scholarly journals Pharmaceutical industry funding of events for healthcare professionals on non-vitamin K oral anticoagulants in Australia: an observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030253
Author(s):  
Behrad Behdarvand ◽  
Emily A Karanges ◽  
Lisa Bero
Keyword(s):  
Pharmaceutical Industry ◽  
Vitamin K ◽  
Healthcare Professionals ◽  
Oral Anticoagulants ◽  
Cross Sectional Study ◽  
Industry Funding ◽  
Cross Sectional ◽  
Independent Information ◽  
Substantial Investment ◽  
Nature Frequency

ObjectivesTo describe the nature, frequency and content of non-vitamin K oral anticoagulant (NOAC)-related events for healthcare professionals sponsored by the manufacturers of the NOACs in Australia. A secondary objective is to compare these data to the rate of dispensing of the NOACs in Australia.Design and settingThis cross-sectional study examined consolidated data from publicly available Australian pharmaceutical industry transparency reports from October 2011 to September 2015 on NOAC-related educational events. Data from April 2011 to June 2016 on NOAC dispensing, subsidised under Australia’s Pharmaceutical Benefits Scheme (PBS), were obtained from the Department of Health and the Department of Human Services.Main outcome measuresCharacteristics of NOAC-related educational events including costs (in Australian dollars, $A), numbers of events, information on healthcare professional attendees and content of events; and NOAC dispensing rates.ResultsDuring the study period, there were 2797 NOAC-related events, costing manufacturers a total of $A10 578 745. Total expenditure for meals and beverages at all events was $A4 238 962. Events were predominantly attended by general practitioners (42%, 1174/2797), cardiologists (35%, 977/2797) and haematologists (23%, 635/2797). About 48% (1347/2797) of events were held in non-clinical settings, mainly restaurants, bars and cafes. Around 55% (1551/2797) of events consisted of either conferences, meetings or seminars. The analysis of the content presented at two events detected promotion of NOACs for unapproved indications, an emphasis on a favourable benefit/harm profile, and that all speakers had close ties with the manufacturers of the NOACs. Following PBS listings relevant to each NOAC, the numbers of events related to that NOAC and the prescribing of that NOAC increased.ConclusionsOur findings suggest that the substantial investment in NOAC-related events made by four pharmaceutical companies had a promotional purpose. Healthcare professionals should seek independent information on newly subsidised medicines from, for example, government agencies or drug bulletins.

scholarly journals The Prescription of Vitamin K Antagonists in a Very Old Population: A Cross-Sectional Study of 8696 Ambulatory Subjects Aged Over 85 Years

2020 ◽  
Vol 17 (18) ◽  
pp. 6685
Author(s):  
Patrick Manckoundia ◽  
Clémentine Rosay ◽  
Didier Menu ◽  
Valentine Nuss ◽  
Anca-Maria Mihai ◽  
...  
Keyword(s):  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Platelet Aggregation Inhibitors ◽  
Cross Sectional Study ◽  
Very Elderly ◽  
Cross Sectional ◽  
Aggregation Inhibitors ◽  
Cardiovascular Medications

We compared very elderly people taking vitamin K antagonists (VKA) and those not taking VKA (noVKA). Individuals were included in the noVKA group if there was no VKA on their reimbursed prescriptions during the study period. We also compared three subgroups, constituted by VKA type (fluindione, warfarin, or acenocoumarol). We included individuals aged over 85 years, affiliated to Mutualité Sociale Agricole of Burgundy, who were refunded for prescribed VKA in September 2017. The VKA and noVKA groups were compared in terms of demographic conditions, registered chronic diseases (RCD), number of drugs per prescription and cardiovascular medications. The three VKA subgroups were compared for the same items plus laboratory monitoring, novel and refill VKA prescriptions, and prescriber specialty. Of the 8696 included individuals, 1157 (13.30%) were prescribed VKA. Mean age was 90 years. The noVKA group had fewer women (53.67 vs 66.08%), more RCD (93.43 vs. 71.96%) and more drugs per prescription (6.65 vs. 5.18) than the VKA group (all p < 0.01). Except for direct oral anticoagulants and platelet aggregation inhibitors, the VKA group took significantly more cardiovascular medications. The most commonly prescribed VKA was fluindione (59.46%). Mean age was higher in the warfarin (90.42) than in the acenocoumarol (89.83) or fluindione (89.71) subgroups (p < 0.01). No differences were observed for sex (women were predominant) or RCD. 13% of subjects in this population had a VKA prescription. Fluindione was the most commonly prescribed VKA.

Influence of Concomitant Treatments under Anticoagulants and Statins in Detecting Signals of Adverse Drug Reactions

2019 ◽  
Vol 45 (08) ◽  
pp. 837-845
Author(s):  
Maria-Isabel Jimenez-Serrania ◽  
Carlos Treceño-Lobato
Keyword(s):  
Adverse Drug Reactions ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Cross Sectional Study ◽  
Drug Reactions ◽  
Cross Sectional ◽  
Risk Of Bleeding ◽  
Reductase Inhibitors ◽  
Increased Risk

AbstractThe aim of the present study was to evaluate the risk of adverse drug reactions (ADRs) of concomitant treatments in patients treated with anticoagulants and statins. The authors performed an observational cross-sectional study in two cohorts of surveyed patients treated with vitamin K antagonists (VKAs) or non–vitamin K antagonist oral anticoagulants (NOACs). Different groups were analyzed based on the drug that each patient was taking, that is, VKAs or NOACs, as well as on the use of HMG CoA reductase inhibitors (statins) versus nonuse of these drugs; they also took into account the potential exposure to other common medications. Descriptive, clinical, and ADR data were reported and analyzed through an adaptation of Bayesian methodology (false discovery rate < 0.05) to detect new signals. Eleven different ADRs in patients on VKAs and statins and 12 in patients on VKAs without statins were found. In evaluating the concomitant therapies, the authors found that analgesics and nonsteroidal anti-inflammatory drugs were the most common therapeutic options, followed by proton pump inhibitors (PPIs). Seven ADRs were observed in patients concomitantly treated with NOACs and statins, whereas NOACs without concomitant statins were associated with a significantly lower risk of bleeding. The risk of observing an ADR among the patients who are concomitantly treated with VKAs and statins is lower than with analgesics or PPI, while the concomitant use of NOACs and statins is associated with both an increment in the number of observed ADRs and increased risk of bleeding.

scholarly journals Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older

2021 ◽  
Vol 18 (9) ◽  
pp. 4443
Author(s):  
Patrick Manckoundia ◽  
Gilles Nuemi ◽  
Arthur Hacquin ◽  
Didier Menu ◽  
Clémentine Rosay ◽  
...  
Keyword(s):  
Vitamin K ◽  
Kidney Diseases ◽  
Angiotensin Receptor Blockers ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Severe Heart Failure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Receptor Blockers

The effectiveness of direct oral anticoagulants (DOAC) is non-inferior to vitamin K antagonists (VKA) to treat atrial fibrillation and venous thromboembolism (VTE). In this cross-sectional study, we compared older persons taking DOACs to those taking VKAs. We included ambulatory individuals ≥80 years, affiliated to Mutualité Sociale Agricole of Burgundy, who were refunded for a medical prescription in September 2017. The demographic conditions, registered chronic diseases (RCD), and number and types of prescribed drugs were compared in the DOAC group and VKA group. Of the 3190 included individuals, 1279 (40%) were prescribed DOACs and 1911 (60%) VKAs. Individuals taking VKAs were older than those taking DOACs (87.11 vs. 86.35 years). In the DOAC group, there were more women (51.92% vs. 48.25%) (p = 0.043), less RCD (89.60% vs. 92.73%) (p = 0.002), less VTE (1.80% vs. 6.59%), less severe heart failure (58.09% vs. 67.87%), less severe hypertension (18.22% vs. 23.60%), less severe kidney diseases (1.49% vs. 3.82%), and fewer drugs per prescription (6.15 vs. 6.66) (p < 0.01 for all). The DOAC group were also less likely to be taking angiotensin receptor blockers (10.79% vs. 13.97%), furosemide (40.81% vs. 49.66%) or digoxin (10.32% vs. 13.66%) than the VKA group (p = 0.009, p < 0.001, and p = 0.005). DOACs were less prescribed than VKAs. Individuals taking VKAs were older and had more severe comorbidities and more drugs per prescription than those taking DOACs.

Usability of a tablet computer designed for older adults: a qualitative approach based on an intra-hospital living-lab for healthcare (Preprint)

2020 ◽  
Author(s):  
Guillaume Sacco ◽  
Pauline Carliez ◽  
Frédéric Noublanche ◽  
Romain Simon ◽  
Anne Renaudin ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Patients ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Satisfaction Score ◽  
Tablet Computer ◽  
Sectional Study ◽  
Cross Sectional ◽  
System Usability Scale ◽  
Perceived Usability

BACKGROUND Usability is the keystone in the evolution of tablet technology in healthcare. The Ardoiz® tablet has been designed with a simplified interface for older adults. OBJECTIVE To assess the perceived usability and satisfaction of the Ardoiz® tablet. METHODS We conducted a mixed methods with cross-sectional study using System Usability Scale (SUS), satisfaction score and workshops, including geriatric patients, healthcare professional and caregivers. RESULTS Between September 25, 2019 and March 11, 2020, 58 participants were included in a cross-sectional study (including 38 patients, mean ±SD 85±6 years, 66% women), 26 in workshops (including 5 patients, mean ±SD 86.4±2.9, 40% women). The SUS was 74±12/100, the satisfaction score was 2.8±0.9/4, with 59% of satisfied participants with the use of Ardoiz® pads. The intent to acquire remained low with 18% (n=6) of participants who would be interested in acquiring the tablet. This tablet computer seemed to be difficult to use by geriatric patients and healthcare professionals, mainly because of its complex homepage. Nevertheless, former caregivers and healthcare professionals thought that the tablet could be of great interest to hospitals for leisure and medical use. The main feedback in order to improve the tablet is to simplify the home page with fewer and more static icons (without switching). CONCLUSIONS Notwithstanding the usability of the tablet, the intent to acquire of Ardoiz® tablet remained low. The interface should be simplified for older adults in order to improve usability and adherence. CLINICALTRIAL NCT04091152

scholarly journals Assessment of Knowledge, Practice and Attitude about Biomedical Waste Management among Healthcare Professionals during COVID-19 Crises in Al-Ahsa

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 747
Author(s):  
Sahbanathul Missiriya Jalal ◽  
Fahima Akhter ◽  
Amal Ismael Abdelhafez ◽  
Ahmed Mansour Alrajeh
Keyword(s):  
Work Experience ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Cross Sectional ◽  
Biomedical Waste ◽  
Respiratory Therapists ◽  
Global Pandemic ◽  
Before And After ◽  
Knowledge Practice

Biomedical waste (BMW) management is an essential practice of healthcare professionals (HCPs) for preventing health and also environmental hazards. Coronavirus disease (COVID-19) has become a global pandemic, posing significant challenges for healthcare sectors. A cross-sectional study was performed to assess the knowledge, practice, and attitude on BMW management among HCPs when taking care of patients with COVID-19 and associated with demographic variables. From Al-Ahsa healthcare sectors, 256 HCPs were selected randomly, of which 105 (41%) had excellent knowledge, 87 (34%) had good knowledge, and 64 (25%) had poor knowledge with a mean score of 13.1 ± 3.6. A higher mean score was (14.4 ± 3.2) obtained by physicians, and (13.6 ± 3.8) nurses than the other HCPs. Regarding practice, 72 (28.1%) HCPs used and discarded PPE while handling biomedical wastes. Additionally, 88 (34.4%) followed proper hand hygiene before and after each procedure and whenever needed. Physicians, nurses, and respiratory therapists had a more favorable attitude than other HCPs. There was a statistically significant association found among knowledge level and educational qualification (p < 0.0001), gender (p < 0.001), and work experience (p < 0.05). Emphasis is needed to train all HCPs regarding proper BMW management during this pandemic to prevent infection transmission.

scholarly journals Factors associated with emotional exhaustion in healthcare professionals involved in the COVID-19 pandemic: an application of the job demands-resources model

2021 ◽  
Author(s):  
Serena Barello ◽  
Rosario Caruso ◽  
Lorenzo Palamenghi ◽  
Tiziana Nania ◽  
Federica Dellafiore ◽  
...  
Keyword(s):  
Emotional Exhaustion ◽  
Patient Engagement ◽  
Healthcare Professionals ◽  
Job Demands ◽  
Cross Sectional Study ◽  
Personal Resources ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

Abstract Purpose The purpose of the present cross-sectional study is to investigate the role of perceived COVID-19-related organizational demands and threats in predicting emotional exhaustion, and the role of organizational support in reducing the negative influence of perceived COVID-19 work-related stressors on burnout. Moreover, the present study aims to add to the understanding of the role of personal resources in the Job Demands-Resources model (JD-R) by examining whether personal resources—such as the professionals’ orientation towards patient engagement—may also strengthen the impact of job resources and mitigate the impact of job demands. Methods This cross-sectional study involved 532 healthcare professionals working during the COVID-19 pandemic in Italy. It adopted the Job-Demands-Resource Model to study the determinants of professional’s burnout. An integrative model describing how increasing job demands experienced by this specific population are related to burnout and in particular to emotional exhaustion symptoms was developed. Results The results of the logistic regression models provided strong support for the proposed model, as both Job Demands and Resources are significant predictors (OR = 2.359 and 0.563 respectively, with p < 0.001). Moreover, healthcare professionals’ orientation towards patient engagement appears as a significant moderator of this relationship, as it reduces Demands’ effect (OR = 1.188) and increases Resources’ effect (OR = 0.501). Conclusions These findings integrate previous findings on the JD-R Model and suggest the relevance of personal resources and of relational factors in affecting professionals’ experience of burnout.

scholarly journals Management of oxygen saturation monitoring in preterm newborns in the NICU: the Italian picture

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Serafina Perrone ◽  
◽  
Maurizio Giordano ◽  
Giuseppe De Bernardo ◽  
Paola Lugani ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Standard Operating Procedures ◽  
Specific Training ◽  
Related Factors ◽  
Cross Sectional ◽  
Survey Form ◽  
Standard Operating ◽  
Oxygen Monitoring

Abstract Background Although many studies emphasize the importance of using oxygen saturation (SpO2) targets in the NICUs, there is a wide variability in used saturation ranges among centers. Primary aim was to draw a representative picture on how the management of oxygen monitoring is performed in the Italian NICUs. Second aim was to identify healthcare-professionals related factors associated with oxygen targeting in the preterm population. Methods Cross-sectional study with data collection via an electronic survey form. A questionnaire containing pre-piloted and open questions on monitoring and management of the SpO2 was administered to neonatologists across the network of the Italian Society of Neonatology. The questions focused on: the infrastructure, specific training, healthcare professionals and patients-related factors. The results of the survey were anonymously collected, summarized and analyzed. Results Out of 378 questionnaires, 93 were correctly filled. Thirty-six different SpO2 ranges were observed. Centers using written standard operating procedures on oxygen management and SpO2 monitoring maintained a correct average range of SpO2 90–95%, avoided hyperoxia and reconsidered saturation targets in relation to comorbidities. 39.8% of responders disabled alarms during neonatal care. One center used biomarkers for complete monitoring of neonatal oxygenation status. Conclusions There is considerable variation in SpO2 targets for preterm infants in the Italian NICUs. Standard operating procedures and specific training for health care personnel are the main factors playing a role for the correct maintenance of the recommended oxygen targets in preterms.

scholarly journals Quality of Life Prior and in the Course of the COVID-19 Pandemic: A Nationwide Cross-Sectional Study with Brazilian Dietitians

2021 ◽  
Vol 18 (5) ◽  
pp. 2712
Author(s):  
Raquel Adjafre da Costa Matos ◽  
Rita de Cassia Coelho de Almeida Akutsu ◽  
Renata Puppin Zandonadi ◽  
Raquel Braz Assunção Botelho
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Social Relationship ◽  
Healthcare Professionals ◽  
Life Quality ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chi Squared

Dietitians as healthcare professionals could decrease their quality of life during the SARS-COV-2 pandemic period; therefore, this study aimed to compare Brazilian dietitians’ perceptions of quality of life before and during the pandemic. This nationwide cross-sectional research aimed to evaluate Brazilian dietitians’ quality of life before and in the course of the COVID-19 pandemic, using a previously validated self-administered instrument WHO-QOL-BREF in Brazilian-Portuguese. The questionnaire was composed of 26 items (four domains) to evaluate life quality (physical, psychological, social relationship, and environment). The questionnaire also presented some sociodemographic variables and three questions about the COVID-19 pandemic. It was applied using GoogleForms® platform (Google LLC, Mountain View, CA, USA). For the statistical analysis of data, Paired T-test, Chi-squared test, and Analysis of Variance were used. A total of 1290 Brazilian dietitians replied to the instrument. Comparing quality of life (QoL) before SARS-COV-2 (3.83 ± 0.59) and during the pandemic (3.36 ± 0.66), data was statistically different. Comparing prior and in the course of the COVID-19 pandemic, all variables and domains presented statistical differences (better before the pandemic period). Among Brazilian dietitians, the psychological health domain was the most affected. The Sars-Cov-2 pandemic negatively impacted the QoL of Brazilian dietitians since health professionals face changes in their lives because of work.

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