scholarly journals Drug Prescription Profiles in Patients with Polypharmacy in Spain: A Large-Scale Pharmacoepidemiologic Study Using Real-World Data

Author(s):  
Miguel Ángel Hernández-Rodríguez ◽  
Ermengol Sempere-Verdú ◽  
Caterina Vicens-Caldentey ◽  
Francisca González-Rubio ◽  
Félix Miguel-García ◽  
...  

We aimed to identify and compare medication profiles in populations with polypharmacy between 2005 and 2015. We conducted a cross-sectional study using information from the Computerized Database for Pharmacoepidemiologic Studies in Primary Care (BIFAP, Spain). We estimated the prevalence of therapeutic subgroups in all individuals 15 years of age and older with polypharmacy (≥5 drugs during ≥6 months) using the Anatomical Therapeutic Chemical classification system level 4, by sex and age group, for both calendar years. The most prescribed drugs were proton-pump inhibitors (PPIs), statins, antiplatelet agents, benzodiazepine derivatives, and angiotensin-converting enzyme inhibitors. The greatest increases between 2005 and 2015 were observed in PPIs, statins, other antidepressants, and β-blockers, while the prevalence of antiepileptics was almost tripled. We observed increases in psychotropic drugs in women and cardiovascular medications in men. By patient´s age groups, there were notable increases in antipsychotics, antidepressants, and antiepileptics (15–44 years); antidepressants, PPIs, and selective β-blockers (45–64 years); selective β-blockers, biguanides, PPIs, and statins (65–79 years); and in statins, selective β-blockers, and PPIs (80 years and older). Our results revealed important increases in the use of specific therapeutic subgroups, like PPIs, statins, and psychotropic drugs, highlighting opportunities to design and implement strategies to analyze such prescriptions’ appropriateness.

Author(s):  
Elżbieta Biernat ◽  
Monika Piątkowska

Objective, the aim is an analysis of sociodemographic factors that had an essential relation with undertaking leisure-time physical activity—LTPA (with particular emphasis on World Health Organization (WHO) health recommendations) by adult Poles from a time-trend perspective. Methods, the paper is based on data retrieved from five large-scale surveys carried out on the representative samples of Poles aged 15–69 in 2014–2018 (n = 7347). In each wave, the Polish long version of the International Physical Activity Questionnaire was used. Results, the participation of Poles in LTPA constantly increases (p < 0.001) and the percentage of people meeting the dose of PA required for health recommendations is growing (on average, met by 43.9% of Polish men and 43.5% of women), which indicates a trend of behaviour of citizens of this country. The probability of realisation of WHO norms was determined by sex, age, place of residence and occupational status. Conclusion: it seems reasonable to develop Polish recommendations and guidelines for specific groups, including females and males, those who live in the villages and in the towns, different age groups: children/adolescents, adults (aged 50 to 59—most vulnerable to physical inactivity), the elderly, and various professional groups (especially farmers and physical workers).


Author(s):  
Ignatios Ioakeim-Skoufa ◽  
Beatriz Poblador-Plou ◽  
Jonás Carmona-Pírez ◽  
Jesús Díez-Manglano ◽  
Rokas Navickas ◽  
...  

The correct management of patients with multimorbidity remains one of the main challenges for healthcare systems worldwide. In this study, we analyze the existence of multimorbidity patterns in the general population based on gender and age. We conducted a cross-sectional study of individuals of all ages from the EpiChron Cohort, Spain (1,253,292 subjects), and analyzed the presence of systematic associations among chronic disease diagnoses using exploratory factor analysis. We identified and clinically described a total of 14 different multimorbidity patterns (12 in women and 12 in men), with some relevant differences in the functions of age and gender. The number and complexity of the patterns was shown to increase with age in both genders. We identified associations of circulatory diseases with respiratory disorders, chronic musculoskeletal diseases with depression and anxiety, and a very consistent pattern of conditions whose co-occurrence is known as metabolic syndrome (hypertension, diabetes, obesity, and dyslipidaemia), among others. Our results demonstrate the potential of using real-world data to conduct large-scale epidemiological studies to assess the complex interactions among chronic conditions. This could be useful in designing clinical interventions for patients with multimorbidity, as well as recommendations for healthcare professionals on how to handle these types of patients in clinical practice.


2018 ◽  
Vol 52 (9) ◽  
pp. 868-875 ◽  
Author(s):  
Sonalie Patel ◽  
Mitchell M. Conover ◽  
Golsa Joodi ◽  
Sarah Chen ◽  
Ross J. Simpson ◽  
...  

Background: In Wake County, NC, sudden unexpected death accounts for 10% to 15% of all natural deaths in individuals 18 to 64 years old. Medications such as aspirin, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, statins, and β-blockers are recommended in guidelines to reduce cardiovascular events and even sudden death (β-blockers). However, guidelines are often underpracticed, even in high-risk patients, with noted disparities in women. Objective: We assessed the relation between prescription of evidence-based medications and sudden unexpected death in Wake County, NC. Methods: We analyzed 399 cases of sudden unexpected death for the time period March 1, 2013 to February 28, 2015 in Wake County, NC. Medications were assessed from available medical examiner reports and medical records and grouped using the third level of the Anatomical Therapeutic Chemical Classification System (ATC) codes. This study was reviewed and exempt by the University of North Carolina’s institutional review board. Results: Among 126 female and 273 male victims, women were prescribed more medications overall than men (6.5 vs 4.3, P = 0.001); however, the use of guideline-directed therapies was not different between genders in the chronic conditions associated with sudden death. Overall, there was remarkably low use of evidence-based medications. Conclusions: Our findings highlight the need to improve prescribing of evidence-based medications and to further explore the relationship between undertreatment and sudden unexpected death.


2020 ◽  
Author(s):  
Beatrice Chipwaza ◽  
Robert David Sumaye ◽  
Maja Weisser ◽  
Winfrid Gingo ◽  
Nicholas Kim-Wah Yeo ◽  
...  

AbstractBackgroundDengue and Chikungunya viruses can cause large-scale epidemics with attack rates exceeding 80%. In Tanzania, there have been repeated outbreaks of dengue fever, the most recent one in 2018 and 2019 mostly reported in coastal areas. Despite its importance, there is limited knowledge on epidemiology of dengue (DENV) and chikungunya (CHIKV) in Tanzania. This study was conducted to investigate the prevalence of DENV and CHIKV in Kilombero district, South-Eastern Tanzania.MethodsA cross-sectional study was conducted at Kibaoni Health Center, in Kilombero district, in the rainy and dry seasons of 2018. Febrile patients of any age and gender were enrolled. Blood samples were taken and screened for DENV and CHIKV viral RNA by real-time RT-PCR assays.ResultsA total of 294 patients were recruited. Most were females (65%), and aged between 14⍰25 years (33%). DENV and CHIKV were detected in 29 (9.9%) and 3 (1.0%) patients, respectively. DENV was detected across all age groups and during both dry and rainy seasons. Although all four DENV serotypes were detected, serotypes 1 and 3 dominated and were present in 14 patients (42.4%) each. Additionally, the study showed DENV-1 and DENV-3 co-infections.ConclusionThis study reveals the co-circulation of all four DENV serotypes and CHIKV in Kilombero district. Importantly, we report the first occurrence of DENV-4 in Tanzania. Unlike previous DENV outbreaks caused by DENV-2, the 2018 outbreak was dominated by DENV-1 and DENV-3. Occurrence of all serotypes suggests the possibility of having severe clinical outcomes in future DENV epidemics in Tanzania.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030039
Author(s):  
Md Al Amin Bhuiyan ◽  
Priyanka Agrawal ◽  
Shirin Wadhwaniya ◽  
Qingfeng Li ◽  
O Alonge ◽  
...  

ObjectiveThis study determines the magnitude and pattern of animal-related injury mortalities and morbidities in rural Bangladesh.Design and settingA cross-sectional survey was conducted in 51 Unions of 7 subdistricts of Bangladesh from June 2013 to September 2013.ParticipantsA total of approximately 1.17 million individuals across all age and gender profiles were included in the survey. The participants had to be residents of the seven subdistricts and have provided consent to participate in the study.Primary and secondary outcome measuresAnimal-related injury characteristics and demographic information was collected in the study. Frequency, proportion and 95% CIs of variables such as type of animal, type of animal attack, activity of the person prior to attack and the seasonality of the injury were reported. Data was then statistically analysed for associations between injury and sociodemographic characteristics.ResultsThe incidence rate of fatal and non-fatal animal-related injuries across all ages were 0.7 (95% CI 0.4 to 1.4) and 1635.3 (95% CI 1612.0 to 1658.0) per 100 000 populations, respectively. Non-fatal animal-related injury rates were highest among adults 18 years and older (1820.6 per 100 000 population (1777.2 to 1865.1)), and in males across all age groups. The most common animal injury was wasp/hornet/bee sting (49%), followed by cow/buffalo (25%), dog bite (9%) and snake bites (9%).ConclusionsAnimal-related injuries are an important public health issue in rural Bangladesh. The incidence of animal-related morbidities was found high in the study area. Males, school-going and productive age groups were at high risk. Immediate attention should be given to prevent these events.


Author(s):  
Beatrice Chipwaza ◽  
Robert David Sumaye ◽  
Maja Weisser ◽  
Winfrid Gingo ◽  
Nicholas Kim-Wah Yeo ◽  
...  

Abstract Background Dengue and Chikungunya viruses can cause large-scale epidemics with attack rates up to 80%. In Tanzania, there have been repeated outbreaks of dengue fever, the most recent one in 2018 and 2019, mostly affecting the coastal areas. Despite its importance, there is limited knowledge on epidemiology of dengue (DENV) and chikungunya (CHIKV) in Tanzania. This study was conducted to investigate the prevalence of DENV and CHIKV in Kilombero valley, Tanzania. Methods A cross-sectional study was conducted at Kibaoni Health Center, in Kilombero valley, South-eastern Tanzania in the rainy and dry seasons of 2018. Febrile patients of any age and gender were enrolled from the outpatient department. Blood samples were taken and screened for DENV and CHIKV viral RNA by real-time RT-PCR assays. Results Overall, 294 patients were recruited. Most were females (65%),and one third of patients aged between 14─25 years. DENV and CHIKV were detected in 29(9.9%) and 3(1.0%) patients, respectively. DENV was detected across all age groups during both dry and rainy seasons. Although all four DENV serotypes were detected, serotypes 1 and 3 dominated and were present in 14 patients (42.4%) each. Additionally, the study showed DENV-1 and DENV-3 co-infections. Conclusion This study reveals the co-circulation of all four DENV serotypes and CHIKV in Kilombero. Importantly, we report the first occurrence of DENV-4 in Tanzania. Unlike previous DENV outbreaks caused by DENV-2, the 2018 outbreak was dominated by DENV-1 and DENV-3. Occurrence of all serotypes suggests the possibility of severe clinical outcomes in future DENV epidemics in Tanzania.


2014 ◽  
Vol 83 (10) ◽  
pp. S41-S44
Author(s):  
Zuzana Derflerová Brázdová ◽  
Helena Klimusová ◽  
Lenka Vorlová ◽  
Jindřich Fiala

Milk and dairy products constitute an important source of energy and nutrients for humans. Food preferences may significantly influence the actual consumption (and thus nutrition) of people at the population level. The objective of the present large-scale survey was to specify current preferences for milk and dairy products with regard to age and sex. The study was conducted across the Moravia region, Czech Republic, on a sample of 451 individuals divided into 4 age groups: children, adolescents, young adults, and elderly people. A graphic scale questionnaire was administered, with respondents rating their degree of preference for each food item by drawing a mark on a 35 mm line. Out of the 115 items in the questionnaire, 11 items represented dairy products. Data was analysed by means of a general linear model using IBM SPSS Statistics software. Preference for milk was lower in the elderly group than the other groups (P < 0.01). In children, the most preferred dairy product was cream, which was in contrast with the elderly group. Significant sex differences were only found with low-fat yoghurt (P < 0.01). The overall preference for dairy products (21.6) was lower than the average preference for all foods on the list (22.5). The cross-sectional study revealed intergenerational differences in preferences for specific dairy products, which were most marked in case of cream, processed cheese, blue cheese, and buttermilk. The knowledge of these differences might help promote more focused action at the community level directed at increasing the overall consumption of dairy products in the population.


2019 ◽  
Vol 7 (11) ◽  
pp. 1879-1883
Author(s):  
Amin Alinezhad ◽  
Molouk Haji Babaei ◽  
Kheirollah Gholami ◽  
Seyed Hamid Khoei

BACKGROUND: Drug interaction is a term used to refer to unfavourable side effects caused by mixing or taking two or more drugs simultaneously. Although it is not possible to identify all drug interactions, awareness of therapeutic team of potential drug interactions, risk factors that enhance the possibility of these interactions and familiarity with mechanisms of drug interactions can help reduce real drug interactions. AIM: The present research seeks to study the frequency and intensity of possible interactions among various age groups and their correlation with doctor’s speciality, time of drug prescription, patient’s gender, etc.MATERIAL AND METHOD: This is observational, cross-sectional research conducted in spring and winter to study the prevalence of drug interactions among 6000 recipes belonging to 2 private and 2 public drug stores. The information associated with recipes was recorded, and drug interactions were studied based upon quick index of interactions using Up to Date software. Quick index of medical interactions is a response to data dealing with how drugs interact with one another. The risk factor is divided into groups A, B, C, D, and X according to this index with each one having its own definition. The data analysis was studied in terms of prevalence type of drug interactions and the possible correlation with other parameters. SPSS v.16 was used for statistical analysis. RESULTS: The average age of the patients was 42.07 ± 21.56 years. The frequency of male patients was 41.7%. An average number of 4.82 ± 1.91 drugs were prescribed for each patient and an average number of 1.95 ± 2.40 drugs had interaction with one another with levels C, D, and X having the following drug interaction levels: 1.60 ± 2.05, 0.275 ± 0.69, and 0.072 ± 0.31. No such interactions were observed in 31.1% (1846 cases) of recipes. The presence of drug interaction was statistically significant in terms of age, season, drug store and speciality of doctor (P-value < 0.05). The average number of interactions in the recipes issued by psychologists, cardiologists, rheumatologist, neurologists, and general practitioners was more, and this result was statistically significant (P-value < 0.05). CONCLUSION: Considering the results achieved in this research, we may conclude that the drug interactions in recipes exhibit a noticeable frequency with the highest frequency observed in level C influenced by factors such as age, season, class of drugs, and expertise of the doctor.


2021 ◽  
Author(s):  
Vana Sypsa ◽  
Sotirios Roussos ◽  
Vasiliki Engeli ◽  
Dimitrios Paraskevis ◽  
Sotirios Tsiodras ◽  
...  

Background: Vaccine hesitancy is a major barrier to achieve large-scale COVID-19 vaccination. We report trends in vaccination intention and associated determinants from surveys in the adult general population in Greece. Methods: Four cross-sectional phone surveys were conducted in November 2020, February, April and May 2021 on nationally representative samples of adults in Greece. Multinomial logistic regression was used on the combined data of the surveys to evaluate independent predictors of vaccination unwillingness/uncertainty. Results: Vaccination intention increased from 67.6% in November 2020 to 84.8%. in May 2021. Individuals aged 65 years or older were more willing to get vaccinated (May 2021: 92.9% vs. 79.5% in 18-39 years, p<0.001) but between age-groups differences decreased over time. Vaccination intention increased substantially in both sexes, though earlier among men than women and was higher in individuals with postgraduate studies (May 2021: 91.3% vs. 84.0% up to junior high). From multivariable analysis, unwillingness and/or uncertainty to get vaccinated was associated with younger age, female gender (in particular in the April 2021 survey), lower educational level and living with a child ≤12 years old. Among those with vaccine hesitancy, concerns about vaccine effectiveness declined over time (21.6% in November 2020 vs. 9.6% in May 2021, p=0.014) and were reported more often by men; safety concerns remained stable over time (66.3% in November 2020 vs. 62.1% in May 2021, p=0.658) and were reported more often by women. Conclusions: Vaccination intention increased substantially over time. Tailored communication is needed to address vaccine hesitancy and concerns regarding vaccine safety.


Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1096
Author(s):  
Minji Jeon ◽  
Jehun Kim ◽  
Chi Eun Oh ◽  
Jin-Young Lee

As worldwide large-scale inoculation of novel vaccines is on the way, the importance of real-world data on safety cannot be overemphasized. We aimed to investigate the adverse events following immunization (AEFIs) associated with the ChAdOx1 nCoV-19 vaccine among healthcare workers (HCWs). We investigated the systemic and local adverse events reported within seven days following the first and second doses of vaccination, using the mobile vaccine adverse events reporting system (MVAERS) developed by our hospital. The response rates were 71.8% (994/1384) and 52.9% (727/1375) after the first and second doses, respectively. The most commonly reported AEFIs were tenderness and pain at the injection site and fatigue after the first and second doses. In comparison to the first dose, the incidence and severity of AEFIs were lower following the second dose. Since the Korean government does not recommend the ChAdOx1 nCoV-19 vaccination for those under 30 years of age, with greater risk than benefit, we additionally compared the AEFIs of age groups under and above 30 years of age. The overall incidence of AEFIs was similar in both the under and over 30 age groups. In conclusion, AEFIs associated with the ChAdOx1 nCoV-19 vaccine were found to be tolerable, and AEFIs associated with the second dose were less common and severe compared to the first dose. Further safety surveillance studies on COVID-19 vaccines are required to validate our findings.


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