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
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
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
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
Brain tumors require precise segmentation for diagnosis and treatment plans due to their complex morphology and heterogeneous characteristics.While MRI-based automatic brain tumor segmentation technology reduces the b...Brain tumors require precise segmentation for diagnosis and treatment plans due to their complex morphology and heterogeneous characteristics.While MRI-based automatic brain tumor segmentation technology reduces the burden on medical staff and provides quantitative information,existing methodologies and recent models still struggle to accurately capture and classify the fine boundaries and diverse morphologies of tumors.In order to address these challenges and maximize the performance of brain tumor segmentation,this research introduces a novel SwinUNETR-based model by integrating a new decoder block,the Hierarchical Channel-wise Attention Decoder(HCAD),into a powerful SwinUNETR encoder.The HCAD decoder block utilizes hierarchical features and channelspecific attention mechanisms to further fuse information at different scales transmitted from the encoder and preserve spatial details throughout the reconstruction phase.Rigorous evaluations on the recent BraTS GLI datasets demonstrate that the proposed SwinHCAD model achieved superior and improved segmentation accuracy on both the Dice score and HD95 metrics across all tumor subregions(WT,TC,and ET)compared to baseline models.In particular,the rationale and contribution of the model design were clarified through ablation studies to verify the effectiveness of the proposed HCAD decoder block.The results of this study are expected to greatly contribute to enhancing the efficiency of clinical diagnosis and treatment planning by increasing the precision of automated brain tumor segmentation.展开更多
With the industrialization of agriculture and the advancement of medical care,human life expectancy has increased considerably and continues to rise steadily.This results in novel and unprecedented challenges,namely o...With the industrialization of agriculture and the advancement of medical care,human life expectancy has increased considerably and continues to rise steadily.This results in novel and unprecedented challenges,namely obesity and neurodegeneration.展开更多
Parkinson’s disease(PD)is a debilitating neurological disorder affecting over 10 million people worldwide.PD classification models using voice signals as input are common in the literature.It is believed that using d...Parkinson’s disease(PD)is a debilitating neurological disorder affecting over 10 million people worldwide.PD classification models using voice signals as input are common in the literature.It is believed that using deep learning algorithms further enhances performance;nevertheless,it is challenging due to the nature of small-scale and imbalanced PD datasets.This paper proposed a convolutional neural network-based deep support vector machine(CNN-DSVM)to automate the feature extraction process using CNN and extend the conventional SVM to a DSVM for better classification performance in small-scale PD datasets.A customized kernel function reduces the impact of biased classification towards the majority class(healthy candidates in our consideration).An improved generative adversarial network(IGAN)was designed to generate additional training data to enhance the model’s performance.For performance evaluation,the proposed algorithm achieves a sensitivity of 97.6%and a specificity of 97.3%.The performance comparison is evaluated from five perspectives,including comparisons with different data generation algorithms,feature extraction techniques,kernel functions,and existing works.Results reveal the effectiveness of the IGAN algorithm,which improves the sensitivity and specificity by 4.05%–4.72%and 4.96%–5.86%,respectively;and the effectiveness of the CNN-DSVM algorithm,which improves the sensitivity by 1.24%–57.4%and specificity by 1.04%–163%and reduces biased detection towards the majority class.The ablation experiments confirm the effectiveness of individual components.Two future research directions have also been suggested.展开更多
背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存...背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存者的长期用药行为、依从态度与行为,并识别与用药行为相关的因素。方法基于2017年在河北省南和县5个乡镇、60个村开展的农村地区脑卒中患者管理研究——中国农村地区脑卒中管理的系统整合技术辅助照护模式研究(SINEMA),本研究对象为曾参与过2017年SINEMA研究且同意参与2024年5—7月随访并完成调查的所有脑卒中幸存者。调查研究对象降压药、他汀类药、抗血小板药和降糖药的用药情况,并使用Maastricht Utrecht Adherence in Hypertension-16(MUAH-16)量表评估其用药依从态度(积极的医疗与药物态度维度)。采用Morisky Green Levine量表测量服用4类药物的患者的用药依从行为(得分为0分定义为依从性高)。使用描述性分析展示患者基本特征、用药依从性状况和多因素Logistic回归分析识别出的相关因素。结果本研究共纳入912名研究对象,平均年龄为(72.0±7.9)岁,其中女性占46.1%(420/912);在药物服用方面,有772例(84.6%)患者自报服用降压药,547例(59.9%)服用抗血小板药,427例(46.8%)服用他汀类药,以及203例(22.3%)服用降糖药。在正在服用4类药物的人群中,降糖药服用依从性为77.3%(157/203),降压药服用依从性为71.5%(552/772)、抗血小板药物服用依从性为71.2%(392/547),他汀类药服用依从性为71.2%(304/427)。调查结果显示49.2%(449/912)的患者具有积极的医疗与药物态度。多因素Logistic回归分析结果显示,在服用降压药的患者中,受教育程度较高(中学及以上:OR=1.87,95%CI=1.13~3.09)、具有积极的医疗与药物态度(OR=1.53,95%CI=1.08~2.17)的患者用药依从性高,可独立完成工作(OR=0.56,95%CI=0.32~0.99)、去村卫生所≥1次/月者(OR=0.68,95%CI=0.53~0.88)用药依从性较低(P<0.05)。在服用抗血小板药的患者中,受教育程度较高(中学及以上:OR=1.79,95%CI=1.09~2.96)的患者用药依从性较高,出血性脑卒中患者(OR=0.55,95%CI=0.31~0.98)用药依从性较低(P<0.05)。在服用他汀类药的患者中,去村卫生所≥1次/月者(OR=0.67,95%CI=0.46~0.98)用药依从性较低(P<0.05)。在服用降糖药的患者中,男性(OR=0.21,95%CI=0.06~0.73)、注册慢性疾病重大疾病保险(OR=0.34,95%CI=0.15~0.79)、去村卫生所≥1次/月者(OR=0.34,95%CI=0.13~0.89)用药依从性较低(P<0.05)。结论本研究结果显示,农村地区具有较长疾病史的脑卒中幸存者具有相对较高的用药依从性,但仍有近三成患者未能规律依从诊疗建议,不同药物类型依从行为的影响因素存在差异,应开展个性化的用药依从干预,增加患者的用药依从性及二级预防行为。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.
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.
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。
基金supported by Institute of Information&Communications Technology Planning&Evaluation(IITP)under the Metaverse Support Program to Nurture the Best Talents(IITP-2024-RS-2023-00254529)grant funded by the Korea government(MSIT).
文摘Brain tumors require precise segmentation for diagnosis and treatment plans due to their complex morphology and heterogeneous characteristics.While MRI-based automatic brain tumor segmentation technology reduces the burden on medical staff and provides quantitative information,existing methodologies and recent models still struggle to accurately capture and classify the fine boundaries and diverse morphologies of tumors.In order to address these challenges and maximize the performance of brain tumor segmentation,this research introduces a novel SwinUNETR-based model by integrating a new decoder block,the Hierarchical Channel-wise Attention Decoder(HCAD),into a powerful SwinUNETR encoder.The HCAD decoder block utilizes hierarchical features and channelspecific attention mechanisms to further fuse information at different scales transmitted from the encoder and preserve spatial details throughout the reconstruction phase.Rigorous evaluations on the recent BraTS GLI datasets demonstrate that the proposed SwinHCAD model achieved superior and improved segmentation accuracy on both the Dice score and HD95 metrics across all tumor subregions(WT,TC,and ET)compared to baseline models.In particular,the rationale and contribution of the model design were clarified through ablation studies to verify the effectiveness of the proposed HCAD decoder block.The results of this study are expected to greatly contribute to enhancing the efficiency of clinical diagnosis and treatment planning by increasing the precision of automated brain tumor segmentation.
文摘With the industrialization of agriculture and the advancement of medical care,human life expectancy has increased considerably and continues to rise steadily.This results in novel and unprecedented challenges,namely obesity and neurodegeneration.
基金The work described in this paper was fully supported by a grant from Hong Kong Metropolitan University(RIF/2021/05).
文摘Parkinson’s disease(PD)is a debilitating neurological disorder affecting over 10 million people worldwide.PD classification models using voice signals as input are common in the literature.It is believed that using deep learning algorithms further enhances performance;nevertheless,it is challenging due to the nature of small-scale and imbalanced PD datasets.This paper proposed a convolutional neural network-based deep support vector machine(CNN-DSVM)to automate the feature extraction process using CNN and extend the conventional SVM to a DSVM for better classification performance in small-scale PD datasets.A customized kernel function reduces the impact of biased classification towards the majority class(healthy candidates in our consideration).An improved generative adversarial network(IGAN)was designed to generate additional training data to enhance the model’s performance.For performance evaluation,the proposed algorithm achieves a sensitivity of 97.6%and a specificity of 97.3%.The performance comparison is evaluated from five perspectives,including comparisons with different data generation algorithms,feature extraction techniques,kernel functions,and existing works.Results reveal the effectiveness of the IGAN algorithm,which improves the sensitivity and specificity by 4.05%–4.72%and 4.96%–5.86%,respectively;and the effectiveness of the CNN-DSVM algorithm,which improves the sensitivity by 1.24%–57.4%and specificity by 1.04%–163%and reduces biased detection towards the majority class.The ablation experiments confirm the effectiveness of individual components.Two future research directions have also been suggested.
文摘背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存者的长期用药行为、依从态度与行为,并识别与用药行为相关的因素。方法基于2017年在河北省南和县5个乡镇、60个村开展的农村地区脑卒中患者管理研究——中国农村地区脑卒中管理的系统整合技术辅助照护模式研究(SINEMA),本研究对象为曾参与过2017年SINEMA研究且同意参与2024年5—7月随访并完成调查的所有脑卒中幸存者。调查研究对象降压药、他汀类药、抗血小板药和降糖药的用药情况,并使用Maastricht Utrecht Adherence in Hypertension-16(MUAH-16)量表评估其用药依从态度(积极的医疗与药物态度维度)。采用Morisky Green Levine量表测量服用4类药物的患者的用药依从行为(得分为0分定义为依从性高)。使用描述性分析展示患者基本特征、用药依从性状况和多因素Logistic回归分析识别出的相关因素。结果本研究共纳入912名研究对象,平均年龄为(72.0±7.9)岁,其中女性占46.1%(420/912);在药物服用方面,有772例(84.6%)患者自报服用降压药,547例(59.9%)服用抗血小板药,427例(46.8%)服用他汀类药,以及203例(22.3%)服用降糖药。在正在服用4类药物的人群中,降糖药服用依从性为77.3%(157/203),降压药服用依从性为71.5%(552/772)、抗血小板药物服用依从性为71.2%(392/547),他汀类药服用依从性为71.2%(304/427)。调查结果显示49.2%(449/912)的患者具有积极的医疗与药物态度。多因素Logistic回归分析结果显示,在服用降压药的患者中,受教育程度较高(中学及以上:OR=1.87,95%CI=1.13~3.09)、具有积极的医疗与药物态度(OR=1.53,95%CI=1.08~2.17)的患者用药依从性高,可独立完成工作(OR=0.56,95%CI=0.32~0.99)、去村卫生所≥1次/月者(OR=0.68,95%CI=0.53~0.88)用药依从性较低(P<0.05)。在服用抗血小板药的患者中,受教育程度较高(中学及以上:OR=1.79,95%CI=1.09~2.96)的患者用药依从性较高,出血性脑卒中患者(OR=0.55,95%CI=0.31~0.98)用药依从性较低(P<0.05)。在服用他汀类药的患者中,去村卫生所≥1次/月者(OR=0.67,95%CI=0.46~0.98)用药依从性较低(P<0.05)。在服用降糖药的患者中,男性(OR=0.21,95%CI=0.06~0.73)、注册慢性疾病重大疾病保险(OR=0.34,95%CI=0.15~0.79)、去村卫生所≥1次/月者(OR=0.34,95%CI=0.13~0.89)用药依从性较低(P<0.05)。结论本研究结果显示,农村地区具有较长疾病史的脑卒中幸存者具有相对较高的用药依从性,但仍有近三成患者未能规律依从诊疗建议,不同药物类型依从行为的影响因素存在差异,应开展个性化的用药依从干预,增加患者的用药依从性及二级预防行为。
