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.
Background: Uncontrolled hyperphosphatemia is the main difficulty facing staff treating patients with end-stage renal disease on hemodialysis. Sevelamer and calcium-containing phosphate binders have been associated with cost burden and tissue calcification, respectively. Therefore, the current trial was targeted to investigate the efficacy of a new phosphate binder, ferric citrate, in a sample of Iraqi patients with end-stage renal disease on hemodialysis. Keywords: Ferric citrate, Hemodialysis Phosphate binder
Background: Practicing self-medication is common and a worrisome issue because of irrational drug use. This study aimed to evaluate self-medication knowledge and views among the final year pharmacy students in Iraq. Methods: A cross-sectional descriptive study was conducted from December 2018 to January 2019. A pre-validated and self-administered questionnaire was recruited to survey pharmacy students at the University of Baghdad and Al-Rafedain University College. The Statistical Package for the Social Sciences version 20 (SPSS v. 20) software used to save and analyze the data. Results expressed as numbers and percentages. Results: A total of 344 students (response rate: 94.24%) with a mean age of 22.10 years includ
... Show MoreAsthma is a chronic inflammatory disease of respiratory airways characterized by distinctive history of respiratory symptoms due to variable airflow obstruction which reverses either spontaneously or in response to certain medications. Acetylcholine is a parasympathetic neurotransmitter which plays fundamental roles in the development of persistent asthma. Treatment guidelines recommend using medium doses of inhaled corticosteroids in addition to another controller bronchodilator instead of using high doses inhaled steroid alone for treatment of moderate to severe persistent asthma. The inhaled long acting muscarinic antagonist, tiotropium, was approved recently to control unresponsive asthma to inhaled corticosteroid with or without a long
... Show MoreObjectives: Many medication errors occur in the hospital, and these can endanger patients. The purpose of this study was to evaluate the incidence of medication errors in hospitalized patients, and to categorize the most frequent types of errors, and to asses the possible measures that may prevent the occurrence of such errors.
Methods: A prospective, exploratory, and evaluative study, using direct observation method to detect medication errors in adult hospitalized patients in medical and surgical units in Baquba Teaching Hospital- Diyala-Iraq.. The files of 299 patients had been reviewed from July 2009 to September 2009, including medication orders and treatment sheets to detect existing errors. The detected errors were recorded and
Background: Ministry of Health, since its establishment, adopted the policy of central financing system and free medical services in all health facilities. The sanction and the decline in per capita spending affect the health financing system, thus in 1997 a new financing policy was adopted as pilot in seven specialized hospital called “self–finance” system in which the cost of care was shifted to the patients, i.e. the funds obtained came from user charges at the health facilities. This system was extended (with some modifications) to all hospitals in 1999 and PHC centers in 2001 and implemented until 2003 when it was discontinued.
Materials and Methods: During the second half of 2004, a review of
Severe acute respiratory corona viruses (SARS-COVs) are a particular category of RNA viruses that have emerged as a potential danger to the human population, triggering epidemics and pandemics that have resulted in catastrophic human mortality. The SARS-CoV2, responsible for the COVID-19 pandemic that began on December 12, 2019 in Wuhan, China, has been linked to bats. A new SARS-CoV-2 variant appeared in late December 2020. Mutations with variants continued to appear until the time of this study. Thus, this study aimed to provide a local database among Iraqi patients about SARS-COV-2 variants as there have been very few local studies documenting its existence and its relationship with the progression and severity of infection.
... Show MoreObjective(s): 1- Assess the effectiveness of health educational program on nurses' knowledge toward Hemodialysis at Pediatric Teaching Hospitals.
2-To find out the relationship between nurses' knowledge about hemodialysis and their demographic Characteristics.
Methods: The study was designed in a pre-experimental pattern for the nurses' working in the Child Welfare Teaching Hospital and the Child's Central Teaching Hospital, and a targeted sample consisting of (30) nurses was selected. It is tested in three periods of pre-test, the first post-test, and the second post-test. Participants were tested before implementing the tutorial (tutorial lectures
... Show MoreMedication safety is an important part of the comprehensive patient safety term. Medication safety is gaining more attention as the World Health Organization set the goal of decreasing medication harm by (50%) for the next 5 years when launching the third global challenge. Studying medication safety in the risk groups such as young ages, children are crucial to learn more about the effect of medicines in this risk group since they are not included in the clinical trials. Adverse drug reaction is defined as any harm resulted from the drug itself during medical process journey, while medication errors are any harm resulted from the treatment process rather than the drug or it is the result of the failure in a step of the treatment process
... Show MoreBack ground : Chronic renal failure (CRF) is characterized by progressive destruction of renal mass with irreversible sclerosis and loss of nephrons over a period of at least months to many years which is treated either by dialysis which includes hemodialysis (HD) and peritoneal dialysis (PD) or renal transplantation.
Objective : To document the elevation of interleukin-6 (IL-6) in Iraqi HD patients, and to what degree that elevation influences secretion of C-reactive protein (CRP), in addition to its
association with other acute phase proteins and kidney function tests .
Method : A total of 75 individuals were included in the present study, 50 individuals were treated with HD compared to 25 healthy volu
Background: Chronic kidney disease is a gradual loss of kidney function with diabetes and hypertension as the leading cause. Chronic kidney disease is one of these systemic diseases that can affect salivary contents. Aims: This study aimed to assess salivary immunoglobulin A, interleukin-6 and C- reactive protein in chronic kidney disease patients on hemodialysis and those on conservative treatment in comparison with control subjects. Materials and methods: Ninety subjects were included in this study divided into three groups: 30 patients with chronic kidney disease on hemodialysis for at least 6 months ago; 30 patients with chronic kidney disease on conservative treatment and 30 healthy control subjects. Secretory immunoglobulin A, inte
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