Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medicati...Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.展开更多
Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and ...Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.展开更多
Treatment adherence among people living with human immunodeficiency virus(PLWH)is a critical determinant of viral suppression and improved quality of life.Medication literacy,as a key factor influencing adherence,is i...Treatment adherence among people living with human immunodeficiency virus(PLWH)is a critical determinant of viral suppression and improved quality of life.Medication literacy,as a key factor influencing adherence,is itself shaped by various psychosocial variables.Existing studies suggest that human immunodeficiency virus(HIV)-related stigma,self-efficacy,and trust in healthcare providers serve as significant mediators in the relationship between health literacy and treatment adherence.This review systematically explores how medication literacy affects treatment adherence in PLWH through intermediary psychosocial mechanisms such as depression,anxiety,and social support.By synthesizing current evidence,we aim to inform the development of targeted psychosocial interventions to enhance treatment outcomes and quality of life for this population.Our findings provide an evidence-based foundation for nursing practice and support innovative strategies in comprehensive HIV care.展开更多
In today’s fast-paced world,many elderly individuals struggle to adhere to their medication schedules,especially those with memory-related conditions like Alzheimer’s disease,leading to serious health risks,hospital...In today’s fast-paced world,many elderly individuals struggle to adhere to their medication schedules,especially those with memory-related conditions like Alzheimer’s disease,leading to serious health risks,hospital-izations,and increased healthcare costs.Traditional reminder systems often fail due to a lack of personalization and real-time intervention.To address this critical challenge,we introduce MediServe,an advanced IoT-enabled medication management system that seamlessly integrates deep learning techniques to provide a personalized,secure,and adaptive solution.MediServe features a smart medication box equipped with biometric authentication,such as fingerprint recognition,ensuring authorized access to prescribed medication while preventing misuse.A user-friendly mobile application complements the system,offering real-time notifications,adherence tracking,and emergency alerts for caregivers and healthcare providers.The system employs predictive deep learning models,achieving an impressive classification accuracy of 98%,to analyze user behavior,detect anomalies in medication adherence,and optimize scheduling based on an individual’s habits and health conditions.Furthermore,MediServe enhances accessibility by employing natural language processing(NLP)models for voice-activated interactions and text-to-speech capabilities,making it especially beneficial for visually impaired users and those with cognitive impairments.Cloud-based data analytics and wireless connectivity facilitate remote monitoring,ensuring that caregivers receive instant alerts in case of missed doses or medication mismanagement.Additionally,machine learning-based clustering and anomaly detection refine medication reminders by adapting to users’changing health patterns.By combining IoT,deep learning,and advanced security protocols,MediServe delivers a comprehensive,intelligent,and inclusive solution for medication adherence.This innovative approach not only improves the quality of life for elderly individuals but also reduces the burden on caregivers and healthcare systems,ultimately fostering independent and efficient health management.展开更多
The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations ...The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.展开更多
Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is infl...Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.展开更多
Background:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This st...Background:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This study investigated the current state and predictors of such participation during this critical period.Methods:A cross-sectional study was conducted among older adults discharged from two tertiary hospitals in Fujian,China(October-December 2023).Data were collected using a general information questionnaire,a self-developed behavior scale,the Health Literacy Management Scale,General Self-Efficacy Scale,Facilitation of Patient Involvement Scale,and Family Support Scale.Analyses included ANOVA,Pearson correlation,and multiple stepwise regression.Results:Among 302 valid responses,the mean score for participation in medication safety behaviors was 68.59±11.62,indicating a moderate level.Health literacy,self-efficacy,healthcare worker support,and family support were positively correlated with participation(all P<0.01).Multiple regression identified daily medication frequency,health literacy,self-efficacy,and healthcare worker support as significant predictors,explaining 18.3%of the variance.Conclusion:Participation in medication safety among older chronic disease patients during care transitions requires improvement.Enhancing health literacy,self-efficacy,and healthcare worker support,while considering medication frequency,can promote patient involvement and medication safety.展开更多
BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid ...BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.展开更多
Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.T...Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.This scoping review thus aimed to explore the evidence of the effects of mobile health care apps on medication adherence in patients with cardiovascular diseases.A comprehensive data search and extraction was done in line with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.A total of 10 studies were included for the review.The mean pooled improvement in adherence was found to be 18%and the most effective tool was the digital therapeutics app discussed in Li et al’s study.Smartphones and apps enhance coronary artery disease management by promoting medication compliance.Challenges include data security and smartphone usage among the elderly.Tailored apps or voice assistants offer potential solutions.展开更多
Objective To explore the medication patterns of Professor Zulong Wang in treating sleep-related painful erection(SRPE)through data mining,aiming to discover new therapeutic strategies for traditional Chinese medicine ...Objective To explore the medication patterns of Professor Zulong Wang in treating sleep-related painful erection(SRPE)through data mining,aiming to discover new therapeutic strategies for traditional Chinese medicine in managing this condition.Methods Medical records of SRPE patients treated by Professor Zulong Wang at the First Affiliated Hospital of Henan University of Chinese Medicine from February 2021 to December 2024 were collected to establish a database.Frequency analysis,association rule analysis,and cluster analysis were employed to examine the frequency of herb use,four properties and five flavors,channel tropisms,and herb combinations.Results A total of 59 prescriptions meeting the criteria were included,involving 81 Chinese herbs,among which 27 herbs were used 10 or more times.The primary herb properties were cold,warm,and neutral,with bitter,sweet,and pungent flavors being most common.The herbs predominantly entered the liver,heart,spleen,and kidney channels.Forty-three commonly used herb combinations were identified,and cluster analysis revealed six core herb groups.Conclusion Professor Zulong Wang primarily treats SRPE with modified Huoluo Xiaoling Dan,focusing on unblocking collaterals and relieving pain,supplemented by soothing the liver and regulating qi,resolving stasis and phlegm,nourishing yin and reducing fire,and tonifying the kidney and activating blood circulation.展开更多
[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital ...[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital of Traditional Chinese Medicine.[Methods]Prescriptions for the treatment of spleen-deficiency irritable bowel syndrome(IBS)were retrieved from the TCM family of the hospital,traditional Chinese medical doctor Wu Zhongli,in the period from November 2023 to April 2024.Microsoft Excel 2007 was employed to set up an information table of TCM prescriptions,and the age,gender,herbal properties,efficacy categories and the frequency of use were analyzed to explore the medication laws of TCM in the hospital for the treatment of spleen-deficiency irritable bowel syndrome.[Results]Among the 259 TCM prescriptions included,152 kinds of TCM decoction pieces were used.The decoction pieces were mainly warm in nature,and decoction pieces cold in nature took the second place.The flavors of the herbs were mostly sweet,bitter and pungent.Most of them were attributive to the spleen,stomach meridian and lung meridians,and the herbs were mainly used for tonifying deficiency and regulating qi.The herbs with higher frequency of use included Radix Glycyrrhiza,Pericarpium Citri Reticulatae,poria,and Angelicae Sinensis Radix,the main effects of which are replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel.[Conclusions]Chinese medicine treatment of IBS with spleen deficiency in hospitals is mainly based on replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel,and Xiangsha Liujunzi Decoction is commonly used in clinical treatment based on syndrome differentiation with modifications.展开更多
Background:Patients are particularly vulnerable to adverse drug events during the transition from hospital to home.This risk is significantly amplified for older adults with chronic diseases,who often manage complex m...Background:Patients are particularly vulnerable to adverse drug events during the transition from hospital to home.This risk is significantly amplified for older adults with chronic diseases,who often manage complex medication regimens involving multiple drugs.Although active patient participation is recognized as a crucial component in safeguarding medication safety,there is currently a lack of a standardized,validated tool specifically designed to assess the level of such participation among this vulnerable population during this critical transition.Therefore,this study aimed to develop and validate a questionnaire for assessing the level of participation in medication safety behaviors among older adults with chronic diseases during the transition from hospital to home.Methods:Guided by the Interactive Patient Participation in Patient Safety theory,the initial questionnaire was developed through literature analysis,qualitative interviews,expert consultation,and pre-testing from April to December 2023.A total of 582 older adults with chronic diseases discharged from two tertiary hospitals in Fuzhou,China were recruited using convenience sampling.Construct validity,content validity,internal consistency,and test-retest reliability were assessed.Results:The final questionnaire comprised 20 items across three dimensions:Participation in Decision-Making,Participation in Care,Participation in Appeals.Exploratory factor analysis showed a cumulative variance contribution of 51.478%.The overall Cronbach’s a coefficient was 0.875,the scale-level content validity index was 0.930,and the test-retest reliability was 0.715.Confirmatory factor analysis indicated an acceptable model fit.Conclusion:The developed questionnaire exhibits good reliability and validity,supporting its use to evaluate participation in medication safety behaviors among Chinese older adults with chronic diseases during the hospital-to-home transition period.展开更多
The objective of the study is to study the impact of pharmaceutical care on medication compliance in asthmatic children. The results will be used to further develop the pharmaceutical care delivered by pharmacists for...The objective of the study is to study the impact of pharmaceutical care on medication compliance in asthmatic children. The results will be used to further develop the pharmaceutical care delivered by pharmacists for asthmatic children, and to promote children＇s asthma control in China. The study was conducted in outpatient department of Beijing Children＇s Hospital from Mar. to Sept., 2009. Asthmatic children （101） were randomly divided into two groups： the intervention group that received routine treatment and complete pharmaceutical care provided by pharmacists and the control group that received routine treatment only. Questionnaires were distributed to both groups and responses were analyzed statistically. Our results showed that the percentage of children using medication following doctor＇s instructions in the intervention group was significantly higher than that in the control group （66.67% and 36.00%, respectively）; the percentage of children correctly using inhaler devices in the intervention group was significantly higher than that in the control group （78.26% and 32.84%, respectively）; children and care givers of the intervention group had significantly more knowledge about medication compliance. In conclusion, the pharmaceutical care provided by pharmacists could improve medication compliance of asthmatic children, and it would be desirable to further develop the pharmaceutical care for asthmatic children across China.展开更多
The mobile APP for medication guidance related to pharmacogenomic is developed to solve various practical problems, such as inconvenient reading of English database, slow updating of paper reference books and lack of ...The mobile APP for medication guidance related to pharmacogenomic is developed to solve various practical problems, such as inconvenient reading of English database, slow updating of paper reference books and lack of shortcut for access.We extracted the medication guidance information related to the pharmacogenomic from ‘Dosing Guidelines’(http://www.pharmgkb.com), ′Table of Pharmacogenomic Biomarkers in Drug Labeling′(http://www.fda.gov/drugs/scienceresearch) and relevant authoritative books.SQLite was used to build the medication guidance information database.We designed and implemented a mobile APP for medication guidance by JavaScript programming language.The APP contained 197 drugs that have been extensively studied and have high levels of evidence.It covered 25 categories, such as anticoagulant and antiplatelet drugs, general antitumor, immunosuppressant drugs, targeted antitumor drugs, antipsychotic drugs, antiepileptic drugs, and proton pump inhibitors and so on.Users can obtain clinical significance and guidance information related to the genotype of the drug by entering the pinyin initials of the generic name of the drug.The mobile APP for medication guidance related to pharmacogenomic based on APICloud could provide practical and convenient pharmaceutical information service for clinical use.展开更多
背景全科医生的培养和发展始终是医学界关注的焦点,而各国对全科医生的培训模式和方法存在显著的差异。目的总结并揭示我国全科医生培养的热点、趋势以及挑战,同时对比国外做法,为我国全科医生的未来发展提供借鉴和指导。方法采用文献...背景全科医生的培养和发展始终是医学界关注的焦点,而各国对全科医生的培训模式和方法存在显著的差异。目的总结并揭示我国全科医生培养的热点、趋势以及挑战,同时对比国外做法,为我国全科医生的未来发展提供借鉴和指导。方法采用文献计量学的方法,以CiteSpace 6.1.R Advanced软件为工具,国内研究分析基于中国知网(CNKI),国外研究分析选取Web of Science核心数据库(WOSCC),对2013—2023年国内外全科医生培养的文献进行筛选与定量化分析,并归纳总结。结果我国全科医生教育的研究数量逐年增长;我国研究机构以首都医科大学全科医学与继续教育学院发文量最多,但各机构间的合作不紧密;国外主要发文国家为英国和澳大利亚;我国全科医生培养研究偏向于教育方法改革和服务方向优化,而同期国外全科医生培养的研究侧重于人工智能技术的应用和对精神心理疾病的关注。结论我国全科医生培养的研究活动增长显著,集中在教育方法改革和服务方向优化,但各研究机构间需加强合作。对比国外研究模式,我国需要更多地引入新兴技术(如人工智能),并提升对精神心理疾病的关注度,以促进全科医生培养的深度和广度发展。展开更多
文摘Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.
基金supported by grant 2011BAI11B01 from the Projects in the Chinese National Science and Technology Pillar Program during the 12th Five-year Plan Periodby grant 2017-I2M-1-004 from the Chinese Academy of Medical Science Innovation Fund for Medical Sciencesby the Major science and technology special plan project of Yunnan Province (202302AA310045)。
文摘Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.
基金Supported by Taizhou Municipal Hospital,No.2025JK317 and No.2025JK318.
文摘Treatment adherence among people living with human immunodeficiency virus(PLWH)is a critical determinant of viral suppression and improved quality of life.Medication literacy,as a key factor influencing adherence,is itself shaped by various psychosocial variables.Existing studies suggest that human immunodeficiency virus(HIV)-related stigma,self-efficacy,and trust in healthcare providers serve as significant mediators in the relationship between health literacy and treatment adherence.This review systematically explores how medication literacy affects treatment adherence in PLWH through intermediary psychosocial mechanisms such as depression,anxiety,and social support.By synthesizing current evidence,we aim to inform the development of targeted psychosocial interventions to enhance treatment outcomes and quality of life for this population.Our findings provide an evidence-based foundation for nursing practice and support innovative strategies in comprehensive HIV care.
文摘In today’s fast-paced world,many elderly individuals struggle to adhere to their medication schedules,especially those with memory-related conditions like Alzheimer’s disease,leading to serious health risks,hospital-izations,and increased healthcare costs.Traditional reminder systems often fail due to a lack of personalization and real-time intervention.To address this critical challenge,we introduce MediServe,an advanced IoT-enabled medication management system that seamlessly integrates deep learning techniques to provide a personalized,secure,and adaptive solution.MediServe features a smart medication box equipped with biometric authentication,such as fingerprint recognition,ensuring authorized access to prescribed medication while preventing misuse.A user-friendly mobile application complements the system,offering real-time notifications,adherence tracking,and emergency alerts for caregivers and healthcare providers.The system employs predictive deep learning models,achieving an impressive classification accuracy of 98%,to analyze user behavior,detect anomalies in medication adherence,and optimize scheduling based on an individual’s habits and health conditions.Furthermore,MediServe enhances accessibility by employing natural language processing(NLP)models for voice-activated interactions and text-to-speech capabilities,making it especially beneficial for visually impaired users and those with cognitive impairments.Cloud-based data analytics and wireless connectivity facilitate remote monitoring,ensuring that caregivers receive instant alerts in case of missed doses or medication mismanagement.Additionally,machine learning-based clustering and anomaly detection refine medication reminders by adapting to users’changing health patterns.By combining IoT,deep learning,and advanced security protocols,MediServe delivers a comprehensive,intelligent,and inclusive solution for medication adherence.This innovative approach not only improves the quality of life for elderly individuals but also reduces the burden on caregivers and healthcare systems,ultimately fostering independent and efficient health management.
文摘The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.
文摘Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.
基金supported by the Natural Science Foundation of Fujian Province,China(Grant No.2023J01133509)by The Key Projects on Civil Affairs Policy and Theory Research in Fujian Province(Grant No.FMZD202402).
文摘Background:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This study investigated the current state and predictors of such participation during this critical period.Methods:A cross-sectional study was conducted among older adults discharged from two tertiary hospitals in Fujian,China(October-December 2023).Data were collected using a general information questionnaire,a self-developed behavior scale,the Health Literacy Management Scale,General Self-Efficacy Scale,Facilitation of Patient Involvement Scale,and Family Support Scale.Analyses included ANOVA,Pearson correlation,and multiple stepwise regression.Results:Among 302 valid responses,the mean score for participation in medication safety behaviors was 68.59±11.62,indicating a moderate level.Health literacy,self-efficacy,healthcare worker support,and family support were positively correlated with participation(all P<0.01).Multiple regression identified daily medication frequency,health literacy,self-efficacy,and healthcare worker support as significant predictors,explaining 18.3%of the variance.Conclusion:Participation in medication safety among older chronic disease patients during care transitions requires improvement.Enhancing health literacy,self-efficacy,and healthcare worker support,while considering medication frequency,can promote patient involvement and medication safety.
文摘BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.
文摘Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.This scoping review thus aimed to explore the evidence of the effects of mobile health care apps on medication adherence in patients with cardiovascular diseases.A comprehensive data search and extraction was done in line with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.A total of 10 studies were included for the review.The mean pooled improvement in adherence was found to be 18%and the most effective tool was the digital therapeutics app discussed in Li et al’s study.Smartphones and apps enhance coronary artery disease management by promoting medication compliance.Challenges include data security and smartphone usage among the elderly.Tailored apps or voice assistants offer potential solutions.
基金supported by the National Natural Science Foundation of China General Program(82174377)National Traditional Chinese Medicine Advantageous Specialty Construction Project(GZY-ZY[2024]90).
文摘Objective To explore the medication patterns of Professor Zulong Wang in treating sleep-related painful erection(SRPE)through data mining,aiming to discover new therapeutic strategies for traditional Chinese medicine in managing this condition.Methods Medical records of SRPE patients treated by Professor Zulong Wang at the First Affiliated Hospital of Henan University of Chinese Medicine from February 2021 to December 2024 were collected to establish a database.Frequency analysis,association rule analysis,and cluster analysis were employed to examine the frequency of herb use,four properties and five flavors,channel tropisms,and herb combinations.Results A total of 59 prescriptions meeting the criteria were included,involving 81 Chinese herbs,among which 27 herbs were used 10 or more times.The primary herb properties were cold,warm,and neutral,with bitter,sweet,and pungent flavors being most common.The herbs predominantly entered the liver,heart,spleen,and kidney channels.Forty-three commonly used herb combinations were identified,and cluster analysis revealed six core herb groups.Conclusion Professor Zulong Wang primarily treats SRPE with modified Huoluo Xiaoling Dan,focusing on unblocking collaterals and relieving pain,supplemented by soothing the liver and regulating qi,resolving stasis and phlegm,nourishing yin and reducing fire,and tonifying the kidney and activating blood circulation.
文摘[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital of Traditional Chinese Medicine.[Methods]Prescriptions for the treatment of spleen-deficiency irritable bowel syndrome(IBS)were retrieved from the TCM family of the hospital,traditional Chinese medical doctor Wu Zhongli,in the period from November 2023 to April 2024.Microsoft Excel 2007 was employed to set up an information table of TCM prescriptions,and the age,gender,herbal properties,efficacy categories and the frequency of use were analyzed to explore the medication laws of TCM in the hospital for the treatment of spleen-deficiency irritable bowel syndrome.[Results]Among the 259 TCM prescriptions included,152 kinds of TCM decoction pieces were used.The decoction pieces were mainly warm in nature,and decoction pieces cold in nature took the second place.The flavors of the herbs were mostly sweet,bitter and pungent.Most of them were attributive to the spleen,stomach meridian and lung meridians,and the herbs were mainly used for tonifying deficiency and regulating qi.The herbs with higher frequency of use included Radix Glycyrrhiza,Pericarpium Citri Reticulatae,poria,and Angelicae Sinensis Radix,the main effects of which are replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel.[Conclusions]Chinese medicine treatment of IBS with spleen deficiency in hospitals is mainly based on replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel,and Xiangsha Liujunzi Decoction is commonly used in clinical treatment based on syndrome differentiation with modifications.
基金supported by the Natural Science Foundation of Fujian Province,China(Grant No.2023J01133509)by The Key Projects on Civil Affairs Policy and Theory Research in Fujian Province(Grant No.FMZD202402).
文摘Background:Patients are particularly vulnerable to adverse drug events during the transition from hospital to home.This risk is significantly amplified for older adults with chronic diseases,who often manage complex medication regimens involving multiple drugs.Although active patient participation is recognized as a crucial component in safeguarding medication safety,there is currently a lack of a standardized,validated tool specifically designed to assess the level of such participation among this vulnerable population during this critical transition.Therefore,this study aimed to develop and validate a questionnaire for assessing the level of participation in medication safety behaviors among older adults with chronic diseases during the transition from hospital to home.Methods:Guided by the Interactive Patient Participation in Patient Safety theory,the initial questionnaire was developed through literature analysis,qualitative interviews,expert consultation,and pre-testing from April to December 2023.A total of 582 older adults with chronic diseases discharged from two tertiary hospitals in Fuzhou,China were recruited using convenience sampling.Construct validity,content validity,internal consistency,and test-retest reliability were assessed.Results:The final questionnaire comprised 20 items across three dimensions:Participation in Decision-Making,Participation in Care,Participation in Appeals.Exploratory factor analysis showed a cumulative variance contribution of 51.478%.The overall Cronbach’s a coefficient was 0.875,the scale-level content validity index was 0.930,and the test-retest reliability was 0.715.Confirmatory factor analysis indicated an acceptable model fit.Conclusion:The developed questionnaire exhibits good reliability and validity,supporting its use to evaluate participation in medication safety behaviors among Chinese older adults with chronic diseases during the hospital-to-home transition period.
文摘The objective of the study is to study the impact of pharmaceutical care on medication compliance in asthmatic children. The results will be used to further develop the pharmaceutical care delivered by pharmacists for asthmatic children, and to promote children＇s asthma control in China. The study was conducted in outpatient department of Beijing Children＇s Hospital from Mar. to Sept., 2009. Asthmatic children （101） were randomly divided into two groups： the intervention group that received routine treatment and complete pharmaceutical care provided by pharmacists and the control group that received routine treatment only. Questionnaires were distributed to both groups and responses were analyzed statistically. Our results showed that the percentage of children using medication following doctor＇s instructions in the intervention group was significantly higher than that in the control group （66.67% and 36.00%, respectively）; the percentage of children correctly using inhaler devices in the intervention group was significantly higher than that in the control group （78.26% and 32.84%, respectively）; children and care givers of the intervention group had significantly more knowledge about medication compliance. In conclusion, the pharmaceutical care provided by pharmacists could improve medication compliance of asthmatic children, and it would be desirable to further develop the pharmaceutical care for asthmatic children across China.
文摘The mobile APP for medication guidance related to pharmacogenomic is developed to solve various practical problems, such as inconvenient reading of English database, slow updating of paper reference books and lack of shortcut for access.We extracted the medication guidance information related to the pharmacogenomic from ‘Dosing Guidelines’(http://www.pharmgkb.com), ′Table of Pharmacogenomic Biomarkers in Drug Labeling′(http://www.fda.gov/drugs/scienceresearch) and relevant authoritative books.SQLite was used to build the medication guidance information database.We designed and implemented a mobile APP for medication guidance by JavaScript programming language.The APP contained 197 drugs that have been extensively studied and have high levels of evidence.It covered 25 categories, such as anticoagulant and antiplatelet drugs, general antitumor, immunosuppressant drugs, targeted antitumor drugs, antipsychotic drugs, antiepileptic drugs, and proton pump inhibitors and so on.Users can obtain clinical significance and guidance information related to the genotype of the drug by entering the pinyin initials of the generic name of the drug.The mobile APP for medication guidance related to pharmacogenomic based on APICloud could provide practical and convenient pharmaceutical information service for clinical use.
文摘背景全科医生的培养和发展始终是医学界关注的焦点,而各国对全科医生的培训模式和方法存在显著的差异。目的总结并揭示我国全科医生培养的热点、趋势以及挑战,同时对比国外做法,为我国全科医生的未来发展提供借鉴和指导。方法采用文献计量学的方法,以CiteSpace 6.1.R Advanced软件为工具,国内研究分析基于中国知网(CNKI),国外研究分析选取Web of Science核心数据库(WOSCC),对2013—2023年国内外全科医生培养的文献进行筛选与定量化分析,并归纳总结。结果我国全科医生教育的研究数量逐年增长;我国研究机构以首都医科大学全科医学与继续教育学院发文量最多,但各机构间的合作不紧密;国外主要发文国家为英国和澳大利亚;我国全科医生培养研究偏向于教育方法改革和服务方向优化,而同期国外全科医生培养的研究侧重于人工智能技术的应用和对精神心理疾病的关注。结论我国全科医生培养的研究活动增长显著,集中在教育方法改革和服务方向优化,但各研究机构间需加强合作。对比国外研究模式,我国需要更多地引入新兴技术(如人工智能),并提升对精神心理疾病的关注度,以促进全科医生培养的深度和广度发展。
