Evaluating psychiatrists’ attitudes and expectations about pharmacists’ role in psychiatry in Jordan

Abstract Objectives Evaluating Jordanian pharmacists’ roles in psychiatry from psychiatrists perspective. Methods An electronic survey was sent to 100 psychiatrists registered in the Jordanian Psychiatrists Association. Statistical analysis included descriptive statistics and multivariate logistic regression. Key findings A total of 80 psychiatrists completed the survey (response rate 80%). Most psychiatrists thought that pharmacists are unable to give individuals with mental illness enough time to discuss their medications (62/80, 77.6%) and to monitor psychotropic medications (PM) efficacy (50/80, 62.6%). Around half of respondents thought that, in the future, pharmacists would not be able to suggest PM for patients (42/80, 52.6%), nor changes in PM dosages (37/80, 46.3%). Most psychiatrists emphasized the importance of psychiatric courses to improve pharmacists’ role. Conclusion Although psychiatrists were generally not satisfied with the current role of pharmacists, they had positive expectations about pharmacists’ competency to do certain activities and to assist them in designing drug therapy plans.

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Telemedicine use by pediatric rheumatologists during the COVID-19 pandemic

Pediatric Rheumatology ◽

10.1186/s12969-021-00565-7 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Rajdeep Pooni ◽

Tova Ronis ◽

Tzielan Lee ◽

Keyword(s):

Clinical Assessment ◽

Patient Engagement ◽

Pediatric Rheumatology ◽

Response Rate ◽

Descriptive Statistics ◽

Electronic Survey ◽

Childhood Arthritis ◽

Survey Response Rate ◽

Qualitative Work ◽

Research Alliance

Abstract Background To characterize various aspects of telemedicine use by pediatric rheumatology providers during the recent pandemic including provider acceptability of telehealth practices, clinical reliability, and clinical appropriateness. Methods An electronic survey was generated and disseminated amongst the Childhood Arthritis and Rheumatology Research Alliance (CARRA) listserv (n = 547). Survey items were analyzed via descriptive statistics by question. Results The survey response rate was 40.8% (n = 223) with the majority of respondents in an attending-level role. We observed that musculoskeletal components of the exam were rated as the most reliable components of a telemedicine exam and 86.5% of survey respondents reported engaging the patient or patient caregiver to help conduct the virtual exam. However, 65.7% of providers reported not being able to elicit the information needed from a telemedicine visit to make a complete clinical assessment. We also noted areas of disagreement regarding areas of patient engagement and confidentiality. We found that approximately one-third (35.8%) of those surveyed felt that their level of burnout was increased due to telemedicine. Conclusion In general, providers found exam reliability (specifically around focused musculoskeletal elements) in telemedicine visits but overall felt that they were unable to generate the information needed to generate a complete clinical assessment. Additionally, there were suggestions that patient engagement and confidentiality varied during telemedicine visits when compared to in-person clinical visits. Further qualitative work is needed to fully explore telemedicine use in pediatric rheumatology.

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Telemedicine Use by Pediatric Rheumatologists during the COVID-19 Pandemic

10.21203/rs.3.rs-109539/v1 ◽

2020 ◽

Author(s):

Rajdeep Pooni ◽

Tova Ronis ◽

Tzielan Lee

Keyword(s):

Clinical Assessment ◽

Patient Engagement ◽

Pediatric Rheumatology ◽

Response Rate ◽

Descriptive Statistics ◽

Electronic Survey ◽

Childhood Arthritis ◽

Survey Response Rate ◽

Qualitative Work ◽

Research Alliance

Abstract Background To characterize various aspects of telemedicine use by pediatric rheumatology providers during the recent pandemic including provider acceptability of telehealth practices, clinical reliability, and clinical appropriateness. Methods An electronic survey was generated and disseminated amongst the Childhood Arthritis and Rheumatology Research Alliance (CARRA) listserv (n = 547). Survey items were analyzed via descriptive statistics by question and correlates amongst burnout and satisfaction with telemedicine were examined via ANOVA with appropriate statistical software. Results The survey response rate was 40.8% (n = 223) with the majority of respondents in an attending-level role. We observed that musculoskeletal components of the exam were rated as the most reliable components of a telemedicine exam and 85.6% of survey respondents reported engaging the patient or patient caregiver to help conduct the virtual exam. However, 63.5% of providers reported not being able to elicit the information needed from a telemedicine visit to make a complete clinical assessment. We also noted areas of disagreement regarding areas of patient engagement and confidentiality. We found that approximately one-third (33.5%) of those surveyed felt that their level of burnout was increased due to telemedicine. Conclusion In general, providers found exam reliability (specifically around focused musculoskeletal elements) in telemedicine visits but overall felt that they were unable to generate the information needed to generate a complete clinical assessment. Additionally, there were suggestions that patient engagement and confidentiality varied during telemedicine visits when compared to in-person clinical visits. Further qualitative work is needed to fully explore telemedicine use in pediatric rheumatology.

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Circulating miR-30d Predicts Survival in Patients with Acute Heart Failure

Cellular Physiology and Biochemistry ◽

10.1159/000459899 ◽

2017 ◽

Vol 41 (3) ◽

pp. 865-874 ◽

Cited By ~ 22

Author(s):

Junjie Xiao ◽

Rongrong Gao ◽

Yihua Bei ◽

Qiulian Zhou ◽

Yanli Zhou ◽

...

Keyword(s):

Heart Failure ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Univariate Logistic Regression Analysis ◽

Kaplan Meier ◽

All Cause Mortality

Background/Aims: Identification of novel biomarkers to identify acute heart failure (AHF) patients at high risk of mortality is an area of unmet clinical need. Recently, we reported that the baseline level of circulating miR-30d was associated with left ventricular remodeling in response to cardiac resynchronization therapy in advanced chronic heart failure patients. However, the role of circulating miR-30d as a prognostic marker of survival in patients with AHF has not been explored. Methods: Patients clinically diagnosed with AHF were enrolled and followed up for 1 year. Quantitative reverse transcription polymerase chain reactions were used to determine serum miR-30d levels. The univariate logistic regression analysis and multivariate logistic regression analysis were used to determine the predictors for all-cause mortality in AHF patients. Kaplan–Meier survival analysis was used to analyze the role of miR-30d in prediction of survival. Results: A total of 96 AHF patients were enrolled and followed up for 1 year. Serum miR-30d was significantly lower in AHF patients who expired in the one year follow-up period compared to those who survived. Univariate logistic regression analysis yielded 18 variables that were associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 4 variables including heart rate, hemoglobin, serum sodium, and serum miR-30d level associated with mortality. ROC curve analysis showed that hemoglobin, heart rate and serum sodium displayed poor prognostic value for AHF (AUCs not higher than 0.700) compared to miR-30d level (AUC = 0.806). Kaplan–Meier survival analysis confirmed that patients with higher serum miR-30d levels had significantly lower mortality (P=0.001). Conclusion: In conclusion, this study shows evidence for the predictive value of circulating miR-30d as 1-year all-cause mortality in AHF patients. Large multicentre studies are further needed to validate our findings and accelerate the transition to clinical utilization.

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Evaluating the Impact of Pharmacists on Clinical Outcomes and Adherence in Patients with Mental Illness: A Literature Review

INTERNATIONAL JOURNAL OF PHARMACEUTICAL EDUCATION AND RESEARCH (IJPER) ◽

10.37021/ijper.v2i1.1 ◽

2020 ◽

Vol 2 (01) ◽

Author(s):

Dalia Mekeel

Keyword(s):

Mental Health ◽

Mental Illness ◽

Clinical Trials ◽

Literature Review ◽

Clinical Outcomes ◽

The United States ◽

Psychotropic Medications ◽

Depression Symptoms ◽

Free Text

Purpose: The purpose of this literature review is to investigate the role of pharmacists in improving clinical outcomes and adherence to psychotropic medications in patients with mental illness. The majority of patients tend to stop taking their medications due to the delayed effects or adverse events. It has been established that pharmacists have a positive effect on patients’ clinical outcomes in different chronic disease states other than mental illness. There is also a stigma associated with how comfortable pharmacists are on counseling patients about psychotropic medications. This literature review will evaluate the level of pharmacists’ involvement in treating patients with mental illness as well as strategies used to achieve persistence and compliance with therapy. Methods: A PubMed search was conducted to identify articles related to mental illness and pharmacists. MeSH terms included “antidepressants”, “adherence”, “pharmacists”, and “bipolar disorder”. A free-text search was conducted using the same terms and to search for the most updated American Psychiatric Association practice guidelines. The National Institute of Mental Health database was searched for current mental health statistics in the United States. Collectively, 62 results returned for the MeSh search. This review included studies on adults with mental disorders who were evaluated by pharmacists for adherence and clinical outcomes between the years of 1995-2019. The results of five clinical trials assessing the role of pharmacists in adherence to psychotropic medications will be discussed in this literature review. Results: The clinical trials included in this review showed a statistically significant increase in adherence to psychotropic medications associated with pharmacists’ interventions. The results were not statistically significant for the clinical outcomes in most studies but presented positive improvements in the inpatient and outpatient settings. Canales et al. results showed that patients receiving pharmacists’ interventions in the inpatient setting had >30% improved clinical outcomes measured by different rating scales. The results of Valenstein et al. study conducted at Veteran Affairs clinics were statistically significant for adherence improvement presented by a 25% increase in medication possession ratio. Aljumah et al. clinical trial had a 18% increase in adherence associated with pharmacist interventions. The EMDADER-TAB trial resulted in a statistically significant decrease in ER visits, significant improvement of the depression symptoms, and overall improvement of severity of symptoms. Conclusion: Mental illness should be treated as any other medical condition that requires interventions whenever clinical outcomes are not optimal. Pharmacists have the skills to evaluate clinical symptoms of different psychiatric disorders as well as the knowledge on therapeutic treatments necessary for the optimization of medication use.

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The impact of participation in support groups on mental health of parents having children with autism

European Journal of Public Health ◽

10.1093/eurpub/ckz186.574 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

R Alibekova ◽

K Kadyrzhanuly ◽

C K Chan ◽

S An ◽

A Gusmanov ◽

...

Keyword(s):

Mental Health ◽

Logistic Regression ◽

Mood Disorders ◽

Support Groups ◽

Parental Support ◽

Children With Autism ◽

P Value ◽

Autistic Children ◽

Multivariate Logistic Regression

Abstract Introduction Whilst there is accumulated evidence about the high prevalence of stress and mood disorders in parents of children with autism, few studies have shown that participating in parental support groups was associated with less mental health problems. This study was aimed to explore the association of participation in support groups with stress and mood disorders in parents of children with autism in Kazakhstan. Methods Participants (n = 146) were recruited to this cross-sectional survey from autism non-governmental organizations and Republican Children’s Rehabilitation Center in Nur-Sultan city during April-December 2018. A 59 item survey consisted of questions on parental socio-demographics, needs, participation in support groups, depression, anxiety and stress (DASS), and Multidimensional Scale of Perceived Social Support (MSPSS). Descriptive, bivariate and multivariate logistic regression analyses were performed in STATA 15. Results 44.4% of parents reported experiencing stress, and almost half of the sample had elevated depressive (53.7%) and anxiety symptoms (47.4%). 45.3% of participants were members of parental organizations; there were no significant differences in the prevalence of stress and mood disorders among members and non-members of parental support groups. Results of the multivariate logistic regression showed that parents with older autistic children (OR 1.37, p-value 0.001), less family support (OR 0.894, p-value 0.044) and higher income (OR 3.01, p-value 0.025) were more likely to be members of support groups. Conclusions These findings indicate the need to increase support groups to under-served populations of Kazakhstan’s families with autistic children. Additional efforts are needed to strengthen the role of support groups in meeting the emotional needs of the parents. Key messages Parents of children with autism spectrum disorder experience elevated level of stress and mood disorders; however participation in support groups was not beneficial for relieving parental distress. Further research is warranted to explore the benefits of participation in support groups, and interventions are needed to strengthen the role of support groups in meeting the needs of parents.

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Serum Irisin Predicts Mortality Risk in Acute Heart Failure Patients

Cellular Physiology and Biochemistry ◽

10.1159/000477867 ◽

2017 ◽

Vol 42 (2) ◽

pp. 615-622 ◽

Cited By ~ 12

Author(s):

Shutong Shen ◽

Rongrong Gao ◽

Yihua Bei ◽

Jin Li ◽

Haifeng Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Curve Analysis ◽

Multivariate Logistic Regression ◽

Roc Curve Analysis ◽

Kaplan Meier ◽

All Cause Mortality

Background/Aims: Irisin is a peptide hormone cleaved from a plasma membrane protein fibronectin type III domain containing protein 5 (FNDC5). Emerging studies have indicated association between serum irisin and many major chronic diseases including cardiovascular diseases. However, the role of serum irisin as a predictor for mortality risk in acute heart failure (AHF) patients is not clear. Methods: AHF patients were enrolled and serum was collected at the admission and all patients were followed up for 1 year. Enzyme-linked immunosorbent assay was used to measure serum irisin levels. To explore predictors for AHF mortality, the univariate and multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used. To determine the role of serum irisin levels in predicting survival, Kaplan-Meier survival analysis was used. Results: In this study, 161 AHF patients were enrolled and serum irisin level was found to be significantly higher in patients deceased in 1-year follow-up. The univariate logistic regression analysis identified 18 variables associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 2 variables namely blood urea nitrogen and serum irisin. ROC curve analysis indicated that blood urea nitrogen and the most commonly used biomarker, NT-pro-BNP, displayed poor prognostic value for AHF (AUCs ≤ 0.700) compared to serum irisin (AUC = 0.753). Kaplan-Meier survival analysis demonstrated that AHF patients with higher serum irisin had significantly higher mortality (P<0.001). Conclusion: Collectively, our study identified serum irisin as a predictive biomarker for 1-year all-cause mortality in AHF patients though large multicenter studies are highly needed.

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Evaluation of factors related to overdose in patients with impaired consciousness who are transported by emergency medical services: an age-specific research

Journal of Pharmaceutical Health Care and Sciences ◽

10.1186/s40780-021-00217-8 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kazuki Nagashima ◽

Megumi Sumida ◽

Shoichi Imanaka ◽

Tatsuro Kuwabara ◽

Ichiro Kaneko ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Drug Overdose ◽

Multivariate Logistic Regression Analysis ◽

Psychotropic Medications ◽

Disorders Of Consciousness ◽

Multivariate Logistic Regression ◽

Impaired Consciousness ◽

Female Sex

Abstract Background Drug overdose accounts for most of the admissions to the emergency department. Prescription drugs, most of which are psychotropic medications, are often misused for drug overdose. The purpose of this study was to investigate the association between overdose in patients transported with disorders of consciousness and psychotropic medications administered prior to transport, so as to enable quick differentiation of drug overdose patients from patients with disorders of consciousness. Methods We evaluated 222 patients transported to the Advanced Critical Care Center of Teikyo University Hospital due to disorders of consciousness. The patients were categorized into two groups: overdose group (n = 128) and control group with other disorders of consciousness (n = 94). Logistic regression models were used to assess the association between disorders of consciousness due to drug overdose and psychotropic drugs prescribed before emergency transportation based on sex and age. Results According to multivariate logistic regression analysis, only female sex (odds ratio [OR] 4.54, 95% confidence interval [CI] 2.43–8.05, P < 0.0001) was associated with overall overdose. Results from the univariate logistic regression analysis showed that in the group of patients aged 40–50 years, female sex (OR 4.36, 95% CI; 1.54–12.4, P = 0.006) and the use of psychotropic drugs (OR 5.05, 95% CI; 1.75–14.6, P = 0.003), benzodiazepines (OR 4.64, 95% CI; 1.61–13.4, P < 0.05), antidepressants (OR 11.4, 95% CI; 2.35–55.8, P = 0.003), and anticonvulsants (OR 4.46, 95% CI; 1.11–17.9, P = 0.035) were associated with overdose. According to multivariate logistic regression analysis, female sex (OR 4.44, 95% CI; 1.37–14.3, P = 0.013) and antidepressants (OR 7.95, 95% CI; 1.21–52.1, P = 0.031) were associated with overdose patients aged 40–50 years. Conclusions As a reference in distinguishing overdose in women in their 40s and 50s who present with impaired consciousness, attention may need to be paid to the type of psychotropic drug used, especially antidepressants.

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An international stakeholder survey of the role of chiropractic qualifying examinations: A qualitative analysis

Journal of Chiropractic Education ◽

10.7899/jce-19-22 ◽

2020 ◽

Vol 34 (1) ◽

pp. 15-30 ◽

Cited By ~ 4

Author(s):

Bart N. Green ◽

Claire D. Johnson ◽

Richard Brown ◽

Charmaine Korporaal ◽

Doug Lawson ◽

...

Keyword(s):

Quality Of Care ◽

Qualitative Analysis ◽

Response Rate ◽

Minimum Standard ◽

Ethical Practices ◽

Electronic Survey ◽

Written Comments ◽

The Cost

Objective: Many countries require examinations as a gateway to chiropractic licensure; however, the relevance of these exams to the profession has not been explored. The purposes of this study were to analyze perceptions of international stakeholders about chiropractic qualifying examinations (CQEs), observe if their beliefs were in alignment with those that society expects of professions, and suggest how this information may be used when making future decisions about CQEs. Methods: We designed an electronic survey that included open-ended questions related to CQEs. In August 2019, the survey was distributed to 234 international stakeholders representing academic institutions, qualifying boards, students, practitioners, association officers, and others. Written comments were extracted, and concepts were categorized and collapsed into 4 categories (benefits, myths, concerns, solutions). Qualitative analysis was used to identify themes. Results: The response rate was 56.4% representing 43 countries and yielding 775 comments. Perceived benefits included that CQEs certify a minimum standard of knowledge and competency and are part of the professionalization of chiropractic. Myths included that CQEs are able to screen for future quality of care or ethical practices. Concerns included a lack of standardization between jurisdictions and uncertainty about the cost/value of CQEs and what they measure. Solutions included suggestions to standardize exams across jurisdictions and focus on competencies. Conclusion: International stakeholders identified concepts about CQEs that may facilitate or hinder collaboration and efforts toward portability. Stakeholder beliefs were aligned with those expected of learned professions. This qualitative analysis identified 9 major themes that may be used when making future decisions about CQEs.

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A 2015 Survey of Forensic Economists: Their Methods, Estimates, and Perspectives

Journal of Forensic Economics ◽

10.5085/0898-5510-26.1.53 ◽

2015 ◽

Vol 26 (1) ◽

pp. 53-83 ◽

Cited By ~ 7

Author(s):

Michael R. Luthy ◽

Michael L. Brookshire ◽

David Rosenbaum ◽

David Schap ◽

Frank L. Slesnick

Keyword(s):

Vocational Rehabilitation ◽

Affordable Care Act ◽

Response Rate ◽

Survey Instrument ◽

Electronic Survey ◽

Forensic Economics ◽

Percentage Points ◽

Paper Survey ◽

E Mail

Abstract In January 2015, 590 e-mail invitations to complete an electronic survey were sent to NAFE (National Association of Forensic Economics) members. The response rate was approximately 33%, almost nine percentage points higher than the last paper survey administered in 2003. The survey covered many of the major topics included in earlier surveys, such as values of important economic variables (e.g., discount rates), trends in the practice of forensic economics (e.g., personal sources of earnings), and open-ended questions concerning ethics and reactions to the survey instrument. On the 2015 Survey instrument there were several new questions concerning such matters as how forensic economists perceive the role of vocational (rehabilitation) experts, the effects of the Affordable Care Act on loss estimates, how members charge for their services, and the size of respondents' practices.

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Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation

The Journal of Vascular Access ◽

10.5301/jva.5000662 ◽

2017 ◽

Vol 18 (3) ◽

pp. 185-191 ◽

Cited By ~ 4

Author(s):

Juan C. Duque ◽

Laisel Martinez ◽

Marwan Tabbara ◽

Denise Dvorquez ◽

Sushil K. Mehandru ◽

...

Keyword(s):

Logistic Regression ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Arteriovenous Fistulas ◽

Ckd Stage ◽

Artery Disease ◽

The University ◽

Fistula Maturation ◽

Arteriovenous Fistula Maturation

Introduction Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation. Methods We included 612 patients who underwent AVF creation between 2003 and 2015 at the University of Miami Hospital and Jackson Memorial Hospital. Effects of uremia on primary failure were evaluated using univariate statistical comparisons and multivariate logistic regression analyses. Results Primary failure occurred in 28.1% and 26.3% of patients with an AVF created prior to or after HD initiation, respectively (p = 0.73). The time of HD initiation was not associated with AVF maturation in multivariate logistic regression analysis (p = 0.57). In addition, pre-operative blood urea nitrogen (p = 0.78), estimated glomerular filtration rate (p = 0.66), and serum creatinine levels (p = 0.14) were not associated with AVF primary failure in pre-dialysis patients. Conclusions Our results show that clearance of uremia with regular HD treatments prior to AVF creation does not improve the frequency of vascular access maturation.

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