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.
The major aim of this research is study the effect of the type of lightweight aggregate (Porcelinite and Thermostone), type and ratio of the pozzolanic material(SF and HRM) and the use of different ratios of w/cm ratio(0.32 and 0.35) on the properties of SCLWC in the fresh and hardened state. SF and HRM are used in three percentage 5%,10%, and 15% as a partial replacement by weight of
cement for all types of SCLWC. The requirements of self-compatibility for SCC are fulfilled by using the high performance superplasticizer (G51) at 1.2liter per 100 kg of cement. The values of air dry density and compressive strength at age of 28 days within the limits of structural lightweight concrete. The air dry density and compressive strength at a
Soft clays are generally characterized by low shear strength, low permeability and high compressibility. An effective method to accelerate consolidation of such soils is to use vertical drains along with vacuum preloading to encourage radial flow of water. In this research numerical modeling of prefabricated vertical drains with vacuum pressure was done to investigate the effect of using vertical drains together with vacuum pressure on the degree of saturation of fully and saturated-unsaturated soft soils. Laboratory experiments were conducted by using a specially-designed large consolidometer cell where a central drain was installed and vacuum pressure was applied. All tests were conducted
... Show MoreGovernment expenditure represents one of the controlling financial policies in the economic affairs and management of the economic cycle in order to achieve price stability, raise the rate of output growth and decrease the level of unemployment. The price stability represents one of the macroeconomic goals that all countries seek without exception, regardless of the economic philosophy adopted by each country; in addition to this is raising the productive capacity and reaching the actual output to the level of the expected output, that is, the level of output related to the natural unemployment rate or what is sometimes called the Non-inflationary unemployment rate. The restriction of government expenditure (G=T+∆B/iP+∆M/P) is
... Show MoreThere is an assumption implicit but fundamental theory behind the decline by the time series used in the estimate, namely that the time series has a sleep feature Stationary or the language of Engle Gernger chains are integrated level zero, which indicated by I (0). It is well known, for example, tables of t-statistic is designed primarily to deal with the results of the regression that uses static strings. This assumption has been previously treated as an axiom the mid-seventies, where researchers are conducting studies of applied without taking into account the properties of time series used prior to the assessment, was to accept the results of these tests Bmanueh and delivery capabilities based on the applicability of the theo
... Show MoreThe aim of this research is analysis the effect of the changes in (GDA, g, inflation) at average and standard economic curriculum in composition of the models, depending on SPSS program in analysis, and according to available date from central bank of Iraq and during the period from 2003 to 2018 and by using OLS and estimate of the equation and the results showed a statistical significance relation in incorporeal level 5% and the R2 value equal to 92.1 refer to the changes in independent variables explain 92% of changes of unemployment and the independent variables effect are very limit depend on estimated parameters in the model and respectively (0.986,0.229,-0.060), the research recommended necessity to active the inve
... Show MoreThroughout this paper we study the properties of the composition operator
C
p1 o
p2 o…o
pn induced by the composition of finite numbers of special
automorphisms of U,
pi (z) i
i
p z
1 p z
Such that pi U, i 1, 2, …, n, and discuss the relation between the product of
finite numbers of automorphic composition operators on Hardy space H2 and some
classes of operators.