Pub Date : 2022-07-21eCollection Date: 2022-01-01DOI: 10.2147/DHPS.S347522
Pungki Afifah Asyraf, Ivanna Fauziyah Kusnadi, Jonathan Stefanus, Miski Aghnia Khairinisa, Rizky Abdulah
Drug hypersensitivity is an inflammatory or immune reaction induced by drugs. It can be fatal if not appropriately treated and cause the risk of long-term complications. Sulfonamides are classified as antimicrobial drugs with a broad spectrum effective for gram-positive and gram-negative bacteria. This antibacterial agent works by competitively inhibiting folic acid synthesis, which prevents the growth and proliferation of microorganisms. In its use as antibiotics, sulfonamides can also cause adverse reactions in specific individuals. It has been widely reported that sulfonamide antimicrobials cause hypersensitivity reactions mediated by IgE or T cells. This review identifies symptoms or signs that can appear, as well as genes associated with sulfonamide hypersensitivity reactions, as sulfonamide may cause hypersensitivity in the form of uveitis, skin rash, Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), parotitis, angioedema, drug reaction with eosinophilia and systemic symptoms (DRESS), and pruritus. In addition, several genes were found to be associated with sulfonamide hypersensitivity, including HLA-A29, HLA-B12, HLA-DR7, HLA-B44, and HLA A*11:01.
{"title":"Clinical Manifestations and Genetic Influences in Sulfonamide-Induced Hypersensitivity.","authors":"Pungki Afifah Asyraf, Ivanna Fauziyah Kusnadi, Jonathan Stefanus, Miski Aghnia Khairinisa, Rizky Abdulah","doi":"10.2147/DHPS.S347522","DOIUrl":"https://doi.org/10.2147/DHPS.S347522","url":null,"abstract":"<p><p>Drug hypersensitivity is an inflammatory or immune reaction induced by drugs. It can be fatal if not appropriately treated and cause the risk of long-term complications. Sulfonamides are classified as antimicrobial drugs with a broad spectrum effective for gram-positive and gram-negative bacteria. This antibacterial agent works by competitively inhibiting folic acid synthesis, which prevents the growth and proliferation of microorganisms. In its use as antibiotics, sulfonamides can also cause adverse reactions in specific individuals. It has been widely reported that sulfonamide antimicrobials cause hypersensitivity reactions mediated by IgE or T cells. This review identifies symptoms or signs that can appear, as well as genes associated with sulfonamide hypersensitivity reactions, as sulfonamide may cause hypersensitivity in the form of uveitis, skin rash, Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), parotitis, angioedema, drug reaction with eosinophilia and systemic symptoms (DRESS), and pruritus. In addition, several genes were found to be associated with sulfonamide hypersensitivity, including HLA-A29, HLA-B12, HLA-DR7, HLA-B44, and HLA A*11:01.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":" ","pages":"113-124"},"PeriodicalIF":1.6,"publicationDate":"2022-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/7e/dhps-14-113.PMC9315057.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40556107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-14eCollection Date: 2022-01-01DOI: 10.2147/DHPS.S338579
Gates Colbert, Shilpa Sannapaneni, Edgar V Lerma
Hyperkalemia remains one of the most difficult consequences of disease state and treatment for patients with chronic kidney disease, heart failure, and diabetes. Controlling hyperkalemia can be difficult, but has become easier with the introduction of novel oral potassium binders. Patiromer was approved in 2015 for the treatment of hyperkalemia by the FDA in the United States. Several pivotal trials proved its efficacy, safety, and improved tolerability compared with previous hyperkalemia treatments. Additionally, many real-world publications and trials have given deeper insights into the capabilities of patiromer. We discuss improved disease state outcomes with combining patiromer with RAASi. This paper will also highlight new trials forthcoming that are highly anticipated to expand the possibilities in using patiromer to improve outcomes and populations.
{"title":"Clinical Efficacy, Safety, Tolerability, and Real-World Data of Patiromer for the Treatment of Hyperkalemia.","authors":"Gates Colbert, Shilpa Sannapaneni, Edgar V Lerma","doi":"10.2147/DHPS.S338579","DOIUrl":"https://doi.org/10.2147/DHPS.S338579","url":null,"abstract":"<p><p>Hyperkalemia remains one of the most difficult consequences of disease state and treatment for patients with chronic kidney disease, heart failure, and diabetes. Controlling hyperkalemia can be difficult, but has become easier with the introduction of novel oral potassium binders. Patiromer was approved in 2015 for the treatment of hyperkalemia by the FDA in the United States. Several pivotal trials proved its efficacy, safety, and improved tolerability compared with previous hyperkalemia treatments. Additionally, many real-world publications and trials have given deeper insights into the capabilities of patiromer. We discuss improved disease state outcomes with combining patiromer with RAASi. This paper will also highlight new trials forthcoming that are highly anticipated to expand the possibilities in using patiromer to improve outcomes and populations.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":" ","pages":"87-96"},"PeriodicalIF":1.6,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/9c/dhps-14-87.PMC9292454.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40541101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To compare the prevalence of self-medication among first- and fifth-year medical students at Kabul University of Medical Sciences. Methods A cross-sectional study was conducted with the participation of all first- and fifth-year medical students by using a short, self-administered questionnaire. The prevalence of self-medication was estimated in the entire study population and also in those who had used medicines in the preceding one week. Results Of the total 302 students, the prevalence of medicine use was 38%. The prevalence of self-medication in all study population was 25.16%, whereas in those who had used medicines was 64.9%. Prescription-only medicines consisted of 59.2% of self-medication. The practice of self-medication and the use of prescription-only medicines were more prevalent among students in their fifth year and among males. While the prevalence of medicine use was the same among males and females, it differed between students in the fifth and first year. Paracetamol, anti-infectives, and non-steroidal anti-inflammatory drugs (NSAIDs) were more frequently used medicines. Conclusion The use of medicines, self-medication and the use of prescription-only medicines were more prevalent among fifth-year students compared to those in the first-year. This apparently reflects the effect of medical education and training. More specific studies are required to address the issue in more detail and to facilitate interventions. The estimation of the prevalence of self-medication by using a short acceptable recall period, confined in those who had used medicines, seems to be more reasonable and accurate than by using a longer recall period in the entire study population. The prevalence of prescription-only medicines in self-medication could also be a useful indicator.
{"title":"Influence of Medical Education on Medicine Use and Self-Medication Among Medical Students: A Cross-Sectional Study from Kabul","authors":"A. Daanish, Ershad Ahmad Mushkani","doi":"10.2147/DHPS.S360072","DOIUrl":"https://doi.org/10.2147/DHPS.S360072","url":null,"abstract":"Objective To compare the prevalence of self-medication among first- and fifth-year medical students at Kabul University of Medical Sciences. Methods A cross-sectional study was conducted with the participation of all first- and fifth-year medical students by using a short, self-administered questionnaire. The prevalence of self-medication was estimated in the entire study population and also in those who had used medicines in the preceding one week. Results Of the total 302 students, the prevalence of medicine use was 38%. The prevalence of self-medication in all study population was 25.16%, whereas in those who had used medicines was 64.9%. Prescription-only medicines consisted of 59.2% of self-medication. The practice of self-medication and the use of prescription-only medicines were more prevalent among students in their fifth year and among males. While the prevalence of medicine use was the same among males and females, it differed between students in the fifth and first year. Paracetamol, anti-infectives, and non-steroidal anti-inflammatory drugs (NSAIDs) were more frequently used medicines. Conclusion The use of medicines, self-medication and the use of prescription-only medicines were more prevalent among fifth-year students compared to those in the first-year. This apparently reflects the effect of medical education and training. More specific studies are required to address the issue in more detail and to facilitate interventions. The estimation of the prevalence of self-medication by using a short acceptable recall period, confined in those who had used medicines, seems to be more reasonable and accurate than by using a longer recall period in the entire study population. The prevalence of prescription-only medicines in self-medication could also be a useful indicator.","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"14 1","pages":"79 - 85"},"PeriodicalIF":1.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44451614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Methotrexate (MTX) has been widely used with a wide range of doses in the treatment of certain neoplastic diseases, severe psoriasis, and rheumatoid arthritis. At higher dose, monitoring of serum MTX elimination is performed because delayed elimination can result in serious and potentially life-threatening toxicities. A number of medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), salicylates, phenylbutazone, phenytoin, sulfonamides, and some oral antibiotics, are known to interact with MTX therapy through various mechanisms. Accumulating evidence suggests that concomitant use of MTX (primarily at high doses) and proton pump inhibitors (PPIs) such as omeprazole, esomeprazole, and pantoprazole may decrease MTX clearance. The majority of the reported cases occurred with the administration of high-dose MTX in patients receiving doses of 300 mg/m2 to 12 g/m2. However, there were also cases of patients taking PPI and experiencing toxicity at doses as low as 10 mg of MTX per week. Although the dosage of MTX is small, the presence of side effect may be delayed and still dangerous. After literature review, it was found that common toxicities associated with low-dose MTX used for inflammatory arthritis include gastrointestinal adverse effects (>10%; ie nausea, stomatitis) and central nervous system toxicity (~20%; ie fatigue, malaise, dizziness, impaired cognition) with weekly administration. Bone marrow suppression (<3%; ie leukopenia, neutropenia, thrombocytopenia) and hepatotoxicity (~15%; ie reversible elevations in transaminases) are less common, and rarely MTX can also cause pulmonary (<1%) and other toxicities. Here, we report two cases who presented with severe pancytopenia 8 and 13 days after taking low-dose MTX and PPI. We highlight that in absence of risk/benefit ratio correctly set, an assessment of appropriateness of PPI prescription before MTX therapy can limit an iatrogenic risk.
{"title":"Pancytopenia Due to Possible Drug–Drug Interactions Between Low-Dose Methotrexate and Proton Pump Inhibitors","authors":"D. Tao, Hui Wang, Fangfang Xia, Wenlu Ma","doi":"10.2147/DHPS.S350194","DOIUrl":"https://doi.org/10.2147/DHPS.S350194","url":null,"abstract":"Abstract Methotrexate (MTX) has been widely used with a wide range of doses in the treatment of certain neoplastic diseases, severe psoriasis, and rheumatoid arthritis. At higher dose, monitoring of serum MTX elimination is performed because delayed elimination can result in serious and potentially life-threatening toxicities. A number of medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), salicylates, phenylbutazone, phenytoin, sulfonamides, and some oral antibiotics, are known to interact with MTX therapy through various mechanisms. Accumulating evidence suggests that concomitant use of MTX (primarily at high doses) and proton pump inhibitors (PPIs) such as omeprazole, esomeprazole, and pantoprazole may decrease MTX clearance. The majority of the reported cases occurred with the administration of high-dose MTX in patients receiving doses of 300 mg/m2 to 12 g/m2. However, there were also cases of patients taking PPI and experiencing toxicity at doses as low as 10 mg of MTX per week. Although the dosage of MTX is small, the presence of side effect may be delayed and still dangerous. After literature review, it was found that common toxicities associated with low-dose MTX used for inflammatory arthritis include gastrointestinal adverse effects (>10%; ie nausea, stomatitis) and central nervous system toxicity (~20%; ie fatigue, malaise, dizziness, impaired cognition) with weekly administration. Bone marrow suppression (<3%; ie leukopenia, neutropenia, thrombocytopenia) and hepatotoxicity (~15%; ie reversible elevations in transaminases) are less common, and rarely MTX can also cause pulmonary (<1%) and other toxicities. Here, we report two cases who presented with severe pancytopenia 8 and 13 days after taking low-dose MTX and PPI. We highlight that in absence of risk/benefit ratio correctly set, an assessment of appropriateness of PPI prescription before MTX therapy can limit an iatrogenic risk.","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"14 1","pages":"75 - 78"},"PeriodicalIF":1.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48918498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Glans, P. Midlöv, Annika Kragh Ekstam, Å. Bondesson, A. Brorsson
Purpose This qualitative study aimed to investigate experiences and perceptions of hospital physicians regarding the discharging process, focusing on information transfer regarding medications. Methods By purposive sampling three focus groups were formed. To facilitate discussions and maintain consistency, a semi-structured interview guide was used. Discussions were audio recorded and transcribed verbatim. Qualitative content analysis was used to analyze the anonymized data. A confirmatory analysis concluded that the main findings were supported by data. Results Identified obstacles were divided into three categories with two sub-categories each: Infrastructure; IT-systems currently used are suboptimal and complex. Hospital and primary care use different electronic medical records, complicating matters. The work organization is not helping with time scarcity and lack of continuity. Distinct routines could help create continuity but are not always in place, known, and/or followed. Physician: knowledge and education in the systems is not always provided nor prioritized. Understanding the consequences of not following routines and taking responsibility regarding the medications list is important. Not everyone has the self-reliance or willingness to do so. Patient/next of kin: For patients to provide information on medications used is not always easy when hospitalized. Understanding information provided can be hard, especially when medical jargon is used and there is no one available to provide support. A central theme, “We're only human”, encompasses how physicians do their best despite difficult conditions. Conclusion There are several obstacles in transferring information regarding medications at discharge. Issues regarding infrastructure are seldom possible for the individual physician to influence. However, several issues raised by the participating physicians are possible to act upon. In doing so medication errors in care transitions might decrease and information transfer at discharge might improve.
{"title":"Obstacles and Opportunities in Information Transfer Regarding Medications at Discharge – A Focus Group Study with Hospital Physicians","authors":"Maria Glans, P. Midlöv, Annika Kragh Ekstam, Å. Bondesson, A. Brorsson","doi":"10.2147/DHPS.S362189","DOIUrl":"https://doi.org/10.2147/DHPS.S362189","url":null,"abstract":"Purpose This qualitative study aimed to investigate experiences and perceptions of hospital physicians regarding the discharging process, focusing on information transfer regarding medications. Methods By purposive sampling three focus groups were formed. To facilitate discussions and maintain consistency, a semi-structured interview guide was used. Discussions were audio recorded and transcribed verbatim. Qualitative content analysis was used to analyze the anonymized data. A confirmatory analysis concluded that the main findings were supported by data. Results Identified obstacles were divided into three categories with two sub-categories each: Infrastructure; IT-systems currently used are suboptimal and complex. Hospital and primary care use different electronic medical records, complicating matters. The work organization is not helping with time scarcity and lack of continuity. Distinct routines could help create continuity but are not always in place, known, and/or followed. Physician: knowledge and education in the systems is not always provided nor prioritized. Understanding the consequences of not following routines and taking responsibility regarding the medications list is important. Not everyone has the self-reliance or willingness to do so. Patient/next of kin: For patients to provide information on medications used is not always easy when hospitalized. Understanding information provided can be hard, especially when medical jargon is used and there is no one available to provide support. A central theme, “We're only human”, encompasses how physicians do their best despite difficult conditions. Conclusion There are several obstacles in transferring information regarding medications at discharge. Issues regarding infrastructure are seldom possible for the individual physician to influence. However, several issues raised by the participating physicians are possible to act upon. In doing so medication errors in care transitions might decrease and information transfer at discharge might improve.","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"14 1","pages":"61 - 73"},"PeriodicalIF":1.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44617358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Medical error is defined as “an act of omission or commission in planning or execution that contributes or could contribute to an unintended result”. It is a serious public health problem that can pose a threat to patient safety and if managed it can be an opportunity to an organizational learning. This study aimed to assess the challenges of error reporting. Methods Explorative qualitative cross-sectional study was conducted. The study was conducted among healthcare providers in Mizan-Tepi University Teaching Hospital. The study participants were selected purposely based on the patient contact hour and had served in this hospital for long period of time. Twenty-one in-depth interviews were undertaken. From each wards, three in-depth interviews were held. Case team leaders and other healthcare providers were identified and interviewed. The data were analyzed thematically. Results Twenty-one healthcare providers were recruited for this study. Majority of the participants, 12 (57.1%) were nurses and midwives and as to marital status, 18 (85.7%) were married. Challenges for reporting medical errors were identified as perceived lack of confidentiality of the medical errors, perceived punitive measures, lack of good reporting system, perceived fear of losing acceptance, lack of learning culture from errors, information asymmetry, mass-media publication of medical errors, avoidance of conflict and attitude of health professionals. Conclusion There were system and individual related challenges for reporting of medical errors. Healthcare managers should enhance medical error reporting for organizational learning by addressing these system and individual factors.
{"title":"Challenges of Medical Error Reporting in Mizan-Tepi University Teaching Hospital: A Qualitative Exploratory Study","authors":"Msganaw Derese, Wubetu Agegnehu","doi":"10.2147/DHPS.S347738","DOIUrl":"https://doi.org/10.2147/DHPS.S347738","url":null,"abstract":"Background Medical error is defined as “an act of omission or commission in planning or execution that contributes or could contribute to an unintended result”. It is a serious public health problem that can pose a threat to patient safety and if managed it can be an opportunity to an organizational learning. This study aimed to assess the challenges of error reporting. Methods Explorative qualitative cross-sectional study was conducted. The study was conducted among healthcare providers in Mizan-Tepi University Teaching Hospital. The study participants were selected purposely based on the patient contact hour and had served in this hospital for long period of time. Twenty-one in-depth interviews were undertaken. From each wards, three in-depth interviews were held. Case team leaders and other healthcare providers were identified and interviewed. The data were analyzed thematically. Results Twenty-one healthcare providers were recruited for this study. Majority of the participants, 12 (57.1%) were nurses and midwives and as to marital status, 18 (85.7%) were married. Challenges for reporting medical errors were identified as perceived lack of confidentiality of the medical errors, perceived punitive measures, lack of good reporting system, perceived fear of losing acceptance, lack of learning culture from errors, information asymmetry, mass-media publication of medical errors, avoidance of conflict and attitude of health professionals. Conclusion There were system and individual related challenges for reporting of medical errors. Healthcare managers should enhance medical error reporting for organizational learning by addressing these system and individual factors.","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"14 1","pages":"51 - 59"},"PeriodicalIF":1.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45440263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The use of herbal medicine is increasing globally, particularly in developing countries including Ethiopia, yet little is known regarding its effect and safety during pregnancy. Pregnant women prefer herbal medicine due to easy accessibility, traditional and cultural beliefs, and comparatively low cost. This study aimed to assess women’s knowledge and attitude towards the effects of herbal medicine usage during pregnancy and associated factors among women who gave birth in the last twelve months in Dega Damot district. Methods A community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 women were selected using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance. Results Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was 49.1% (95% CI: 46–52) and 57.3% (95% CI: 54–61), respectively. Access to media, had antenatal care visit, being urban dweller, history of herbal medicine usage, and a short distance to reach the nearby health facility were significantly associated with women’s knowledge about effects of herbal medicine usage. Besides, being primiparous and short traveling time to reach the nearby health facility was significantly associated with women’s attitude towards the effects of herbal medicine usage during pregnancy. Conclusion Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was low. It is important to design strategies to improve the accessibilities of maternal health services, and expand access to media will have a great role in improving women’s knowledge and attitude towards herbal medicine usage during pregnancy.
{"title":"Knowledge and Attitude of Women Towards Herbal Medicine Usage During Pregnancy and Associated Factors Among Mothers Who Gave Birth in the Last Twelve Months in Dega Damot District, Northwest Ethiopia","authors":"Tazeb Alemu Anteneh, Abayneh Aklilu Solomon, Animut Tagele Tamiru, Nebiyu Solomon Tibebu, Haymanot Nigatu Alemu, Selam Yibeltal Desalegn, Hiwotie Getaneh Ayalew, Marta Yimam Abegaz, Azmeraw Ambachew Kebede","doi":"10.2147/DHPS.S355773","DOIUrl":"https://doi.org/10.2147/DHPS.S355773","url":null,"abstract":"Background The use of herbal medicine is increasing globally, particularly in developing countries including Ethiopia, yet little is known regarding its effect and safety during pregnancy. Pregnant women prefer herbal medicine due to easy accessibility, traditional and cultural beliefs, and comparatively low cost. This study aimed to assess women’s knowledge and attitude towards the effects of herbal medicine usage during pregnancy and associated factors among women who gave birth in the last twelve months in Dega Damot district. Methods A community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 women were selected using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance. Results Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was 49.1% (95% CI: 46–52) and 57.3% (95% CI: 54–61), respectively. Access to media, had antenatal care visit, being urban dweller, history of herbal medicine usage, and a short distance to reach the nearby health facility were significantly associated with women’s knowledge about effects of herbal medicine usage. Besides, being primiparous and short traveling time to reach the nearby health facility was significantly associated with women’s attitude towards the effects of herbal medicine usage during pregnancy. Conclusion Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was low. It is important to design strategies to improve the accessibilities of maternal health services, and expand access to media will have a great role in improving women’s knowledge and attitude towards herbal medicine usage during pregnancy.","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"14 1","pages":"37 - 49"},"PeriodicalIF":1.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47173898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thaw Zin Lin, Isareethika Jayasvasti, S. Tiraphat, S. Pengpid, Manisthawadee Jayasvasti, Phetlada Borriharn
Background The spread and emergence of antimicrobial resistance is the significant public health concerns over past decades. The major leading cause comes from irrational use of antibiotics. Aim To explore the characteristics of rational use of antibiotics and identify its predictive factors among public sector living in Nakhon Nayok Province, Thailand. Methods This project was conducted by using the data-source from Rational Use of Antibiotics (RUA) Survey Project at Nakhon Nayok Province. A cross-sectional community-based study method and face to face interviews were conducted. Two hundred fifty-four participants were selected by using Quota sampling method. Descriptive statistics were used to describe the sociodemographic and antibiotics use characteristics. Chi-square test were utilized to determine the association between explanatory variables and major outcome while multiple logistic regression was analysed to identify the predictors of antibiotics use behavior. Results The mean age of the participants was 42 years, those with aged between 35 and 56 had more rational use of antibiotics behavior than those with 13–34 years while older adults (57–78 years) were significantly associated with irrational use of antibiotics [AOR = 0.38; 95% CI (0.17–0.85)] than those with less than 34 years of age. Less than half (45.7%) and about one third of them (31.1%) showed adequate knowledge and appropriate attitude towards antibiotics use. An adequate knowledge [AOR = 3.37; 95% CI (1.92–5.90)], appropriate attitude [AOR = 2.90; 95% CI (1.54–5.43)], not using antibiotics within last 3 months [AOR = 1.89; 95% CI (1.04–3.43)], and not visiting drugstore when having three main diseases [AOR = 2.04; 95% CI (1.06–3.92)] were the significant predictors of rational antibiotics use (p-value <0.05). Conclusion Strategies development in terms of knowledge and attitude enhancement about antibiotics use particularly at the different ages together with RDU pharmacy encouragement and policy restriction of community drugstores antibiotics sales are the most effective method to promote rational antibiotics use behavior in the public sector.
{"title":"The Predictors Influencing the Rational Use of Antibiotics Among Public Sector: A Community-Based Survey in Thailand","authors":"Thaw Zin Lin, Isareethika Jayasvasti, S. Tiraphat, S. Pengpid, Manisthawadee Jayasvasti, Phetlada Borriharn","doi":"10.2147/DHPS.S339808","DOIUrl":"https://doi.org/10.2147/DHPS.S339808","url":null,"abstract":"Background The spread and emergence of antimicrobial resistance is the significant public health concerns over past decades. The major leading cause comes from irrational use of antibiotics. Aim To explore the characteristics of rational use of antibiotics and identify its predictive factors among public sector living in Nakhon Nayok Province, Thailand. Methods This project was conducted by using the data-source from Rational Use of Antibiotics (RUA) Survey Project at Nakhon Nayok Province. A cross-sectional community-based study method and face to face interviews were conducted. Two hundred fifty-four participants were selected by using Quota sampling method. Descriptive statistics were used to describe the sociodemographic and antibiotics use characteristics. Chi-square test were utilized to determine the association between explanatory variables and major outcome while multiple logistic regression was analysed to identify the predictors of antibiotics use behavior. Results The mean age of the participants was 42 years, those with aged between 35 and 56 had more rational use of antibiotics behavior than those with 13–34 years while older adults (57–78 years) were significantly associated with irrational use of antibiotics [AOR = 0.38; 95% CI (0.17–0.85)] than those with less than 34 years of age. Less than half (45.7%) and about one third of them (31.1%) showed adequate knowledge and appropriate attitude towards antibiotics use. An adequate knowledge [AOR = 3.37; 95% CI (1.92–5.90)], appropriate attitude [AOR = 2.90; 95% CI (1.54–5.43)], not using antibiotics within last 3 months [AOR = 1.89; 95% CI (1.04–3.43)], and not visiting drugstore when having three main diseases [AOR = 2.04; 95% CI (1.06–3.92)] were the significant predictors of rational antibiotics use (p-value <0.05). Conclusion Strategies development in terms of knowledge and attitude enhancement about antibiotics use particularly at the different ages together with RDU pharmacy encouragement and policy restriction of community drugstores antibiotics sales are the most effective method to promote rational antibiotics use behavior in the public sector.","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"14 1","pages":"27 - 36"},"PeriodicalIF":1.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49281020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract A commonly reported definition of polypharmacy is the numerical definition of 5 or more medications daily, and definitions have ranged from 2 or more to 11 or more medications. In this case report, an extreme case of polypharmacy is presented, highlighted by the inordinate number of drugs used over time throughout the patient’s care. A 48-year-old African American female with multiple comorbidities experienced a serious adverse drug event (ADE) prompting reporting to MedWatch, the US Food and Drug Administration’s adverse drug event reporting system. The patient’s concomitant medications included 146 drug entities, across 82 therapeutic drug categories. It is apparent that the greatest influence on the occurrence of polypharmacy was the presence of multiple comorbidities, and treatment centered around addressing each morbidity with drug therapy. This case illustrates the insidious nature of polypharmacy and raises questions as to the appropriate progression and limits on the use of multiple medications.
{"title":"An Atypical Case of Extreme Polypharmacy","authors":"Michael A. Veronin","doi":"10.2147/DHPS.S332954","DOIUrl":"https://doi.org/10.2147/DHPS.S332954","url":null,"abstract":"Abstract A commonly reported definition of polypharmacy is the numerical definition of 5 or more medications daily, and definitions have ranged from 2 or more to 11 or more medications. In this case report, an extreme case of polypharmacy is presented, highlighted by the inordinate number of drugs used over time throughout the patient’s care. A 48-year-old African American female with multiple comorbidities experienced a serious adverse drug event (ADE) prompting reporting to MedWatch, the US Food and Drug Administration’s adverse drug event reporting system. The patient’s concomitant medications included 146 drug entities, across 82 therapeutic drug categories. It is apparent that the greatest influence on the occurrence of polypharmacy was the presence of multiple comorbidities, and treatment centered around addressing each morbidity with drug therapy. This case illustrates the insidious nature of polypharmacy and raises questions as to the appropriate progression and limits on the use of multiple medications.","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"14 1","pages":"19 - 26"},"PeriodicalIF":1.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48125162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-26eCollection Date: 2022-01-01DOI: 10.2147/DHPS.S325150
Fitsum Demissie, Kelil Ereso, Getahun Paulos
Background: Self-medication with antibiotics is being practiced worldwide with high prevalence, mostly in developing countries. Several factors induce the practice of self-medication, such as irrational and uncontrolled dispensing of medicinal substances, difficulty accessing health-care systems, and cost of diagnosis. Thus, this study assessed the prevalence of self-medication with antibiotics, and its associated factors among the community of Bule-Hora town, South West Ethiopia.
Methods: A community-based cross-sectional study design was used. All households residing in Bule Hora town were used as source population and households in the selected kebeles were included by using a systematic random sampling method. Eight hundred twenty-six study participants were selected for the study. Pre-tested structured questionnaires had been used to collect the required data. Then the collected data were checked for completeness and analyzed by using SPSS version 20. Odds ratios with 95% C.I. were used to measure the association between independent variables and outcome and variables with p-value <0.05 had been considered statistically significant.
Results: Prevalence of self-medication with antibiotics in the past 12 months prior to the data collection was found to be 38.9% [95% CI (1.56, 1.64)]. Being male (AOR = 1.53; 95% CI: 0.489, 0.869) with p value of 0.004, no health insurance scheme (AOR = 2.16; 95% CI: 0.274, 0.779) and availability of some drugs in shop (AOR = 12.98; 95% CI: 0.017, 0.353) with p value of 0.001 were found to be significantly associated with self-medication of antibiotics.
Conclusion: The study revealed that more than one-third of the respondents practiced self-medication. Availability and irrational dispensing of some drugs in the shops were significantly associated with self-medication practice. Therefore, it is important to educate society on the appropriate use of drugs and discourage the use of prescription drugs without medication order.
{"title":"Self-Medication Practice with Antibiotics and Its Associated Factors Among Community of Bule-Hora Town, South West Ethiopia.","authors":"Fitsum Demissie, Kelil Ereso, Getahun Paulos","doi":"10.2147/DHPS.S325150","DOIUrl":"https://doi.org/10.2147/DHPS.S325150","url":null,"abstract":"<p><strong>Background: </strong>Self-medication with antibiotics is being practiced worldwide with high prevalence, mostly in developing countries. Several factors induce the practice of self-medication, such as irrational and uncontrolled dispensing of medicinal substances, difficulty accessing health-care systems, and cost of diagnosis. Thus, this study assessed the prevalence of self-medication with antibiotics, and its associated factors among the community of Bule-Hora town, South West Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study design was used. All households residing in Bule Hora town were used as source population and households in the selected kebeles were included by using a systematic random sampling method. Eight hundred twenty-six study participants were selected for the study. Pre-tested structured questionnaires had been used to collect the required data. Then the collected data were checked for completeness and analyzed by using SPSS version 20. Odds ratios with 95% C.I. were used to measure the association between independent variables and outcome and variables with p-value <0.05 had been considered statistically significant.</p><p><strong>Results: </strong>Prevalence of self-medication with antibiotics in the past 12 months prior to the data collection was found to be 38.9% [95% CI (1.56, 1.64)]. Being male (AOR = 1.53; 95% CI: 0.489, 0.869) with p value of 0.004, no health insurance scheme (AOR = 2.16; 95% CI: 0.274, 0.779) and availability of some drugs in shop (AOR = 12.98; 95% CI: 0.017, 0.353) with p value of 0.001 were found to be significantly associated with self-medication of antibiotics.</p><p><strong>Conclusion: </strong>The study revealed that more than one-third of the respondents practiced self-medication. Availability and irrational dispensing of some drugs in the shops were significantly associated with self-medication practice. Therefore, it is important to educate society on the appropriate use of drugs and discourage the use of prescription drugs without medication order.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":" ","pages":"9-18"},"PeriodicalIF":1.6,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/42/dhps-14-9.PMC8801374.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39885921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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