Continued Use Of Medication Research Articles

A Study of Self- Medication Uses without a Prescription among Iraqi Patients in Baghdad City

Background: Medicines are those chemical compounds which consist of a single substance or more and areobtained through natural (plant or animal), as well as industrial methods, by chemical reactions that utilizedin the treatment of diseases that can infect human and animals or alleviate illness, prevention or diagnosing.Self-medication is the unwanted medical use of prescription and / or over-the-counter drugs. These practiceshave become an encouraging global form of self-care when it comes to minor ailments. Well it is not limitedto over-the-counter medicines. This also includes the use of prescription medications such as antibiotics.Objective: This study explores the extent of a widespread phenomenon of medicines usage without a doctorprescription, and studied the self-medication practices reasons among patients in the city of Baghdad.Methods: A cross-sectional descriptive study was conducted by questionnaires were distributed randomlyto 300 adults in different age group, sex and level of education at PHC in Baghdad city.Result: In this study, findings depict that the (34.3%) of study male participants are aged (30-39) years old.In regarding with education, thirty-four percent are primary school graduated and work a housewife residentin rural areas. Also, the (53 %), (12.3%) respectively take drugs in the last months for flu. The (64.7%) ofdrugs was prescribed by physician and (35.3%) of drug take without prescription because (16.3%) of themnot have access to physician care. The source of drugs supplies, the (31.7%) take it from others source and(38.3%) of information on the use of these drugs was obtained from physicians. The most common types ofdrugs used without prescription the result indicated that (39.0) was antibiotics and (53.3%) of sample notcommitment by dose, Reading instructions & advertence with complication. Also the (73%) of sample don’tuses or depending upon herbs.Conclusion & Recommendations: The continued use of medications without a prescription is an alarmingproblem in the country of Iraq. The prevalence of self-medication management is high in Middle Easterncountries and is often associated with inappropriate drug use. Therefore, it is necessary to understand therelationship between the various factors that favor the management of self-medication and to evaluate theevolving trends to help us develop strategies to reduce the health risks associated with drugs among thepeople of the Middle East.The recommendations included the imposition of regulatory measures that restrict access to prescriptionmedications only in countries where antibiotics are available over the counter. Another recommendation,which has emerged in several studies, is to improve the use of media campaigns to effectively guide publiceducation programs.

The Frequency and Perceived Effectiveness of Pain Self-Management Strategies Used by Individuals With Migraine.

ABSTRACTBackgroundMigraine is ranked among the most important causes of disability worldwide. Some effective migraine treatments have been identified. However, little is known regarding the treatment strategies used by patients with migraine to manage pain or their efficacy.PurposeThis study was designed to (a) investigate the pain management strategies used by migraineurs and their perceived effectiveness and (b) evaluate the association between the number of strategies used and their overall perceived effectiveness.MethodsA cross-sectional design with consecutive sampling was used in a medical center in Taiwan. Individuals with migraine (N = 174) completed self-administered questionnaires and in-depth interviews to assess the frequency and perceived effectiveness of a variety of pain management strategies.ResultsMost participants reported using prescription medications (56%) and over-the-counter medications (51%), which were rated as having good efficacy rates of 78% and 81%, respectively. Traditional Chinese medicine (17%) and folk remedies (13%) were used less frequently and rated as relatively less effective at 65% and 48%, respectively. About half (47%) reported using more than one pain management strategy. Significantly more of those who reported using multiple pain management strategies reported at least “some effect” than those who reported using one strategy only (73% vs. 27%, p = .001).ConclusionsPrescription medications showed good usage rate and good perceived efficacy. However, about half of the participants used multiple pain management strategies, supporting the need for further research to evaluate the efficacy of combination treatments and to identify those combinations that may have the most additive and/or synergistic effects. Furthermore, the findings indicate that continued use of medications for migraine management is appropriate for many individuals because of the relatively high rates of perceived efficacy for this strategy found in this study.

Factors related to adherence to drug treatment in public university workers

Objective: to analyze factors associated with medication adherence among public university workers who reported use of continuous medication. Methods: cross-sectional study carried out with 629 workers from a public university. Data were collected through interviews using forms adapted from the Brazilian Ministry of Health and analyzed using the chi-square test. Results: three hundred thirty-one (52.6%) participants were users of continuous medication, of these, 175 (52.9%) had a partially satisfactory adherence pattern and 156 (47.1%) a totally satisfactory pattern. Workers with chronic back problems, depression, weakness/tiredness, dyspnea, and chest pain had significantly less adherence to drug treatment (p≤0.050). Sociodemographic and labor characteristics, polypharmacy, and type of medication were not associated with medication adherence (p>0.050). Conclusion: satisfactory drug adherence was observed among the participants in relation to drug treatment, and the presence of some symptoms and specific chronic diseases was associated with partially satisfactory drug adherence.

Functional capacity, risk of falling and chronic pain in older adults during the COVID-19 pandemic: a telemonitoring study

OBJECTIVE: To compare active and sedentary older adults regarding functional capacity, risk of falling, and chronic pain in a population assisted by telemonitoring during the pandemic lockdown. METHODS: This analytical, cross-sectional study included 104 older adults who were telemonitored during the COVID-19 lockdown by a team from a Brazilian Unified Health System outpatient clinic specializing in geriatrics and gerontology. A structured interview was used to collect data. Following normality testing with the Shapiro-Wilk test, Student’s t-test was used for group comparisons. Associations were analyzed using the χ2 test, and the odds ratio was calculated in a 2x2 table of sedentarism and falls in the last six months. The data were analyzed using SPSS version 26.0, with p ≤ 0.05 considered significant. RESULTS: The 57 active older adults had a lower rate of continuous medication use (24.84 vs 27.62%), fewer falls (50 vs 32.11%), less pain (12.31 vs 3.83%), and greater independence in basic activities of daily living (44.39 vs 26.46%). CONCLUSIONS: Older adults who were physically active in the midst of social distancing had better functional capacity in basic activities of daily living, fewer falls, and less pain than their sedentary peers. Independence in instrumental activities of daily living did not differ significantly between the groups.

Automedicação nos estudantes do ensino superior da saúde

Enquadramento: a automedicação envolve o uso de medicamentos para tratar distúrbios ou sintomas autodiagnosticados, ou o uso intermitente ou continuado de medicação prescrita por um médico para tratamento crónico ou doenças ou sintomas recorrentes. Objetivos: caraterizar a prática da automedicação nos estudantes do ensino superior da saúde. Metodologia: estudo quantitativo e descritivo. Amostra constituída por 301 estudantes. Recolha de dados com recurso a questionário e análise de dados efetuada através do Statistical Package for the Social Sciences (SPSS). Resultados: verifica-se automedicação em 93,4% dos estudantes do ensino superior saúde. Os sinais e sintomas mais frequentes foram as cefaleias (29,8%), dismenorreia (13,5%) e febre (9,9%). Os medicamentos mais utilizados foram os analgésicos/antipiréticos (34,6%), os anti-inflamatórios (29,2%), vitaminas e sais minerais (7,4%). Conclusão: a automedicação entre os estudantes do ensino superior é elevada, pelo que é fulcral abordar esta problemática ao longo do curso de forma a minimizar os riscos associados a este consumo.

Deprescribing in Older Adults: Is Evidence for Continued Medication Use Generalizable Beyond Age 75?

Older adults over the age of 75 are severely underrepresented in many of the clinical trials used to justify the continued use of medications for chronic disease prevention in advanced age. The gaps in evidence in this population have fueled an interest in research to better understand the potential benefits and harms associated with the continued use of medications with uncertain benefit in advanced age. Deprescribing, the intentional reduction or discontinuation of medications, has recently gained traction as an important component of the prescribing process, but raises questions about the safety of stopping medications. This presentation will provide an overview of the evolution of deprescribing research and how this has shaped my career as a geriatric health services researcher. Specifically, I will address early studies that defined the field, challenges and opportunities for studying deprescribing in older adults, and future directions and priorities in deprescribing research.

Maxillary osteonecrosis induced by antiresorptive medication (bisphosphonate) in a patient with multiple myeloma - Case report

Objective: to describe the clinical case of a patient with multiple myeloma, who developed maxillary osteonecrosis induced by anti-resorptive medication (bisphosphonate) submitted to a conservative and surgical therapeutic approach and subsequent prosthetic rehabilitation. Patients and methods: the case report is presented based on a simple review of the literature and clinical experience for the diagnosis, clinical staging of the lesion, carrying out the excision of the necrotic bone, debridement, lesion control and making a obturator prosthesis. Results: Despite the difficulty offered by the pathological condition and continuous use of medication, the treatment employed was successful, restoring health and providing a better quality of life to the patient, which allowed the obturation prosthesis to be made in the 8-month postoperative period. Conclusion: The result obtained emphasizes the importance of knowledge of the staging of the lesion for the application of the treatment protocol, in addition to recognizing patients at risk for the practice of prevention in dental treatments.

Use of Preventive Medications in Patients With Nonobstructive Coronary Artery Disease: Analysis of the PROMISE Trial

BackgroundNonobstructive coronary artery disease (NOCAD) is commonly found on coronary computed tomography angiography (CCTA) during evaluation for coronary artery disease (CAD). There are no guidelines for the medical management of NOCAD, and practice is variable. We aimed to compare patterns of preventive medication use and continuation after identifying NOCAD vs normal coronaries or obstructive CAD on CCTA. MethodsWe analyzed data from the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial dataset, restricted to patients with ≥2 follow-up visits after CCTA. We categorized patients as having either obstructive CAD, NOCAD, or normal coronaries. The primary outcome was the proportion of patients reporting continued use of combination preventive medications, defined as a statin, an antithrombotic, and a renin–angiotensin system blocker throughout follow-up after CCTA. Secondary outcomes included the proportion of visits reporting combination therapy and individual medications. ResultsWe included 4388 patients, with a mean follow-up of 2.3 years. Most patients had NOCAD (48.6%), with normal coronaries in 38.9%, and obstructive CAD in 10.1%. Among NOCAD patients, the mean age was 61 years, and 47.2% were women. A total of 9.1% of NOCAD patients continued combination therapy, vs 12.4% with obstructive CAD, and 3.3% with normal coronaries (P < 0.001), primarily due to lower use of statins and antithrombotic agents. Similarly, patients with obstructive CAD, NOCAD, and normal coronaries reported using combination therapy during a mean of 35%, 24%, and 9% of visits, respectively (P < 0.001). ConclusionsFew patients with NOCAD identified by CCTA used or continued combination preventive cardiovascular medications. Patients with NOCAD represent an at-risk population with potential for optimization of preventive medications.

PHENYTOIN-INDUCED GENERALIZED GINGIVAL GROWTH: A CASE REPORT

Phenytoin is a drug of choice in the treatment of epilepsy and convulsive disorders. It is associated with a number of side effects. The one of greater interest for dental surgeon is the gingival overgrowth. An 18-year-old male, autistic, during an epileptic crisis, fell from his own height. The main complaint was related to dentoalveolar trauma. During anamnesis, it was observed a generalized upper and lower gingival overgrowth, improper oral hygiene and tooth mobility (21). It was mentioned use of phenytoin for 5 years. Diagnosis of gingival overgrowth associated with continuous use of medication and chronic periodontitis was hypothesized. He required neurologic opinion and hematological and diagnostic imaging exams to plan surgical procedure under general anaesthesia. The treatment plan consisted of full mouth gingivectomy, followed by thorough scaling, and root planning. Further dental extraction was performed (21). Gingival tissue was sent for histopathological evaluation. It confirmed the gingival overgrowth diagnosis. Phenytoin is a drug of choice in the treatment of epilepsy and convulsive disorders. It is associated with a number of side effects. The one of greater interest for dental surgeon is the gingival overgrowth. An 18-year-old male, autistic, during an epileptic crisis, fell from his own height. The main complaint was related to dentoalveolar trauma. During anamnesis, it was observed a generalized upper and lower gingival overgrowth, improper oral hygiene and tooth mobility (21). It was mentioned use of phenytoin for 5 years. Diagnosis of gingival overgrowth associated with continuous use of medication and chronic periodontitis was hypothesized. He required neurologic opinion and hematological and diagnostic imaging exams to plan surgical procedure under general anaesthesia. The treatment plan consisted of full mouth gingivectomy, followed by thorough scaling, and root planning. Further dental extraction was performed (21). Gingival tissue was sent for histopathological evaluation. It confirmed the gingival overgrowth diagnosis.

PMU25 Measuring Medication Adherence: Application of Group-Based Trajectory MODEL for Australians with Chronic Health Conditions Requiring Continuous Use of Medication

PMU25 Measuring Medication Adherence: Application of Group-Based Trajectory MODEL for Australians with Chronic Health Conditions Requiring Continuous Use of Medication

Prescription Psychoactive Medication Use in Adolescent Survivors of Childhood Cancer and Association With Adult Functional Outcomes.

BackgroundThis study estimates the prevalence and identifies predictors of psychoactive medication use in adolescent survivors of childhood cancer (aged 12-18 years) and its associations with functional outcomes at young adulthood (aged 18-28 years).MethodsThis retrospective cohort study includes 5665 adolescent survivors of childhood cancer at no less than 5 years postdiagnosis (53.8% male, median age = 15 years, interquartile range [IQR] = 13-16 years) and 921 adolescent sibling controls. Parent-reported psychoactive medication use during adolescence was collected at baseline. After a median of 8 years, functional outcomes and social attainment were self-reported during adulthood (n = 3114, median age = 22 years, IQR = 20-24 years). Multivariable log-binomial models evaluated associations among risk factors, medication use, and adult outcomes.ResultsHigher prevalence of psychoactive medication use was reported in survivors compared with siblings (18.3% vs 6.6%; 2-sided P < .001), with trends for increasing antidepressant and stimulant use in recent treatment eras. After adjusting for cancer treatment and baseline cognitive problems, psychoactive medication use during adolescence was associated with impaired task efficiency (relative risk [RR] = 1.20, 95% confidence interval [CI] = 1.01 to 1.43) and memory (RR = 1.27, 95% CI = 1.05 to 1.52) during adulthood. Survivors who reported continued use of medications from adolescence to adulthood demonstrated poorer emotional regulation (RR = 1.68, 95% CI = 1.24 to 2.27) and organization (RR = 1.82, 95% CI = 1.28 to 2.59) compared with nonusers. Adolescent opioid use was associated with somatization symptoms (RR = 1.72, 95% CI = 1.09 to 2.73) during adulthood, after adjusting for cancer treatment and baseline behavioral problems. They were also more likely to not complete college (RR = 1.21, 95% CI = 1.04 to 1.41) or work full-time (RR = 1.60, 95% CI = 1.23 to 2.08) compared with nonusers.ConclusionUse of psychoactive medication is more prevalent among adolescent survivors compared with siblings and does not normalize adult outcomes, as evidenced by poorer functional outcomes during young adulthood.

Atuação do farmacêutico clínico e comunitário frente a pandemia da COVID-19

Esta pesquisa tem por objetivo apresentar a importância da atuação do profissional farmacêutico frente a pandemia do COVID-19. Trata-se de uma revisão bibliográfica que foi realizada com base em dados coletados das plataformas de pesquisa Science Direct, Pubmed, Medline e em sites oficiais do governo brasileiro. Como critério de inclusão selecionou-se artigos de 2019 e 2020 entre os dias 15 de setembro de 2019 a 13 de maio de 2020, em inglês e completos que tratam da temática em questão. Os resultados encontrados indicam que a atuação do farmacêutico nas equipes de saúde que estão enfrentando essa pandemia é fundamental uma vez que esse profissional tem o conhecimento dos medicamentos, suas interações e reações adversas a medicamentos. O gerenciamento da farmácia hospitalar nesse momento é imprescindível para que não haja escassez de medicamento e nem desperdícios, e dentro das farmácias comunitárias a atuação do farmacêutico dá-se por meio de informações sobre prevenção e controle da COVID-19, bem como orientações para aqueles pacientes que já possuem outras comorbidades e fazem uso contínuo de medicamentos. Assim o farmacêutico comunitário e clínico que estão atuando frente a essa pandemia têm se tornado um profissional indispensável uma vez que, possui total respaldo para integrar as equipes de saúde para contribuir com seu conhecimento e habilidade sobre os medicamentos.

Implementation of an in-patient hip fracture liaison services to improve initiation of osteoporosis medication use within 1-year of hip fracture: a population-based time series analysis using the RE-AIM framework

To examine implementation of an in-patient hip fracture liaison service (H-FLS) to improve osteoporosis medication use after hip fracture using the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance). Using population-based administrative data from 7 quarters before and up to 7 quarters after H-FLS implementation, we examined new starts, continued use, and overall use (new starts + continued use) of osteoporosis medication after hip fracture. A total of 1427 patients 50years and older that underwent hip fracture surgery at 1 of 2 tertiary hospitals in a Canadian province and survived to 12months post-fracture were included. We also compared treatment initiation rates by sex and hospital. Of the 1427 patients, 1002 (70.2%) were female (mean age = 79.3 ± 11.9years) and 425 (29.8%) were male (mean age = 73.8 ± 13.8years). Based on pre-fracture residence within the health zone, 1101 (69%) were considered eligible (Reach). New starts of osteoporosis medication increased from 24.7% pre- to 43.9% post-implementation of the H-FLS (p < 0.001) (effectiveness). The proportion of patients prescribed osteoporosis medication prior to a hip fracture remained consistent (15.1% pre-; 14.7% post-implementation; p = 0.88) with a resultant improvement in overall medication use from 39.8% pre- to 58.6% post-implementation (p < 0.001). Both sites significantly improved medication initiation (site 1: 27.9% pre- to 40.3% post-implementation; site 2: 19.6% pre- to 50.0% post-implementation; p < 0.001 for both) (adoption). Medication initiation in females improved from 26.0% pre- to 43.4% post-implementation while initiation in males improved from 21.7% pre- to 45.1% post-implementation (p < 0.001[females]; p = 0.001[males]) (implementation). Post-implementation, elevated initiation rates were retained over the 7 quarters (p = 0.81) (maintenance). An H-FLS based in two tertiary hospital sites significantly improved use of osteoporosis medications after hip fracture in both males and females.

Depression in the elderly of a rural region in Southern Brazil.

The aim of this study is to estimate the prevalence of depression and its associated factors in elderly residents of the rural area of Rio Grande/RS. In this cross-sectional population-based study performed with 994 elderly (≥ 60 years), whose sampling was based on the 2010 Demographic Census, the Patient Health Questionnaire 9 (PHQ-9) was used for Major Depressive Episode (EDM) screening. Descriptive, bivariate and multivariate analyses were performed using logistic regression. The overall prevalence for Major Depressive Episode screening was 8.1%. The variables independently associated with depression were: female gender, continuous use of medications, chronic diseases, body mass index and worse health perception. The creation of programs target at the elderly in the rural area, aimed at screening, early diagnosis of depression and maintenance of treatment, encompassing several factors related to health, are important actions that must be fostered by the health system.

Antioxidants Consumption and Depression: A Cross-Sectional Analysis of the ELSA-Brasil Study

Abstract Objectives To evaluate the association between depression and consumption of retinol, vitamins C and E, selenium and zinc in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. Methods This study is part of the ELSA-Brasil, a population-based cohort study with 15,105 civil servants aged 35–74 years. In this analysis, we included cross-sectional data from the baseline examination conducted from August 2008 to December 2010. Antioxidants consumption was measure by The Food Frequency Questionnaire (FFQ) using the Nutrition Data System for Research (NDSR) software. Depression disorder was accessed by a Clinical Interview Schedule Revised (CIS-R). The use of antidepressant drugs was recorded during a face-to-face systematic interview about use of continuous medication in the prior two weeks. Logistic regression models were built comparing two groups: DEP1 - no depression by CIS-R and no current antidepressants use, and DEP2 - depression by CIS-R or current use of antidepressant. Model 1 yield crude values and model 2 adjusted by age, sex and total energy. These analyses were carried out using the software Stata and P &amp;lt; 0.05 was considered significant. Results A total of 11.7% (n = 1761) of the sample was identified with depression by CIS-R or current use of antidepressants. Median antioxidant intake for DEP1 and DEP2 were respectively 434.76 mg and 419.73 mg for retinol; 196.84 mg and 193.87 mg for vitamin C; 9.30 mg and 9.03 mg for vitamin E; 192.24 μg and 189.24 μg for selenium, and 14.62 mg and 14.39 mg for zinc. In model 1, retinol (OR = 0.99, 95% CI = 0.99–0.99, P = 0.008) and vitamin E (OR = 0.99, 95% CI = 0.98–0.99, P = 0.036) intake levels were inversely associated with depression. In model 2 only retinol (OR = 0.99, 95% CI = 0.99–0.99, P = 0.011) intake was inversely associated with depression disorder. Conclusions A lower intake of retinol was significantly associated with more occurrence of depression or antidepressant use. Although the magnitude of ORs is small, these results suggest a possible protective effect on retinol intake against depression disorder. Funding Sources The ELSA-Brazil baseline study was supported by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology (Studies and projects financier and CNPq National Research Council).

Self-care management practices for arterial hypertension and diabetes mellitus among elderly people in Campinas, Brazil, in three periods

The objective of this study was to estimate the prevalence of self-care management practices - both with and without medication - in elderly hypertensive and diabetic patients in Campinas, Brazil, in three periods. Data from health surveys conducted in three periods 2001-2002, 2008-2009 and 2014-2015 were analyzed. The prevalence of hypertension, diabetes, the continuous use of medication, and all behavioral practices showed an overall increase in the period analyzed, with a significant drop in both the non-regular use of medications and routine doctor visits on the part of individuals without a private health plan. The results evidenced advances in diet-related practices among individuals without health plans as well as those who reported having healthcare coverage, highlighting improvements in drug treatment and physical activity. Adherence to medication and health behaviors for the management of morbidities was shown to be consistent in the period evaluated. These indicators reinforce the need to maintain and expand policies directed at health education and pharmaceutical assistance in the country.

Comparing Outcomes Between Thiazide Diuretics and Other First-line Antihypertensive Drugs in Long-term Nursing Home Residents

PurposeHypertension occurs in >50% of US nursing home (NH) residents, but it is unclear which antihypertensive classes offer the best balance of benefits and risks in this population. The objectives of this study were to describe the patterns of antihypertensive medication treatment in this population, focusing on thiazide diuretics, and to determine the association between thiazide diuretics (DIURs) and outcomes important to NH patients. MethodsThis observational cohort study was conducted in long-term NH residents treated for hypertension in the second quarter (Q2) of 2013, from all US NHs. The primary exposure was the frequency of use of antihypertensive treatment class (DIURs, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers [ARBs], calcium channel blockers, and β-blockers) according to Medicare Part D dispensing data. Because DIUR-related urinary symptoms were a focus, residents receiving nonthiazide diuretics were excluded. We ascertained continued medication use by class from Q2 to Q4 of 2013, and ascertained 6-month incontinence and hospitalization using data from Medicare claims and the Minimum Data Set. FindingsOf 152,902 NH residents treated for hypertension, 52.2% were treated with β-blockers (22% as a single agent), 39.7% with calcium channel blockers (14% as a single agent), 38.8% with angiotensin-converting enzyme inhibitors (14% as a single agent), 14.2% with DIURs (2% as a single agent), and 13.2% with ARBs (4% as a single agent). Overall, 55.1% were treated with 1 drug; 33.2%, with 2 drugs; and 11.8%, with 3 or more drugs. From Q2 to Q4, DIURs were more likely to have been discontinued than any other class (19.4% vs 14.1%–16.1% for each of the other 4 classes; all, p < 0.05) and less likely to have been started than any other class except ARBs (1.4% vs 3.8%–5.3% for each of the other 3 classes). Urinary incontinence occurred in 76.6% of the sample. In a multivariate logistic regression model, new DIUR use from Q2 to Q4 of 2013 was not significantly associated with urinary incontinence in Q4, and none of the antihypertensive drug classes were associated with 6-month hospitalization. ImplicationsIn 2013, long-term NH residents treated for hypertension were least likely to receive, more likely to discontinue, and less likely to start a new DIUR than any other first-line antihypertensive medication. DIURs were not associated with increased incontinence or hospitalization, so in the absence of indications for other drugs, DIURs may be a reasonable first-line choice for hypertension treatment in this population.

Evaluation of Home Environments of People Over the Age of 65 in Terms of Home Accident Information

Background: Home accidents pose serious problems that threaten public health.This study aims to evaluate the home environments of the elderly and to identifyrisky situations in terms of home accidents. Methods: This study was performed as adescriptive study between February and April 2015 and included 324 individuals aged65 years and above. As for data collection tools, an interview form involving personalinformation with 23 questions and a home safety checklist with 26 questions preparedby researchers in line with the literature were used. The validity and reliability of thehome security checklist were checked by Guler P et al. in 2002. Forms were filled outusing observation and interview techniques by the researchers during the home visits.Data were transferred to a computer and evaluated. Number and percentile tests wereused for data analysis. R esults: The average score of the risk of home accidents for theelderly was found to be 14.00  4.91. The first items threatening home security wereidentified as the absence of bath and toilet bars. The relationships between the maritalstatus of the elderly, working status, whether or not living together, income status,continuous use of medication, diagnosis of chronic illness and point average of homeaccident risk were statistically significant (p < 0.05). Conclusion: In the presentstudy, it was determined that the elderly are at risk of experiencing home accidents. Atthe end of this work, planning and implementation of domestic regulations, training,and necessary nursing interventions are proposed to reduce the risk of home accidents.Key words: home environments–older people–home accident–nursing

Kadınların Kanser Taramalarına Katılımını Etkileyen Faktörler

Giriş: Kanser, önemli bir halk sağlığı sorunudur. Kanser tarama birimine başvuran kadınların kanser taramasına bakışları, tarama yaptırma durumları ve yaptırmalarına katkı sağlayan faktörler araştırılarak kanser ile mücadelede hedefe yönelik stratejilerin geliştirilmesi amaçlanmıştır.Yöntem: İlçe Sağlık Müdürlüğü Kanser Birimi’ne başvuran ve çalışmaya katılmayı kabul eden 200 kadın ile çalışma yürütüldü. Kanser taraması ile ilgili durumlarının değerlendirilmesi amacıyla 20 soruluk bir anket, onamları alınarak bireylere uygulandı.Bulgular: Çalışmaya katılanların %93'ü evli, çoğunluğu ev hanımı (%61) idi. %40,5'inde en az bir kronik hastalık mevcuttu. 82 kişinin (%41) ailesinde kanser tanısı alan kişi vardı. Kanser taraması yaptırmayan 86 kişinin %25,6'sı "Bilmiyordum-Haberim yoktu", %25,6'sı "Yaşım taramaya uygun değildi", %20,9'u "Fırsatım olmadı", %11,6'sı ise "Korkuyordum" cevaplarını verdi. Aile hekimine başvurular %74,5 yeni başlayan-kısa süreli hastalık için, %65 sürekli kullandığı ilaçları yazdırmak için ve %41 genel muayene amaçlı idi. Kadınların %51,5'i aile hekimi tarafından, %23'ü ebe/hemşire tarafından, %14'ü ise başka hekimler tarafından taramalara yönlendirilmiş, %58,5'i taramayı aile hekimi/ebe/hemşire yönlendirmesi nedeniyle, %31'i ise kendisi kontrol amaçlı istediği için yaptırdığını belirtti. Sonuç: Kişilerin kanser taramaları hakkında bilgilendirilmesi ve özellikle hekimler tarafından yönlendirilmesi ile tarama oranları değerli şekilde artacaktır. Aile hekimi ile bireyler arasındaki ilişki güçlendirilerek taramalara yönelik çekinceler ortadan kaldırılabilir.

Transforming care in Cornwall: A review of the quality of the lives of people with learning disabilities a decade post‐discharge from hospital

Accessible summary The government wants people with learning disabilities and/or autism to move out of hospitals back to their homes. Cornwall did this in 2007, and we asked the people who moved and their carers how they are now. They have generally done well, and nearly all have stayed in their homes with lots of support. Various factors such as accommodation, social network, skill acquisition and impact of their past were explored. AbstractBackgroundIn the light of the current national guidance to reduce the number of inpatient learning disability beds, a review was completed of the quality of lives of the people who had been former inpatients in Cornwall at the time of closure of the learning disability inpatient facilities almost 10 years before transforming care.Materials and MethodsAll former inpatients who were discharged from the learning disability inpatient setting in Cornwall were invited to participate either directly or through their carers or family members. Measures of current activity levels and semi‐structured interviews on quality of life were conducted.ResultsThe majority interviewed had person‐centred plans, health action plans and positive behaviour support plans. Guernsey Community Participation &amp; Leisure Assessment showed overall the study group did not meet comparative standards laid out by the scale in any of the subdomains (p &lt; .05). Peoples' lives were varied, with a lack of informal relationships, meaningful occupation, homeownership and advocacy being relatively poor for all. Alongside this, to enable people to have safer lives, restrictive practices were commonplace particularly continuous supervision and use of psychotropic medication to manage behavioural risk.ConclusionsThis study highlights that people with complex concerns with a history of placement breakdowns and past institutionalisation can be settled successfully and safely in local communities. However, it is difficult for many of them to achieve a satisfactory quality of life long term. The obligation for this lies with service providers to provide adequate support to overcome that difficulty.