METHODS: This cross-sectional study was conducted at the University of Jordan Hospital in Amman, Jordan. During the study period, a convenience sample of patients admitted to the internal medicine and surgical wards were approached to take part in this study. Following patients' recruitments, patients were interviewed and their medical files were reviewed to obtain demographic and clinical information regarding their medical conditions and their regular use of medicines. Then, the prevelence of patients with polypharmacy were identified, and factors predicting polypharmacy among them were determined.
RESULTS: Among the 300 participants who agreed to participate in this study, females represented 45.3% of the recruited sample (n = 139), and around 48.0% (n = 144) of the study sample were elderly people (≥65 years old). Most of the recruited patients (n = 248, 82.7%) were found to use polypharmacy (≥ 5 medications). Hypertension was the most frequent medical condition among study participants (n = 240, 80.0%) followed by diabetes (n = 185, 61.7%). Results of logistic regression analysis showed that polypharmacy was only significantly affected by patients' age (OR = 2.149, P-value = .024) and monthly income (OR = 0.336, P-value = .009), while other factors were not associated with polypharmacy. Elderly patients (≥65 years) were found to have polypharmacy more significantly than non-elderly patients. Also, those with lower monthly income (<500 JD) were found to use lower polypharmacy compared with those with higher monthly income (>500 JD).
CONCLUSION: The present study showed that polypharmacy is prevalent among patients in Jordan. While polypharmacy was not affected by smoking status, gender, BMI and educational level, it was significantly affected by monthly income and age. Further plans should be put in place to reduce polypharmacy, starting with effective pharmaceutical care services leading to treatment optimisation and ensuring desired treatment outcomes.
METHODS USED TO CONDUCT THE REVIEW: This review was conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) recommendation. Electronic databases including MEDLINE, CINAHL, PubMed, Embase, Cochrane Databases and Cochrane Central Register of Controlled Trials were searched up to March 2017 for relevant trials. The methodological quality of included trials was assessed by using a modified version of the Newcastle-Ottawa Quality Assessment Scale for Case-Control and Cohort Studies. A meta-analysis was conducted using the random-effect model to combine the rate of mortality and length of stay outcomes.
FINDINGS OF THE REVIEW: Nine observational trials involving 2128 patients were considered eligible for inclusion. Although based on low quality evidence, there was a statistically significant difference in favour of the impact of de-escalation on hospital stay but not mortality (MD -5.96 days; 95% CI -8.39 to -3.52).
INTERPRETATIONS AND IMPLICATIONS OF THE FINDINGS: This review highlights the need for more rigorous studies to be carried out before a firm conclusion on the benefit of de-escalation therapy is supported.
METHODS: The medical records for NHL patients who had undergone HDT followed by AHSCT from October 1997 to November 2016 from two hospitals in Klang Valley, Malaysia were obtained from the medical record database and analysed retrospectively through statistical analysis.
RESULTS: A total of 148 patients were retrospectively identified post-AHSCT, where the majority of whom had B cell lymphoma (53.4%). Majority of patients (88.5%) were in complete remission before AHSCT. The overall survival (OS) and event-free survival (EFS) at 3 years were 68.9% and 60.8%, respectively. The major cause of death was disease progression at 73.9%, while transplant-related mortality was 15.2%, with a median follow-up period of 179.5 weeks.
CONCLUSION: Our study illustrates the promising outcomes of HDT with AHSCT in NHL patients in a resource-limited country. We recommend larger studies to be conducted in the future with a longer duration of follow-up to validate our findings.
METHODS: This cross-sectional study included data from 344 older (173 inpatients and 171 outpatients) patients, aged 60 years and above, through validated questionnaires. Medication appropriateness was assessed via Medication Appropriateness Index (MAI) tool, whereas Beers and Screening Tool of Older Person's Potentially Inappropriate Prescribing (STOPP) criteria were used to evaluate PIMs and potentially inappropriate prescribing (PIP), respectively. The Drug Burden Index (DBI) and polypharmacy, as well as PROs, included Groningen Frailty Indicator (GFI), Katz Index of Independence in Activities of Daily Living (Katz ADL) and Older People's Quality of Life (OPQOL) were also evaluated.
RESULTS: Overall, inpatients received significantly higher medications (6.90 ± 2.70 vs 4.49 ± 3.20) than outpatients. A significantly higher proportion of inpatients received at least one PIM (65% vs 57%) or PIP (57.4% vs 17.0%) and higher mean MAI score (1.76 ± 1.08 and 1.10 ± 0.34) and DBI score (2.67 ± 1.28 vs 1.49 ± 1.17) than outpatients. Inpatients had significantly higher total OPQOL (118.53 vs 79.95) and GFI score (5.44 vs 3.78) than outpatients. We only found significant correlations between GFI and DBI and total OPQOL and the number of PIMs.
CONCLUSIONS: Proportions of PIMs and DBI exposure were significantly higher in an inpatient setting. No significant correlations between exposures to inappropriate medications or drug burden and PROs were observed.
MATERIALS AND METHODS: A total of 134 postgraduate trainees from the departments of general surgery (Surgical), orthopaedic surgery (Ortho), otorhinolaryngology (ENT), obstetrics and gynaecology (OBGYN), as well as anaesthesiology and intensive care (Anaesth) were recruited. A validated questionnaire was used to assess awareness and knowledge. All participants attended a medical-education session and completed the questionnaire as preassessment and postassessment. Data were analysed, and comparisons between disciplines were conducted.
RESULTS: The trainees' awareness of LAST was overall poor at preassessment which improved almost 6-folds at postassessment. Surprisingly, only 20 (45.5%) participants from the anaesthesiology group had awareness of LAST at preassessment, and none of the participants were from surgical, orthopaedic, and obstetrics and gynaecology departments. Preassessment scores were significantly higher in the anaesth group as compared to all other groups; with a difference in the average score for Anaesth vs Surgical of 3.46 (95%, CI:2.17, 4.74), Anaesth vs Ortho of 3.64 (95%, CI:2.64, 4.64), Anaesth vs ENT of 3.43 (95%, CI:2.20, 4.67), and Anaesth vs OBGYN of 6.93 (95%, CI:5.64, 8.21). However, there was no significant difference of awareness scores between all participants at postassessment scores.
CONCLUSION: The overall level of awareness was poor. However, the implementation of an education session significantly improved the knowledge and awareness across all disciplines.
MATERIALS AND METHODS: A prospective online questionnaire based survey was carried out among the pharmacy students about knowledge, attitude perception and practice of antibiotics using 5-point "Likert scale" and true/false responses. The responses range from strongly agree to strongly disagree, and always to never were recorded. The data were analysed by using simple descriptive statistics.
RESULTS: Out of 300 students approached 212 responded and the response rate was found to be 71%. In this study, most (95%) of the students were aware of the emerging problem of antibiotic resistance due to inappropriate use of antibiotics. Majority (89%) of the students agreed the inappropriate use of antibiotics can increase the overall cost of treatment. However, over half of the (54%) students were not aware of the antibiotic resistance that may be a nation-wide problem of Kingdom of Saudi Arabia. The net positive response (NPR) and net other response (NOR) of all items in perception on antibiotics received more or less equal responses.
CONCLUSION: The knowledge of antibiotics usage among the students are considerably good compared with previous studies. However, the attitude, perception and practice on antibiotics usage among the pharmacy students are very poor. It alarms the need of appropriate education to enlighten antibiotic awareness for the better disease prevention and health outcomes for the benefit of patient community.
MATERIALS AND METHODS: A prospective cross-sectional study was carried out to evaluate the prescribing, and dispensing errors in outpatients who seek patient counseling at the tertiary care multispecialty hospital. The data were collected from various sources such as patient's prescriptions and dispensing records from the pharmacy.
RESULTS: A total of 500 prescriptions were screened and identified 65.60% of prescriptions with at least any one type of medication errors. Out of 328 prescriptions, 96.04% were handwritten and 3.96% were computerised prescriptions. Among the 328 prescriptions with medication errors, 32.62% noticed prescribing errors, 37.80% with dispensing errors, and 29.58% with both prescribing and dispensing errors. Out of these 328 prescriptions, 74.09% prescriptions were found to have polypharmacy.
DISCUSSION: Medication errors are serious problems in healthcare and can be a source of significant morbidity and mortality in healthcare settings. The present study showed that dispensing errors were the most common among the types of medication errors, in these particularly wrong directions were the most common types of errors.
CONCLUSION: This study concludes that the overall prevalence of medication errors was around 80%, but there were no life-threatening events observed. A clinical pharmacist can play a major role in this situation appears to be a strong intervention and early detection and prevention of medication errors and thus can improve the quality of care to the patients.