scholarly journals Medications in Patients with Dementia and Behavioral Disturbance

Author(s):  
Wenjun Zhong ◽  
Xinyue Liu ◽  
Tiffini Voss ◽  
Sauzanne Khalilieh ◽  
Rezaul Karim Khandker ◽  
...  

Background: Behavioral disturbance (BD) is common in dementia patients, with no FDA approved medications for this condition. Little data exists on the real-world medication use in this population. Objective: To describe real-world medications use in this population. Methods: A cross-sectional study was conducted using the MarketScan database for outpatient medications and the Cerner database for inpatient medications. The study period was Oct 2015–Jun 2018. Patients with dementia and BD were identified through ICD-10-CM. We examined outpatient medications prescribed during 6-month before or after BD event date, and inpatient medications during inpatient visits, especially on central nervous systems (CNS) drugs including antidementia drugs, antidepressants, antipsychotics, anxiolytics, and anticonvulsants. Results: A total of 56,544 outpatients and 34,245 patient hospitalizations were assessed separately. Among outpatients, patients filled more medications after a BD event. The use of the five CNS drug classes generally increased after a BD event, and the largest increase was seen in antipsychotics (23%to 33%). Among inpatients, the median number of medications used in each hospitalization was 14. The use of antipsychotics was particularly high (64%), followed by anxiolytics (51%). A list of 60 unique medications were suggested to be the commonly used drugs in dementia patients with BD. Conclusion: In dementia patients with BD, anti-dementia medications, antidepressants, anticonvulsants, hypnotics and antipsychotics were the most used drug classes. Antidepressants and antipsychotics use were more frequent after a BD event, which suggests a need for safe drugs targeting BD in dementia patients.

2021 ◽  
Vol 281 ◽  
pp. 312-320
Author(s):  
Minghuan Wang ◽  
Qian Zhao ◽  
Caihong Hu ◽  
Yang Wang ◽  
Jie Cao ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Nafees Ahmad ◽  
Amer Hayat Khan ◽  
Irfanullah Khan ◽  
Amjad Khan ◽  
Muhammad Atif

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.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021966 ◽  
Author(s):  
Federica Dellafiore ◽  
Cristina Arrigoni ◽  
Francesco Pittella ◽  
Gianluca Conte ◽  
Arianna Magon ◽  
...  

AimThe aim of this study was to critically analyse and describe gender differences related to self-care among patients with chronic heart failure (HF).Methods and resultsA monocentric real-world cohort of 346 patients with chronic HF in follow-up was used for this cross-sectional study. We report data related to the cohort’s demographic and clinical characteristics. Self-care was assessed using the Self-Care of Heart Failure Index before patients’ discharge. After bivariate analysis, logistical regression models were used to describe the relationship between gender, self-care behaviours and self-care confidence. While men were found to have more than quadruple the risk of poor self-care than women (OR 4.596; 95% CI 1.075 to 19.650), men were also found to be approximately 60% more likely to have adequate self-care confidence than women (OR 0.412; 95% CI 0.104 to 0.962). Considering that self-care confidence is described as a positive predictor of behaviours, our results suggest a paradox. It is possible that the patient–caregiver relationship mediates the effect of confidence on behaviours. Overall, adequate levels of self-care behaviours are a current issue, ranging 7.6%–18.0%.ConclusionThis study sets the stage for future research where elements of the patient–caregiver relationship ought to be considered to inform the planning of appropriate educational interventions. We recommend routinely measuring patients’ self-care behaviours to guide their follow-up and as a basis for any changes in their daily life behaviours.


2016 ◽  
Vol 32 (2) ◽  
pp. 85-90
Author(s):  
MRK Khan ◽  
AN Rizvi ◽  
MA Habib ◽  
MK Hasan ◽  
A Mamun ◽  
...  

Background: Dementia is a chronic & progressive neurodegenerative disorder affecting usually older people of more than 65 years in which there are disturbances of multiple higher cortical functions including memory, thinking, orientation & others. Dementia patients are increasing in number as the population of older age group is increasing. All types of dementia are treatable, at least with psychosocial interventions. So, accurate diagnosis and evaluation of etiological pattern is essential. Methods: This cross sectional study was carried out in the Department of Neurology, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2012 to December 2012 on 88 patients with dementia diagnosed on the basis of mini mental state examination and DSM-IV criteria. Results: Vascular dementia was the underlying diagnosis in most of the cases (43.3 %) followed by Alzheimers Disease (20.2%) and Parkinson Disease (9%). Other causes were Mixed Dementia, Intracranial Space Occupying Lesion, Post Encephalitic, Hypoxic Encephalitic, Chronic Subdural Haematoma and Tubercular Meningitis. Conclusion: Vascular dementia is more than Alzheimer’s Dementia in Bangladesh. Multiple vascular risk factors contribute to this. Bangladesh Journal of Neuroscience 2016; Vol. 32 (2): 85-90


2016 ◽  
Vol 19 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Juliana Ladeira Garbaccio ◽  
Amanda Domingos Ferreira ◽  
Amanda Laís Gonçalves Gama Pereira

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.


Author(s):  
Susmita Bhattacharya ◽  
Amit Kyal ◽  
Payel Mondal ◽  
Partha Mukhopadhyay ◽  
Mrinalini Chowdhury ◽  
...  

Background: Most of the couples suffering from infertility report it to be the most stressful and depressing period of their life, more so if it is a primary infertility. Studies regarding the prevalence and role of infertility-specific stress especially in eastern part of India is very limited. The objective of the present study was to estimate the prevalence of infertility-specific stress and its role in marital adjustment in women diagnosed with infertility.Methods: It was a cross-sectional study done on 80 married couple diagnosed with infertility (both primary and secondary) over 1 year from July 2016 to June,2017. Dyadic Adjustment Scale (DAS), "semi-structured questionnaire" compiled by the authors and "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)" were used for the evaluation. The analysis was done using SPSS (version 16) and Chi-square test.Results: Around 86% infertile women and 21% infertile men were found to suffer from mental stress. Infertility related stress were more in patients with primary infertility than in secondary one. Women mostly (56.5%) coped with stress by self-blaming whereas men (58.2%) by blaming the partner.Conclusions: Mental stress was significantly associated with infertility. In fact, maladjustment in marital relation caused by the stress adversely affected the conjugal life and thus also the fertility. Proper counselling of both partners might be helpful to solve this problem.


Author(s):  
Yoan Chou ◽  
Dharmady Agus ◽  
Dwi Jani Juliawati

Background: Medical education is full of burden and pressure, so that medical students are prone to get depressive disorder and anxiety disorder. These have been proven by several researches conducted in the faculties of medicine from abroad as well as in Indonesia. Medical students, either preclinical or clinical, need to face many obstacles, but clinical students have more demands than preclinical students and they are directly responsible for patient safety. The more demands of the clinical students made them prone to have more depressive and anxiety disorder.Method: This research was conducted as a cross-sectional study on 200 students on Atma Jaya Medicine Faculty by choosing 100 pre-clinical and clinical students with simple random sampling. Data were collected with structured interviews by using MINI ICD-10 instrument to determine the depressive and anxiety disorder.Results: There were significant differences between the proportion of depressive disorder and anxiety disorder among preclinical and clinical students in FKUAJ 2015 (p = 0.044 and p = 0.048). The proportion of depressive disorder and anxiety disorder in clinical students are higher than preclinical students (29% vs. 17% and 38% vs. 25%).Conclusions: Clinical students are more prone to get depressive disorder 1,99 times and anxiety disorder 1,84 times than preclinical students FKUAJ year 2015 


2018 ◽  
Vol 6 (3) ◽  
pp. 96-101
Author(s):  
Satish Kumar Deo ◽  
Sita Rijal ◽  
Tulza K.C

Background: Antibiotics are considered to be among the most commonly sold drug classes globally. Antibiotic resistance is a recognized public health issue at the local, national and global levels.Objectives: The aim of this study was to identify awareness of general public regarding the use and resistance of antibiotics.Methodology: A descriptive cross-sectional study was conducted in Kathmandu in November 2016 using a quantitative questionnaire among 120 adult people aged 20–60 years. Convenience sampling method was used and information on use of antibiotics and resistance was obtained using semi-structured questionnaire through interview method. Descriptive statistics was done to describe the respondent’s level of awareness regarding use of antibiotics and resistance.Results: Among the total respondents, majority had incorrect awareness as regards to action, reasons for using antibiotics, possible side effects of the antibiotic. Seventy one percent of the respondents had not heard about antibiotic resistance. The study finding showed that about 66.7% of the participants had inadequate awareness towards use and resistance of antibiotics.Conclusion: The findings demonstrate that the overall awareness on antibiotic use and resistance is poorly understood among our respondents. This information can be utilized in future educational and antibiotic resistance awareness raising campaigns.


2017 ◽  
Vol 16 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Mohammad Yousuf Rathor ◽  
Mohammad Arif Shahar ◽  
Ahmad Marzuki Bin Omar ◽  
Azarisman SM Shah ◽  
Mohammad Hadzri Hasmoni ◽  
...  

Objective: Patients beliefs determine their response to an illness and its management especially if it is chronic. Studies assessing patient’s knowledge of their epilepsy are scarce. We report the first objective study evaluating knowledge, attitude and practices of epilepsy patients referred to a tertiary care centre in East Coast of Malaysia.Materials and Methods: A cross sectional study using pre-tested, semi-structured questionnaire among consenting epilepsy patients.Results: The demographic details and responses to a questionnaire assessing their insight towards epilepsy were recorded. Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean = 31.63 ± 13.41). Majority (53.8%) of them aged equal or less than 30 years. The median number of years they had epilepsy was 8.0 (4.0, 18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (0.3, 4.5) years. The average number of years they were receiving treatment from a hospital was 5.50 ± 5.84. Most (90.9%) did not know the cause of epilepsy; however 93.9 % were aware that it can be treated with modern drugs. While only 22.7 % believed that faith healers can treat epilepsy, 74.2% had tried other forms of treatment. Negative attitude was reflected in the belief that epilepsy is due to supernatural powers (1.5%) and that epilepsy is contagious (17.4 %). Positive attitude included that PWE can take a job (66.7%), allowing a child with epilepsy to study (80%), not objecting children to play with a child with epilepsy (54.5%), marry (65.9%) and having children (58.3%).Conclusions: Patients with epilepsy are not knowledgeable about their disorder. This is true regardless of age, educational background, or number of years with epilepsy. The results suggest that there is a critical need to enhance epilepsy education and improve attitudes towards epilepsy beyond seizure control.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.545-553


2020 ◽  
Vol 16 (2) ◽  
pp. 138-147
Author(s):  
Sevostyanova E. Viktorovna ◽  
Nikolaev Y. Alekseevich ◽  
Polyakov V. Yakovlevich ◽  
Mitrofanov I. Michailovich

: Comorbidity of hypertension and hepatobiliary pathology has negative medical and social consequences, including an increase in the indicators of hospital admissions, disability and mortality. Objective: The aim was to study the occurrence of hypertension combined with hepatobiliary diseases depending on social status, gender and age in 2003-2017 and their influence on indicators of metabolic processes in patients with a therapeutic profile. Methods: A cross-sectional study using the inpatients’ medical record database of the clinic of Federal Research Centre for Basic and Translational Medicine (Novosibirsk, Russia), which collects demographics, diagnoses (using ICD-10 codes), procedures and examinations of all inpatients from 2003-2017 was conducted. The incidence of comorbidity of hypertension and hepatobiliary pathology depending on age, gender and social status, based on the analysis of 13496 medical records was examined. A comparative analysis of biochemical parameters characterizing the main types of metabolism (lipid, protein, carbohydrate and purine) was carried out in 3 groups of patients: with hypertension; with hepatobiliary pathology, and with a combined pathology. Results: During the years 2003-2005, there was the greatest frequency of this comorbidity in workers, in women, in the age group 60 years and older. In 2009-2017, the highest incidence was observed in the male administrative staff. In patients with this comorbidity, more pronounced changes in carbohydrate, protein, lipid and purine metabolism were found in comparison with groups of patients with isolated diseases. Conclusion: The results highlight the need to improve the system of prevention and treatment of comorbidity taking into account sex, age, occupation and features of metabolism.


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