Industry payments to physicians and prescribing branded memantine and donepezil combination

2020 ◽  
pp. 10.1212/CPJ.0000000000000870
Author(s):  
Zachary A. Marcum ◽  
Ching-Yuan Chang ◽  
Douglas Barthold ◽  
Holly M. Holmes ◽  
Wei-Hsuan Lo-Ciganic, MSPharm
Keyword(s):  
Median Number ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Improve Medication Adherence ◽  
Cross Sectional ◽  
Part D ◽  
Once Daily ◽  
Independent Variable ◽  
Additional Payment ◽  
Physician Prescribing

ABSTRACTObjective:Once-daily extended-released memantine with donepezil (hereafter memantine/donepezil) may improve medication adherence but has a 60-fold higher cost compared to combined generic components. Little is known about factors associated with prescribing memantine/donepezil. We examined the association between pharmaceutical industry payments to physicians and prescribing memantine/donepezil in Medicare.Methods:A cross-sectional study. Using 2015-2016 Centers for Medicare and Medicaid Services Open Payments and Part D prescription databases, we identified unique physicians who prescribed ≥11 memantine/donepezil prescriptions from 2015 to 2016. Outcome variable was the number of memantine/donepezil prescriptions written per physician per year. Key independent variable was physician receipt of industry payments defined in two models: (1) number of payments, and (2) amount of payment ($100 units) for memantine/donepezil received per physician per year. Multivariable Poisson regression was used, adjusting for potential confounders.Results:Among 4,895 unique eligible physicians in 2015-2016, the median number of memantine/donepezil prescriptions per physician per year was 19.5 (25th percentile=13, 75th percentile=32). Physicians received between 0 and 75 payments per year (median=1, 25th percentile=0, 75th percentile=2.5) for memantine/donepezil, totaling an average of $92 per year (median=$10.5, 25th percentile=$0, 75th percentile=$33.20). Every 1 additional payment received was associated with a 2% increase in new memantine/donepezil prescriptions prescribed per physician per year (rate ratio [RR]=1.02, 95% confidence interval [CI]=1.02-1.02). Every $100 increase in payment for memantine/donepezil was associated with a 0.3% increase in new memantine/donepezil prescriptions prescribed per physician per pear (RR=1.003, 95% CI=1.002-1.004).Conclusions:Receipt of industry payments for memantine/donepezil was independently associated with increased likelihood of physician prescribing memantine/donepezil in Medicare.

scholarly journals Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045992
Author(s):  
Eugene Budu ◽  
Bright Opoku Ahinkorah ◽  
Richard Gyan Aboagye ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Abdul-Aziz Seidu ◽  
...  
Keyword(s):  
Healthcare Utilisation ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Childhood Vaccination ◽  
Outcome Variable ◽  
Service Utilisation ◽  
Sectional Study ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Sub Saharan

ObjectiveThe objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.DesignOur study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.ParticipantsA total of 60 964 mothers of children aged 11–23 months were included in the study.Outcome variablesThe main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).ResultsThe average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.ConclusionThe study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.

Social inequality in parent–infant relations: Epidemiological study of community nurse records

2021 ◽  
pp. 140349482098313
Author(s):  
Bjørn E. Holstein ◽  
Sofie Weber Pant ◽  
Janni Ammitzbøll ◽  
Trine Pagh Pedersen
Keyword(s):  
Community Sample ◽  
Occupational Status ◽  
Home Visits ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Immigrant Parents ◽  
First Year ◽  
Cross Sectional ◽  
Parents And Children ◽  
First Year Of Life

Background: Some studies suggest that favourable socioeconomic circumstances are associated with better parent–child relations but the documentation of such an association is limited and inconsistent. Few studies focused on infancy, few studies relied on objective measurement of parent–infant relations, and few studies included more than one measurement of parent–infant relations in the first year of life. Aims: To report the prevalence of objectively measured problems in parent–infant relations during the first year of life and to examine the association between socioeconomic circumstances and parent–infant relations in an unselected community sample of infants. Methods: Cross-sectional study of a community sample of children from birth to 10 months in 15 municipalities in Denmark, n = 11,765. The exposure variables were population register data about socioeconomic circumstances: (a) parents’ education, (b) family composition, (c) parents’ origin, and (d) parents’ occupational status. The outcome variable was the health visitor’s concerns about the parent–infant relation assessed at four home visits from birth to 10 months after delivery. Results: The proportion of children with concerns about the parent–infant relation was 10.5%, 7.8% at one home visit and 2.8% at two or more home visits. Logistic regression analyses showed that all four indicators of socioeconomic circumstances were associated with concerns about the parent–infant relation in the first year of life. Conclusions: The risk of problematic parent–infant relations were significantly elevated among, children of immigrant parents, and children of parents with shorter education and not in education or work.

scholarly journals Doctors’ Knowledge of Hypertension Guidelines Recommendations Reflected in Their Practice

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Nafees Ahmad ◽  
Amer Hayat Khan ◽  
Irfanullah Khan ◽  
Amjad Khan ◽  
Muhammad Atif
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Median Number ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Attitude Score ◽  
Cross Sectional ◽  
Uncomplicated Hypertension ◽  
Adequate Knowledge ◽  
Hypertension Guidelines

Aim. To evaluate doctors’ knowledge, attitude, and practices and predictors of adherence to Malaysian hypertension guidelines (CPG 2008). Methods. Twenty-six doctors involved in hypertension management at Penang General Hospital were enrolled in a cross-sectional study. Doctors’ knowledge and attitudes towards guidelines were evaluated through a self-administered questionnaire. Their practices were evaluated by noting their prescriptions written to 520 established hypertensive outpatients (20 prescriptions/doctor). SPSS 17 was used for data analysis. Results. Nineteen doctors (73.07%) had adequate knowledge of guidelines. Specialists and consultants had significantly better knowledge about guidelines’ recommendations. Doctors were positive towards guidelines with mean attitude score of 23.15±1.34 points on a 30-point scale. The median number of guidelines compliant prescriptions was 13 (range 5–20). Statistically significant correlation (rs = 0.635, P<0.001) was observed between doctors’ knowledge and practice scores. A total of 349 (67.1%) prescriptions written were guidelines compliant. In multivariate analysis hypertension clinic (OR = 0.398, P=0.008), left ventricular hypertrophy (OR = 0.091, P=0.001) and heart failure (OR = 1.923, P=0.039) were significantly associated with guidelines adherence. Conclusion. Doctors’ knowledge of guidelines is reflected in their practice. The gap between guidelines recommendations and practice was seen in the pharmacotherapy of uncomplicated hypertension and hypertension with left ventricular hypertrophy, renal disease, and diabetes mellitus.

scholarly journals Development of ‘16-Holes Manual Dexterity Pegboard’ and the Normal Value of 6 Years Old Children

1970 ◽  
Vol 2 (01) ◽  
pp. 37-44
Author(s):  
Fanny Aliwarga ◽  
Ferial Hadipoetro ◽  
Angela BM Tulaar ◽  
Surjanto H
Keyword(s):  
Nutritional Status ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Manual Dexterity ◽  
Cross Sectional ◽  
Normal Value ◽  
Dependent Variables ◽  
Standard Normal ◽  
Independent Variable ◽  
The Mean

Objectives: Obtaining the standard normal value of 6 years old children aged six year, and testing our hypothesis if girls’ dexterity is higher than boys.Methods: The design of this study was a cross sectional study of six years old students of public elementary school in South Jakarta. Inclusion criteria included age six years old, no neurological andorthopedic problem, normal nutritional status and right handed. Location based-random sampling was performed. Dependent variables comprised of age, sex and nutritional status. Independent variable wasthe result of ‘16-Holes Three-Jaw Chuck Manual Dexterity Pegboard’ test. Statistical analysis was done by descriptive analysis and Mann Whitney Test.Results: There were 191 girls and 191 boys who fulfilled the criteria. The ‘16-Holes Three-Jaw Chuck Manual Dexterity Pegboard’ test allowed subjects to be assessed for their ability to put numbers of pegwithin 15 seconds. The mean number of pegs placed for girls was 6.92 pegs (CI 95% 6.76 – 7.08) and boys was 6.49 pegs (CI 95% 6.33 – 6,65)Conclusions: Girls are able to place more pegs than boys in a given time. Furthermore, girls’ manual dexterity is superior to boys (p 0,000).Keywords: Manual dexterity, standard normal value, pegboard, sex differences.

scholarly journals Prevalence of Dental Caries in Children

2021 ◽  
Vol 11 (1) ◽  
pp. 4-6
Author(s):  
Muhammad Alam Sikder ◽  
Tasneem Faruqui ◽  
KM Abdullah Al Harun ◽  
Sajjad Mahmud ◽  
Radia Faruqui
Keyword(s):  
Cross Sectional Study ◽  
Health Condition ◽  
Cross Sectional ◽  
Once Daily ◽  
Decayed Tooth ◽  
Dmft Index ◽  
Study Population ◽  
The Mean ◽  
Status Data ◽  
Oral Condition

This cross sectional study on oral condition among school going children in Sylhet city was conducted at Osmani Medical High School, Dorgah Gate, Sylhet, Bangladesh. This study was carried out on 8th October, 2019 among 208 students, mostly 12 years aged studying in Class VI. The main objective of the study was to assess the oral health condition of school going children through decayed, missing, and filled teeth (DMFT) status. Data was collected by personal interview and clinical examination of the respondents. Among 208 children, 96 (46.2%) were boys and 112 (53.8%) were girls. Among all, 63 (30.3%) respondents brush their teeth once daily while 137 (65.9 %) respondents brush twice a day, and 8 (3.8 %) of them brush their teeth more than twice daily. Fluoride containing toothpaste is used by 73 (35.1 %) students, 112 (53.8 %) students did not know whether their toothpaste contain fluoride or not, and 23 (11.1 %) students do not use fluoride. Among all respondents, 125(60.09 %) did not have any decayed tooth, while 83(39.90 %) had tooth decay, and 20(9.6 %) had their teeth filled. Normal gingival condition was found in 185 (88.94 %) subjects, but 23(11.06 %) of them had red or swollen gingiva. The mean DMFT of the study population was 1.19 which is considered as “low” according to “WHO quantification for the DMFT index”. Update Dent. Coll. j: 2021; 11 (1): 4-6

scholarly journals Self-skincare knowledge and practice described by elderly persons in the mid-west of Minas Gerais

2016 ◽  
Vol 19 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Juliana Ladeira Garbaccio ◽  
Amanda Domingos Ferreira ◽  
Amanda Laís Gonçalves Gama Pereira
Keyword(s):  
The Elderly ◽  
Median Number ◽  
Cross Sectional Study ◽  
Skin Aging ◽  
Minas Gerais ◽  
Sample Population ◽  
Elderly Persons ◽  
Cross Sectional ◽  
Basic Care ◽  
And Gender

The present study aimed to assess the knowledge and practices reported by the elderly in relation to basic care of one's skin. A cross sectional study was performed from November 2011 to August 2012 in Arcos, Minas Gerais, based on a structured questionnaire administered to 250 elderly persons, with answers statistically analyzed. Knowledge and practices of self-skincare were evaluated from the median number of ten questions answered by the elderly. Most of the sample population were women (54.8%), aged between 60 and 69 years (52.4%), with a primary education (71.6%) and working in a job where they were exposed to direct sunlight (58.0%). The majority (76.4%) said they did not use protective sun filter despite considering it important (77.6%). The use of body moisturizing creams was reported by 55.6%. An association (p<0.05) was identified between the variables practice/knowledge and gender and practice outdoor activity. Further studies can be conducted as a result of the present research to clarify factors related to non-adherence to self-skincare, and educational measures should be put in place for the entire population, regardless of age, to prevent pathological skin aging.

scholarly journals Willingness to Accept COVID-19 Vaccine and Its Determinants among Nigeria Citizens: A Web-based Cross-sectional Study

2021 ◽  
pp. 13-22
Author(s):  
Olanrewaju Davies Eniade ◽  
Abayomi Olarinmoye ◽  
Agofure Otovwe ◽  
Funke E. Akintunde ◽  
Omowumi O. Okedare ◽  
...  
Keyword(s):  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Willingness To Accept ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Other Information ◽  
Level Of Significance ◽  
To Receive

Background: The peculiarity in Nigerians’ demographic, socio-economic and cultural pattern necessitated the need to explore potential COVID-19 vaccine acceptance. This study investigated the determinants of willingness to receive COVID-19 vaccine in Nigeria. Methods: An online cross-sectional study among the general population in Nigeria. Data were collected using an electronic questionnaire.  A total of 368 individuals participated in the research. The outcome variable was willingness to accept COVID-19 vaccine coded as “Yes=1 and No=0.”  Basic socio-demographic information of participants and other information related to COVID-19 were obtained. Stata MP 14 was used for the statistical analysis. Descriptive statistics were presented, test of association were carried out using chi square and a binary logistic regression was used to assess the determinants of willingness to accept COVID-19 vaccine. All analyses were performed at 5% level of significance. Results: The mean age of the respondents was 29.4 + 9.65 years.  Majority of the study participants were female (58.9%), Yoruba (74.7%) and dwellers of urban area (68.5%). Also, 85.6% have attained tertiary level of education. Two-fifth (40.5%) of respondent reported their willingness to take the COVID-19 if made available. Majority (69.8%) of those that are willing to take the vaccine would prefer a live attenuated form and 39.6% would prefer the vaccine administered intramuscularly. Age group≥40 years (AOR: 5.20, CI: 1.02- 26.41), currently married (AOR: 2.81, CI: 1.05 – 7.53) and susceptibility to COVID 19 infection (AOR: 2.52, CI: 1.21 – 5.26) were associated with likelihood of willingness to accept COVID-19 vaccine. Conclusion: Despite the fact that majority were at risk of COVID-19 infection, willingness to receive COVID-19 vaccine was low among Nigerians. Level of maturity in terms of age and marriage as well as susceptibility to COVID-19 infection increased the likelihood of accepting COVID-19 infection. In Furtherance, younger ones, unmarried and non-susceptible individual may require more efforts tailored towards enrichment of understanding about the importance of COVID-19 vaccine in other to improve the acceptance of COVID-19 vaccine in Nigeria.

scholarly journals Dukungan Keluarga terhadap Kepatuhan Minum Obat pada Pasien DM Tipe II

2020 ◽  
Vol 6 (1) ◽  
pp. 39-45
Author(s):  
Reny Sulistyowati ◽  
Agnes Dewi Astuti
Keyword(s):  
Medication Adherence ◽  
Family Support ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Information Support ◽  
Improve Medication Adherence ◽  
Cross Sectional ◽  
Study Approach ◽  
Type 2 Dm

The level of adherence usually decreases in patients with chronic conditions compared to acute conditions; this is related to the long-term nature of chronic disease due to the most rapid decrease in adherence after the first 6 months of therapy. The decline in compliance not only resulted in poor health outcomes but also had a significant impact on health costs. The purpose of this study was to determine family support for medication adherence in type 2 DM patients. This study used descriptive correlational using a cross-sectional study approach of 100 respondents. Patient demographic data and family support were obtained using a questionnaire while the level of compliance used Morisky Medication Adherence Scales. The results show that there is a relationship between family support and medication adherence in patients with type 2 diabetes, which is viewed from 4 dimensions: appreciation support, emotional support, information support, and instrumental support. Support from family can improve medication adherence in type 2 DM patients.

scholarly journals Utilization of Urban Health Extension Program Services and Associated Factors among Hosanna Dwellers, Hadiya Zone, southern Ethiopia: A Community Based Cross-Sectional Study

2019 ◽  
Author(s):  
Birhannu Jikamo ◽  
Temesegen Woelamo ◽  
Mekonen Samuel
Keyword(s):  
Urban Health ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Southern Ethiopia ◽  
Cross Sectional ◽  
Health Extension Program ◽  
Study Participants ◽  
Extension Program ◽  
Hadiya Zone ◽  
Model Family

Abstract Abstract Background: In 2009, in Hadiya zone reported that establishment of Urban Health Extension Program (UHEP) which is subsequent declaration of after the country of Ethiopia. Major contribution of the declared UHEP is to provide accessible service to the potentially vulnerable groups of <5children pregnant women. Therefore, the aim of this study was to assess the utilization and associated factors of the urban health extension program services in Hossana Town, Hadiya Zone, southern Ethiopia, 2018 Methods: we conducted community based cross-sectional study in Hossana town, Hadiya Zone southern Ethiopia. Households were recruited by using systematic random sampling technique and study participants also by using random sampling techniques. A total of 403 study participants were participated in this study. Strength of measure of association between explanatory variables with outcome variable reported using the Odds Ratio (OR) with 95% confidence interval. Bivariate and multivariate binary logistic regression analysis was performed to identify predictors. P-value < 0.05 used to identify factors significantly associated with outcome variable. Results: Out of 403 households, 397(98.5%) of response rate obtained. The mean score of community knowledge about the utilization of urban health extension program service (UHEP) was 2.352 (SD ±1.156. Regarding knowledge towards UHEP, of 166 (42%) of the respondents had good knowledge towards UHEP service while 231 (58%) had poor knowledge towards UHEP service utilization. The total number of households which graduated as a model family was 79 (19.9%). In the adjusted multivariate model, those respondents in the age group of 36-45 year were 3.73 times(AOR = 3.73; 95% CI:1.04-3.37) more likely to be utilized health extension program services as compared with those respondents in the age group of 18-24year. Those households which graduated as a model family were 2.2 times (AOR = 2.18; 95% CI: 1.36- 3.51) higher odds of utilized health extension program service as compared with those households which didn’t graduated as a model family. Conclusions: The coverage of utilization of urban health extension program service was low in the study setting compared with previous study. There were also identified predictors that were associated with utilization of urban health extension program service.

scholarly journals Correlation between Nutritional Status and Pneumonia among 6-59 Months Years Old in Tangerang, Banten

2020 ◽  
Author(s):  
Zico Permadi ◽  
◽  
Maria Ekawati ◽  
Citra Ayu Aprilia ◽  
◽  
...  
Keyword(s):  
Nutritional Status ◽  
Community Health Center ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five ◽  
Independent Variable ◽  
Weight For Age ◽  
Children Under 5

ABSTRACT Background: Pneumonia is still causing the most deaths among children in developing countries. This disesase often occurs in children under 5 years of age. Nutritional status is a factor that is closely related to infectious diseases such as pneumonia. This study aimed to examine the correlation between nutritional status and pneumonia among 6-59 months years old in Tangerang, Banten. Subject and Methods: A cross-sectional study was conducted at Pakuhaji Community Health Center, Tangerang, Banten, from January to February 2018. A total of 29 children under five were enrolled in this study. The dependent variable was pneumonia. The independent variable was nutritional status. The data were collected from direct measurement of the children under five and questtioner. The data were analyzed by Chi-square. Results: As many as 16 children under five (55.17%) had pneumonia, 7 children under five (24.13%) were malnutrition, 3 children under five (10.34%) were short, and 5 children under five (7.24%) were thin. Nutritional status based on weight for age and weight for height had differences in nutritional status with the incidence of pneumonia among children under five, and they were statistically significant (p< 0.001). Conclusion: Nutritional status is associate with the incidence of pneumonia among 6-59 months years old (children under five) in Tangerang, Banten. Keywords: pneumonia incidence rate, pneumonia, nutritional status, chidren under five Correspondence: Citra Ayu Aprilia. Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta. Email: [email protected]. Mobile: +628122090545. DOI: https://doi.org/10.26911/the7thicph.03.13

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