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.
It has been revealed previously that chronic liver disease (CLD) may be associated to hormonal fluctuations. The current study, therefore, aimed to evaluate some hormones in CLD patients compared with non-CLD individuals. This case control study was conducted at Gastroenterology and Hepatology Teaching Hospital, Medical city, Baghdad, Iraq during December 2021 to May 2022. One hundred and twenty male patients with CLD (age:14-75 years) and 120 control males (age: 24-70 years) were involved in this study. Serum samples were taken from all individuals and were then analysed for many tests which included hormones (Cortisol, testosterone, prolactin, insulin and thyroid stimulating hormone TSH); biochemical analysis (Prothrombin time
... Show MoreBackground: obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific low back pain (LBP). However, the relationship between obesity and LBP remain to date unsupported by an objective measurement of the mechanical behavior of spine and it is morphology in obese subjects. . Objectives: To identify the relationship between obesity and LBP regarding (height, weight, sleeping, chronic diseases, smoking, and steroid). Method: A cross-sectional study was conducted from the first of January 2016 to January 2018 in obe
... Show MoreCongenital adrenal hyperplasia is a group of autosomal recessive disorders. The most frequent one is 21-hydroxylase deficiency. Analyzing
Intervention in International Relations from the concepts that are still highly
controversial among those he considers a breach of international law and the UN Charter and
in violation of the rule , and those who felt that the need provided, however, that this is linked
motives humanity recognized by the international community , because the international
variables proved the inadequacy of the principle of non-interference and the principle of
sovereignty as the traditional variables international , and therefore most of the international
practice came a bus with many of the behaviors that reflect a decline in its entirety to these
principles , and became adapt these principles with international reality is too compl
Pharmaceutical care is a patient-centered, outcomes oriented practice that requires the pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. In addition, the presence of clinical pharmacists has led to a higher quality of patient education and provision of complete detailed information for patients. In developed countries Pharm D has become the professional degree for practice of Pharmacy. The graduates will be enrolled in a pharmacy residency program; admission to the residency programs is available to Pharm D graduates of an accredit
... Show MoreIn today's cities, it is easy to see large numbers of vacant lands and unused abandoned sites in downtown areas that are not only ugly but also potentially becoming fertile ground for criminal activities that endanger residents and visitors and contribute to the further degradation of neighborhoods,
can provide reuse of spaces Neglected opportunities to reshape the appearance of the city and to improve the city center for its users that the presence of many neglected sites, whether they were abandoned buildings or sites for destroyed buildings in Mosul after the war on ISIS and with large areas amid the urban fabric led to the emergence of the research problem is (lack of urban planning to reactivate abandoned sites within the ci
... Show MoreThere are different types of corruptions such as administrative, political, economic and financial corruption. The corruption forms also varied such as bribery, nepotism and extortion. All types and forms of corruption play significant role in the all economic variables generally and on investments in particular, and the corruption used to be an intermediate means in reducing the rate of economic growth. The corruption contributes in reducing the domestic investments via pay bribery by investors to officials’ persons for supplemental contracts and tenders which finally leads to reduction in the investment efficiency. The corruption also contributes in rise of operational costs for the investment projects. In additio
... Show MoreThe current research aims to test the relationship of the entrepreneurial leadership and its factors (strategic factors, communication factors, personal factors, motivational factors) in managing the organizational crisis and its stages (detection of warning signs, readiness and prevention, containment of damages, restoration of activity, learning) among a sample of companies of the Ministry Water resources (Al-Fao State Company for the implementation of irrigation projects, Al-Rafidain Company for the implementation of dams, Iraq Company for the implementation of irrigation projects), as well as standing at the level of interest of the research companies in the search variables and their factors and stages, there is no doubt tha
... Show MoreThe problem of the study is concerned with the work of The Iraqi Airways Company in political, economic, and social environment that suffers instability for many years. This has its negative outcomes regarding its decisions of providing services to its markets and customers as a result of the orientations, behavior, and marketing values the company management adopted. The aim of this study is to investigate the marketing philosophy adopted by the management and to identify the extent it suits the materialistic and the human capacities of the company and its current environmental circumstances within the marketing culture common to the thoughts and behaviors of the management and their employees. And in order to achiev
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