Prescription Medications Research Articles

Physicians’ attitudes toward gastroprotective strategies for nonsteroidal anti-inflammatory drug prescription

Introduction There is a paucity of information regarding providers’ attitudes toward gastric-protective strategies with concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDs). We aimed to assess gastric-protective strategies used upon prescribing NSAIDs and providers’ awareness of societal guidelines for preventing NSAID-induced gastric complications. Methods A standardized 10-item questionnaire was sent to all orthopedic providers in North Carolina and South Carolina. The survey design and refinement were based on a literature review, item generation, and small and large focus group discussions. Results Forty-two orthopedists responded to the survey (response rate 16%). The most frequently used NSAIDs were meloxicam (79%), naproxen (69%), and ibuprofen (64%). NSAIDs were most commonly prescribed on an as-needed basis (52%), followed by <3 months (43%). The most common indications were degenerative arthritis (95%) and herniated disk (45%). Gastrointestinal adverse effects of NSAIDs were managed by discontinuing NSAID therapy (73%) or switching to a cyclooxygenase-2 (COX-2) inhibitor (40%). A small proportion were managed by referring to another physician (36%). Some clinicians prescribed gastric prophylaxis for patients at high risk for NSAID-induced gastric complications (24%). The academic setting was significantly associated with gastric prophylaxis and frequent assessment for NSAID-induced gastric adverse events. Providers with >20 years of experience showed similar trends. In low-risk patients, compliance with gastroprotective prophylaxis prescription was low (5%). Most providers were unaware of the societal guidelines for NSAID-induced gastric complications or the preventive strategies. Conclusion Prescription of gastric-protective medications with concurrent NSAID therapy is relatively low among orthopedists. Academic setting and higher years of experience showed a significant trend toward more gastric-protective medication prescription, COX-2 inhibitor use, and frequent assessments for gastric adverse events when prescribing NSAID therapy. Provider education on the latest societal guidelines and computer-based alerts can increase compliance and assessment for NSAID-induced gastric complications and preventive strategies.

Medication Burden Before and After Prescription of Biologics in Patients with Inflammatory Bowel Disease.

Background: Biologics are a cornerstone in the treatment of severe cases of inflammatory bowel disease (IBD) and aim to control the disease and improve quality of life. This study investigated changes in nonbiologic medication prescriptions for IBD patients initiating biologic therapy in Germany. Methods: This study used data from anonymized pharmacy records in the German longitudinal prescription (LRx) database and included biologic-naive IBD patients who received their first biologic therapy prescription between 2016 and 2022. Changes in prescription rates and pill counts for nonbiologic medications (corticosteroids, 5-aminosalicylates (5-ASA), proton pump inhibitors, analgesics, immunosuppressants, Vitamin D, iron, and antibiotics) before and after the initiation of biologic therapy were assessed using descriptive statistics, McNemar's tests, and Poisson regression models, adjusting for age and sex. Results: A total of 29,559 biologic-naive IBD patients were included. Prior to index, 91.2% received at least one nonbiologic medication prescription, where corticosteroids and 5-ASA were the most common. Postindex, the overall prescription rate decreased to 87.7%, with significant reductions in prescriptions observed for corticosteroids, 5-ASA, and immunosuppressants (p-values < 0.001). The mean (SD) pill count dropped from 704 (1712) to 514 (1651), with the largest mean differences (95% CI) having been for corticosteroids (-77.9 [-80.3 to -75.5]), 5-ASA (-61.6 [-65.2 to -58.1]), and immunosuppressants (-55.0 [-57.5 to -52.6]). Older patients tended to have greater decreases in pill counts for corticosteroids and 5-ASA, while males showed statistically significant reductions in pill count for immunosuppressants compared with females. Conclusions: This study demonstrates that the prescription of nonbiologic medications significantly decreased after biologic therapy initiation. The use of biologics may therefore lead to improved disease management and potentially better patient outcomes.

Accelerating adverse pregnancy outcomes research amidst rising medication use: parallel retrospective cohort analyses for signal prioritization

BackgroundPregnant women are significantly underrepresented in clinical trials, yet most of them take medication during pregnancy despite the limited safety data. The objective of this study was to characterize medication use during pregnancy and apply propensity score matching method at scale on patient records to accelerate and prioritize the drug effect signal detection associated with the risk of preterm birth and other adverse pregnancy outcomes.MethodsThis was a retrospective study on continuously enrolled women who delivered live births between 2013/01/01 and 2022/12/31 (n = 365,075) at Providence St. Joseph Health. Our exposures of interest were all outpatient medications prescribed during pregnancy. We limited our analyses to medication that met the minimal sample size (n = 600). The primary outcome of interest was preterm birth. Secondary outcomes of interest were small for gestational age and low birth weight. We used propensity score matching at scale to evaluate the risk of these adverse pregnancy outcomes associated with drug exposure after adjusting for demographics, pregnancy characteristics, and comorbidities.ResultsThe total medication prescription rate increased from 58.5 to 75.3% (P < 0.0001) from 2013 to 2022. The prevalence rate of preterm birth was 7.7%. One hundred seventy-five out of 1329 prenatally prescribed outpatient medications met the minimum sample size. We identified 58 medications statistically significantly associated with the risk of preterm birth (P ≤ 0.1; decreased: 12, increased: 46).ConclusionsMost pregnant women are prescribed medication during pregnancy. This highlights the need to utilize existing real-world data to enhance our knowledge of the safety of medications in pregnancy. We narrowed down from 1329 to 58 medications that showed statistically significant association with the risk of preterm birth even after addressing numerous covariates through propensity score matching. This data-driven approach demonstrated that multiple testable hypotheses in pregnancy pharmacology can be prioritized at scale and lays the foundation for application in other pregnancy outcomes.

Correlation between marginal bone loss around dental implants and various systemic diseases: a cross-sectional study.

Diminished bone levels or the lack of osseointegration can lead to higher rates of failure of dental implants. The present study is aimed to evaluate the correlation between hypertension, diabetes mellitus and hyperlipidemia, on the marginal bone loss (MBL) surrounding dental implants among patients attending the University of Nevada, Las Vegas dental clinics. Clinical notes from patients at the University of Nevada, Las Vegas (UNLV) dental clinics were analyzed using AxiUm™ software. The study included patients with dental implants diagnosed with hypertension, diabetes mellitus, and hyperlipidemia who attended the UNLV School of Dental Medicine clinics from 2012 to 2022. Exclusions were made for patients with acquired immune deficiency syndrome and those with a limited number of radiographs. A search was conducted using keywords such as 'systemic disease,' 'marginal bone loss,' 'dental implant,' 'high cholesterol,' 'hypertension,' and 'diabetes' within the system. Out of 1,310 potentially eligible patients, 57 fulfilled the inclusion criteria. The total number of evaluated implants was 165. 18% of the sample patients were 55 to 64 years of age, and 79% were 65 or above. 45.6% of patients reported having more than four systemic diseases and 67% of patients had four or more prescription medications. Patients diagnosed with hypertension (78.95%) or hyperlipidemia (73.68%) had the highest presence of marginal bone loss surrounding the dental implant(s) while those with diabetes (40.35%) had the least amount of MBL. Patients diagnosed with both hypertension and hyperlipidemia (29.82%) experienced the highest incidence of MBL around implants. The medications prescribed to combat these health issues, such as statins and antihypertensive, also showed the same trends and corresponded with a higher prevalence of MBL. Within the limitations of the present investigation, patients diagnosed with hyperlipidemia and hypertension were more likely to exhibit MBL surrounding dental implants.

Associations of semaglutide with first-time diagnosis of Alzheimer's disease in patients with type 2 diabetes: Target trial emulation using nationwide real-world data in the US.

Emerging preclinical evidence suggests that semaglutide, a glucagon-like peptide receptor agonist (GLP-1RA) for type 2 diabetes mellitus (T2DM) and obesity, protects against neurodegeneration and neuroinflammation. However, real-world evidence for its ability to protect against Alzheimer's disease (AD) is lacking. We conducted emulation target trials based on a nationwide database of electronic health records (EHRs) of 116 million US patients. Seven target trials were emulated among 1,094,761 eligible patients with T2DM who had no prior AD diagnosis by comparing semaglutide with seven other antidiabetic medications. First-ever diagnosis of AD occurred within a 3-year follow-up period and was examined using Cox proportional hazards and Kaplan-Meier survival analyses. Semaglutide was associated with significantly reduced risk for first-time AD diagnosis, most strongly compared with insulin (hazard ratio [HR], 0.33 [95% CI: 0.21 to 0.51]) and most weakly compared with other GLP-1RAs (HR, 0.59 [95% CI: 0.37 to 0.95]). Similar results were seen across obesity status, gender, and age groups. These findings support further studies to assess semaglutide's potential in preventing AD. Semaglutide was associated with 40% to 70% reduced risks of first-time AD diagnosis in T2DM patients compared to other antidiabetic medications, including other GLP-1RAs. Semaglutide was associated with significantly lower AD-related medication prescriptions. Similar reductions were seen across obesity status, gender, and age groups. Our findings provide real-world evidence supporting the potential clinical benefits of semaglutide in mitigating AD initiation and development in patients with T2DM. These findings support further clinical trials to assess semaglutide's potential in delaying or preventing AD.

Improving Collaborative Interactions Between Humans and Artificial Intelligence to Achieve Optimal Patient Outcomes in the Healthcare Industry

The introduction of Artificial Intelligence (AI) into the healthcare industry holds immense promise for improving patient outcomes. However, the interaction between healthcare professionals and AI systems is critical to fully realize the potential benefits. Artificial intelligence (AI) applications have transformed healthcare. This study is based on a general literature review uncovering the role of Al in healthcare and focuses on the following key aspects: medical imaging and diagnostics, virtual patient care, medical research and drug discovery, patient engagement and compliance, rehabilitation and other administrative applications. The impact of AI is observed in detecting clinical conditions in medical imaging and diagnostic services, controlling the outbreak of coronavirus disease 2019 (COVID-19) with early diagnosis, providing virtual patient care using Ai-powered tools, managing electronic health records, augmenting patient engagement and compliance with the treatment plan, reducing the administrative workload of healthcare professionals (HCPs), discovering new drugs and vaccines, spotting medical prescription errors, extensive data storage and analysis, and technology-assisted rehabilitation. Nevertheless, this science pitch meets several technical, ethical, and social challenges, including privacy, safety, the right to decide and try, costs, information and consent, access, and efficacy, while integrating AI into healthcare. The governance of AI applications is crucial for patient safety and accountability and for raising HCPs’ belief in enhancing acceptance and boosting significant health precisely address regulatory, ethical, and trust issues while advancing the acceptance and implementation of AI. Since COVID-19 hit the global health system, the concept of AI has created a revolution in healthcare, and such an uprising could be another step forward to meet future healthcare needs.

Prodromal Phase of Idiopathic Generalized Epilepsy: A Register-Based Case Control Study.

Idiopathic generalized epilepsy (IGE) is associated with distinct behavioral traits, symptoms of frontal lobe dysfunction, and psychiatric comorbidity. Whether psychiatric symptoms are part of the IGE endophenotype or secondary to the burden of chronic disease is unknown. In this study, we aimed at describing the sequence of appearance of psychiatric and epilepsy symptoms in patients with IGE. Inclusion criteria for this cohort study were diagnosis of IGE with age at diagnosis at 10-25 years. We created 2 mutually exclusive cohorts, 1 based on ICD-10 codes in Danish registers with a first IGE diagnosis from January 1, 2005, to December 31, 2018, and a second patient cohort treated at Odense University Hospital and the Danish Epilepsy Centre in the same period. Each case was matched with 10 age-matched, sex-matched, and geography-matched normal population controls from the Danish registers. We compared social status, health care utilization, and psychiatric diagnoses between the groups in the 5 years preceding epilepsy diagnosis, at diagnosis, and at the end of the study period using the Wilcoxon rank-sum test and confirmatory logistic regression models. We identified 1,009 patients for the register-based cohort (55.1% female; mean age at diagnosis [SD]: 15.9 [±3.8] years) and 402 patients for the hospital-based cohort (56.2% female; mean age at diagnosis [SD]: 18.3 [±7.4] years) and matched them to 10,090 and 4,020 controls, respectively. IGE cohorts and controls did not differ at birth. In the 5 years before their IGE diagnosis, register patients had an increasing number of contacts with hospitals (mean visits [SD]: cases: 8.3 [±5.6], controls: 6.6 [±4.5]) and their general practitioners (mean visits [SD]: cases: 48.7 [±26.3], controls: 45.3 [±24.5]) and received more prescriptions for psychiatric medications (prescriptions: cases: 4.2%, controls: 2.5%, p = 0.003) compared with controls. Patients had a higher rate of psychiatric comorbidity (comorbidity: cases: 26.5%, controls: 17.8%, p < 0.0001) at the end of the study than controls. Data were similar in the hospital-based cohort. Our data suggest a prodromal phase of IGE detectable approximately 5 years before the first seizure characterized by increased health care utilization and greater use of prescription medicine for psychiatric symptoms.

Temporal trends in the prevalence of GP registrars’ long-term paediatric asthma control medications prescription

Asthma is one of the most common chronic illnesses affecting children. Long-term asthma control medications (LTACMs) are an important aspect of asthma management, with under-prescription associated with poor asthma control and increased asthma deaths. This study aimed to document temporal trends in the prescribing of LTACMs for paediatric patients for asthma-related presentations to Australian general practice registrars (trainees). Longitudinal analyses of data from 2010 to 2022 from the Registrars Clinical Encounters in Training study were undertaken. Proportions of paediatric presentations where LTACMs were prescribed were calculated, and temporal trends analysed and graphed. There was no change over time in registrar prescribing of LTACMs for paediatric asthma, although temporal changes were seen in the types of LTACMs prescribed. The lack of temporal increase in overall LTACMs prescription, despite evidence showing their importance in preventing asthma morbidity and mortality, has significant educational, clinical, and policy implications.

High-Risk Medications in Persons Living With Dementia

Individuals with Alzheimer disease (AD) and Alzheimer disease-related dementias (ADRD) may be at increased risk for adverse outcomes relating to inappropriate prescribing of certain high-risk medications, including antipsychotics, sedative-hypnotics, and strong anticholinergic agents. To evaluate the effect of a patient/caregiver and prescriber-mailed educational intervention on potentially inappropriate prescribing to patients with AD or ADRD. This prospective, open-label, pragmatic randomized clinical trial, embedded in 2 large national health plans, was conducted from April 2022 to June 2023. The trial included patients with AD or ADRD and use of any of 3 drug classes targeted for deprescribing (antipsychotics, sedative-hypnotics, or strong anticholinergics). Patients were randomized to 1 of 3 arms: (1) a mailing of educational materials specific to the medication targeted for deprescribing to both the patient and their prescribing clinician; (2) a mailing to the prescribing clinician only; or (3) a usual care arm. Analysis was performed using a modified intention-to-treat approach. The primary study outcome was the dispensing of the medication targeted for deprescribing during a 6-month study observation period. Secondary outcomes included changes in medication-specific mean daily dose and health service utilization. Among 12 787 patients included in the modified intention-to-treat analysis, 8742 (68.4%) were female, and the mean (SD) age was 77.3 (9.4) years. The cumulative incidence of being dispensed a medication targeted for deprescribing was 76.7% (95% CI, 75.4-78.0) in the patient and prescriber mailing group, 77.9% (95% CI, 76.5-79.1) in the prescriber mailing only group, and 77.5% (95% CI, 76.2-78.8) in the usual care group. Hazard ratios were 0.99 (95% CI, 0.94-1.04) for the patient and prescriber group and 1.00 (95% CI, 0.96-1.06) for the prescriber only group compared with the usual care group. There were no differences between the groups for secondary outcomes. These findings suggest medication-specific educational mailings targeting patients with AD or ADRD and their clinicians are not effective in reducing the use of high-risk medications. ClinicalTrials.gov Identifier: NCT05147428.

Clinical and demographic factors determining patient fracture risk decision point (FRDP): The improving risk communication in osteoporosis (RICO) project.

This part of the Improving Risk Communication in Osteoporosis (RICO) study aims to understand patients' willingness to initiate osteoporosis treatment given a hypothetical fracture probability-derived from the FRAX® Risk Assessment Tool-and how age, fracture history, and numeric literacy may influence this. In 2022-2023, 332 postmenopausal women at risk of fracture were interviewed from nine countries to determine participants' Fracture Risk Decision Point (FRDP), the lowest probability of major osteoporotic fracture at which they would accept an osteoporosis medication. Participants' FRDP was evaluated given eight hypothetical 10-year FRAX scores. In countries with FRAX-based treatment thresholds, over half of the participants per country reported an FRDP that was below the threshold. Collectively, 79.2% demonstrated FRDPs at or below their respective threshold. Age and fracture history did not have a strong influence on FRDP; however, those who demonstrated higher levels of numeric literacy reported a significantly higher median FRDP (10%) compared to those who showed lower levels (5%, p < 0.001). Most patients were willing to accept an osteoporosis medication prescription at a hypothetical FRAX probability that was even lower than that of their nationally recommended treatment threshold. Literacy scores had a significant influence on FRDP whereas age and fracture history did not.

Semaglutide and smoking cessation in individuals with type 2 diabetes mellitus: there is no smoke without fire!

Tobacco use represents the leading preventable risk factor for premature deaths worldwide. A meta-analysis of 74 epidemiological studies, including 3.2 million individuals with type 2 diabetes mellitus (T2DM) from 33 countries, reported a pooled prevalence of smoking of 20.8% among individuals with T2DM. Cigarette smoking further aggravates existing deleterious vascular effects of T2DM. Namely, chronic hyperglycemia and exposure to cigarette smoke cause additive injurious effect on the endothelium, leading to an acceleration of vascular complications seen in persons with T2DM and tobacco use disorders (TUD). In a recent study, Wang and colleagues found that semaglutide use was associated with a significantly lower risk for medical encounters for TUD, when compared to other antidiabetic drug classes; indeed, this effect was strongest compared with insulins and weakest compared with other glucagon-like peptide-1 receptor agonists. Semaglutide was associated with reduced smoking cessation medication prescriptions and counseling. Similar findings were observed irrespective of the presence of obesity. Therefore, semaglutide use might be useful in terms of smoking cessation among individuals with T2DM, thus offering an additional benefit for this constantly growing population. However, those interesting findings should be confirmed through dedicated, large-scale randomized controlled trials.

Cannabis

Objective: Almost half of U.S. states have passed recreational cannabis laws as of May 2024. While considerable evidence to date indicates cannabis may be a substitute for prescription opioids in the treatment of pain, it remains unclear if patients are treating pain with cannabis alone or concomitantly with other medications. Method: Using data from a national sample of commercially insured adults, we examine the effect of recreational cannabis legalization (through two sequential policies) on prescribing of opioids, NSAIDS, and other pain medications by implementing synthetic control estimations and constructing case-study level counterfactuals for the years 2007-2020. Results: Overall, we find recreational cannabis legalization is associated with a decrease in opioid fills among commercially insured adults in the U.S., and we find evidence of a compositional change in prescriptions of pain medications more broadly. Specifically, we find marginally significant increases in prescribing of non-opioid pain medications after recreational cannabis becomes legal in some states. Once recreational cannabis dispensaries open, we find statistically significant decreases in the rate of opioid prescriptions (13% reduction from baseline, p &lt; .05) and marginally significant decreases in the average daily supply of opioids (6.3% decrease, p &lt; .10) and number of opioid prescriptions per patient (3.5% decrease, p &lt; .10). Conclusions: These results suggest that substitution of cannabis for traditional pain medications increases as the availability of recreational cannabis increases. There appears to be a small shift once recreational cannabis becomes legal, but we see stronger results once users can purchase cannabis at recreational dispensaries. The decrease in opioids and marginal increase in non-opioid pain medication may reflect patients substituting opioids with cannabis and non-opioid pain medications, either separately or concomitantly. Reductions in opioid prescription fills stemming from recreational cannabis legalization may prevent exposure to opioids in patients with pain and lead to decreases in the number of new opioid users, rates of opioid use disorder, and related harms.

Nationwide burden of sudden cardiac death among patients with a psychiatric disorder

BackgroundPatients with psychiatric disorders have increased all-cause mortality compared with the general population. Previous research has shown that there is a fourfold increased risk of sudden cardiac death (SCD) among...

Using artificial intelligence and machine learning to reduce patient wait times and increase patient satisfaction.

Madam, Prolonged patient waiting time has long been a significant source of dissatisfaction among patients. Waiting time has been recognized by WHO as one of the key elements of a responsive healthcare system [1]. A study conducted by Bleustein et al. suggested that longer wait times negatively impacted the patient’s confidence in the care provider and the perceived quality of care.[2] Furthermore, in large hospital settings, patients are expected to queue up multiple times before meeting with their physician, which amplifies their stress. We would like to highlight that the incorporation of artificial intelligence (AI) in healthcare can help reduce patient and physician stress. Strategies such as telemedicine and online registration have been acquired in efforts to resolve this issue but these techniques may burden doctors with extra responsibilities. However, introducing an AI-based physician assistance programme, which was able to model itself on the decision-making requirements of the doctor significantly reduced the wait time and the burden on the hospital [3]. Xiaoqing Li et al developed an AI-based model that helped patients automatically order any investigations. Implementation of the model reduces waiting time while also playing a pivotal role in creating alternative methods to improve patient flow. [4] The results of these studies prove that implementation of an AI-based model in daily medicine has helped improve patient experience and minimize hospital burden. The implementation of AI in place of traditional methods, helps enhance patient satisfaction by not only significantly reducing waiting time but also ensuring that patients receive care appropriate to their condition. Moreover, it helps reduce, the workload on the physician and enables them to focus more on the patient. Being a new concept in healthcare AI may not be free of error. This might lead to inaccuracies in medication prescription, investigations, imaging, scheduling of appointments and diagnosis in atypical cases. Patient confidentiality is also an extremely important aspect of healthcare and in an attempt to protect the privacy of the patients, AI models may not have free reign over the patients’ data which may prevent them from assisting in medical practices. Furthermore, there are no organizations that customize the AI models according to the needs of the individual hospital or clinic. Moreover, human interaction is a critical aspect of healthcare which would be significantly impacted by the use of AI which could result in patients being unable to express themselves or feeling a sense of apathy. Furthermore, developing countries are not well equipped to implement AI in daily practice, hence it would not be a practical solution for them. [5] Further research needs to be conducted with regards to the use of AI models in hospitals to understand how they impact patient wait times and satisfaction, alongside their ability to optimize healthcare.

Individualized medication card assists the elderly with medication understanding and adherence

Objective: In the outpatient setting, polypharmacy and poor communication among providers has left a gap in drug education involving the elderly population. Linking all of these providers with an accurate medication regimen may be the answer. Nurses can play a pivotal role in drug-related problems in the elderly population. The aim of this study is to use a liaison nurse to help educate the elderly population on the importance of adherence and understanding their medications by using an individualized medication card.Methods: This study used a descriptive study design. A convenience sample (n = 16) of patients, who were sixty-five years of age or older and were taking five prescription medications daily was employed. After collecting patient demographic information, a counseling session was performed with the patient on their medications using an individualized medication card. Data was then collected via two follow-up phone calls at two and four weeks after initial counseling session using a medication questionnaire and a set of five follow-up questions.Results: Sixteen participants received counseling on their medications and an individualized medication card to take home. Only thirteen participants were reached via phone call, two weeks after their initial counseling session. Of these thirteen, two had lost or forgotten their medication card. Eleven reported that the medication card had been helpful in understanding and adhering to their medications. Of the participants who kept their cards, all were satisfied with the counseling materials and methods used.Conclusions: The findings indicate that the elderly population who were taking five or more prescription medications showed benefit from counseling on their medications using an individualized medication card. Such a tool will help nurse practitioners guide elderly patients in medication education and adherence in future practice.

VirtualPharm: Bridging healthcare through telepharmacy

The word "telepharmacy" refers to a type of pharmaceutical care in which patients and pharmacists communicate by information and communication technology (ICT) even though they are not in the same location. Telepharmacy has been used to solve the scarcity of pharmacists and offer pharmaceutical services to underprivileged communities. Due to geographic and demographic constraints, however, rural inhabitants and towns frequently may not have easy access to healthcare services. A more recent term for pharmaceutical service delivery is telepharmacy, which allows patients who live far from a hospital, pharmacy, or other healthcare facility to receive healthcare services from a qualified pharmacist, including medication review, patient counseling, and prescription verification. Increased comfort with the medication-use system, patient safety, and job satisfaction were shown by nurses' survey results.Actually, after a pharmacist's intervention, there has been evidence of better control over hypertension, dyslipidemia or diabetes, successful smoking cessation, and a decrease in hospitalization among heart failure patients. Telepharmacy services are developed and offered using a range of technology, care models, and interventions, catering to a diverse range of individuals with various clinical conditions. Video conferencing is used in pharmacy for management, instruction, and training needs. The telephone has evolved from a device for dialing and speaking to a multimodal communication tool. Refill authorization, prior authorization, prescription counseling, and formulary compliance monitoring are all provided by call centers, while medical equipment are being connected to phone lines to provide remote monitoring and therapy. Telepharmacy is a useful tool for community pharmacies to improve drug dispensing safety and lessen the strain on the healthcare system.

Factors associated with a history of acute traumatic cycling injuries in 60 941 cycling race entrants in South Africa: SAFER study XLII

BackgroundInformation on acute traumatic cycling injuries (ATCIs) in the 12 months prior to entry in a cycling race and the predisposing factors have not been well-researched.ObjectiveDetermine factors associated with a...

Association of Insomnia with Functional Outcomes Relevant to Daily Behaviors and Sleep-Related Quality of Life among First Nations People in Two Communities in Saskatchewan, Canada.

Insomnia is a common sleep complaint in Canada and is associated with increased use of health care services and economic burden. This paper examines the association of insomnia with functional outcomes relevant to daily behaviors and sleep-related quality of life among First Nations participants using the Functional Outcomes of Sleep Questionnaire (FOSQ-10). The First Nations Sleep Health Project follow-up survey was conducted in partnership with two Cree First Nations in the summer of 2022, where 355 individuals participated. Statistical analysis was conducted using logistic regression models. The mean age of the participants was 40.76 ± 14.60 (SD) years, and 59.4% were females. The prevalence of chronic insomnia (Insomnia Severity Index score of ≥15) was 21.0%, with more females (26.1%) than males (13.8%) experiencing it among the 348 participants. Overall, the mean FOSQ-10 score was 17.27 ± 2.98 among the 350 participants, with those who had clinical insomnia reporting significantly lower scores than those without clinical insomnia (mean ± SD: 14.6 ± 3.9 vs. 18.0 ± 2.1; p < 0.001). The FOSQ-10 scores indicated sleep-related functional impairment (FOSQ-10 total score < 17.90) in 46.6% of participants. After adjusting for age, excessive daytime sleepiness, sex, and regular use of prescription medication, we found that clinical insomnia was significantly associated with functional impairments. In fact, a person with clinical insomnia was 3.5 times more likely to have functional impairments than those without clinical insomnia. This study highlights the significant association between insomnia and functional impairments related to daily behaviors and quality of life in two First Nation communities. Identifying this association can help healthcare providers to diagnose and treat patients with insomnia in these communities.

Potentially inappropriate prescription of medications to older adults who access a community pharmacy in Peru

Polypharmacy in older adults is associated with a higher incidence of medication-related problems, such as pharmacological interactions, adverse reactions, and medication errors. This study aimed to identify and evaluate potentially inappropriate prescription of medications (PIP) using the screening tool of older persons’ prescriptions/screening tool to alert doctors to right treatment (STOPP/START) criteria in a representative community pharmacy in Trujillo, Peru. The population sample consisted of 158 subjects, with 66.5% between 65 and 69 years old, 53.8% male, and 77.9% receiving between 3 and 4 medications. Medical prescriptions were analyzed using the explicit STOPP/START version 2 criteria, revealing that 93.7% of patients presented STOPP criteria (to stop medication) and 53.8% presented START criteria (to start medication). The most frequently identified STOPP criterion was the gradual withdrawal of benzodiazepines, while the most frequently identified START criterion was the initiation of antihypertensive treatment in patients with systolic blood pressure &amp;gt; 160 mmHg and diastolic blood pressure &amp;gt; 90 mmHg. Principal component analysis showed that the high prevalence of PIP was significantly associated (p &amp;lt; 0.05) with the number of prescribed medications and as age decreases, the number of medical diagnoses also decreases. It is concluded that there is a high prevalence of PIP in the studied population, posing a greater challenge in older adults, highlighting the importance of addressing prescribing practices with greater involvement of community pharmacists.

Родительская приверженность лечению детей с психическими расстройствами как клинико-психологическая проблема

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objectives. &lt;/strong&gt;A child&amp;rsquo;s illness is a major challenge that imposes restrictions on all family members. Not all parents of sick children strictly follow medical prescriptions, which emphasizes the importance of developing recommendations to improve parental adherence to treatment. It is necessary to distinguish between the terms adherence and compliance, where the former emphasizes active participation, and the latter &amp;mdash; the actual implementation of prescriptions without an emphasis on involvement. The purpose of the study is to systematize approaches to the problem of adherence to treatment to operationalize the concept of &amp;ldquo;parental adherence to treatment&amp;rdquo;.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods.&amp;nbsp;&lt;/strong&gt;The analysis of Russian and foreign studies of the concept of parental adherence was conducted. Russian works were selected based on relevance and availability of an evidence base for the study. Due to the low prevalence of the term in Russian studies, foreign sources had a great influence on the operationalization of the concept. Foreign sources were selected depending on the development depth of the problem and the representativeness of the sample to actualize the problematic of the phenomenon of parental treatment adherence in the field of clinical psychology. The following electronic resources were used for the analysis: eLIBRARY.ru, PubMed, ResearchGate, ConnectedPapers and others.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results.&amp;nbsp;&lt;/strong&gt;The main components of the phenomenon of parental adherence to treatment are identified: following the recommendations of doctors and establishing trusting relationships between parents, medical personnel and the child. Such relationships contribute to more effective treatment and accompany the child in the rehabilitation process. Given the possible difficulties with accepting treatment, interpersonal interaction between parents and doctors helps to individualize the treatment plan taking into account the characteristics of each family. The authors provide a definition of the phenomenon of &amp;ldquo;parental adherernce to treatment&amp;rdquo;.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusions. &lt;/strong&gt;Currently, the problem of increasing the level of parental treatment adherence is emphasized by the parents&amp;rsquo; lack of knowledge of child rehabilitation methods and their emotional rejection of the diagnosis. Therefore, operationalizing the concept of parental adherence to treatment will aid in formulating more useful recommendations on treating a child for parents.&lt;/p&gt;