scholarly journals Medication Reconciliation and Drug–Drug Interactions: An Old Process with a New Approach

2021 ◽  
Author(s):  
Shahram Ala ◽  
Sufia Tonkaboni ◽  
Aliyeh Bazi ◽  
Ebrahim Salehifar
Keyword(s):  
Drug Interactions ◽  
Medication Reconciliation ◽  
Cross Sectional Study ◽  
High Rate ◽  
Cross Sectional ◽  
New Approach ◽  
Drug History ◽  
North Of Iran ◽  
History Of ◽  
Hospital Wards

Background: The occurrence of drug–drug interactions (DDIs) and insufficient attention to medication reconciliation is one of the important challenges of pharmacotherapy in hospitalized patients. The aim of this study was to determine the extent of drug–drug interactions in patients based on medication reconciliation strategy. Methods: This descriptive cross-sectional study was performed for six months in patients admitted to Imam Reza Hospital in Amol, North of Iran. The data were obtained by using a medication reconciliation tool through a random sampling of patients admitted in Hospital wards from May 2014 until October 2014. A total of 200 patients were enrolled in the study. All patients had a history of medication use before admission. The drug interactions have been checked according to Drug Interaction Facts between newly prescribed drug and medication patient using before admission. The number and frequency of data were summarized by SPSS21 statistical software. Results: Major and Moderate DDIs were found in 7.5% and 64% of prescriptions. The most frequent DDIs were seen in those who were taking psychiatric drugs (33%) and cardiovascular drugs (30%). Most DDIs occurred among women over 60 years of age. The most frequently occurring DDIs was pharmacokinetics interaction between clopidogrel and atorvastatin (n=9). Other frequent interactions were between ceftriaxone and heparin (n=8) and metoprolol and insulin (n=3). Conclusion: This study showed a high rate of drug interactions and especially confirms the importance of medication reconciliation in providing a comprehensive drug history and exploring drug interactions.

scholarly journals High Rate of Obesity-Associated Hypertension among Primary Schoolchildren in Sudan

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Zeena Salman ◽  
Gregory D. Kirk ◽  
Mark D. DeBoer
Keyword(s):  
Family History ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Sub Saharan Africa ◽  
High Rate ◽  
Cross Sectional ◽  
Primary Schoolchildren ◽  
History Of ◽  
Family History Of Hypertension

Cardiovascular disease (CVD) frequently has roots in childhood, including following childhood-onset hypertension. Incidence of CVD has increased in developing countries in East Africa during recent urbanization. Effects of these shifts on childhood hypertension are unclear. Our objectives were to (1) Determine the prevalence of hypertension among primary schoolchildren in Khartoum, Sudan; (2) Determine whether hypertension in this setting is associated with obesity. We performed a cross sectional study of 6-12y children from two schools randomly selected in Khartoum, Sudan. Height, weight, BMI, BP and family history of hypertension were assessed. Age-, height- and gender-specific BP curves were used to determine pre-hypertension (90–95%) and hypertension (>95%). Of 304 children, 45 (14.8%) were overweight; 32 (10.5%) were obese; 15 (4.9%) were pre-hypertensive and 15 (4.9%) were hypertensive. Obesity but not family history of hypertension was associated with current hypertension. In multiple logistic regression, adjusting for family history, children who were obese had a relative-risk of 14.7 (CI 2.45-88.2) for systolic hypertension compared to normal-weight children. We conclude that overweight and obesity are highly prevalent among primary schoolchildren in urban Sudan and are strongly associated with hypertension. That obesity-associated cardiovascular sequelae exist in the developing world at young ages may be a harbinger of future CVD in sub-Saharan Africa.

Treponemal infection rates, risk factors and pregnancy outcome in a rural area of Senegal

2003 ◽  
Vol 14 (3) ◽  
pp. 208-215 ◽  
Author(s):  
Emmanuel Lagarde ◽  
Emmanuelle Guyavarch ◽  
Jean-Pierre Piau ◽  
AÏssatou Gueye-Ndiaye ◽  
Karim Seck ◽  
...  
Keyword(s):  
Treponema Pallidum ◽  
Population Based ◽  
Cross Sectional Study ◽  
High Rate ◽  
Syphilis Infection ◽  
Cross Sectional ◽  
History Of ◽  
Treponemal Infection ◽  
Active Syphilis

A rural population of east Senegal has been under demographic surveillance for more than 30 years and a high rate of infertility has been reported. The aim of the study is to describe HIV and treponemal infection epidemiology and association with outcome of pregnancy in a population of rural Senegal. A population-based cross-sectional study was conducted among 952 randomly-selected adults of a rural community of Senegal. No participant was found to be infected with HIV, 11% had evidence of past syphilis and 5% of active syphilis. Active syphilis was associated among men with age, long-term mobility and having partners in an urban area in the last 12 months and among women with being divorced or widowed. No association was found between past or active syphilis and abortion or stillbirth but women aged 40 and more with past or active syphilis were significantly more likely to have had no history of gestation than women with no evidence of syphilis infection. In conclusion our results call for more research to understand the epidemiology of treponemal infection and to elucidate types of Treponema pallidum involved.

scholarly journals High rate of major drug–drug interactions of lopinavir–ritonavir for COVID-19 treatment

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Juan Macías ◽  
Ana Pinilla ◽  
Francisco A. Lao-Dominguez ◽  
Anaïs Corma ◽  
Enrique Contreras-Macias ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Drug Interactions ◽  
High Frequency ◽  
Cross Sectional Study ◽  
Charlson Index ◽  
High Rate ◽  
Cross Sectional ◽  
Concomitant Medications ◽  
The Impact ◽  
Major Drug

AbstractThe impact of drug–drug interactions (DDI) between ritonavir-boosted lopinavir (LPV-r) to treat patients with coronavirus disease 2019 (COVID-19) and commonly used drugs in clinical practice is not well-known. Thus, we evaluated the rate and severity of DDI between LPV-r for COVID-19 treatment and concomitant medications. This was a cross-sectional study including all individuals diagnosed of SARS-CoV-2 infection treated with LPV-r and attended at a single center in Southern Spain (March 1st to April 30th, 2020). The frequency [95% confidence interval (95% CI)] of potential and major DDI were calculated. Overall, 469 patients were diagnosed of COVID-19, 125 (27%) of them were prescribed LPV-r. LPV-r had potential DDI with concomitant medications in 97 (78%, 95% CI 69–85%) patients, and in 33 (26%, 95% CI 19–35%) individuals showed major DDI. Twelve (36%) patients with major DDI and 14 (15%) individuals without major DDI died (p = 0.010). After adjustment, only the Charlson index was independently associated with death [adjusted OR (95% CI) for Charlson index ≥ 5: 85 (10–731), p < 0.001]. LPV-r was discontinued due to side effects in 31 (25%) patients. Management by the Infectious Diseases Unit was associated with a lower likelihood of major DDI [adjusted odds ratio (95% CI): 0.14 (0.04–0.53), p = 0.003). In conclusion, a high frequency of DDI between LPV-r for treating COVID-19 and concomitant medications was found, including major DDI. Patients with major DDI showed worse outcomes, but this association was explained by the older age and comorbidities. Patients managed by the Infectious Diseases Unit had lower risk of major DDI.

scholarly journals Medication Reconciliation during Admission at University Hospital

2020 ◽  
Vol 13 (1) ◽  
pp. 1
Author(s):  
Tatiane Contin ◽  
Liliane Bernardes Campos ◽  
Mônica Cristina Toffoli-Kadri ◽  
Vanessa T. Gubert de Matos
Keyword(s):  
Prescription Drugs ◽  
Medication Reconciliation ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Medication History ◽  
Cross Sectional ◽  
Mato Grosso ◽  
Home Based ◽  
History Of

INTRODUCTION: Medication reconciliation is the process of comparing the most accurate list of all medications that a patient is taking with the list of prescription drugs within the healthcare system while considering the patient&rsquo;s allergies and history of side effects. OBJECTIVES: To reconcile medication upon the patients&rsquo; admission to a university hospital in the municipality of Campo Grande, Mato Grosso do Sul, Brazil. METHOD: A prospective, cross-sectional study was conducted between June 2018 and May 2019 at the medical clinic unit of an university hospital. Discrepancies observed between the prescription and the best possible medication history were classified as intentional discrepancy; undocumented intentional; and unintentional. RESULTS: A total of 1,134 discrepancies were found between home-based drugs and those prescribed upon admission to the MCU. Among the discrepancies, 815 (72%) were intentional, 89 (8%) were undocumented intentional, and 230 (20%) were unintentional. The number of consultation sources and the number of medicines in use at home showed significant correlation with the occurrence of unintentional discrepancies (p = 0.039 and p = 0.008, respectively). A total of 318 pharmaceutical interventions were performed, 230 related to unintended discrepancies. Of these, 138 (60%) interventions were not accepted. CONCLUSION: The study verified the high frequency of drug omission, conferring treatment interruption and the need for pharmaceutical assistance of polymedicated patients.

scholarly journals High rate of major drug-drug interactions of lopinavir-ritonavir for COVID-19 treatment

2020 ◽  
Author(s):  
Juan Macias ◽  
Ana Pinilla ◽  
Francisco A Lao-Dominguez ◽  
Anais Corma ◽  
Enrique Contreras-Macias ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Drug Interactions ◽  
High Frequency ◽  
Cross Sectional Study ◽  
Charlson Index ◽  
High Rate ◽  
Cross Sectional ◽  
Concomitant Medications ◽  
The Impact ◽  
Major Drug

The impact of drug-drug interactions (DDI) between ritonavir-boosted lopinavir (LPV-r) to treat patients with coronavirus disease 2019 (COVID-19) and commonly used drugs in clinical practice is not well-known. Thus, we evaluated the rate and severity of DDI between LPV-r for COVID-19 treatment and concomitant medications. This was a cross-sectional study including all individuals diagnosed of SARS-CoV-2 infection treated with LPV-r and attended at a single center in Southern Spain (March 1st to April 30th, 2020). The frequency [95% confidence interval (95% CI)] of potential and major DDI were calculated. Overall, 469 patients were diagnosed of COVID-19, 125 (27%) of them were prescribed LPV-r. LPV-r had potential DDI with concomitant medications in 97 (78%, 95% CI: 69%-85%) patients, and in 33 (26%, 95% CI: 19%-35%) individuals showed major DDI. Twelve (36%) patients with major DDI and 14 (15%) individuals without major DDI died (p=0.010). After adjustment, only the Charlson index was independently associated with death [adjusted OR (95% CI) for Charlson index ≥5: 85 (10-731), p <0.001]. LPV-r was discontinued due to side effects in 31 (25%) patients. Management by the Infectious Diseases Unit was associated with a lower likelihood of major DDI [adjusted odds ratio (95% CI): 0.14 (0.04-0.53), p=0.003). In conclusion, a high frequency of DDI between LPV-r for treating COVID-19 and concomitant medications was found, including major DDI. Patients with major DDI showed worse outcomes, but this association was explained by the older age and comorbidities. Patients managed by the Infectious Diseases Unit had lower risk of major DDI.

scholarly journals The frequency of risk factors for pulmonary tuberculosis in tuberculosis patients in Babol, Northern Iran, during 2008-2015

2018 ◽  
Vol 31 (3) ◽  
pp. 144-147
Author(s):  
Mehran Shokri ◽  
Rahmatollah Najafi ◽  
Jalal Niromand ◽  
Arefeh Babazadeh ◽  
Mostafa Javanian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Smoking History ◽  
Northern Iran ◽  
Cross Sectional ◽  
Underlying Illness ◽  
North Of Iran ◽  
History Of ◽  
Age Profile

Abstract In the current study, we investigated the risk factors for tuberculosis in patients admitted to the Ayatollah Rouhani Hospital in Babol, north of Iran. This cross-sectional study was conducted on 207 patients with proven tuberculosis during the years 2008-2015. Demographic data such as age and sex, smoking, history of underlying illness, illness symptoms, and laboratory results were collected and analyzed at a significant level of less than 0.05. From 207 patients, 136 were male (65.7%), 71 were female (34.3%), and 76 of them (37.3%) were smokers. It is notable that most patients (29.5%) were over the age of 71. The relation between age profile and being tuberculosis has been studied, but the co-relation was found to be not significant. The most common complaint has been coughing (60.9%). While investigating underling diseases, the most common illness has found to be Diabetes (11.3%). Based our finding, there was a significant relationship between gender and smoking with tuberculosis. Accordingly, as smoking is one of the risk factors for tuberculosis, smokers and non-smokers should be informed that smoking carries the risk for tuberculosis. Such a program should be particularly addressed to males.

scholarly journals Clinical Epidemiology and Paraclinical Findings in Tuberculosis Patients in North of Iran

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Farhang Babamahmoodi ◽  
Ahmad Alikhani ◽  
Jamshid Yazdani Charati ◽  
Amir Ghovvati ◽  
Fatemeh Ahangarkani ◽  
...  
Keyword(s):  
Clinical Epidemiology ◽  
Wide Spectrum ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Cross Sectional ◽  
Significant Difference ◽  
North Of Iran ◽  
History Of ◽  
The Mean ◽  
Mean Time

Background. Mycobacterium tuberculosis (M.TB) causes a wide spectrum of clinical diseases. The prevalence of TB is different in various parts of Iran and throughout the world. The present study aimed to determine the clinical epidemiology and paraclinical findings of TB. Methods. A cross-sectional study was conducted from 2008 to 2013. Patient demographic, clinical, and radiologic characteristics, picked up from the TB patient’s files, were collected using a standard questionnaire format. Data was entered and analyzed using the SPSS version 16 statistical software and P value < 0.05 was considered statistically significant. Results. Out of 212 patients enrolled in this study 62% were male and the mean age was about 50 years old. 98.6% were Iranian, and 46.2% were rural. Prevalence of smear-positive TB was 66.4%. Prevalence of positive PPD was 50.7% with no significant difference between HIV-positive and -negative patients (P = 0.8). Prevalence of diabetes mellitus was 17%. 36% of the patients had history of smoking and about 29.3% were addicted to narcotics. Cough was the most common symptom (94.5%) and 84% had sputum. 15 cases (7%) had extrapulmonary TB. The mean time between the onset of symptoms and admission was 46.5 days. The delay for admission between urban and rural populations was not significantly different (P = 0.68); but for those who were in prison, the delay was significant (P = 0.02). About 46% of the patients had cavitary lesions in CXRs. Conclusion. Timely diagnosis of TB especially in prisoners by understanding its most important epidemiologic characteristics and clinical features can help to make an early treatment and prevent spread of mycobacteria and their complications.

scholarly journals Discrepancies in drug histories at admission to gastrointestinal surgery, internal medicine and geriatric hospital wards in Central Norway: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e013427 ◽  
Author(s):  
Janne Kutschera Sund ◽  
Olav Sletvold ◽  
Trude Cecilie Mellingsæter ◽  
Randi Hukari ◽  
Torstein Hole ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Selection Criteria ◽  
Drug Information ◽  
Gastrointestinal Surgery ◽  
Cross Sectional Study ◽  
Clinical Impact ◽  
Sectional Study ◽  
Cross Sectional ◽  
Drug History ◽  
Hospital Wards

ObjectivesTo compare discrepancies in drug histories among patients acutely admitted to different hospital wards, classify the discrepancies according to their potential clinical impact and identify appropriate selection criteria for patients that should be subject to a detailed drug history at admission.DesignCross-sectional study.SettingTwo gastrointestinal surgery wards and one geriatric ward at St Olav’s University Hospital in Trondheim and two general internal medicine wards at Ålesund Hospital in Ålesund, Norway.ParticipantsAll patients acutely admitted to these wards during a period of three months were asked to participate in the study. A total of 168 patients were included. For each patient, drug information available at admission was compared with information from drug lists obtained from the general practitioner and (if applicable) the home care services/the nursing home.Primary and secondary outcome measuresNumber of patients with one or more discrepancies in their drug history. Type and clinical impact of the discrepancies found. Selection criteria for patients that should be subject to a detailed drug history.ResultsIn total, 83% had at least one discrepancy in their drug history. Omission of a drug accounted for 72% of the discrepancies, whereas a difference in dosing was the cause of the remaining 28%. 9% of the discrepancies had the potential to cause severe harm or discomfort. We found no significant differences in the number of discrepancies between hospital wards, genders, ages or levels of care.ConclusionsThis study demonstrates the importance of collecting drug information from all available sources when a patient is admitted to hospital. As we found no significant differences in discrepancies between subgroups of patients, we suggest that medication reconciliation should be performed for all patients.

Patterns of Migraine Disease in Otolaryngology: A CHEER Network Study

2018 ◽  
Vol 159 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Kristine A. Schulz ◽  
Elnaz Esmati ◽  
Frederick A. Godley ◽  
Claude L. Hill ◽  
Ashkan Monfared ◽  
...  
Keyword(s):  
General Population ◽  
Assessment Tool ◽  
Cross Sectional Study ◽  
High Rate ◽  
Research Network ◽  
Medical Illness ◽  
Cross Sectional ◽  
Brain Abnormality ◽  
History Of ◽  
Specific Symptoms

Objective To evaluate the prevalence of migraine disease in an otolaryngologic cohort and migraine-related otologic and sinonasal symptoms in this population. Study Design Cross-sectional study utilizing the CHEER (Creating Healthcare Excellence through Education and Research) network for recruitment. Setting Patients were recruited in a cross-sectional and pragmatic manner in 14 CHEER sites between June 2015 and March 2017 (9 academic, 5 community based). Subjects and Methods Patients were included if they were aged ≥18 years and seen for any concern that was not head and neck cancer. Patients with any history of brain abnormality or headaches that began within 2 weeks of a medical illness, trauma, or head injury were excluded. Patients were screened for migraine with a validated instrument. If they screened positive on the Migraine Assessment Tool (MAT+), the subjects also filled out validated and custom questionnaires for sinonasal, otologic, and migraine-specific symptoms. Results Of 1458 patients screened, 235 (16.1%) screened positive for migraine (MAT+), which is higher than general population (13%, P < .001). The MAT+ group was significantly younger (47.2 vs 55.6 years of age, P < .001) and predominantly women (80.0% vs 55.9%, P < .001). The MAT+ cohort commonly reported ear- and sinus-related symptoms, such as tinnitus (70.5%), ear pressure (61.9%), balance problems (82%), facial pressure (85%), and rhinorrhea (49.9%). There were significantly higher levels of sinus burden with higher levels of dizziness handicap, Jonckheere-Terpstra test = 11,573.00, z = 7.471, P < .001. Conclusion Migraine disease has a higher prevalence in an otolaryngologic cohort than in the general population, presenting with a high rate of sinonasal and otologic symptoms that may be due to or exacerbated by migraines.

Seroimmunity status to Measles-Mumps-Rubella-Varicella-Pertussis- Diphtheria -Tetanus among Students Accepted to Mazandaran University of Medical Science, Sari, North of Iran, 2018-2019: Planning for Prevetive Method.

2021 ◽  
Author(s):  
Hana Saffar ◽  
Sayed Jaber Mousavi ◽  
Hiva Saffar ◽  
Hanieh Shiraj ◽  
Saffar Mohammed-Jafar
Keyword(s):  
Relative Proportion ◽  
Varicella Vaccine ◽  
Medical Science ◽  
Cross Sectional Study ◽  
Adult Type ◽  
Cross Sectional ◽  
National Immunization ◽  
North Of Iran ◽  
History Of ◽  
Full Protection

Abstract Background. Healthcare sciences students(HSS)are at the higher risk of exposure to several infections during training. The most important are measles, mumps, varicella, pertussis and influenza, that are transmitted easily via respiratory routes. These infections are vaccine preventable, and commonly are more complicated while develop during adulthood. Confirming immunity before training are recommended, however, adherence to the policy is not satisfactory universally. To evaluate immunity status, and to determine the most appropriate approach to provide full protection against these infections, this study was designed. Methods. A cross-sectional study among newly accepted HSS was conducted. Their past vaccination status, and medical history of compatible clinical diseases were sought by personal interview and self-administered questionnaire. Sera specific IgG antibodies to these infections were measured using ELISA. The relative proportion of seroimmune students were calculated. The correlation between past clinical diseases and their immune status particularly among those who showed no history of earlier vaccination were determined. The most appropriate policy to provide full protection was determined. The collected data were analyzed using descriptive statistical methods as appropriate. Results. Overall, 242 students with mean age 23.9 years, 59% female were participated. All HSS declared that they had been vaccinated according to the national immunization program. Among them 188 students with additional dose of measles- rubella (MR), and 54 by measles- mumps- rubella (MMR) vaccines were re-vaccinated.Overall seropositivity rates were as: measles-80.1%, mumps-64%, rubella-93.4%, varicella-78.5%, pertussis-46.5%, diphtheria-87.3%, and tetanus-87.2%. There were not significant differences between two groups of HSS; MR vs MMR re-vaccinated students. The most cost-benefits strategy to provide immunity against MMR agents were universal vaccination. Conclusion. Nearly 63%of HSS were susceptible to MMR viruses, and universal MMR vaccination of the students just before training was the most appropriate policy to provide immunity. Efforts should be made to incorporate adult-type acellular pertussis vaccine to diphtheria- tetanus toxoids to and varicella vaccine provide protection against these agents.

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