Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled in the deprescribing program. The median age was 51.5 years, 56.8% were males, and hypertension was the most common etiology for their chronic kidney disease (CKD); 78% had comorbidities. After deprescription, there was a significant reduction in the number of medications from 6.0 to 4.0 and a reduction in the number of pills from 7.0 to 5.0. Medication adherence accessed using the Arabic version of Morisky, Green, and Levine’s (MGL) adherence scale also had a significant reduction from 2.0 to 1.0. Conclusion: A pharmacist-led deprescribing program is a successful strategy for decreasing the number of medications and daily pills prescribed while simultaneously improving hemodialysis patients' adherence to their regimens without compromising the patient’s safety.
Abstract:
This research sheds light on the major sins (fornication and sodomy) as two crimes that are prohibited by the divine laws, including its conclusion by the Islamic Sharia. Major sins so that life and the universe are organized, and the individual lives a life of chastity and purity free of filth and filth. The Islamic message included a set of preventive measures and remedial methods that, if the ummah were to apply them, they would live a decent life full of noble goals.
The concept of deficit in public budget becomes a chronic economic phenomenon in most of the world, whether the advanced countries or developing countries. Despite the difference in the visions of the economic schools to accept or reject the deficit in public budget but the opinion that prevailed is the necessity of the state to reduce the public spending which led to a continuous deficits in the public budget which consequently increased the government borrowing ,increase income taxes and wealth, consequently this weakened the in motivation in private investment which contributed to the increase of in factionary stagnation , so that governments have to cover the lack of local funding sources which become difficult to be eq
... Show Moreتعد مراجعة النظير واحدة من الأســاليب الحديثة فــي مجال الرقابة والتدقيق ونشــأة كأداة لقياس مــدى فاعليــة الرقابــة علــى الجــودة هو لبنة أساسية في إدارة الجودة الشاملة ووسيلة لتحســين أدوات الرقابــة المعمول بها، وللتحقق من مدى الانسجام بين المعايير الدولية للأجهزة العليا للرقابة المالية والمحاسبة والاجراءات المعمول بها من قبل الاجهزة العليا للرقابة وعليه فأن مراجعة النظير أداة تستخدم ف
... Show MoreEnvironmental stress affects the yield of sorghum. This impact can be reduced by seed stimulation technique and determining the appropriate planting date. An experiment was conducted in the spring and fall seasons of 2022. Randomized complete block design with split-plot arrangement in four replications was used. Planting dates (spring season: February 15th, March 1st, 15th, April 1st, 15th; fall season: June 15th, July 1st, 15th, August 1st, 15th) were assigned to the main plots. Seed stimulation treatments (banana peel extract 35% + citric acid 100 mg L-1 and soaking in distilled water only) were applied to the subplots. The interaction treatment of soaking with banana peel extract + citric acid and the planting date of April 15th showed
... Show MoreThis study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
... Show MoreThis study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
... Show MoreFinancial institutions, including banks, remain a major target for money launderers in order to transfer illegal funds to legitimate funds through limited internal audit procedures and external auditing.
The study is a study of the operations of money laundering and what can be done by the verification efforts when integrated in the fight against them, by analyzing the level of cooperative relationship and communication between them. To achieve the objectives of the study, a questionnaire prepared for this purpose was distributed to an appropriate sample of (60) auditors of the internal audit staff of the Central Bank of Iraq and the external auditors working in the Federal control foundation Accordingly , appropriate methods wer
... Show MoreIntroduction: Salivary melatonin is a critical antioxidant that contributes to oral health by mitigating oxidative stress. Psychological stress linked to thumb sucking may disrupt oral homeostasis, leading to conditions such as dental caries and fungal infections. Aim: This study explores the relationships between thumb sucking, salivary melatonin levels, dental caries, and the presence of Candida albicans (CA) in children. Materials and methods: A case-control study was conducted with 60 children aged 4-5 years at the University of Baghdad’s College of Dentistry. Participants were divided into thumb-sucking (n=30) and non-thumb-sucking (n=30) groups. Salivary melatonin levels were measured using enzyme-linked immunoso
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