METHODS: Six CADDs (three containing dobutamine 10 mg/mL in 0.9% sodium chloride and three containing dobutamine 10 mg/mL in 5% glucose) were prepared and stored at 4°C for 7 days, followed by 12 hours at 35°C and then for another 12 hours at 25°C. An aliquot (n = 3) was withdrawn aseptically at 0, 24, 48, 72, 96, 120, 144 and 168 hours when stored at 4°C, and at 0, 6 and 12 hours when stored at the other two temperatures. Each sample was analysed for dobutamine concentration using a stability-indicating high-performance liquid chromatography. All the samples were also evaluated for change in pH, colour and for particle content.
RESULTS AND DISCUSSION: No evidence of particle formation, colour or pH change was observed throughout the study period. Dobutamine, when admixed with 0.9% sodium chloride or 5% glucose, was found to be chemically stable for at least 168 hours at 4°C and for another 12 hours at 35°C and for another 12 hours at 25°C.
WHAT IS NEW AND CONCLUSIONS: Our findings will allow health professionals to provide a weekly supply of dobutamine-containing CADDs to patients for home infusions. Continuous infusion over a 24-hour period using one CADD per day will also decrease the number of exchanges required and thus reduce the risk of catheter-related bloodstream infections.
METHOD: A review and comparison of mobile apps available in Google's Play Store (Android system) and Apple's App Store (iOS system) were performed. The comparison was based on the availability of options, especially DoReADI functionalities. The assessment criteria were as follows: requirement for an Internet connection, subscription fee charged, size of app, dose recommendation, drug indication, dose calculator, drug picture, dose adjustment, pregnancy safety, interaction checker, interaction classification, clinical teaching advice, contraindicated drug, black box warning, adverse effect, contraindication or precaution, as well as toxicology and pharmacology information.
RESULTS: Eight mobile medical apps were included and used to compare their features and functionalities. The 4 apps that scored the highest (14/17 points) are: Lexicomp®, Epocrates®, Micromedex®, and Drugs.com ®. Lexicomp and Micromedex do not provide the image of the drug and have an access subscription fee. Epocrates does not provide interaction classification and clinical teaching advice, and occupies a large space in the memory to be installed. Meanwhile, My Blue Book® scored the lowest (9/17 points) because certain features such as toxicology information, drug interaction, clinical teaching advice, contraindicated drug, and black box warning were not included.
CONCLUSION: Based on the features assessment criteria of each mobile medical application, Lexicomp, Epocrates, Micromedex, and Drugs.com are the apps that scored the highest. Epocrates and Micromedex are useful for checking drug interactions. In addition, some of the apps have additional features for the DoReADI criteria, for example, dose calculator and interaction classification.
CONCLUSION: To investigate neurological manifestations of COVID-19, it is essential to employ valid and reliable diagnostic criteria and standard definitions of the factors of interest. Although population-based studies are lacking, well-defined inception cohorts, including hospitalized individuals, outpatients, and community residents, can serve as valuable compromises. These cohorts should be evaluated for the presence of common comorbidities, alongside documenting the primary non-neurological manifestations of the infectious disease. Lastly, patients with COVID-19 should be followed beyond the acute phase to assess the persistence, duration, and severity of neurological symptoms, signs, or diseases.
OBJECTIVES: To review the literature on trials conducted among older adults residing in care homes within the UK and collate evidence on their methodological characteristics and outcomes.
METHODS: A systematic rapid review methodology was employed. MEDLINE, EMBASE and CENTRAL were searched in two incremental stages: stage 1 searched for oral health-related trials conducted within the UK care homes up to July 2021, whereas stage 2 sought for general health-related trials in the same setting from 2011 to 2021. The quality of included studies was assessed using Cochrane's RoB 2 and ROBINS-I tools. Findings were summarised descriptively.
RESULTS: Five oral health and 33 general health-related trials involving care home residents were included for analysis. The most common trial design was parallel group with two arms (n = 25) involving individual randomisation (n = 21). Consent was mainly obtained from residents and/or their proxies (n = 24), followed by residents only (n = 13) and care homes only (n = 1). Based on available data, the number needed to screen to recruit one participant ranged from 2 to 40 (median: 3; Q1-Q3: 2-9). Attrition rates ranged from 0% to 73% (median: 21%; Q1-Q3: 13%-32%) for follow-up periods between 1 and 52 weeks. The studies were of mixed methodological quality.
CONCLUSION: This rapid review outlines the methodological characteristics and outcomes of trials conducted among older adults in UK care homes. The findings of this review provide valuable information to assist in navigating and designing future research in this complex setting.