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
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
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
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
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
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
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
[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
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
Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney tra...Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.展开更多
Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guide...Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guidelines.Methods:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members.The validated questionnaire was then translated into regional languages,Kannada and Malayalam.The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP questionnaire.The safety of the medication was assessed using the FDA drug safety classification for pregnancy.Results:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,respectively.Among 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during pregnancy.Counselling pregnant women regarding diet and medication usage is crucial in maternal care.展开更多
Transdermal medications are an useful yet underutilized tool in the field of psychiatry.Despite numerous advantages of using this route of medication delivery,transdermal medications remain less popular compared to ot...Transdermal medications are an useful yet underutilized tool in the field of psychiatry.Despite numerous advantages of using this route of medication delivery,transdermal medications remain less popular compared to other routes of medication administration such as oral and intramuscular routes in the management of various psychiatric conditions.In this editorial,we examine the advantages of transdermal medications with a brief overview of transdermal being used in psychiatry and other medical specialties.We discuss the factors that play a role in their limited usage in psychiatry.We highlight certain patient categories who can specifically benefit from them and discuss potential solutions that can broaden the perspective of treating clinicians making this an intriguing avenue in the field of psychiatry.展开更多
With the acceleration of society’s aging process,the widespread phenomenon of polypharmacy among the elderly has become a significant concern.This research aimed to analyze potential inappropriate medication among 17...With the acceleration of society’s aging process,the widespread phenomenon of polypharmacy among the elderly has become a significant concern.This research aimed to analyze potential inappropriate medication among 178 inpatients in the geriatric general department of our hospital from January 2022 to September 2022.The participants were randomly assigned to an observation group and a control group.The observation group received pharmaceutical intervention,whereas the control group did not.The objective was to explore the impact of pharmaceutical intervention on polypharmacy in this population.The results revealed that after pharmaceutical intervention,there were no significant differences in medication adherence,medication appropriateness index(MAI),quantity of medicine,and potentially inappropriate medication(PIM)in the control group compared to before the intervention(P>0.05).However,the observation group showed significant improvement(P<0.05).The proportion of patients with good adherence increased from 57%to 78%,and the percentage of patients with MAI scores over 10 decreased from 60%to 40%.Moreover,there was a reduction in the number of medications prescribed,with only 47%of patients receiving more than five different types compared to the initial rate of 64%.Additionally,the occurrence of PIM declined from an initial rate of 64%to just 44%,surpassing that observed in the control group.Therefore,the implementation of pharmaceutical intervention can effectively enhance medication adherence and appropriateness among elderly patients,mitigate the risk of PIM,and promote rational medicine utilization.展开更多
Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hyp...Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.展开更多
Objective To explore the medication rules of traditional Chinese medicine(TCM)and mechanism of action of hub herb pairs for treating insomnia.Methods Totally 104 prescriptions were statistically analyzed.The associati...Objective To explore the medication rules of traditional Chinese medicine(TCM)and mechanism of action of hub herb pairs for treating insomnia.Methods Totally 104 prescriptions were statistically analyzed.The association rule algorithm was applied to mine the hub herb pairs.Network pharmacology was utilized to analyze the mechanism of the hub herb pairs,while molecular docking was applied to simulate the interaction between receptors and herb molecules,thereby predicting their binding affinities.Results The most frequently used herbs in TCM prescriptions for treating insomnia included Semen Ziziphi Spinosae,Radix Glycyrrhizae,Radix et Rhizoma Ginseng,and Poria cum Radix Pini.Among them,the most commonly used were the supplementing herbs,followed by heat-clearing,mind-calming,and exterior-releasing ones,with their properties of warm and cold,flavors of sweet,Pungent,and bitter,and meridian tropisms of liver,lungs,spleen,kidneys,heart,and stomach.The hub herb pairs based on the association rules included Radix Astragali-Radix et Rhizoma Ginseng,Rhizoma Chuanxiong-Radix Glycyrrhizae,Seman Platycladi-Semen Ziziphi Spinosae,Pericarpium Citri Reticulatae-Radix Glycyrrhizae,Radix Polygalae-Semen Ziziphi Spinosae,and Radix Astragali-Semen Ziziphi Spinosae.Network pharmacology revealed that the cAMP signaling pathway might play a key role in treating insomnia synergistically with HIF-1 signaling pathway,prolactin signaling pathway,chemical carcinogenesis receptor activation,and PI3K-Akt signaling pathway.Molecular docking indicated that there was good binding between the active ingredients of the hub herb pairs and the hub targets.Conclusions This study identified six hub herb pairs for treating insomnia in TCM.These hub herb pairs may synergistically treat insomnia with HIF-1 signaling pathway,prolactin signaling pathway,chemical carcinogenesis receptor activation,and PI3K-Akt signaling pathway through the cAMP signaling pathway.展开更多
Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods...Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.展开更多
BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investiga...BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.展开更多
BACKGROUND The intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia was unknown.AIM To explore the intervention value of a drug-p...BACKGROUND The intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia was unknown.AIM To explore the intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia.METHODS Overall,98 out-patients and in-patients with chronic schizophrenia treated in our hospital from February 2022 to January 2023 were included and randomly divided into the study(50 patients)and control groups(48 patients).For 3 months,the control group was treated with conventional drugs,and the research group with a comprehensive intervention model of drug-psychology-society-skills.Data were obtained for the mini mental assessment scale(MMSE),Montreal cognitive assessment scale(MoCA),positive and negative symptom scale,insight and treatment attitude scale,cognitive ability scale and social skills[personal and social function scale(PSP)].The adverse reactions were observed.RESULTS After the intervention,the MMSE and MoCA scores improved in both groups.MoCA scores in the study group(26.58±3.21)were significantly(P<0.05)higher than those in the control group(24.68±3.02),MMSE scores were not significantly higher.Post-intervention,positive and negative symptom scores improved in both groups,and the positive and negative symptom scores in the study group[(12.01±2.58)and(32.51±2.11)]were significantly(P<0.05)different than those in the control group[(14.54±2.33)and(33.74±2.55)].Post-intervention,insight and treatment attitudes questionnaire scores of both groups were improved and compared with the control group(7.97±3.02),the study group(13.56±6.35)had significantly(P<0.05)higher scores.Post-intervention,the MATRICS consensus cognitive battery score of both groups was improved and compared with the control group(38.44±6.23),the score of the study group was significantly(P<0.05)increased(43.51±6.01).Post-intervention,the PSP score of the study group(78.38±6.63)was significantly(P<0.05)higher than that of the control group(74.52±7.01).During the intervention period,the incidence of adverse reactions in the study group was 6.25%,not significantly different from that in the control group(8.33%).During the intervention,both groups experienced adverse reactions,with no significant difference between groups(P>0.05).CONCLUSION The comprehensive intervention model based on drug-psychology-society-skills has obvious intervention effects on patients with chronic schizophrenia,which improves their cognitive ability and reduces their positive and negative symptoms.Simultaneously,it improves the self-knowledge of patients,improves their attitude toward treatment,effectively promotes the recovery of patients'social functions,and is safe.Therefore,it is worthy of being vigorously promoted and widely used in clinics.展开更多
[Objectives]This study was conducted to analyze the medication rules of clinical prescriptions of traditional Chinese medicine decoction pieces for the treatment of novel coronavirus pneumonia(COVID-19)during the epid...[Objectives]This study was conducted to analyze the medication rules of clinical prescriptions of traditional Chinese medicine decoction pieces for the treatment of novel coronavirus pneumonia(COVID-19)during the epidemic in multiple regions based on data mining technology,so as to provide a reference for the treatment of COVID-19 with traditional Chinese medicine.[Methods]The traditional Chinese medicine prescriptions used since the outbreak of COVID-19 in Hubei Province during the fight against the epidemic from February 25,2020 to February 14,2022,the traditional Chinese medicine prescriptions used by Guizhou traditional Chinese medicine expert team aiding Hubei Province,the traditional Chinese medicine prescriptions for rehabilitation and conditioning of patients in Ezhou of Hubei Province after discharge,the traditional Chinese medicine prescriptions for the prevention and treatment of COVID-19 in Guizhou Province,and the traditional Chinese medicine prescriptions for the treatment of COVID-19 collected from the end of 2019 to the present from the Chinese database of CNKI were collected as the data of this study.Excel was used to establish a database and enter it into the TCM inheritance calculation platform V3.5,and the association rules and k-means clustering algorithm were used to analyze the frequency of herbal medicines in prescriptions during the treatment of COVID-19,the frequency of four natures,five flavors,meridian distribution,and drug combinations.[Results]A total of 1859 COVID-19 patients treated with traditional Chinese medicine were included,and the proportion of males was higher than that of females,and middle-aged and elderly people were the most common group.A total of 2170 prescriptions of traditional Chinese medicine were included,involving a total of 383 traditional Chinese medicines.High-frequency medicines included poria,Radix Bupleuri,Radix Scutellariae,Herba Pogostemonis,Fructus Forsythiae,Flos Loniceraeetc.The four natures were mainly concentrated in cold,warm and neutral,and the five flavors were mainly concentrated in bitter,pungent and sweet.The herbal medicines were mainly attributed to the lungs and stomach meridians,and were mainly of heat-clearing,exterior syndrome-relieving and diuresis-promoting and damp-clearing types.A total of 24 high-frequency herbal combinations and 35 association rule were excavated,and 3 types of formulas were obtained by cluster analysis.[Conclusions]The analysis results and medicine combinations obtained in the formulas are consistent with the traditional Chinese medicine treatment theory of COVID-19 caused by wind-heat filth accompanied with damp and toxin.展开更多
Although significant advances have been made in understanding the pathophysiology of psychiatric disorders(PDs),therapeutic advances have not been very convincing.While psychotropic medications can reduce classical sy...Although significant advances have been made in understanding the pathophysiology of psychiatric disorders(PDs),therapeutic advances have not been very convincing.While psychotropic medications can reduce classical symptoms in patients with PDs,their long-term use has been reported to induce or exaggerate various pre-existing metabolic abnormalities including diabetes,obesity and non-alcoholic fatty liver disease(NAFLD).The mechanism(s)underlying these metabolic abnormalities is not clear;however,lipid/fatty acid accumulation due to enhanced de novo lipogenesis(DNL)has been shown to reduce membrane fluidity,increase oxidative stress and inflammation leading to the development of the aforementioned metabolic abnormalities.Intriguingly,emerging evidence suggest that DNL dysregulation and fatty acid accumulation could be the major mechanisms associated with the development of obesity,diabetes and NAFLD after long-term treatment with psychotropic medications in patients with PDs.In support of this,several adjunctive drugs comprising of anti-oxidants and antiinflammatory agents,that are used in treating PDs in combination with psychotropic medications,have been shown to reduce insulin resistance and development of NAFLD.In conclusion,the above evidence suggests that DNL could be a potential pathological factor associated with various metabolic abnormalities,and a new avenue for translational research and therapeutic drug designing in PDs.展开更多
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.
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.
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.
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.
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[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 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.
基金This work was supported by the Natural Science Foundation of Hunan Province,China (2024JJ9201)。
文摘Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.
文摘Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guidelines.Methods:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members.The validated questionnaire was then translated into regional languages,Kannada and Malayalam.The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP questionnaire.The safety of the medication was assessed using the FDA drug safety classification for pregnancy.Results:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,respectively.Among 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during pregnancy.Counselling pregnant women regarding diet and medication usage is crucial in maternal care.
文摘Transdermal medications are an useful yet underutilized tool in the field of psychiatry.Despite numerous advantages of using this route of medication delivery,transdermal medications remain less popular compared to other routes of medication administration such as oral and intramuscular routes in the management of various psychiatric conditions.In this editorial,we examine the advantages of transdermal medications with a brief overview of transdermal being used in psychiatry and other medical specialties.We discuss the factors that play a role in their limited usage in psychiatry.We highlight certain patient categories who can specifically benefit from them and discuss potential solutions that can broaden the perspective of treating clinicians making this an intriguing avenue in the field of psychiatry.
基金Hospital Pharmacy Research Foundation of Guangdong(Grant No.2022A14)。
文摘With the acceleration of society’s aging process,the widespread phenomenon of polypharmacy among the elderly has become a significant concern.This research aimed to analyze potential inappropriate medication among 178 inpatients in the geriatric general department of our hospital from January 2022 to September 2022.The participants were randomly assigned to an observation group and a control group.The observation group received pharmaceutical intervention,whereas the control group did not.The objective was to explore the impact of pharmaceutical intervention on polypharmacy in this population.The results revealed that after pharmaceutical intervention,there were no significant differences in medication adherence,medication appropriateness index(MAI),quantity of medicine,and potentially inappropriate medication(PIM)in the control group compared to before the intervention(P>0.05).However,the observation group showed significant improvement(P<0.05).The proportion of patients with good adherence increased from 57%to 78%,and the percentage of patients with MAI scores over 10 decreased from 60%to 40%.Moreover,there was a reduction in the number of medications prescribed,with only 47%of patients receiving more than five different types compared to the initial rate of 64%.Additionally,the occurrence of PIM declined from an initial rate of 64%to just 44%,surpassing that observed in the control group.Therefore,the implementation of pharmaceutical intervention can effectively enhance medication adherence and appropriateness among elderly patients,mitigate the risk of PIM,and promote rational medicine utilization.
文摘Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.
基金National Natural Science Foundation of China(82360905)Gansu Provincial University Teachers'Innovation Fund Projects(2023A-092 and 2024B-109).
文摘Objective To explore the medication rules of traditional Chinese medicine(TCM)and mechanism of action of hub herb pairs for treating insomnia.Methods Totally 104 prescriptions were statistically analyzed.The association rule algorithm was applied to mine the hub herb pairs.Network pharmacology was utilized to analyze the mechanism of the hub herb pairs,while molecular docking was applied to simulate the interaction between receptors and herb molecules,thereby predicting their binding affinities.Results The most frequently used herbs in TCM prescriptions for treating insomnia included Semen Ziziphi Spinosae,Radix Glycyrrhizae,Radix et Rhizoma Ginseng,and Poria cum Radix Pini.Among them,the most commonly used were the supplementing herbs,followed by heat-clearing,mind-calming,and exterior-releasing ones,with their properties of warm and cold,flavors of sweet,Pungent,and bitter,and meridian tropisms of liver,lungs,spleen,kidneys,heart,and stomach.The hub herb pairs based on the association rules included Radix Astragali-Radix et Rhizoma Ginseng,Rhizoma Chuanxiong-Radix Glycyrrhizae,Seman Platycladi-Semen Ziziphi Spinosae,Pericarpium Citri Reticulatae-Radix Glycyrrhizae,Radix Polygalae-Semen Ziziphi Spinosae,and Radix Astragali-Semen Ziziphi Spinosae.Network pharmacology revealed that the cAMP signaling pathway might play a key role in treating insomnia synergistically with HIF-1 signaling pathway,prolactin signaling pathway,chemical carcinogenesis receptor activation,and PI3K-Akt signaling pathway.Molecular docking indicated that there was good binding between the active ingredients of the hub herb pairs and the hub targets.Conclusions This study identified six hub herb pairs for treating insomnia in TCM.These hub herb pairs may synergistically treat insomnia with HIF-1 signaling pathway,prolactin signaling pathway,chemical carcinogenesis receptor activation,and PI3K-Akt signaling pathway through the cAMP signaling pathway.
基金funded by the Taylor’s University Flagship Research Grant(TUFR/2017/002/03).
文摘Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.
文摘BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.
文摘BACKGROUND The intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia was unknown.AIM To explore the intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia.METHODS Overall,98 out-patients and in-patients with chronic schizophrenia treated in our hospital from February 2022 to January 2023 were included and randomly divided into the study(50 patients)and control groups(48 patients).For 3 months,the control group was treated with conventional drugs,and the research group with a comprehensive intervention model of drug-psychology-society-skills.Data were obtained for the mini mental assessment scale(MMSE),Montreal cognitive assessment scale(MoCA),positive and negative symptom scale,insight and treatment attitude scale,cognitive ability scale and social skills[personal and social function scale(PSP)].The adverse reactions were observed.RESULTS After the intervention,the MMSE and MoCA scores improved in both groups.MoCA scores in the study group(26.58±3.21)were significantly(P<0.05)higher than those in the control group(24.68±3.02),MMSE scores were not significantly higher.Post-intervention,positive and negative symptom scores improved in both groups,and the positive and negative symptom scores in the study group[(12.01±2.58)and(32.51±2.11)]were significantly(P<0.05)different than those in the control group[(14.54±2.33)and(33.74±2.55)].Post-intervention,insight and treatment attitudes questionnaire scores of both groups were improved and compared with the control group(7.97±3.02),the study group(13.56±6.35)had significantly(P<0.05)higher scores.Post-intervention,the MATRICS consensus cognitive battery score of both groups was improved and compared with the control group(38.44±6.23),the score of the study group was significantly(P<0.05)increased(43.51±6.01).Post-intervention,the PSP score of the study group(78.38±6.63)was significantly(P<0.05)higher than that of the control group(74.52±7.01).During the intervention period,the incidence of adverse reactions in the study group was 6.25%,not significantly different from that in the control group(8.33%).During the intervention,both groups experienced adverse reactions,with no significant difference between groups(P>0.05).CONCLUSION The comprehensive intervention model based on drug-psychology-society-skills has obvious intervention effects on patients with chronic schizophrenia,which improves their cognitive ability and reduces their positive and negative symptoms.Simultaneously,it improves the self-knowledge of patients,improves their attitude toward treatment,effectively promotes the recovery of patients'social functions,and is safe.Therefore,it is worthy of being vigorously promoted and widely used in clinics.
基金Supported by Public Health and Epidemic Prevention and Control Project of Guiyang Bureau of Science and Technology([2022]-4-4-5)Guizhou Provincial Key Discipline of Traditional Chinese Medicine and Ethnic Medicine:Clinical Traditional Chinese Medicine(QZYYZDXK(JS)-2023-04).
文摘[Objectives]This study was conducted to analyze the medication rules of clinical prescriptions of traditional Chinese medicine decoction pieces for the treatment of novel coronavirus pneumonia(COVID-19)during the epidemic in multiple regions based on data mining technology,so as to provide a reference for the treatment of COVID-19 with traditional Chinese medicine.[Methods]The traditional Chinese medicine prescriptions used since the outbreak of COVID-19 in Hubei Province during the fight against the epidemic from February 25,2020 to February 14,2022,the traditional Chinese medicine prescriptions used by Guizhou traditional Chinese medicine expert team aiding Hubei Province,the traditional Chinese medicine prescriptions for rehabilitation and conditioning of patients in Ezhou of Hubei Province after discharge,the traditional Chinese medicine prescriptions for the prevention and treatment of COVID-19 in Guizhou Province,and the traditional Chinese medicine prescriptions for the treatment of COVID-19 collected from the end of 2019 to the present from the Chinese database of CNKI were collected as the data of this study.Excel was used to establish a database and enter it into the TCM inheritance calculation platform V3.5,and the association rules and k-means clustering algorithm were used to analyze the frequency of herbal medicines in prescriptions during the treatment of COVID-19,the frequency of four natures,five flavors,meridian distribution,and drug combinations.[Results]A total of 1859 COVID-19 patients treated with traditional Chinese medicine were included,and the proportion of males was higher than that of females,and middle-aged and elderly people were the most common group.A total of 2170 prescriptions of traditional Chinese medicine were included,involving a total of 383 traditional Chinese medicines.High-frequency medicines included poria,Radix Bupleuri,Radix Scutellariae,Herba Pogostemonis,Fructus Forsythiae,Flos Loniceraeetc.The four natures were mainly concentrated in cold,warm and neutral,and the five flavors were mainly concentrated in bitter,pungent and sweet.The herbal medicines were mainly attributed to the lungs and stomach meridians,and were mainly of heat-clearing,exterior syndrome-relieving and diuresis-promoting and damp-clearing types.A total of 24 high-frequency herbal combinations and 35 association rule were excavated,and 3 types of formulas were obtained by cluster analysis.[Conclusions]The analysis results and medicine combinations obtained in the formulas are consistent with the traditional Chinese medicine treatment theory of COVID-19 caused by wind-heat filth accompanied with damp and toxin.
文摘Although significant advances have been made in understanding the pathophysiology of psychiatric disorders(PDs),therapeutic advances have not been very convincing.While psychotropic medications can reduce classical symptoms in patients with PDs,their long-term use has been reported to induce or exaggerate various pre-existing metabolic abnormalities including diabetes,obesity and non-alcoholic fatty liver disease(NAFLD).The mechanism(s)underlying these metabolic abnormalities is not clear;however,lipid/fatty acid accumulation due to enhanced de novo lipogenesis(DNL)has been shown to reduce membrane fluidity,increase oxidative stress and inflammation leading to the development of the aforementioned metabolic abnormalities.Intriguingly,emerging evidence suggest that DNL dysregulation and fatty acid accumulation could be the major mechanisms associated with the development of obesity,diabetes and NAFLD after long-term treatment with psychotropic medications in patients with PDs.In support of this,several adjunctive drugs comprising of anti-oxidants and antiinflammatory agents,that are used in treating PDs in combination with psychotropic medications,have been shown to reduce insulin resistance and development of NAFLD.In conclusion,the above evidence suggests that DNL could be a potential pathological factor associated with various metabolic abnormalities,and a new avenue for translational research and therapeutic drug designing in PDs.
