scholarly journals Prevalence of simultaneous use of alcohol and prescription medication in older adults: findings from a cross-sectional survey (Health Survey for England 2013)

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e023730 ◽  
Author(s):  
John Foster ◽  
Swatee Patel

ObjectivesTo investigate the concurrent use of ‘at-risk’ (AR) drinking (>10 units of alcohol per week) and prescription medications, while controlling for sociodemographic, and health-related factors, among older adults (aged 65–89 years).DesignCross-sectional survey.SettingData from Health Survey of England, 2013.InterventionsNone.ParticipantsGeneral population survey of 2169 adults aged 65–89 years.Primary outcome measuresAR drinking (>10 units per week). Secondary outcome was AR drinking defined as >14 units of alcohol per week limit (the cut-off used by the Department of Health for AT drinking).ResultsTwenty-seven per cent (n=568) of the sample were AR drinkers. Factors associated with alcohol consumption were gender, age, social class, marital status, rurality of dwelling, deprivation index, self-reported general health, cigarette smoking, body mass index, exercise level, health and well-being scores’ and number of prescription drugs. Logistic regression analysis showed that males were more likely to be AR drinkers (OR 3.44, 95% CI 2.59 to 4.57, p<0.0001) than females. Each year increase in age, lowered the probability of AR drinking by a factor of 0.95 (95% CI 0.93 to 0.98, p<0.0001). Using prescription drugs reduced AR drinking by a factor of 0.92 (95% CI 0.85 to 0.93, p=0.033), after controlling for age, sex and rurality of dwelling. No other predictors were significant. Similar results were obtained for AR drinking of >14units per week.ConclusionAR drinking is more likely in older men than women. The odds of AR drinking lessens, as individuals age, and using prescription drugs also reduces AR drinking.

2018 ◽  
Vol 68 (675) ◽  
pp. e711-e717 ◽  
Author(s):  
Taofikat B Agbabiaka ◽  
Neil H Spencer ◽  
Sabina Khanom ◽  
Claire Goodman

BackgroundPolypharmacy is common among older adults, with increasing numbers also using prescription drugs with herbal medicinal products (HMPs) and dietary supplements. There is no reliable evidence from the UK on concurrent use of HMPs and dietary supplements with prescription drugs in older adults.AimTo establish prevalence of concurrent prescription drugs, HMPs, and dietary supplements among UK community-dwelling older adults and identify potential interactions.Design and settingCross-sectional survey of older adults registered at two general practices in South East England.MethodA questionnaire asking about prescription medications, HMPs, and sociodemographic information was posted to 400 older adults aged ≥65 years, identified as taking ≥1 prescription drug.ResultsIn total 155 questionnaires were returned (response rate = 38.8%) and the prevalence of concurrent HMPs and dietary supplements with prescriptions was 33.6%. Females were more likely than males to be concurrent users (43.4% versus 22.5%; P = 0.009). The number of HMPs and dietary supplements ranged from 1 to 8, (mean = 3, median = 1; standard deviation = 1.65). The majority of concurrent users (78.0%) used dietary supplements with prescription drugs. The most commonly used dietary supplements were cod liver oil, glucosamine, multivitamins, and vitamin D. Others (20.0%) used only HMPs with prescription drugs. Common HMPs were evening primrose oil, valerian, and Nytol Herbal® (a combination of hops, gentian, and passion flower). Sixteen participants (32.6%) were at risk of potential adverse drug interactions.ConclusionGPs should routinely ask questions regarding herbal and supplement use, to identify and manage older adults at potential risk of adverse drug interactions.


10.2196/14021 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e14021 ◽  
Author(s):  
Lance Garrett Shaver ◽  
Ahmed Khawer ◽  
Yanqing Yi ◽  
Kris Aubrey-Bassler ◽  
Holly Etchegary ◽  
...  

Background Facebook has shown promise as an economical means of recruiting participants for health research. However, few studies have evaluated this recruitment method in Canada, fewer still targeting older adults, and, to our knowledge, none specifically in Newfoundland and Labrador (NL). Objective This study aimed to assess Facebook advertising as an economical means of recruiting a representative sample of adults aged 35 to 74 years in NL for a cross-sectional health survey. Methods Facebook advertising was used to recruit for a Web-based survey on cancer awareness and prevention during April and May 2018; during recruitment, additional advertisements were targeted to increase representation of demographics that we identified as being underrepresented in our sample. Sociodemographic and health characteristics of the study sample were compared with distributions of the underlying population to determine representativeness. Cramer V indicates the magnitude of the difference between the sample and population distributions, interpreted as small (Cramer V=0.10), medium (0.30), and large (0.50). Sample characteristics were considered representative if there was no statistically significant difference in distributions (chi-square P>.01) or if the difference was small (V≤0.10), and practically representative if 0.10<V≤0.20. The cost per recruit of Facebook advertising was compared with a quote for a random digit dialing (RDD)–recruited postal survey to determine if this method was economical. Results Facebook advertising is feasible and economical to conduct survey research, reaching 34,012 people, of which 2067 clicked on the ad, for a final sample size of 1048 people at Can $2.18 per recruit versus the quoted Can $23,316.05 for 400 recruits (Can $35.52 per recruit) via RDD. The sample was representative of rural and urban geography (P=.02; V=0.073), practically representative of age (P=.003; V=0.145) and income (P<.001; V=0.188), and over-representative of women (P<.001; V=0.507) and higher levels of education (P<.001; V=0.488). The sample was representative of the proportion of people with a regular health care provider (P=.94; V=0.025), diabetes prevalence (P=.002; V=0.096), and having had a colonoscopy or sigmoidoscopy (P=.27; V=0.034), and it was practically representative of smoking status (P<.001; V=0.14), and body mass index (P<.001; V=0.135). The sample was not representative of arthritis prevalence (P<.001; V=0.573), perceived health (P<.001; V=0.384), or time since last seasonal flu shot (P<.001; V=0.449). Conclusions Facebook advertising offers an easy, rapid, and economical means to recruit a partially representative (representative or practically representative of 8 of the 13 characteristics studied) sample of middle-aged and older adults for health survey research. As Facebook uses a nonrandom targeting algorithm, caution is warranted in its applications for certain types of research.


BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033804 ◽  
Author(s):  
Binbin Xu ◽  
Jinghui Zhang ◽  
Jianmei Hou ◽  
Mengdan Ma ◽  
Zhihong Gong ◽  
...  

ObjectivesThe present study aimed to assess the level of knowledge on peripherally inserted central catheter (PICC) maintenance among nurses in China and to analyse the related factors influencing this variable.DesignA cross-sectional survey.SettingNinety-one hospitals at three different levels in Hunan Province, China: county hospitals, municipal hospitals and provincial hospitals.ParticipantsA total of 4110 registered nurses engaged in clinical work related to intravenous infusion.Primary and secondary outcome measuresNurses’ knowledge of PICC maintenance was measured by the score of an anonymous, self-reported questionnaire.ResultsThe mean score of PICC maintenance among 4110 nurses was 72.86±14.86. 83.5% of the participants exhibited a score of 60 or above, and 34.1% of them exhibited a good grade with a score of 80 or above. The difference in the correct rate among different dimensions was statistically significant (H=17.721, p<0.01). The generalised linear model indicated that the factors influencing the nurses’ PICC maintenance knowledge included gender, age, professional title, work setting and previous history of PICC maintenance training.ConclusionsIn conclusion, the knowledge of PICC maintenance was at a medium level among nurses in Hunan province, China. Multiple steps should be taken to improve the nurses’ PICC maintenance knowledge, including disseminating PICC maintenance knowledge in multiple ways, such as courses, lectures, seminars and new media. Particular attention should be given to populations who responded poorly in this survey, and targeted education for nurses should be distributed based on their performance on specific dimensions, such as the replacement of dressing and needle-free connectors. In addition, the quality of the nurses’ practical performance could be measured in the future.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048107
Author(s):  
Caroline Bell ◽  
Jonathan Williman ◽  
Ben Beaglehole ◽  
James Stanley ◽  
Matthew Jenkins ◽  
...  

ObjectivesTo compare psychological outcomes, experiences and sources of stress over the COVID-19 lockdown in New Zealand in essential workers (healthcare and ‘other’ essential workers) with that of workers in nonessential work roles.DesignOnline cross-sectional survey.SettingConducted in New Zealand over level 4 lockdown in April/May 2020.ParticipantsFindings from employed participants (2495) are included in this report; 381 healthcare workers, 649 ‘other’ essential workers and 1465 nonessential workers.Primary and secondary outcome measuresMeasures included psychological distress (Kessler Psychological Distress Scale (K10)), anxiety (Generalised Anxiety Disorder (GAD-7)), well-being (WHO-5), alcohol use, subjective experiences and sources of stress. Differences between work categories were quantified as risk ratios or χ2 tests.ResultsAfter controlling for confounders that differed between groups of essential and nonessential workers, those in healthcare and those in ‘other’ essential work were at 71% (95% CI 1.29 to 2.27) and 59% (95% CI 1.25 to 2.02) greater risk respectively, of moderate levels of anxiety (GAD-7 ≥10), than those in nonessential work. Those in healthcare were at 19% (95% CI 1.02 to 1.39) greater risk of poor well-being (WHO-5 <13). There was no evidence of differences across work roles in risk for psychological distress (K10 ≥12) or increased alcohol use. Healthcare and ‘other’ essential workers reported increased workload (p<0.001) and less uncertainty about finances and employment than those in nonessential work (p<0.001). Healthcare and nonessential workers reported decreased social contact. No difference by work category in health concerns was reported; 15% had concerns about participants’ own health and 33% about other people’s health.ConclusionsDuring the pandemic lockdown, essential workers (those in healthcare and those providing ‘other’ essential work) were at increased risk of anxiety compared with those in nonessential work, with those in healthcare also being at increased risk of poor well-being. This highlights the need to recognise the challenges this vital workforce face in pandemics.


BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e021366 ◽  
Author(s):  
Sabrina Zeike ◽  
Lena Ansmann ◽  
Lara Lindert ◽  
Christina Samel ◽  
Christoph Kowalski ◽  
...  

ObjectivesNurses are generally found to be vulnerable to burnout, but nurses working in cancer care are even more so, since this profession is characterised by continuous confrontation with suffering and death. This study was designed to identify cut-off scores for job strain, that is, low job control and high job demands, for a sample of nurses working in breast cancer care. The main goal was to find cut-off scores, which predict the risk of nurses of developing a mental disorder from high job strain.DesignThe design was a cross-sectional survey study.SettingThe study is based on an employee survey in breast cancer centres in Germany.Participants688 nurses received a questionnaire; 329 nurses from 33 hospitals participated in the survey (return rate: 50.2%).Primary and secondary outcome measuresDependent variable: psychological well-being, measured by the WHO-5 Well-being Index; independent variables: job control and job demands, measured by the Job Content Questionnaire (JCQ).ResultsMultivariable analysis indicates that low job control and high job demands are prognostic factors for low well-being. In a receiver operating curve (ROC) analysis, the cut-off scores, which demonstrated a maximum Youden index, were 34.5 for job control and 31.4 for job demands. The combination of both scales from a logistic regression analysis resulted in an area under the curve of 0.778. Sensitivity and specificity are 70.3% and 74.2%, respectively. The total of correct classification was 63.3%.ConclusionThe determined cut-off scores indicate that there is a risk of becoming psychologically ill from a high workload when an individual reaches a score of ≤34.5 for job control and ≥31.4 for job demands. The described method of establishing risk-based cut-off scores is promising for nursing practice and for the field of occupational health. Transferability and generalisability of the cut-off scores should be further analysed.


2021 ◽  
Author(s):  
Barbara Studer-Luethi ◽  
Maria Brasser ◽  
Simon Lusti ◽  
Rahel Schaerli

Abstract BackgroundIn recent decades, the proportion of older adults in the population has continued to rise and with it the need for intervention programs to maintain cognitive functions into old age. Multiple lifestyle factors, first and foremost physical, cognitive, and social activities, have been shown to be crucial to forestalling decline in cognitive functions. However, since Covid-19 has curtailed opportunities for such activities, strategies must be designed to support older adults to remain cognitively healthy. MethodsThis study describes a newly developed ongoing publicly available preventive intervention, called brain coach, to support and stimulate cognitive activity in older adults. The intervention consists of weekly recommendations for evidence-based physical, cognitive, social, mindful, and creative activation exercises that can be integrated in daily life. 660 participants participated in an online cross-sectional survey examining experienced benefits and changes in relation to the program.ResultsParticipants reported benefits in memory, well-being, attitudes towards the brain, and lifestyle habits. Importantly, time invested in the intervention as well as some characteristics of participants, such as personality and positive attitude toward brain health, show positive relationships with these experienced benefits. Further research will explore the effects of such a multimodal intervention in a longitudinal randomized controlled trial study.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030968 ◽  
Author(s):  
Tom Bourne ◽  
Harsha Shah ◽  
Nora Falconieri ◽  
Dirk Timmerman ◽  
Christoph Lees ◽  
...  

ObjectivesTo determine the prevalence of burnout in doctors practising obstetrics and gynaecology, and assess the association with defensive medical practice and self-reported well-being.DesignNationwide online cross-sectional survey study; December 2017–March 2018.SettingHospitals in the UK.Participants5661 practising obstetrics and gynaecology consultants, specialty and associate specialist doctors and trainees registered with the Royal College of Obstetricians and Gynaecologists.Primary and secondary outcome measuresPrevalence of burnout using the Maslach Burnout Inventory and defensive medical practice (avoiding cases or procedures, overprescribing, over-referral) using a 12-item questionnaire. The odds ratios (OR) of burnout with defensive medical practice and self-reported well-being.Results3102/5661 doctors (55%) completed the survey. 3073/3102 (99%) met the inclusion criteria (1462 consultants, 1357 trainees and 254 specialty and associate specialist doctors). 1116/3073 (36%) doctors met the burnout criteria, with levels highest amongst trainees (580/1357 (43%)). 258/1116 (23%) doctors with burnout reported increased defensive practice compared with 142/1957 (7%) without (adjusted OR 4.35, 95% CI 3.46 to 5.49). ORs of burnout with well-being items varied between 1.38 and 6.37, and were highest for anxiety (3.59, 95% CI 3.07 to 4.21), depression (4.05, 95% CI 3.26 to 5.04) and suicidal thoughts (6.37, 95% CI 95% CI 3.95 to 10.7). In multivariable logistic regression, being of younger age, white or ‘other’ ethnicity, and graduating with a medical degree from the UK or Ireland had the strongest associations with burnout.ConclusionsHigh levels of burnout were observed in obstetricians and gynaecologists and particularly among trainees. Burnout was associated with both increased defensive medical practice and worse doctor well-being. These findings have implications for the well-being and retention of doctors as well as the quality of patient care, and may help to inform the content of future interventions aimed at preventing burnout and improving patient safety.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e040178
Author(s):  
Amy Pui Pui Ng ◽  
Weng Yee Chin ◽  
Eric Yuk Fai Wan ◽  
Julie Chen ◽  
Chak Sing Lau

ObjectiveTo estimate the prevalence and severity of burnout and explore the factors associated with burnout among Hong Kong medical graduates up to 20 years post-graduation.DesignCross-sectional survey.SettingHong Kong.ParticipantsDoctors who graduated from the University of Hong Kong between 1995 and 2014.Primary and secondary outcome measuresBurnout as measured by the Copenhagen Burnout Inventory (CBI), alcohol consumption as measured by the Alcohol Use Disorders Identification Test Version C, lifestyle behaviours (hours of sleep and work, exercise, smoking, substance use), career satisfaction and sociodemographic characteristics were obtained using paper or online questionnaires.ResultsResponse rate was 30.9% (496/1607). Prevalence of CBI burnout was 63.1% (personal), 55.9% (work-related) and 35.4% (patient-related). The mean CBI subscale scores were 57.4±21.4 (personal), 48.9±7.4 (work-related) and 41.5±21.8 (client-related). Factors associated with personal and patient-related burnout included age (coeff −0.437, 95% CI −0.779 to −0.095 and coeff −0.596, 95% CI −0.965 to −0.228, respectively), practice setting (coeff −5.759, 95% CI −10.665 to −0.853 and coeff −5.317, 95% CI −10.602 to −0.032, respectively) and regular exercise (coeff −6.855, 95% CI −11.102 to −2.608 and coeff −6.769, 95% CI −11.333 to −2.205, respectively). Gender (coeff 5.1, 95% CI 1.382 to 8.818), average hours of sleep per night (coeff −5.200, 95% CI −7.139 to −3.262) and work hours per week (coeff 0.226, 95% CI 0.099 to 0.353) were associated with personal burnout only. No factors were significantly associated with work-related burnout.ConclusionBurnout is highly prevalent among Hong Kong medical graduates. Younger doctors, women and those working in the public sector appear to be at higher risk for burnout and may benefit from targeted interventions. Policymakers and healthcare authorities should consider measures to help reduce burnout by enabling adequate sleep, reducing work hours and encouraging exercise.


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