questionnaire, the results are as follows: the patient's name and age are often present, while the gender, doctor's name, and stamp are often absent. The main issue lies in the clarity of the font for the drug's name, dose, and dosage form. In the second model of the prescriptions, the results are as follows: the patient's name is mostly present, while gender and diagnosis are absent in about 40% of the prescriptions, the doctor's name is mostly absent, and only 2% of the prescriptions have the doctor's stamp and number in the syndicate, and the main issue lies in the clarity of the font for the drug's name, dose, and dosage form., as it is unclear in between 20-30% of the prescriptions. We found that the patient's information is present in most prescriptions the opposite of the questionnaire in which it is less. Also in the prescriber's information, the analysis in our result for prescription contradicted the questionnaires, as most prescribers in the questionnaire are present, we also found that during the analysis of drug information in prescription not clear more than in the questionnaire. From this research, we concluded that there are many errors in prescriptions, possibly because of the large number of cases that need to be seen by the doctor and the speed of writing, and perhaps because doctors forget the vocabulary of the names of medicines. Because of the many errors in handwritten prescriptions, we must immediately switch to computerized prescription writing.

Examining the clinical role and educational preparation of heart failure nurses across Europe. A survey of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the ESC.

To describe the clinical practice and educational preparation of heart failure (HF) nurses across Europe and determine the key differences between countries. A survey tool was developed, in English, by the Heart Failure Association Patient Care committee of the European Society of Cardiology (ESC). It was translated into eight languages, before electronically disseminated by nurse ambassadors, presidents of HF national societies and through social media. A total of 837 nurses involved in the daily care of patients with HF from 15 countries completed the survey. Most nurses, 78% (n = 395) worked within a hospital outpatient setting, and 51% (n = 431) had access to a specialized HF multidisciplinary team. Nurses performed a range of activities including patient education to promote self-care, virtual and in-person symptom monitoring. A third had more than 5-year experience in cardiac care and 22% (n = 182) prescribed HF medications. There was a significant correlation between HF nurses that prescribed HF medications and access to a specialist multidisciplinary team (p = 0.04). A small number of nurses, mainly from Belgium, supported invasive monitoring (n = 68, 8%) with 14% (n = 120) of mostly Danish nurses supporting exercise programmes. The majority of nurses surveyed were committed to further academic professional development, with 41% (n = 343) having completed a HF course. The role of the HF nurse varies across Europe, however involvement in patient education, symptom monitoring and follow-up remain core to their practice. In specific activities including the prescribing of HF medications and involvement in invasive monitoring, practice has advanced with collaboration in the multidisciplinary team. Consequently, harmonization of education, training and career pathways are required to standardize HF care aligned with expert guidelines across Europe.

Aggressive Intravenous Hydration and a Defined Plant-Based Diet Safely and Effectively Treated Type 5 Cardiorenal Syndrome with Stage E Heart Failure-Related Cardiogenic Shock: A Case Report

Background and Clinical Significance: Heart failure and kidney diseases often coexist and are difficult to clinically manage. Dysfunction in either organ exacerbates dysfunction in the other, potentially leading to cardiorenal syndrome (CRS). CRS has five different subtypes, with CRS type 5 being the most problematic given that it consists of an acute insult superimposed upon chronic CRS. Additionally, type 5 CRS can be complicated by heart failure-related cardiogenic shock (HF-CS), which is associated with increased hospitalizations and has a high 1-year mortality rate. The standard treatment for patients with HF-CS consists of guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF) as tolerated, along with inotropic therapies and surgical mechanical left ventricular (LV) support, guided by invasive hemodynamic monitoring. Case Presentation: This case study reports the presentation of a 57-year-old man who presented with type 5 CRS who rapidly decompensated to stage E HF-CS and was effectively and safely treated with aggressive intravenous hydration, a defined plant-based diet (DPBD), and reduction of guideline-directed prescription medications without invasive hemodynamic monitoring. Conclusions: Hydration, a DPBD, and a reduction in medication burden may be effective in CRS. Pilot studies are warranted to evaluate the efficacy of this intervention in CRS in a larger cohort.

The effectiveness of antidepressant therapy against anhedonia in patients with alcohol dependence

The article presents the results of a scientific study aimed at determining the effectiveness of the drug Vortioxetine (Brintellix) in the treatment of affective spectrum disorders in patients with alcohol dependence in a drug treatment hospital, since the drug is promising for widespread use in the drug therapy of a number of mental disorders and in the future could be included in the standard of medical care in the field of psychiatry-addictology. It is known that anhedonia is one of the mental disorders in withdrawal syndrome, which provokes relapses of an addictive disorder and negatively affects the duration and quality of remissions of patients with an addiction profile. At the same time, the study of antidepressant therapy in the treatment of alcohol dependence remains relevant, since poor tolerance, side effects, and deterioration of the patient's general condition may affect adherence to drug therapy. In the present study, anhedonia was assessed on the Snaith-Hamilton SHAPS scale, anxiety-depressive manifestations using the HADS hospital anxiety and depression scale and quality of life according to the SF-36 questionnaire during 24 weeks of follow-up.The result of drug therapy with Vortioxetine was the relief of affective disorders in alcohol dependence, which contributed to the improvement of overall subjective well-being, the degree of satisfaction with the quality of life and a decrease in anxiety-depressive tendencies and anhedonia. In addition, minimal and minor adverse reactions when taking Vortioxetine affected the increased adherence of the examined patients to medical prescriptions and recommendations.Conclusions. The use of Vortioxetine in the treatment of affective disorders among patients suffering from alcohol dependence provides new opportunities to help people suffering from alcohol addiction. Vortioxetine can be recommended both at the stage of inpatient care and outpatient treatment, since when it was taken, stable positive dynamics of antidepressant, anti-anxiety and antiangedonic effects were recorded.

Desprescribing antihypertensives in older people in primary care: subgroup analysis of the MINOR randomised clinical trial.

Polypharmacy is often required for older adults with hypertension, and excessive treatment is associated with a high risk of adverse reactions, including hypotension. To evaluate the deprescribing of antihypertensive medications guided by pharmacists using home blood pressure monitoring in older adults with hypotension. A subgroup of older adults with signs or symptoms of hypotension, included in the MINOR clinical trial, was analysed. In the MINOR procedures, each patient was provided with a device to conduct blood pressure measurement at home for 1week, following which a report was generated and shared with pharmacists (intervention group) or family physicians (control group). In the intervention group, a pharmacist suggested optimising pharmacotherapy; meanwhile, in the control group, a family physician alone determined the necessary treatment adjustments. Differences in mean blood pressure, the patients with symptoms/signs of hypotension, and the antihypertensive medication deprescribing between both groups were analysed. Seventy-two patients were evaluated (35, control group; 37, intervention group). The intervention group showed a significant reduction in medication prescriptions (- 28.6%; P < 0.001), especially beta-blockers (- 74.2%), loop diuretics (- 83.3%), and aldosterone antagonists (- 80%). The mean office blood pressure in the intervention group increased (14.1mmHg systolic and 6.9mmHg diastolic), remaining below the target range (140/90mmHg). The intervention group showed a significantly reduction in hypotensive symptoms than the control group (64.9% vs. 20%) (P < 0.001). The data highlight an important role for pharmacists in optimizing hypertension management in older people. Deprescribing antihypertensives can limit symptomatic hypotension. Registered on ClinicalTrials.gov under number NCT04861727.

Characteristics, Perspectives, and Experiences of Cyproheptadine Users at Community Pharmacies in the Context to Prescription Medication Misuse

Some people abuse the antihistamine medication cyproheptadine in an attempt to reach their desired shape, weight, and appearance. This study aims to investigate the characteristics of cyproheptadine misusers as well as their behaviors, perceptions, experiences, and sources of information regarding using this medication. A descriptive cross-sectional study was carried out in Sebha City among customers of community pharmacies. Each customer who has taken cyproheptadine was invited to participate in this research. The data was collected from April 2022 until September 2022. Almost all of the participants (n=99, 96.1%) reported they purchased cyproheptadine from community pharmacies and obtained the drug without a prescription n=79 (76.7%). Over half of the respondents (n=53, 51.5%) use this drug for increasing appetite, compared to (n=25,24.3%) and (n=19, 18.4%) respondents who said they used it to improve their shape and lose weight, respectively. Most participants indicated they were unaware of other uses of a drug (n=72, 69.9%) or its side effects (n=61, 59.2%). Furthermore, twenty participants (19.4%) denied receiving information concerning the precautions and contraindications of using cyproheptadine. The highest rate of source of drug information reported by participants was “friends or family member” (n=34, 33%) followed by pharmacists (n=29, 28.2%). Community pharmacies must employ qualified pharmacists on staff to give customers trustworthy information regarding prescription pharmaceuticals such as cyproheptadine.

Clinician contributions to central nervous system-active polypharmacy among older adults with dementia in the United States.

Exposure to central nervous system (CNS)-active polypharmacy-overlapping exposure to three or more CNS-active medications-is potentially harmful yet common among persons living with dementia (PLWD). The extent to which these medications are prescribed to community-dwelling PLWD by individual clinicians versus distributed across multiple prescribers is unclear. We identified community-dwelling Medicare beneficiaries with a dementia diagnosis and Medicare Parts A, B, and D coverage for at least one month in 2019. Using fill date and days' supply for prescriptions filled between January 1, 2019 and December 31, 2019, we identified beneficiaries exposed to CNS-active polypharmacy (i.e., >30 days of overlapping exposure to three or more antidepressant, antipsychotic, antiseizure, benzodiazepine, opioid, nonbenzodiazepine benzodiazepine receptor agonists, or skeletal muscle relaxant medications). We examined the number and type of clinicians who contributed to polypharmacy person-days among PLWD. The cohort included 955,074 PLWD who were primarily female (64.0%), were White (78.5%), and had a mean age of 83.4 years (standard deviation 8.0). Notably, 14.3% were exposed to CNS-active polypharmacy. At the person level, 24.6% of PLWD experienced polypharmacy prescribed by a single clinician. Considering total days of exposure, 45.3% of polypharmacy person-days were prescribed by a single clinician. Primary care physicians prescribed 63.0% of polypharmacy person-days and accounted for the plurality of days for all seven medication classes, followed by psychiatrists for antipsychotics and benzodiazepines and primary care advanced practice providers (APPs) for antidepressants and antiseizure medications. In this cross-sectional analysis of Medicare claims data, primary care clinicians (both physicians and APPs) prescribed the majority of medications that contributed to CNS-active polypharmacy for PLWD. Future research is needed to identify strategies to support primary care clinicians in appropriate prescribing of CNS-active medications to PLWD.

Charting a course: Use of Electronic Health Records in skills‐based pharmacy education

AbstractIntroductionCompetent navigation of an electronic health record (EHR) has become a critical skill for health professionals, and pharmacists need to be adept in EHR utilization given the extent of EHR involvement in routine medication management. Limited data exists related to current approaches to teaching EHR skills in pre‐Advanced Pharmacy Practice Experiences (pre‐APPE) pharmacy curricula.ObjectivesThe purpose of this study was to describe activities, utilization, and barriers to implementation of teaching EHRs (tEHRs) into pharmacy curricula in skills‐based courses.MethodsFaculty members of the Big Ten Academic Alliance Skills‐Based Education and Assessment Collaborative (BTAA‐SBEAC) were surveyed. The questionnaire included open‐ended questions related to tEHR type, curriculum placement, and current use of tEHRs, as well as barriers to incorporation of tEHRs in the curriculum. Inductive content analysis was used to evaluate qualitative responses.ResultsA representative from all 10 colleges within the BTAA responded. Most programs focused on EHR teaching in the second and third years of the curriculum. All respondents reported having access to a tEHR for internal case building. The tEHR was used by all institutions to allow students to practice in gathering patient information as the first step in the Pharmacists' Patient Care Process. Other activities commonly performed using the tEHR included patient care documentation, medication order verification, prescription processing, and medication reconciliation. Faculty time and cost were barriers identified for successful tEHR implementation.ConclusionMultiple skills are taught through the utilization of a tEHR among the colleges within the BTAA. These activities vary between institutions, and barriers exist that limit expansion and consistent integration across a skills‐based curriculum. Recognition of EHR utilization as an essential pharmacy skill can allow for development of formalized learning outcomes, leading to better support and integration throughout skills‐based courses.

Exploring public perception and utilization of medication home delivery services in the United Arab Emirates: a cross-sectional study

IntroductionThe Medication Home Delivery (MHD) service from community pharmacies involves the safe and efficient delivery of pharmaceuticals (prescription and non-prescription medications), and health products directly to the patient’s/consumer’s home. There are several issues encountered by the users of the MHD service that have an impact on their satisfaction with the service. The study aimed to assess the public’s perceptions of the MHD service in the United Arab Emirates (UAE), their willingness to utilize it, and the practical use of the service.MethodA cross-sectional exploratory study was conducted in the UAE using a validated online survey. The inclusion criteria were adults residing in the UAE. Statistical analysis was performed to identify the association between the variables, the service use, and the level of service efficiency.ResultsA total of 556 participants filled out the survey, with 69.4% of them using the service. The majority of participants were females (75.9%) and aged less than 40 years old (71.6%). Three variables showed a statistically significant association with the use of the MHD service (P < 0.05): the participant’s educational level, their medical/health background, and the frequency of visits to community pharmacies. The most common issues raised were receiving the wrong order, delay in delivery, and paying delivery fees. Most participants agreed that the MHD service reduces the risk of exposure during pandemics, serves the elderly, serves disabled people, makes it more comfortable for parents with children at home, and reduces overcrowding in health facilities, as well as the MHD service making pharmacy services more efficient.ConclusionThe study indicated positive perceptions among the public in the UAE towards the MHD service. However, there was a concern that this service may diminish the communication between pharmacists and patients, which potentially minimizes the amount of information received by patients regarding their treatments.

The addition of cannabis to prescription drug monitoring programs and medication fills in Medicaid.

To date, there is considerable evidence of the medical applications of cannabis, however concerns regarding the safety of cannabis are also mounting. To improve the safety of cannabis, nine states have added medical cannabis to their state PDMPs, helping providers to take patient cannabis use into consideration when making prescribing decisions. Across a variety of models using Medicaid State Drug Utilization claims data, I find statistically significant reductions in severely and moderately contraindicated medication fills across two outcomes. In my main specification, adding cannabis to a state PDMP is associated with a 14.4% (p<0.01) and 7.74% (p<0.001) decrease in the units per prescription, for severely and moderately contraindicated medications, respectively, as compared to states with legal medical cannabis dispensaries open. An interesting spillover effect of adding cannabis to PDMPs is an apparent decrease in the prescribing of scheduled narcotics, with Schedule II medications seeing a moderately significant decrease and Schedule IV medications seeing a 11.4% decrease (p<0.01) in the prescribing rate and a 16.2% decrease (p<0.001) in the units per prescription. The main analysis was conducted using the Borusyak etal. (2023) Imputation Estimator with a robustness check using the Callaway and Sant'Anna (2021) difference-in-difference. This work presents evidence that adding cannabis to a state PDMP impacts provider prescribing decisions involving medications that are contraindicated for use with cannabis as well as controlled substances. This paper demonstrates that adding cannabis to PDMPs influences prescribing and thus has the potential to make medical cannabis use safer. Conversely, this work indicates providers may have bias against patients who use cannabis and deny them life-improving medications (like controlled ADHD medication or opioids) on the basis of medical cannabis use. This paper also contributes to the literature comparing DD outcomes estimated using Borusyak, Jaravel, and Spiess' (2023) Imputation Estimator and Callaway and Sant'Anna's (2021) DD Estimator.

Pharmacy Closures and Anticonvulsant Medication Prescription Fills

This study examines the relationship between pharmacy closures and anticonvulsant prescription fills and number of days supplied.

Antihypertensive Medication Category Prescriptions and Blood Pressure Control in African Surinamese and Ghanaian Migrants with Hypertension in Amsterdam, The Netherlands: The HELIUS Study.

West African (WA) migrants in Europe have higher hypertension rates than the host populations. For African migrants, guidelines recommend diuretics and/or calcium channel blockers (CCB) for primary cardiovascular disease prevention, but data on antihypertensive medication (AHM) prescription patterns or related hypertension control rates are lacking. We assessed AHM prescription patterns and its relation to hypertension control among hypertensive WA migrants in the Netherlands compared to the host population. Cross-sectional data from WA or Dutch origin participants from the HELIUS study were used. Participants with treated hypertension and without diabetes, cardiovascular disease, or microalbuminuria were selected. We used logistic and linear regression analyses to assess the association between AHM categories and hypertension control rates (systolic blood pressure (BP) ≤ 140 mmHg and diastolic BP ≤ 90 mmHg) and the systolic BP levels. We compared 999 WA participants and 314 Dutch participants. Hypertension control rates were lower in the WA origin compared to Dutch origin participants (44.3% versus 58.0%, p < 0.001). For WA participants, prescription rates for any AHM category were: CCB (54.8%), diuretics (18.5%) beta-blocking agents (27.3%) and renin-angiotensin system blockers (52.6%). Prescription rates were higher for CCB and similar for diuretics compared to the Dutch participants. Neither CCB nor diuretics were associated with better control rates. Compared to Dutch participants, West African participants had similar diuretic prescriptions but significantly higher prescriptions for CCB. However, neither medications was associated with better hypertension control. Future research should explore physician and patient factors to improve hypertension control.