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.
Multiple sclerosis (MS) is a chronic, inflammatory, immune mediated disease of the central nervous system, mostly affecting young adults with mean age of 30 years, twice as high in women compared to men. The etiology of MS is not fully elucidated. MS symptoms are directly related to demyelination and axonal loss, along with other psychological symptoms, can result in functional limitations, disability and reduced quality of life (QoL). The QoL assessments in patients with a chronic disease may contribute to improving treatment and could even be of prognostic value. The goals of this study were to compare the QoL of Iraqi patients with relapsing remitting multiple sclerosis (RRMS),using three different diseas
... Show MoreThe global health crisis resulting from the spread of the Corona virus, which the World Health Organization described on January 30, 2020 as a public health emergency of international concern, then returned to describe it as a pandemic on March 11, 2020, and the measures and procedures taken by government authorities in different countries of the world, whether at the highest level of imposing a comprehensive curfew or what is called globally home quarantine and thus disrupting all sectors and activities in the state, whether public or private (with the exception of some sectors such as the health, media and security sectors), or at a lower level than that, such as reducing work rates in different sectors by rates that vary from one country
... Show MorePraise be to God, Lord of the worlds, and prayers and peace be upon our master and beloved Muhammad, the wise guide and great teacher, the guide to a straight path, the one sent as a mercy to the worlds, and upon his good and chosen family, his chosen companions, the working scholars, and those who follow them in righteousness until the Day of Judgment.
And after:
One of the important controversial topics shared between the sciences of the Noble Hadith and the Fundamentals of God is the issue of the innovator in terms of accepting and rejecting his narration and testimony, and the difference in it leads to disagreement in many branches of jurisprudence that were based on texts narrated by innovated narrators or those accu
... Show MoreThe research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen
... Show MoreThe growing population and the rising standard of living in cities as well as the increased commercial, industrial and agricultural activities around the world led to
massive production of waste containing different materials and one of them is the municipal solid waste (MSW), so there is a major problem facing the cities around the world about the waste, how to collect, transfer it and how to discard it. Because the accumulation of wastes, whether in the city alleys or in its squares and especially in its residential areas affect the health of their populations besides this situation will be a major indication of the deteriorating quality of life in the city, as hygiene considered a fundamental criterion for the city beauty as well
The development of technology used in computerized programs is considered on of the most important topics that is responsible for creating tools that can be used in the business environment, the audit profession is one of those professions that received this development. In order for this profession to be more effective, there must be a tool based on sound (correct) scientific basis that can be based upon to enhance the quality of auditing. The research also aims to propose a computerized program to plan the auditing process according to the methods appropriate to the working environment in the audit offices and companies in Iraq. The computerized program was applied to the research sample and the hypothesis of the research has been prov
... Show MoreThis research came with the aim of showing the impact of governance mechanisms on tax avoidance practices, and in light of this, the financial data of the joint stock companies (industrial, service, agricultural, and hotels) listed in the Iraq Stock Exchange amounting to (35) companies were collected during the period (2009-2020). Through the financial reports published on the market website, multiple linear regression analysis was used as a tool to study the relationship between variables, and (Eviews 12) program was used for analysis and hypothesis testing. To achieve the objectives of the research,(administrative ownership, board size, board independence, women's membership) was adopted as an indicator of the dimensions of governance, an
... Show MoreThe current research aims to test the impact of the strategy of merger (as an explanatory variable) in human resources management practices (as a response variable), and the importance of the subject being an important topic that mimics the Iraqi environment, where has seen many mergers that have not been addressed by former researchers in the field. In addition, the future prospects carry many mergers, and the problem of research was the lack of understanding among departments in how to manage the integration and deal with it, on the basis of scientific which reflected negatively on the practices of human resources management, and the research was based on two main hypotheses Six sub-hypotheses emerge to explore the correlation
... Show MoreCountries have faced the challenges of high levels of public debt and seek to define the optimum limits to reduce risks to which the financial system can be exposed and its impact on the economy as a whole. Hence the importance of research in studying the impact of internal and external public debt components on indicators of stability of the financial system for the period 2005-2017 for the purpose of knowing the extent of the financial stability indicators response to the high level of the public debt from its optimum ratio, as the aim of the research is to estimate and analyze the dynamic relationship of short and long term between the components of public debt and indicators of financial stability using the (ARDL) model that
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