1
|
Yadeta DA, Manyazewal T, Demessie DB, Kleive D. Incidence and predictors of postoperative complications in Sub-Saharan Africa: a systematic review and meta-analysis. FRONTIERS IN HEALTH SERVICES 2024; 4:1353788. [PMID: 38784705 PMCID: PMC11112115 DOI: 10.3389/frhs.2024.1353788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/17/2024] [Indexed: 05/25/2024]
Abstract
Background Postoperative complications remain a significant challenge, especially in settings where healthcare access and infrastructure disparities exacerbate. This systematic review and meta-analysis aimed to determine the pooled incidence and risk factors of postoperative complications among patients undergoing essential surgery in Sub-Saharan Africa (SSA). Method PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, and Google Scholar were searched from January 2010 to November 2022 for completed studies reporting the incidence and risk factors associated with postoperative complications among patients undergoing essential surgery in SSA. Severity of postoperative complications was ranked based on the Clavien-Dindo classification system, while risk factors were classified into three groups based on the Donabedian structure-process-outcome quality evaluation framework. Studies quality was appraised using the JBI Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI), and data were analyzed using Comprehensive Meta-Analysis (CMA) software. The study protocol adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42023414342). Results The meta-analysis included 19 studies (10 cohort and 9 cross-sectional) comprising a total of 24,136 patients. The pooled incidence of postoperative complications in SSA was 20.2% (95% CI: 18.7%-21.8%), with a substantial heterogeneity of incidence observed. The incidence varied from 14.6% to 27.5% based on the Clavien-Dindo classification. The random-effects model indicated significant heterogeneity among the studies (Q = 54.202, I = 66.791%, p < 0.001). Contributing factors to postoperative complications were: structure-related factors, which included the availability and accessibility of resources, as well as the quality of both the surgical facility and the hospital.; process-related factors, which encompassed surgical skills, adherence to protocols, evidence-based practices, and the quality of postoperative care; and patient outcome-related factors such as age, comorbidities, alcohol use, and overall patient health status. Conclusion The meta-analysis reveals a high frequency of postoperative complications in SSA, with noticeable discrepancies among the studies. The analysis highlights a range of factors, encompassing structural, procedural, and patient outcome-related aspects, that contribute to these complications. The findings underscore the necessity for targeted interventions aimed at reducing complications and improving the overall quality of surgical care in the region. Systematic Reviews Registration https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42023414342).
Collapse
Affiliation(s)
- Daniel Aboma Yadeta
- School of Public Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Dereje Bayissa Demessie
- School of Public Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | |
Collapse
|
2
|
Nicholson K, Liu W, Fitzpatrick D, Hardacre KA, Roberts S, Salerno J, Stranges S, Fortin M, Mangin D. Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review. THE LANCET. HEALTHY LONGEVITY 2024; 5:e287-e296. [PMID: 38452787 DOI: 10.1016/s2666-7568(24)00007-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/28/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024] Open
Abstract
Multimorbidity (multiple conditions) and polypharmacy (multiple medications) are increasingly common, yet there is a need to better understand the prevalence of co-occurrence. In this systematic review, we examined the prevalence of multimorbidity and polypharmacy among adults (≥18 years) and older adults (≥65 years) in clinical and community settings. Six electronic databases were searched, and 87 studies were retained after two levels of screening. Most studies focused on adults 65 years and older and were done in population-based community settings. Although the operational definitions of multimorbidity and polypharmacy varied across studies, consistent cut-points (two or more conditions and five or more medications) were used across most studies. In older adult samples, the prevalence of multimorbidity ranged from 4·8% to 93·1%, while the prevalence of polypharmacy ranged from 2·6% to 86·6%. High heterogeneity between studies indicates the need for more consistent reporting of specific lists of conditions and medications used in operational definitions.
Collapse
Affiliation(s)
- Kathryn Nicholson
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada; Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
| | - Winnie Liu
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Daire Fitzpatrick
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Kate Anne Hardacre
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Sarah Roberts
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jennifer Salerno
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada; Department of Family Medicine, Western University, London, ON, Canada; Department of Medicine, Western University, London, ON, Canada; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Dee Mangin
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada; Department of General Practice, University of Otago, Christchurch, New Zealand
| |
Collapse
|
3
|
Ha JH, Burt J, Randell S, VanSteelandt A. Accidental substance-related acute toxicity deaths in older adults in 2016 and 2017: a national chart review study. Health Promot Chronic Dis Prev Can 2024; 44:89-100. [PMID: 38501680 DOI: 10.24095/hpcdp.44.3.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Limited research exists on substance-related acute toxicity deaths (ATDs) in older adults (≥60 years) in Canada. This study aims to examine and describe the sociodemographic characteristics, health histories and circumstances of death for accidental ATDs among older adults. METHODS Following a retrospective descriptive analysis of all coroner and medical examiner files on accidental substance-related ATDs in older adults in Canada from 2016 to 2017, proportions and mortality rates for coroner and medical examiner data were compared with general population data on older adults from the 2016 Census. Chisquare tests were conducted for categorical variables where possible. RESULTS From 2016 to 2017, there were 705 documented accidental ATDs in older adults. Multiple substances contributed to 61% of these deaths. Fentanyl, cocaine and ethanol (alcohol) were the most common substances contributing to death. Heart disease (33%), chronic pain (27%) and depression (26%) were commonly documented. Approximately 84% of older adults had contact with health care services in the year preceding their death. Only 14% were confirmed as having their deaths witnessed. CONCLUSIONS Findings provide insight into the demographic, contextual and medical history factors that may influence substance-related ATDs in older adults and suggest key areas for prevention.
Collapse
Affiliation(s)
| | - Jacqueline Burt
- Office of Drug Research and Surveillance, Health Canada, Ottawa, Ontario, Canada
| | - Shane Randell
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | |
Collapse
|
4
|
Cowans C, Love A, Tangiisuran B, Jacob SA. Uncovering the Hidden Burden of Pharmaceutical Poisoning in High-Income and Low-Middle-Income Countries: A Scoping Review. PHARMACY 2023; 11:184. [PMID: 38133459 PMCID: PMC10747954 DOI: 10.3390/pharmacy11060184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/28/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Pharmaceutical poisoning is a significant global public health concern, causing approximately 190,000 deaths annually. This scoping review aims to comprehensively map the available literature on pharmaceutical poisoning and compare patterns between high-income countries (HICs) and low-middle-income countries (LMICs). A systematic search was performed across the following databases: Embase, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL. Studies included were from 1 January 2011 to 31 December 2020, in English, with full text available. Seventy-nine articles were included in the study; 21 were from LMICs and 58 were from HICs. Toxic exposure was largely intentional (77%) in LMICs and accidental (68%) in HICs. Drugs acting on the nervous system were responsible for 95% of toxicities worldwide with analgesics accounting for the largest subtherapeutic group in both LMICs (40%) and HICs (58%). Notable statistics were that HICs accounted for 99% of opioid overdoses, and LMICs accounted for 19% of anti-epileptic-induced toxicities. Overall, the medical outcomes due to poisonings were generally worse in LMICs. The review provides possible interventions to target specific geographic locations, based on the trends identified, to reduce the burden worldwide. Many gaps within the literature were recognised, calling for more robust analytical research.
Collapse
Affiliation(s)
- Claire Cowans
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
| | - Anya Love
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
| | - Balamurugan Tangiisuran
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia;
| | - Sabrina Anne Jacob
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor, Malaysia
| |
Collapse
|
5
|
Loving VA, Johnston BS, Reddy DH, Welk LA, Lawther HA, Klein SC, Cranford CM, Reed RC, Rangan P, Morris MF. Antithrombotic Therapy and Hematoma Risk during Image-guided Core-Needle Breast Biopsy. Radiology 2023; 306:79-86. [PMID: 35997610 DOI: 10.1148/radiol.220548] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background For image-guided core-needle breast biopsy (CNBB), it remains unclear whether antithrombotic medication should be withheld because of hematoma risk. Purpose To determine hematoma risk after CNBB in patients receiving antithrombotic medication and to stratify risk by antithrombotic type. Materials and Methods This HIPAA-compliant retrospective study included US-, stereotactic-, or MRI-guided CNBBs performed across six academic and six private practices between April 2019 and April 2021. Patients were instructed to continue antithrombotic medications, forming two groups: antithrombotic and nonantithrombotic. Hematomas were defined as new biopsy-site masses with a diameter of 2 cm or larger on postprocedure mammograms. Hematomas were considered clinically significant if management involved an intervention other than manual compression. Patient age, type of antithrombotic medication, practice type, image guidance modality, needle gauge and type, and outcome of pathologic analysis were recorded. Multivariable logistic regression analysis was used to analyze variables associated with hematomas. Results A total of 3311 biopsies were performed in 2664 patients (median age, 60 years; IQR, 48-70 years; 2658 women). The nonantithrombotic group included 2788 biopsies, and the antithrombotic group included 523 biopsies (328 low-dose aspirin, 73 full-dose antiplatelet drugs, 51 direct oral anticoagulants, 36 warfarin, 32 daily nonsteroidal anti-inflammatory drugs, three heparin or enoxaparin). The antithrombotic group had a higher overall hematoma rate (antithrombotic group: 49 of 523 biopsies [9.4%], nonantithrombotic group: 172 of 2788 biopsies [6.2%]; P = .007), but clinically significant hematoma rates were not different (antithrombotic group: two of 523 biopsies [0.4%], nonantithrombotic group: one of 2788 biopsies [0.04%]; P = .07). At multivariable analysis, age (odds ratio [OR], 1.02; 95% CI: 1.01, 1.03; P < .001), 9-gauge or larger needles (OR, 2.1; 95% CI: 1.28, 3.3; P = .003), and full-dose antiplatelet drugs (OR, 2.5; 95% CI: 1.29, 5.0; P = .007) were associated with higher hematoma rates. US guidance (OR, 0.26; 95% CI: 0.17, 0.40; P < .001) and 10-14-gauge needles (OR, 0.53; 95% CI: 0.36, 0.79; P = .002) were predictive of no hematoma. Conclusion Because clinically significant hematomas were uncommon, withholding antithrombotic medications before core-needle breast biopsy may be unnecessary. Postbiopsy hematomas were associated with full-dose antiplatelet drugs, patient age, and 9-gauge or larger needles. No association was found with other types of antithrombotic medication. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Chang and Yoen in this issue.
Collapse
Affiliation(s)
- Vilert A Loving
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - Brian S Johnston
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - Denise H Reddy
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - Leslie A Welk
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - Hannah A Lawther
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - Shayna C Klein
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - Caroline M Cranford
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - R Christopher Reed
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - Pooja Rangan
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| | - Michael F Morris
- From the Division of Diagnostic Imaging, Banner MD Anderson Cancer Center, 2940 E Banner Gateway Dr, Suite 150, Gilbert, AZ 85234 (V.A.L., B.S.J., D.H.R., L.A.W., H.A.L., S.C.K., M.F.M.); Banner Imaging, Glendale, Ariz (C.M.C.); Radiology Imaging Associates, Englewood, Colo (R.C.R.); Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine (P.R.), and Department of Radiology (M.F.M.), Banner-University Medical Center Phoenix, Phoenix, Ariz
| |
Collapse
|
6
|
Rodrigues AR, Teixeira-Lemos E, Mascarenhas-Melo F, Lemos LP, Bell V. Pharmacist Intervention in Portuguese Older Adult Care. Healthcare (Basel) 2022; 10:1833. [PMID: 36292280 PMCID: PMC9602367 DOI: 10.3390/healthcare10101833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 09/07/2024] Open
Abstract
Healthy ageing has become one of the most significant challenges in a society with an increasing life expectancy. Older adults have a greater prevalence of chronic disease, with the need for multiple medications to appropriately control these issues. In addition to their health concerns, ageing individuals are prone to loneliness, dependence, and economic issues, which may affect their quality of life. Governments and health professionals worldwide have developed various strategies to promote active and healthy ageing to improve the quality of life of older adults. Pharmacists are highly qualified health professionals, easily accessible to the population, thus playing a pivotal role in medication management. Their proximity to the patient puts them in a unique position to provide education and training to improve therapeutic adherence and identify medication-related problems. This paper aims to address the importance of Portuguese community pharmacists in the medication management of older adults, emphasising their intervention in health promotion, patient education, medication-related problems, deprescription, dose administration aids, and medication review and reconciliation. We also discuss home delivery services and medication management in long-term care facilities.
Collapse
Affiliation(s)
- Ana Rita Rodrigues
- Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Edite Teixeira-Lemos
- CERNAS-IPV Research Centre, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal
| | - Filipa Mascarenhas-Melo
- Drug Development and Technology Laboratory, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, 3000-548 Coimbra, Portugal
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Luís Pedro Lemos
- Nuclear Medicine Department, Centro Hospitalar e Universitário de Coimbra, 3000-548 Coimbra, Portugal
| | - Victoria Bell
- Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, 3000-548 Coimbra, Portugal
| |
Collapse
|
7
|
SHRESTHA R, SHRESTHA S, SAPKOTA B, KHANAL S, KC B. Challenges Faced by Hospital Pharmacists in Low- Income Countries Before COVID-19 Vaccine Roll- Out: Handling Approaches and Implications for Future Pandemic Roles. Turk J Pharm Sci 2022; 19:232-238. [DOI: 10.4274/tjps.galenos.2021.37974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
8
|
Safari D, DeMarco EC, Scanlon L, Grossberg GT. Over-The-Counter Remedies in Older Adults: Patterns of Use, Potential Pitfalls, and Proposed Solutions. Clin Geriatr Med 2021; 38:99-118. [PMID: 34794706 DOI: 10.1016/j.cger.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Over-the-counter (OTC) products such as pharmaceuticals, dietary supplements, vitamins, and herbal remedies are widely available and copiously used by older adults for health maintenance and symptom management. Owing to physiology, multimorbidity, and polypharmacy, this population is particularly vulnerable to inappropriate use of OTC products, adverse effects, and drug interactions. While OTC pharmaceuticals are bound by FDA-approved standards, dietary supplements are regulated differently, resulting in variable quality and increased possibility for adulteration. Internationally, standards for OTC products vary widely. Accessible educational information, improved provider-patient communication, and revision of regulatory policy could improve safety for older adult users of OTC products.
Collapse
Affiliation(s)
- Delavar Safari
- Department of Psychiatry & Behavioral Neuroscience, Division of Geriatric Psychiatry, School of Medicine, Saint Louis University, 1438 S Grand Boulevard, St Louis, MO 63104, USA.
| | - Elisabeth C DeMarco
- Department of Psychiatry & Behavioral Neuroscience, Division of Geriatric Psychiatry, School of Medicine, Saint Louis University, 1438 S Grand Boulevard, St Louis, MO 63104, USA
| | - Lillian Scanlon
- Department of Psychiatry & Behavioral Neuroscience, Division of Geriatric Psychiatry, School of Medicine, Saint Louis University, 1438 S Grand Boulevard, St Louis, MO 63104, USA
| | - George T Grossberg
- Department of Psychiatry & Behavioral Neuroscience, Division of Geriatric Psychiatry, School of Medicine, Saint Louis University, 1438 S Grand Boulevard, St Louis, MO 63104, USA
| |
Collapse
|
9
|
Joshi G, Kabra A, Goutam N, Sharma A. An Overview on Patient-Centered Clinical Services. BORNEO JOURNAL OF PHARMACY 2021. [DOI: 10.33084/bjop.v4i2.1978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Drug-related problems (DRPs) had often been a concern in the system that needed to be detected, avoided, and addressed as soon as possible. The need for a clinical pharmacist becomes even more important. He is the one who can not only share the load but also be an important part of the system by providing required advice. They fill out the patient's pharmacotherapy reporting form and notify the medical team's head off any drug-related issues. General practitioners register severe adverse drug reactions (ADRs) yearly. As a result of all of this, a clinical pharmacist working in and around the healthcare system is expected to advance the pharmacy industry. Its therapy and drugs can improve one's health quality of life by curing, preventing, or diagnosing a disease, sign, or symptom. The sideshows, on the other hand, do much harm. Because of the services they offer, clinical pharmacy has grown in popularity. To determine the overall effect and benefits of the emergency department (ED) clinical pharmacist, a systematic review of clinical practice and patient outcomes will be needed. A clinical pharmacist's anatomy, toxicology, pharmacology, and medicinal chemistry expertise significantly improves a patient's therapy enforcement. It is now important to examine the failure points of healthcare systems as well as the individuals involved.
Collapse
Affiliation(s)
- Gaurav Joshi
- University Institute of Pharma Sciences, Chandigarh University
| | - Atul Kabra
- University Institute of Pharma Sciences, Chandigarh University
| | | | | |
Collapse
|
10
|
Senthilkumar CS, Malla TMUD, Akhter S, Sah NK, Ganesh N. Susceptibility of the Bhopal-methyl isocyanate (MIC)-gas-tragedy survivors and their offspring to COVID-19: What we know, what we don't and what we should? CIENCIA & SAUDE COLETIVA 2020; 25:4225-4230. [PMID: 33027359 DOI: 10.1590/1413-812320202510.2.28682020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 11/21/2022] Open
Abstract
There is credible evidence that the 1984-Bhopal-methyl isocyanate (MIC)-gas-exposed long-term survivors and their offspring born post-exposure are susceptible to infectious/communicable and non-communicable diseases. Bhopal's COVID-19 fatality rate suggests that the MIC-gas tragedy survivors are at higher risk, owing to a weakened immune system and co-morbidities. This situation emboldened us to ponder over what we know, what we don't, and what we should know about their susceptibility to COVID-19. This article aims at answering these three questions that emerge in the minds of public health officials concerning prevention strategies against COVID-19 and health promotion in the Bhopal MIC-affected population (BMAP). Our views and opinions presented in this article will draw attention to prevent and reduce the consequences of COVID-19 in BMAP. From the perspective of COVID-19 prophylaxis, the high-risk individuals from BMAP with co-morbidities need to be identified through a door-to-door visit to the severely gas-affected regions and advised to maintain good respiratory hygiene, regular intake of immune-boosting diet, and follow healthy lifestyle practices.
Collapse
Affiliation(s)
- Chinnu Sugavanam Senthilkumar
- Central Research Laboratory, Rajas Dental College & Hospital. Kavalkinaru Junction, Tirunelveli Dt. Tamil Nadu India.
| | - Tahir Mohi-Ud-Din Malla
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences. Srinagar Jammu & Kashmir India
| | - Sameena Akhter
- Clinical Cytogenetics Laboratory, Department of Research, Jawaharlal Nehru Cancer Hospital & Research Centre. Bhopal Madhya Pradesh India
| | | | - Narayanan Ganesh
- Clinical Cytogenetics Laboratory, Department of Research, Jawaharlal Nehru Cancer Hospital & Research Centre. Bhopal Madhya Pradesh India
| |
Collapse
|