Factors associated with the use of over-the-counter sleep aids containing diphenhydramine: A cross-sectional study in Saudi Arabia

Introduction

Diphenhydramine, either alone or in combination with pain relievers, is one of the widely used over-the-counter sleep aids. However, few studies have evaluated the use of diphenhydramine-containing products, such as Panadol Night, in Saudi Arabia. Therefore, the objectives of this study were to assess the prevalence of Panadol Night use and to identify factors associated with its use in the Eastern Province of Saudi Arabia.

Methods

A cross-sectional study was conducted among adults aged 18 years or older in the Eastern Province of Saudi Arabia. Data were collected through an online self-administered questionnaire from 05 March 2022 to 20 March 2022. Chi-square tests and multivariable logistic regression models were used to examine the associations between Panadol Night use in the past month and independent variables.

Results

A total of 1244 adults participated in the survey. Approximately, 42.3% reported that they have used Panadol Night in their lifetime; 12.1% used Panadol Night in the past month. The majority of the Panadol Night users (62.4%) reported that their use was based on their family/friends' recommendations, while 23.6% used Panadol Night based on healthcare providers' recommendations. The multivariable logistic regression models showed that gender, health related fields, perceived safety and effectiveness of Panadol Night, a history of insomnia, trouble sleeping due to pain, and sleep quality were significantly associated with the use of Panadol Night in the past month.

Conclusions

Our findings indicated that adults' perceptions of the effectiveness and safety of Panadol Night were significantly associated with its use. Also, adults in non-health related fields were more likely to use Panadol Night compared to those in health related fields. This suggests the need for raising awareness about the appropriate use of Panadol Night. Community pharmacists can play an essential role in educating patients during the time of purchase.

Assessment of knowledge, attitude, and practices of acute kidney injury incidence with co-administration of piperacillin/tazobactam and vancomycin among healthcare workers: A cross-sectional study

Background

No studies have identified a link between acute kidney injury (AKI) incidence due to the co-administration of vancomycin and piperacillin/tazobactam (VPT) and healthcare providers' knowledge, attitudes, and practices. We aimed to (1) assess the knowledge, attitudes, and practices towards AKI due to VPT co-administration among healthcare providers in Saudi Arabia, and (2) examine the relationship between healthcare providers' knowledge and attitudes about AKI due to VPT co-administration and their practices.

Methods

This cross-sectional study was conducted between February 2022 and April 2022. Healthcare providers, including physicians, pharmacists, and nurses, were included in the study population. The correlation coefficient assessed the relationship between knowledge, attitude, and practice. Spearman's rho was used as a test statistic.

Results

Of the invited healthcare providers, 192 responded to the survey. A significant difference in knowledge was found among healthcare providers for two variables: the definition of AKI (p < 0.001) and appropriate management of AKI due to VPT (p = 0.002). Physicians were found to rely less on the most common causative organisms of infection to guide empirical antibiotic therapy (p < 0.001). In addition, physicians were less likely to switch piperacillin/tazobactam to cefepime or meropenem in combination with vancomycin with AKI incidence (p = 0.001). A positive attitude towards the perceived AKI risk with VPT was positively correlated with avoiding using VPT unless no alternatives were available (Rho = 0.336) and taking protective measures when using VPT (Rho = 0.461).

Conclusion

Deviation has been observed in the knowledge, attitudes, and practices of AKI incidence with the co-administration of piperacillin/tazobactam and vancomycin among healthcare workers. Interventions at the organizational level are recommended to guide best practices.

Identifying knowledge gaps in heart failure research among women using unsupervised machine-learning methods

Aim: To identify knowledge gaps in heart failure (HF) research among women, especially postmenopausal women. Materials & methods: We retrieved HF articles from PubMed. Natural language processing and text mining techniques were used to screen relevant articles and identify study objective(s) from abstracts. After text preprocessing, we performed topic modeling with non-negative matrix factorization to cluster articles based on the primary topic. Clusters were independently validated and labeled by three investigators familiar with HF research. Results: Our model yielded 15 topic clusters from articles on HF among women. Atrial fibrillation was found to be the most understudied topic. From articles specific to postmenopausal women, five clusters were identified. The smallest cluster was about stress-induced cardiomyopathy. Conclusion: Topic modeling can help identify understudied areas in medical research.

Five-year trend in healthcare access and patient-reported health outcomes among women veterans

BACKGROUND

This study aimed to describe the five-year trend in healthcare access, health-related quality of life (HRQoL), and health outcomes in women Veterans.

METHODS

A retrospective, pooled, cross-sectional study design was employed. Five-year trend was assessed using 2013 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) data. Bivariate, multivariable logistic regression, and ordinary least squares regression analyses were conducted.

RESULTS

A total of 6561 women Veterans, aged 18 to 64 years (3534 in 2013 and 3027 in 2017) were included. Compared to 2013, more women Veterans in 2017 reported increased healthcare insurance and decreased cost as a barrier to care. Women Veterans with health insurance were less likely to report cost as a barrier to care. There were no statistically significant differences in HRQoL in bivariate or ordinary least squares regression analyses between BRFSS years.

CONCLUSION

Federal policy and Veterans Health Administration expansion have had an impact on improving healthcare access to women Veterans. However, increased healthcare access alone does not translate into improved HRQoL or health outcomes for women Veterans. Future policies should not only focus on increasing healthcare access, but also improving health outcomes, especially HRQoL. The quality of the healthcare accessed must be a focus for future research and policy.

Serious Psychological Distress and Emergency Room Use among Adults with Multimorbidity in the United States

OBJECTIVES

(1) To examine the association between serious psychological distress (SPD) and emergency room (ER) use in the past 12 months among adults with multimorbidity in the United States (US) and (2) to investigate the association between SPD and the reasons for ER use.

METHODS

The current study used a cross-sectional design with retrospective data from the 2015 National Health Interview Survey. Logistic regression models were used to assess the association between SPD and ER use among adults with multimorbidity. Among ER users, adjusted logistic regression models were conducted to examine the association between SPD and the reasons for the ER use.

RESULTS

After controlling for other variables, adults with multimorbidity and SPD were more likely to use ER than those with multimorbidity and no SPD (AOR = 1.61, 95% CI = 1.26, 2.04). Among ER users, there were no significant associations between SPD and the reasons for ER use after controlling for other variables.

CONCLUSION

Adults with multimorbidity and SPD were more likely to use ER as compared to those with multimorbidity and no SPD. Among adults with multimorbidity, routine screening for SPD may be needed to reduce the ER use.