Aim Potentially inappropriate medications (PIMs) in older people are associated with the increased use of health care services. The aim of this study was to investigate the prevalence of PIMs among the elderly being referred to pharmacies in Tehran using the Beers criteria of 2012, and identify factors related to PIMs. Methods This cross-sectional study was conducted on elderly patients (60 years and above) referred to pharmacies in Tehran, in 2017. The Beers' criteria 2012 were used to evaluate PIMs. The logistic regression analysis was used to find sociodemographic predictors of PIMs. Results The mean age of 1591 patients was 70.51 years. The overall prevalence of PIMs was 26.0%. The most frequent PIMs, in order of frequency, included diclofenac (13.5%), alprazolam (9.3%), and chlordiazepoxide (9.1%) and clonazepam (8.4%). The pain medications were found to be most common PIMs (37.6%). Polypharmacy (OR=3.64, CI 95%: .81-4.70; p<0.001), number of chronic disease (OR=2.371, CI 95%:1.71-3.28; p<0.001) insomnia (OR=1.45, CI 95%: 1.13-1.87; p<0.01) and type of specialists were found as PIMs risk factors. Internal medicine specialists prescribed PIMs significantly fewer times than other specialists(OR=0.59, CI 95%: 0.40-0.88; p<0.01, and the orthopedic specialists prescribed PIMs significantly more times than other physicians (OR=3.23, CI 95%: 5.76-1.81; p<0.001). Conclusion High prevalence of PIMs among Iranian elderly patients implies a need for the development and operationalization of scientific guidelines for the use of medicines. It is also necessary to hold training courses for physicians to be educated in such cases.
Aim To assess prescription pattern among Iranian communitydwelling older adults. Methods This cross-sectional study employed a cluster random sampling to obtain a sample of 1591 patients aged 60 years and over referred to pharmacies in Tehran, 2017. Data were collected using a questionnaire: socio-demographic characteristics, type of pharmacy visited, the municipal district, the university covering the pharmacy, the number and names of prescribed drugs, drug category, type of insurances and physician's socio-demographic profile (age, gender, type of specialization, and work experience). Results The mean age of the patients was 70.51±7.84. A total of 5838 drugs were prescribed, giving an average of 3.73±2.24 drugs per patient (ranging of 1-15). Polypharmacy was noticed in 32.4% patients. Cardiovascular drugs accounted for 20.8% of the prescriptions, antidiabetics 8.8%, nutritional agents and vitamins 7.6%, and analgesics, anti-inflammatory drugs and antipyretics accounted for 7.5%. Conclusion Developing educational programs on geriatric pharmacology general practitioners and more supervision among community-dwelling older adults might have effects on prescription pattern. There is a need for prescriber training and retraining with emphasis on the geriatric population.
Aim Ethical values are the basis of the behaviour and performance of professional care staff. This study aimed to identify inter-professional ethical values in aged care. Methods This qualitative thematic content analysis study was conducted in Khorramabad, Iran, from September 2018 to June 2109, and 36 core members of the aged care team (including 24 nurses, 5 physicians, 3 physiotherapists, and 4 social workers) were selected through the purposive sampling method and interviewed in depth. The data were analysed using the directed content analysis and the method of Zhang and Wildemuth. Results Four main themes of providing professional care, preserving the integrity of the aged, observing the dignity of the aged, establishing human relationship, along with 21 subthemes were extracted as ethical values in aged care. Conclusion The results of this study indicate that providing ethical aged care is influenced by the specific conditions of this age group. In addition to general ethical values such as providing professional care, providing ethical aged care is based on ethical values such as promoting social interaction, promoting peace and comfort, preserving and promoting independence, and autonomy in aged care. Promoting collaborative care and paying more attention to the human dimensions of communication and interaction were other emphasized values.
Aim To assess the cochlear damage caused by cisplatin in the rat cochlea based on decreased signal to noise ratio (SNR) values on otoacoustic emission (OAE) examination and increased expression of signal transducer and activator of transcription 1 (STAT 1) and vascular endothelial growth factor (VEGF) on immunohistochemical examination. Methods Twenty-four Rattus norvegicus were divided into 4 groups and injected with 8 mg/kgBW of cisplatin intraperitoneally except for control group. The SNR on OAE examination were checked before the treatment and on day 3, 4, and 7 after the treatment. The cochleas were stained immunohistochemically, followed by assessment of the cochlear organ of Corti damage based on STAT 1 and VEGF expression. Results A decrease in the mean of SNR value was found in accordance with the length of cisplatin exposure. The STAT 1 and VEGF expression increased with duration of cisplatin exposure. A correlation was found between SNR values, STAT 1, and also VEGF expression (p<0.05). Conclusion An increase of STAT 1 and VEGF expression influences cochlear damage due to cisplatin administration. There was a correlation between STAT 1 and VEGF expression with SNR values in the cochlear organ of Corti of Rattus norvegicus exposed to cisplatin.