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.
ABSTRICT:
This study is concerned with the estimation of constant and time-varying parameters in non-linear ordinary differential equations, which do not have analytical solutions. The estimation is done in a multi-stage method where constant and time-varying parameters are estimated in a straight sequential way from several stages. In the first stage, the model of the differential equations is converted to a regression model that includes the state variables with their derivatives and then the estimation of the state variables and their derivatives in a penalized splines method and compensating the estimations in the regression model. In the second stage, the pseudo- least squares method was used to es
... Show MoreBackground: The development of orthodontic biomaterials that attract less biofilm has been a goal for decades. Adhesion and colonization of cariogenic streptococci are considered to play key roles in the development of enamel demineralization related to orthodontic materials. The aim of this study was to quantitatively evaluate the Mutans streptococci adhesion to coated orthodontic archwires (Epoxy and Teflon) and uncoated archwires (stainless steel and nickel-titanium) with respect to incubation time in the presence and absence of saliva. Material and Method: Six types of archwires stainless steel and nickel titanium with two type of coating (Epoxy, Teflon) were used in this study. Twelve specimens of each archwire were incubated in steri
... Show MoreThis research includes structure interpretation of the Yamama Formation (Lower Cretaceous) and the Naokelekan Formation (Jurassic) using 2D seismic reflection data of the Tuba oil field region, Basrah, southern Iraq. The two reflectors (Yamama and Naokelekan) were defined and picked as peak and tough depending on the 2D seismic reflection interpretation process, based on the synthetic seismogram and well log data. In order to obtain structural settings, these horizons were followed over all the regions. Two-way travel-time maps, depth maps, and velocity maps have been produced for top Yamama and top Naokelekan formations. The study concluded that certain longitudinal enclosures reflect anticlines in the east and west of the study ar
... Show MoreThe study of biopolymers and their derivative materials had received a considerable degree of attention from researchers in the preparation of novel material. Biopolymers and their derivatives have a wide range of applications as a result of their bio-compatibility, bio-degradability and non-toxicity. In this paper, chitosan reacted with different aldehydes(2,4 –dichloro- benzaldehyde or 2-methyl benzaldehyde), different ketones (4-bromoacetophenone or 3-aminoacetophenone) to produce chitosan schiff base (1-4) . Chitosan schiff base (1-4) reacted with glutaric acid or adipic acid in acidic media in distilled water according to the steps of Fischer and Speier to produce compounds (5-12)
... Show MoreFree radicals are reactive compounds, their excessive production is considered to be an important cause of oxidative damage in biomolecules causing degenerative diseases. Polyphenols are one of the most important groups of secondary metabolites of plants, which have an antioxidant activity depending on their properties as hydrogen donors. Echinops polyceras Boiss. (Asteraceae) is one of Echinops genus species that spread in Syria, Lebanon, and Palestine. Phytochemicals found in this species leaves have been extracted with gradient polarity solvents, and primary screening of the secondary metabolites was established. The phenolic compounds and flavonoids contents were determined. The free radicals scavenging act
... Show MoreAmong all the common mechanical transmission elements, gears still playing the most dominant role especially in the heavy duty works offering extraordinary performance under extreme conditions and that the cause behind the extensive researches concentrating on the enhancement of its durability to do its job as well as possible. Contact stress distribution within the teeth domain is considered as one of the most effective parameters characterizing gear life, performance, efficiency, and application so that it has been well sought for formal gear profiles and paid a lot of attention for moderate tooth shapes. The aim of this work is to investigate the effect of pressure angle, speed ratio, and correction factor on the maxi
... Show MoreIn this research, the problem of multi- objective modal transport was formulated with mixed constraints to find the optimal solution. The foggy approach of the Multi-objective Transfer Model (MOTP) was applied. There are three objectives to reduce costs to the minimum cost of transportation, administrative cost and cost of the goods. The linear membership function, the Exponential membership function, and the Hyperbolic membership function. Where the proposed model was used in the General Company for the manufacture of grain to reduce the cost of transport to the minimum and to find the best plan to transfer the product according to the restrictions imposed on the model.
In this paper, the dynamic behaviour of the stage-structure prey-predator fractional-order derivative system is considered and discussed. In this model, the Crowley–Martin functional response describes the interaction between mature preys with a predator. e existence, uniqueness, non-negativity, and the boundedness of solutions are proved. All possible equilibrium points of this system are investigated. e sucient conditions of local stability of equilibrium points for the considered system are determined. Finally, numerical simulation results are carried out to conrm the theoretical results.