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
The research aims to shed light on the extent to which the practices of performance management in achieving organizational excellence in one of the formations and the Ministry of Finance (GCT). The importance of the selection of these organizations is that they occupies a large and exceptional importance in the national economy through income redistribution add it to cover a large part of the state budget revenues, these organizations possess functionally diverse cadre of them pregnant initial certification and other senior and he fairly stable To meet this target, and on the basis of the data search exploratory researcher built model hypothesis for the search included variable impressionist and
... Show MoreChemical spray pyrolysis technique was used at substrate temperature 250 ˚C with annealing temperature at 400 ˚C (for 1hour) to deposition tungsten oxide thin film with different doping concentration of Au nanoparticle (0, 10, 20, 30 and 40)% wt. on glass substrate with thickness about 100 nm. The structural, optical properties were investigated. The X-ray diffraction shows that the films at substrate temperature (250 ˚C) was amorphous while at annealing temperature have a polycrystalline structure with the preferred orientation of (200), all the samples have a hexagonal structure for WO3 and Au gold nanoparticles have a cubic structure. Atomic force microscopy (AFM) was used to characterize the morphology of the films. The optical pr
... Show MoreThis research has investigated the effect of the customer knowledge management CKM in sustainable promotion SP. The research conducted a quantitative method on a sample of employees in the Al-Furat State Company for Chemical Industries affiliated / the Ministry of Industry and Minerals in Iraq. The research’s problem presented a set of questions, one of the most important was (is there a relation and impact between the dimensions of customer knowledge management and sustainable promotion). The aim of the research is to identify the extent to which customer knowledge management activities are applied in understudy organization. This research adopted the questionnaire as a main instrument to collect information from (140) participants in
... Show MoreIn this work, we studied the effect of power variation on inductively coupled plasma parameters using numerical simulation. Different values were used for input power (750 W-1500 W), gas temperature 300K, gas pressure (0.02torr), 5 tourns of the copper coil and the plasma was produced at radio frequency (RF) 13.56 MHZ on the coil above the quartz chamber. For the previous purpose, a computer simulation in two dimensions axisymmetric, based on finite element method, was implemented for argon plasma. Based on the results we were able to obtain plasma with a higher density, which was represented by obtaining the plasma parameters (electron density, electric potential, total power, number density of argon ions, el
... Show MoreDue to the Geographical links, language is one of the multiple affects among Arabs and Turks. As the different studies demonstrate, Turkish contains many words derived from other languages, yet Arabic remains the language that has great affects on Turkish. Unlike Turkish language, Arabic is a derivative language that requires no suffixes. Thus, Arabic verbs are tuned into Turkish verbs by adding auxiliary verbs. The present study traces some of the Turkish compound words of Arabic roots with an explanation that shows the Auxiliary added to form the Turkish verb as found in the stories of Otman Chevek Sawy’s Like A voice in the Dark. The conclusion sums up the findings of the study illustrated by numbers.
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... Show MoreAim: The aim of this study is to determine the correlation between levels of certain seminal biochemical parameters and serum reproductive hormones, on the one hand, and sperm function tests, on the other hand, in asthenospermic patients. Patients and Methods: Sixty asthenospermic patients and twenty fertile men as a control group were included in this study. Semen samples were collected to perform seminal fluid analysis. Total protein, cholesterol, calcium, creatine kinase, and fructose were measured in the seminal plasma. Blood samples were collected for hormonal assay of serum reproductive hormones: testosterone, prolactin, luteinizing hormone, and follicle-stimulating hormone. Results: The results revealed a significant positive correla
... Show MoreAim: To determine the expression of tissue inhibitors of metalloproteinases (TIMP-2) in oral squamous cell carcinoma (OSCC) and the difference in its expression level between positive and negative HPV-16 (human papilloma virus- 16) OSCC patients. Methods: This study was conducted on 33 biopsies obtained from patients with OSCC and 10 normal oral mucosa as controls. In situ hybridization (ISH) was used to investigate the presence of HPV-16, while immunohistochemistry (IHC) was used to estimate the expression level of TIMP-2. Results: The TIMP-2 was expressed in 27 (81.8%) of OSCC sections with no significant difference between its expression level in HPV-16 positive and HPV-16 negative OSCC cases (p=0.058). TIMP-2 was found to be hig
... Show Moreprotein oxidation through oxidative stress, which represents the overall status of the protein in the cell/tissue. Due to their increased levels of AOPPs were reported during T2DM. The aim of this study was to assess AOPP level in T2DM subjects with foot ulcer (DFU) and explore its correlation with infection. Type 2 diabetic patients (n=108) and healthy subjects (n=25) were enrolled in this study. The T2DM group was subdivided to diabetic patients without complications (n=25) and eighty-three (83) of them have diabetic foot. They were sub- grouped into two groups according to presence Osteomyelitis and abscess, and in reliance on medical analysis of WBC count and CRP. Group of diabetic without superficial or deep ulcer and no osteomyelitis
... Show MoreThe study aimed to evaluate the level of MMP‑2 in acute myeloid leukemia (AML) patients in comparison with that in remission status, and healthy subjects, and to find its correlation with hematologic parameters. This study included sixty newly diagnosed AML patients. Remission status was assessed after induction chemotherapy. The overall survival (OS) was determined after 6 months. The plasma MMP‑2 level was measured at diagnosis by enzyme immunoassay. Twenty‑eight healthy individuals were recruited as a control group. Plasma MMP‑2 was higher in AML patients than in healthy individuals (P = 0.005). The level of MMP‑2 was much higher in the M5 subtype than in the other subtypes (P = 0.0001). There was no statistically significant d
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