Drug, Healthcare and Patient Safety最新文献

{"title":"Chemotherapy-Induced Toxicities in Pediatric Cancer Patients: A Cross-Sectional Survey Using a Child- and Caregiver-Reported Outcome Tool in Tanzania.","authors":"Deogratias M Katabalo, Esther Njile, Benson R Kidenya, Anthony Cuthbert Liwa, Kristin Schroeder","doi":"10.2147/DHPS.S548441","DOIUrl":"https://doi.org/10.2147/DHPS.S548441","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy remains the cornerstone of pediatric cancer treatment, yet its cytotoxic nature often results in chemotherapy-induced toxicities, adverse effects arising from damage to healthy, rapidly dividing cells. Data describing these toxicities from the patient and caregiver perspective are scarce in sub-Saharan Africa. This study assessed the types, severity, and determinants of Chemotherapy-Induced Toxicities among pediatric cancer patients in Tanzania.</p><p><strong>Methodology: </strong>A descriptive cross-sectional study was conducted over six months at Bugando Medical Center. Pediatric patients aged birth to 18 years receiving chemotherapy were enrolled. Toxicities were assessed using a locally validated, Swahili-translated version of the Pediatric Patient-Reported Outcomes Common Terminology Criteria for Adverse Events tool. Children aged ≥ 7 years self-reported their symptoms, while caregivers provided proxy reports for younger children and those who can not express themselves. Associations between chemotherapy-induced toxicities and demographic or treatment variables were analysed using multivariate logistic regression to adjust for potential confounding factors or variables (p < 0.05).</p><p><strong>Results: </strong>Of 120 participants (55.8% male), all experienced at least one Chemotherapy-Induced Toxicity, with a mean of five per participant. The most common toxicities were alopecia (82.5%), taste changes (74.2%), vomiting (44.2%), and nausea (35%). Most events were mild (grade 1). In multivariable analysis, cancer classification was the only significant predictor of toxicity, with solid tumors showing higher odds of ≥ Grade 2 Chemotherapy-induced toxicities compared with hematologic cancers (AOR = 7.42, p = 0.047). Other factors showed no statistically significant associations.</p><p><strong>Conclusion: </strong>Chemotherapy-induced toxicities were frequent, with most children experiencing multiple symptoms across organ systems. Cancer classification was the only factor significantly associated with higher-grade toxicities. Integrating child- and caregiver-reported outcome measures into pediatric oncology practice could enhance early identification of toxicities, support timely management, and inform national strategies to improve treatment safety and quality of life for children with cancer in Tanzania.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"548441"},"PeriodicalIF":3.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Missed Medication Doses and Outcomes of Hospitalized Patients Living with HIV in Uganda.","authors":"Mary Madalen Angut, Humphrey Atwijukiire, Brian Mushabe, Katusabe Shamim, Brenda Namanda, Charles Mondo, Emmanuel Seremba, Charles Kabugo, Joseph Baruch Baluku","doi":"10.2147/DHPS.S572681","DOIUrl":"10.2147/DHPS.S572681","url":null,"abstract":"<p><strong>Background: </strong>Missed Medication Doses (MMD) are a common but preventable form of medication error that compromise treatment outcomes. Evidence on the burden and consequences of MMD among hospitalized people living with HIV (PLHIV) in Uganda remains limited.</p><p><strong>Methods: </strong>We conducted a cross-sectional study at KNRH, Kampala, Uganda, reviewing medical records of PLHIV admitted to the infectious diseases unit between January 2022 and December 2023. Eligible files included treatment charts documenting prescribed and administered parenteral medications. Descriptive statistics summarized patient characteristics and prevalence of MMD. Associations between patient factors and MMD were assessed using chi-square tests and multivariable logistic regression. Outcomes examined included length of hospital stay, in-hospital mortality, and readmission.</p><p><strong>Results: </strong>Of 814 records screened, 462 met the inclusion criteria. Patients were predominantly female (61.0%), with a mean age of 25.8 years (SD 14.4). Overall, 403 patients (87.2%; 95% CI: 84.1-90.0) experienced at least one MMD. Missed doses were common across nearly all medications, with omission rates exceeding 80% for ceftriaxone, paracetamol, metronidazole, omeprazole, metoclopramide, and levofloxacin, and approaching 100% for furosemide, co-amoxiclav, ondansetron, enoxaparin, albumin, and artesunate. Lower odds of MMD were independently associated with Luo ethnicity (aOR = 0.15, 95% CI: 0.03-0.59), separated marital status (aOR = 0.16, 95% CI: 0.03-0.73), and Muslim faith (aOR = 0.21, 95% CI: 0.07-0.61). Older age was associated with a modest increase in risk (aOR = 1.02 per year, p = 0.032). Length of hospital stay did not differ significantly between patients with and without MMD. Overall in-hospital mortality was high (69.0%) and was lower among patients with documented MMD compared to those without (p < 0.001).</p><p><strong>Conclusion: </strong>Missed parenteral medication doses are highly prevalent among hospitalized PLHIV in Uganda. Strengthening medication administration and documentation systems is urgently needed to improve patient safety and outcomes.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"572681"},"PeriodicalIF":3.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prosthetic Loosening in a Total Hip Arthroplasty Patient After Breast Cancer Chemotherapy and Hormonal Therapy: A Case Report.","authors":"Jiemin Li, Shixun Li, Changchuan Li, Zhong Chen, Yue Ding","doi":"10.2147/DHPS.S543323","DOIUrl":"https://doi.org/10.2147/DHPS.S543323","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown that there are a lot of risk factors that could cause periprosthetic osteolysis and aseptic loosening, threatening the life-span of the hip prosthesis. Breast cancer is one of the most frequent malignancy in women. However, the use of breast cancer chemotherapy and hormonal therapy has been shown to significantly elevate the risk of osteoporosis. Chemotherapy can systematically suppress the anabolism of various organs, ultimately leading to bone metabolism dysfunction and osteolysis. Aromatase inhibitors (AI) function by inhibiting the conversion of androgens to estrogen, thereby reducing systemic estrogen levels, which is essential for maintaining bone mass; however, prolonged estrogen deprivation can lead to osteoporosis, which has been proven to pose a significant threat to the survival of hip implants.</p><p><strong>Case presentation: </strong>In this case, the patient suffered hip joint tuberculosis and took intertrochanteric osteotomy procedure at age 24. Seventeen years after, she took Total Hip Arthroplasty (THA). She then undertook chemotherapy and hormonal therapy for breast invasive ductal carcinoma (BI-RADS category III), 1 year after her primary THA. Three years later, she was diagnosed with aseptic loosening of her hip prosthesis. A summary and analysis of her treatment were conducted.</p><p><strong>Conclusion: </strong>Breast cancer chemotherapy and hormonal therapy might be a threat to the stability of THA prosthesis. More attention should be paid when a Total Hip Arthroplasty patient received chemotherapy and hormonal therapy. Further research is needed to fully understand the impact of breast cancer treatments, as current therapies like hormonal therapy can increase the risk of osteoporosis and fractures.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"543323"},"PeriodicalIF":3.4,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Events Associated with Tirzepatide: Updated Pharmacovigilance Analysis Using FAERS (2022 Q1-2025 Q1) with an Adapted Time-to-Onset Method.","authors":"Saisai Gu","doi":"10.2147/DHPS.S556918","DOIUrl":"10.2147/DHPS.S556918","url":null,"abstract":"<p><strong>Purpose: </strong>Tirzepatide, the first dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist with rapidly expanding clinical use, requires detailed post-marketing pharmacovigilance to monitor emerging safety signals. This study aims to identify and characterize specific adverse events (AEs) associated with tirzepatide utilizing FDA Adverse Event Reporting System (FAERS).</p><p><strong>Patients and methods: </strong>The datasets were cleaned and standardized using Python, a programming language for data processing, and MySQL, a database management system, to ensure accuracy and consistency before analysis. Subsequently, AE signals were detected via four quantitative disproportionality algorithms, sorted and categorized by demographics, gender, and clinical prioritization, with a modified Weibull model developed to analyze AE onset timing.</p><p><strong>Results: </strong>A total of 67,305 cases (75.83% female) and 137,583 adverse events were identified related to tirzepatide. One hundred and forty-four AE signals showed statistically significant signals suggesting a potential association with tirzepatide, with several new including postmenopausal haemorrhage and menstrual disorder (implying regulatory interference on sex hormones), Wernicke's encephalopathy and sleep disorder (malnutrition caused by low intake). Pancreatitis, impaired gastric emptying, dehydration and cholelithiasis carried higher risks with serious clinical outcomes. Sleep disorder, delayed gastric emptying, and medullary thyroid cancer are more common in males; starvation ketoacidosis and incorrect injection site, in females. The median time-to-onset (TTO) was 6.36 days (Interquartile Range (IQR) 0.85-31.2) with the Weibull shape parameter (β) of 0.44, indicating an early failure profile.</p><p><strong>Conclusion: </strong>This study uncovered new risks of tirzepatide, including AEs associated with skin, menstruation, psychiatric and nervous system. Median TTO was corrected to within a week, highlighting the need for early monitoring before clinicians prescribe tirzepatide, and special attention should be given to patients who have pre-existing digestive dysfunction, malnutrition, or a family history of thyroid disease.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"556918"},"PeriodicalIF":3.4,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digoxin Toxicity at Standard Doses in a Child with Subclinical Elevation of Thyrotrophin: A Case Report.","authors":"Mohammadrafie Khorgami, Mohammad Dalili, Bahareh Karimian","doi":"10.2147/DHPS.S553017","DOIUrl":"10.2147/DHPS.S553017","url":null,"abstract":"<p><p>Digoxin toxicity poses a challenge for patients using the drug. Electrolyte disturbances, renal failure, and drug interactions are common predisposing factors. Hypothyroidism can increase the risk of digoxin toxicity primarily. This research reports a 7-year-old boy receiving digoxin 6 μg/kg/day presented with nausea and second-degree atrioventricular block secondary to ongoing digoxin toxicity. Initiation of levothyroxine for subclinical elevation of thyrotrophin resulted in rapid resolution of symptoms and normalization of digoxin levels.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"17 ","pages":"265-267"},"PeriodicalIF":3.4,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Knowledge, Attitudes, and Practices on Antibiotic Use and Resistance Among Healthcare Workers in Monrovia, Liberia: A Facility-Based Cross-Sectional Study.","authors":"Bode Ireti Shobayo, Victor Saah Taylor, Bluefin Masell Freeman, James Saysay Kokro, Sampson K P Chea","doi":"10.2147/DHPS.S564658","DOIUrl":"10.2147/DHPS.S564658","url":null,"abstract":"<p><strong>Background: </strong>Globally, healthcare systems are currently facing a significant challenge in terms of antibiotic resistance. Healthcare professionals actively participate in the process of prescribing, dispensing and administering antibiotics.</p><p><strong>Objective: </strong>We examined the knowledge, attitudes and practices regarding antibiotic use and antibiotic resistance among healthcare professionals working in a tertiary hospital located in Monrovia, Liberia.</p><p><strong>Methods: </strong>A hospital-based cross-sectional survey was carried out from January to June, 2023 involving 61 healthcare workers at the ELWA Hospital, Liberia. A purposive sample of healthcare workers across diverse professional roles was surveyed using a structured questionnaire on antibiotic use and resistance. Data were analyzed in SPSS v25 using descriptive statistics to summarize participant characteristics and inferential tests to explore variable associations.</p><p><strong>Results: </strong>Participants ages ranged from 20 to 60 years (mean = 40.7 ± 5) and nurses constituted the majority professional group (59%). Most respondents (68.9%) disagreed that antibiotics are effective against viral infections (OR = 0.45; p = 0.020). However, 36.1% believed antibiotics could be stopped when symptoms resolve and 24.6% believed leftover antibiotics could be reused (OR = 0.33; p = 0.002). Majority, 72.1% and 70.5%, reported never using antibiotics for body pain or headaches, respectively (OR = 3.67; p = 0.001 and OR = 4.78; p < 0.001). Despite this, 39.3% admitted to sometimes or always storing leftover antibiotics and 39.3% agreed or strongly agreed that stopping antibiotics early is safe (OR = 0.36; p = 0.016).</p><p><strong>Conclusion: </strong>The study identified persistent gaps in healthcare workers' knowledge, attitudes, and practices regarding antibiotic use and resistance, despite encouraging awareness in some areas. Misconceptions such as premature discontinuation and reuse of leftover antibiotics were common. Findings underscore the need for targeted education and strengthened stewardship programs in Liberia's healthcare settings.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"17 ","pages":"253-264"},"PeriodicalIF":3.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Status and Research Trends in Deprescribing: A Bibliometric Review.","authors":"Changcheng Shi, Xinyi Li, Yan Wu, Wangjun Qin, Lihong Liu","doi":"10.2147/DHPS.S557043","DOIUrl":"10.2147/DHPS.S557043","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy has emerged as a major global public health concern. To mitigate its adverse effects, deprescribing has been introduced and integrated into clinical practice. This study aims to analyze the current research landscape and identify emerging trends in deprescribing from a bibliometric perspective.</p><p><strong>Methods: </strong>Relevant studies on deprescribing published prior to December 2024 were retrieved from the Web of Science Core Collection database. Bibliometric analysis and visualization of co-authorship, citation, co-citation, co-occurrence, and burst detection were performed using VOSviewer, CiteSpace, and Bibliometrix.</p><p><strong>Results: </strong>A total of 1809 publications were identified, with a marked increase over the past decade. The field is dominated by contributions from developed countries, notably the United States, Australia, and Canada. Studies primarily focus on chronic conditions, such as psychiatric disorders, cardiometabolic diseases, and chronic pain, and the medications used to treat them. Influential publications highlighted barriers and facilitators of deprescribing, deprescribing tools, and deprescribing interventions and their associated outcomes. Burst detection analysis pointed to increasing attention on pharmaceutical care and implementation science.</p><p><strong>Conclusion: </strong>This study presents the first comprehensive bibliometric overview of deprescribing. The findings demonstrate that the field has grown rapidly but remains dominated by developed countries and a limited set of chronic diseases. The integration of implementation science frameworks emerges as a promising approach to enhance the design and evaluation of deprescribing interventions. Future studies should broaden their scope to include a wider range of diseases and medications, and encourage greater participation from developing countries.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"17 ","pages":"239-252"},"PeriodicalIF":3.4,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145586325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and Barriers to Prescription Medication Sharing: A Qualitative Study from the Public's Perspective in Saudi Arabia.","authors":"Faten Alhomoud, Kawthar Alhaddad, Yaqeen Aldaqdouq, Zahrah Hassan Aljuzair, Farah Kais Alhomoud, Fatemah M Alsaleh, Basmah Alfageh, Marwan A Alrasheed, Mohra Aladwani, Mona Almanasef","doi":"10.2147/DHPS.S553530","DOIUrl":"10.2147/DHPS.S553530","url":null,"abstract":"<p><strong>Background: </strong>Prescription medication sharing (PMS) poses significant health risks, including side effects, delayed care, and worsening of illness. Despite these risks, evidence explaining why people share or avoid sharing prescription medicines remains scarce. To address this gap, the present study explored the perceived facilitators and barriers to PMS among the public in the Kingdom of Saudi Arabia (KSA) using a qualitative approach.</p><p><strong>Methods: </strong>A qualitative study using face-to-face, semi-structured interviews was conducted in the Eastern Province with 60 participants, selected through a convenience sampling strategy. Eligibility criteria included the ability to communicate in Arabic or English, age ≥18 years, and taking a prescribed medication. Interviews continued until data saturation was achieved. Audio recordings were transcribed verbatim and analysed thematically using QSR NVivo 10 software.</p><p><strong>Results: </strong>The study included 60 participants. Most participants were female, younger adults, and university educated. Thematic analysis identified two main themes: facilitators and barriers of PMS. Facilitators included saving time and cost, limited access to medicines or healthcare services, availability of leftover medicines, socio-cultural factors, and prior experience or knowledge about an illness and its treatment. Barriers included unsafe or ineffective treatment, awareness of public health risks, risk of dependence, and risk of non-adherence among lenders. These themes reflected a complex interaction of individual, cultural, and system-level influences. While some drivers aligned with international findings, others were more specific to the Saudi context, such as over-prescribing by doctors, brand preferences, misuse of insurance, medicine accumulation, strong family ties, cultural expectations of generosity, stigma-related communication gaps, and personal illness experiences.</p><p><strong>Conclusion: </strong>This study provides the first qualitative insight into PMS in Saudi Arabia, highlighting how cultural norms, family dynamics, and healthcare system factors shape this behavior. The findings underscore the need for culturally informed policies and public health strategies to reduce risks and promote safe medication practices. Pharmacist-led counselling and community-based campaigns focused on safe medication use and proper disposal can further support safer medication practices and reduce the risks associated with PMS.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"17 ","pages":"221-237"},"PeriodicalIF":3.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing Interprofessional Medication Reviews in Home Care Patients - A Feasibility Study.","authors":"Carla Meyer-Massetti, Anita Sommer, Estelle Kaiser, Anna Maria Peschak, Marina Preisig, Carole Elodie Aubert, Raphael Dimitri Mäder, Lisa Ramseier, Irene Stefanie Riesen, Stefanie Lettieri-Amstutz, Daniela Rölli, Nicole Schönenberger, Christoph R Meier","doi":"10.2147/DHPS.S519424","DOIUrl":"10.2147/DHPS.S519424","url":null,"abstract":"<p><strong>Background: </strong>Medication-related problems are especially frequent among home-care patients, who are predominantly older, multimorbid, polymedicated and interact with multiple professionals, necessitating timely, complete and accurate drug information communication.</p><p><strong>Aim: </strong>To pilot a standardised approach to interprofessional home-care medication management focusing on deprescribing.</p><p><strong>Methods: </strong>Home-care patients, cared for in their own homes by one professional nursing agency in the city of Bern, Switzerland, aged ≥64 and taking ≥4 prescribed medications were assessed for medication-related risk with the interprofessional, 10-item doMESTIC RISK tool. Community pharmacists performed structured medication reviews for at-risk patients, communicating with primary care physicians via standardised form.</p><p><strong>Results: </strong>Nurses initiated 106 risk analyses (as defined in the process) in consenting patients, with 76 (72%) completed by pharmacists; 30 analyses could not be completed due to missing information. Out of 76 patients with a completed risk assessment, 26 patients did not need a medication review; one score was missing. The 49 patients qualifying for a medication review were on average 84.0 ± 7.7 years old and took a mean of 11.2 ± 4.5 prescribed medications regularly and 2.8 ± 3.5 prescribed as-needed medications. Pharmacists identified a median of two problems per patient, suggesting 64 potential interventions. Forty-three priority interventions for 18 patients were communicated to physicians, mostly dose reduction (27%) and therapy cessation (23%). Despite providing comprehensive information in the requests, physicians only reacted to 50% of pharmacists' recommendations (9/18 patients), accepting 57% of pharmacists suggestions in nine patients, predominantly deprescribing (nine medications).</p><p><strong>Conclusion: </strong>While pharmacists identified medication improvements through structured medication reviews, limited access to clinical information and insufficient communication between health care professionals were key barriers. Strengthening interprofessional collaboration and structured communication through shared platforms allowing clinical data exchange is essential to optimizing medication management in home-care. Clarification of the roles of the team members must be improved.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"17 ","pages":"209-220"},"PeriodicalIF":3.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing of a National Diagnostic Reference Level for Radiation Dose in Digital Paediatric Pelvic X-Rays in Jordan: A Multicenter Retrospective Study.","authors":"Malak AlHawadi, Mohammad Ayasrah","doi":"10.2147/DHPS.S507740","DOIUrl":"10.2147/DHPS.S507740","url":null,"abstract":"<p><strong>Background: </strong>Paediatric pelvic X-rays are essential for diagnosing injuries and developmental abnormalities but pose radiation risks to sensitive children. Dose Reference Levels (DRLs) play a critical role in optimising radiographic procedures, ensuring both safety and high-quality imaging.</p><p><strong>Objective: </strong>This research aimed to establish a National Dose Reference Level (NDRL) for digital paediatric pelvic X-rays in Jordan to optimise radiation doses, improve diagnostic accuracy, and minimise risks.</p><p><strong>Methods: </strong>A Multicenter retrospective analysis was performed on paediatric Anterior-Posterior (AP) digital pelvic X-rays from various 12 Jordanian healthcare institutions. Parameters including Kilovoltage peak (kVp), milli Ampere second (mAs), and Focal to Skin Distance (FSD) were collected. Entrance Surface Dose (ESD) was indirectly calculated following international guidelines.</p><p><strong>Results: </strong>The study analysed 1,674 paediatric pelvic X-rays, finding a mean ESD of 0.69 milli-Gray (mGy). The 75th percentile ESD, or (DRL), was 0.612 mGy overall, with age-specific DRLs of 0.265 mGy (0 to <1 year), 0.382 mGy (1 to <5 years), 0.704 mGy (5 to <10 years), and 0.995 mGy (10 to ≤15 years).</p><p><strong>Conclusion: </strong>The study revealed age-dependent variations and notable disparities in radiation doses among various healthcare institutions in Jordan. Establishing the NDRL of 0.612 mGy provides a benchmark for dose optimisation and aligns Jordan's practices with international standards. The findings can guide national radiation protection policies and clinical guidelines, enhance paediatric imaging practices, and minimise unnecessary radiation exposure.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"17 ","pages":"197-207"},"PeriodicalIF":3.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}