Journal of Clinical Pharmacy and Therapeutics最新文献

{"title":"Exploring the Impact of Medication Regimen Complexity on Health-Related Quality of Life in Patients with Multimorbidity","authors":"Begashaw Melaku Gebresillassie,&nbsp;Abebe Tarekegn Kassaw","doi":"10.1155/2023/1744472","DOIUrl":"10.1155/2023/1744472","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Patients with multiple chronic conditions often have complex medication regimes which negatively impact their health-related quality of life (HRQoL), and there is limited evidence on this topic, particularly from the resource limiting set-up. Hence, this study is aimed at assessing the impact of medication regimen complexity on HRQoL in patients with multiple chronic conditions at a university hospital in Ethiopia. <i>Method</i>. A cross-sectional study was conducted on adult patients who had at least two long-term diseases and were already receiving medical therapy for the relevant disorders. The validated 65-item Medication Regimen Complexity Index (MRCI) and the EuroQol-5-Dimensions-5-Levels (EQ-5D-5L) instruments were used to assess MRC and HRQoL, respectively. The Welch test for unequal variance and Fisher’s exact test were used to assess the impact of different variables on HRQoL. <i>Results</i>. The study surveyed 416 participants, with a 98.3% response rate, the majority of whom were female (<i>n</i> = 267, 64.2%) and had two chronic conditions (<i>n</i> = 215, 51.7%). About 46.4% of patients were taking five or more medications, with a significantly higher proportion at the high regimen complexity level (<i>P</i> = 0.001). The average MRCI score was 9.73 ± 3.38, indicating a high level of complexity. Patients with high MRCI scores reported more problems in mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. There was a negative correlation between the MRCI score and HRQoL as measured by the EQ-5D-Index (<i>r</i> = −0.175; <i>P</i> &lt; 0.001) and the EuroQol-Visual Analogue Scale score (<i>r</i> = −0.151; <i>P</i> = 0.002). In addition, there was a statistically significant difference in the mean EQ-5D-Index (<i>P</i> = 0.001) and EQ-VAS scores (<i>P</i> = 0.001) across low, medium, and high MRCI levels. <i>Conclusion</i>. Medication regimen complexity was prevalent among patients with multimorbidity and was associated with a decrease in HRQoL. Therefore, interventions addressing medication-related issues should be a priority to improve the well-being of patients with multiple chronic conditions.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1744472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48091487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Resistance and Biofilm Production in Uropathogens from Renal Disease Patients Admitted to Tribhuvan University Teaching Hospital, Nepal","authors":"Anuja Dahal,&nbsp;Kamal Shrestha,&nbsp;Rashmi Karki,&nbsp;Saraswati Bhattarai,&nbsp;Shiva Aryal,&nbsp;Satish Kumar Deo,&nbsp;Balmukunda Regmi,&nbsp;Mark Willcox,&nbsp;Shyam Kumar Mishra","doi":"10.1155/2023/4867817","DOIUrl":"10.1155/2023/4867817","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Various antibiotics are prescribed empirically by physicians to cope with infections in renal disease patients. A urinary tract infection (UTI) is often caused by biofilm-forming multidrug-resistant (MDR) uropathogens. This study aimed to analyze the antibiogram of UTI strains from renal disease patients and the biofilm-forming ability of those strains. <i>Methods</i>. 102 patients clinically diagnosed with a UTI and renal disease were recruited into the study from August 2017 to January 2018. Clean-catch midstream urine samples were processed for the isolation and identification of the bacteria following standard methodologies. The antibiogram of the isolates (<i>n</i> = 106) was produced by the Kirby–Bauer disc diffusion method. Detection of biofilm formation was performed in tissue culture plates. <i>Results</i>. The incidence of a UTI in renal disease was 19.1%. Most patients were diagnosed with chronic kidney disease (18.63%), nephrotic syndrome (16.67%), and nephrolithiasis (14.71%). The commonest uropathogens were <i>Escherichia coli</i> (52.8%), <i>Klebsiella pneumoniae</i> (16%), and <i>Enterococcus</i> spp. (15.0%). Ceftriaxone was the most common antibiotic prescribed empirically (37%), whereas nitrofurantoin was the most prescribed antibiotic as adjusted therapy (36.1%). Among the first- and second-line antibiotics, most Gram-negative bacteria were sensitive to amikacin (70.7%), meropenem (70.7%), cefoperazone-sulbactam (70.0%), piperacillin-tazobactam (67.2%), gentamicin (66.7%), and nitrofurantoin (66.7%). Most Gram-positive bacteria were sensitive to doxycycline (90.0%), nitrofurantoin (72.2%), gentamicin (66.7%), and tetracycline (62.5%). All MDR Gram-negative uropathogens were susceptible to colistin sulfate and polymyxin B. Among the 106 isolates, 74.5% produced biofilms and 70.8% were MDR. In 67.0% of cases, including both MDR and biofilm-producing bacteria, the empirical therapy needed adjustment. <i>Conclusions</i>. Aminoglycoside, carbapenem, beta-lactam combination agents, and nitrofuran group of antibiotics may be the optimal first-line empirical therapies for uropathogens in hospitalized renal disease patients. Regular surveillance of resistance patterns and the study of biofilm formation in uropathogens must be performed to ensure effective management of the patients.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/4867817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46864844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of the UK Pharmacy Profession’s Educational Needs on Pharmacogenomics","authors":"Victoria Rollinson,&nbsp;Neil French,&nbsp;Richard Turner,&nbsp;Munir Pirmohamed","doi":"10.1155/2023/2388845","DOIUrl":"10.1155/2023/2388845","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. The aim of this exploratory study was to ascertain the current educational status of pharmacogenomics (PGx) within the present and future UK pharmacy profession, in addition to ascertaining future educational and infrastructure needs of pharmacists to adopt PGx into practice. <i>Methods</i>. A 35-question survey was sent electronically to practicing pharmacists, preregistration pharmacists, and Master of Pharmacy (MPharm) students throughout the UK between April 2018 and May 2019. Responses were anonymous and analysed using GraphPad Prism 8 and SPSS statistics 26. <i>Results</i>. In total, 264 participants, where data could be used for analysis, responded to the survey. This comprised 196 practicing pharmacists and 68 preregistration pharmacists/MPharm students. The findings demonstrated variation in undergraduate level exposure to PGx between those who had qualified within the past 10 years and those who had qualified over 10 years ago. Over 60% of qualified pharmacists did not feel confident in identifying drugs that require PGx testing. Nearly three quarters of respondents cited that PGx guidelines were needed to help facilitate a PGx service, although 63.6% also stated that they had previously never looked for a PGx recommendation. Most respondents cited PGx as a low or medium learning priority. <i>Conclusion</i>. Our survey suggests that further education is required to prepare the UK pharmacy workforce for the advent of PGx. A focus on the provision of, and education around, PGx guidelines is needed. In addition, the disparity identified between pharmacists at different stages of their career will need to be addressed with tailored and targeted educational packages.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/2388845","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42145484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Survival Effect of Metformin on Non-Small Cell Lung Cancer Treated with Chemotherapy: A Systematic Review","authors":"Qin Li,&nbsp;Qiao Fan,&nbsp;Ji Wu","doi":"10.1155/2023/5575513","DOIUrl":"10.1155/2023/5575513","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. Metformin is a common antidiabetic drug that has been reported to serve as an anticancer agent in combination with other therapies. But the effect of the addition of metformin on the survival of non-small cell lung cancer (NSCLC) patients undergoing chemotherapy is still controversial. We conducted this systematic review to evaluate the survival effect of metformin added to chemotherapy in NSCLC patients. <i>Methods</i>. Electronic literature search was performed in the PubMed, Embase, and Web of Science databases from their inception up to April 2023. The study region, study design, histological subtype of the NSCLC, tumor stage, treatment strategy, sample size, follow-up duration, diabetes status, and HR of OS or PFS of the included studies were extracted. The quality was assessed through Cochrane collaboration’s tool for RCT and the Newcastle–Ottawa scale (NOS) for observational studies, respectively. <i>Results and conclusions</i>. Eleven studies with a total of 4606 patients were finally included. Five RCTs showed a high risk of bias due to the open-label nature while six retrospective studies were of high quality. Two studies of NSCLC patients with diabetes reported significant benefits in overall survival from metformin addition, while one study of patients without diabetes reported a negative effect on the survival of metformin addition. The survival impact of metformin added to chemotherapy on unresectable NSCLC patients remains inconclusive. The survival benefit might be more prominent in patients with diabetes, awaiting further evidence.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5575513","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41719417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Fluconazole on the Pharmacokinetics of Pyrotinib Maleate: A Single-Center, Open, Single-Dose, Self-Controlled Study in Healthy Chinese Participants","authors":"Yuanming Song,&nbsp;Wenyu Zhang,&nbsp;Peng Chen,&nbsp;Rui Liang,&nbsp;Hengli Zhao,&nbsp;Qing Wen","doi":"10.1155/2023/9514938","DOIUrl":"10.1155/2023/9514938","url":null,"abstract":"<div>\u0000 <p><i>What Is Known and Objective.</i> Pyrotinib maleate, also known as pyrotinib, is an irreversible dual receptor tyrosine kinase inhibitor that primarily targets the epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2). Cytochrome P450 3A4 (CYP3A4) enzyme mainly catalyzes pyrotinib, and its metabolism is influenced apparently by CYP3A4 strong inhibitor, but the effect of CYP3A4 moderate inhibitor is still unclear as a moderate inhibitor of CYP3A4 enzyme. This study evaluated the effect of fluconazole, a widespread antifungal medication, on the pharmacokinetics and safety tolerance of pyrotinib. <i>Methods</i>. This study was an open, single-dose, and self-controlled clinical trial. Eighteen healthy Chinese participants were enrolled in this study. All participants were administered fluconazole on days 6–18 and pyrotinib on days 1 and 9. The maximum plasma concentration (<i>C</i>_max), time to <i>C</i>_max (<i>T</i>_max), area under the concentration–time curve from time 0 to the last measurable concentration (AUC_0<i>−t</i>), area under the concentration–time curve from time 0 extrapolated to infinity (AUC_{0<i>−∞</i>}), terminal elimination half-life (<i>t</i>_1/2), apparent volume of distribution (<i>V</i>_<i>z</i><i>/F</i>), and apparent clearance (CL<i>/F</i>) were calculated using WinNonlin software (version 8.1). Safety tolerance was assessed throughout the process. <i>Results and Discussion</i>. Compared with the single administration of pyrotinib, the exposure level was enhanced significantly after the coadministration of pyrotinib and fluconazole. The geometric mean ratios (pyrotinib + fluconazole/pyrotinib alone) of <i>C</i>_max, AUC_0<i>−t</i>, and AUC_{0<i>−∞</i>} were 2.16, 3.6, and 3.5, respectively. The parameter of <i>t</i>_1/2 is 14.16 h and 24.03 h, and CL<i>/F</i> is 275.06 L/h and 78.42 L/h, for pyrotinib alone and with fluconazole. No serious adverse events were reported in this trial, and no participant withdrew from the trial because of adverse events. <i>What Is New and Conclusion</i>. The PK profile of pyrotinib, a CYP3A4 substrate, was significantly influenced by fluconazole, with increased exposure levels and prolonged <i>t</i>_1/2. Dosage adjustment is suggested for the clinical application of pyrotinib when coadministered with fluconazole or other CYP3A4 inhibitors/inducers.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/9514938","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48010467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Paclitaxel and Carboplatin for Platinum-Sensitive Ovarian Cancer: A Systematic Review and Meta-Analysis","authors":"Yan Zhou,&nbsp;Wei Guo","doi":"10.1155/2023/1951412","DOIUrl":"10.1155/2023/1951412","url":null,"abstract":"<div>\u0000 <p><i>Purpose.</i> Paclitaxel and carboplatin are novel anticancer drugs that have emerged in recent years, while there is still a lack of clinical consensus on these two drugs. The study conducted a meta-analysis and systematic review to analyze the efficacy and safety of paclitaxel and carboplatin for platinum-sensitive ovarian cancer. <i>Methods.</i> A systematic search was carried out in three databases of the Cochrane Library, Embase, and PubMed from the inception of each database to March 2021, and defined the progression-free survival and overall survival as the primary outcomes. Data analysis was performed using STATA 15.1. <i>Results.</i> Altogether, five randomized controlled trials (RCTs) were included in the meta-analysis, involving 2,740 patients, including 1317 in the CD (carboplatin doxorubicin) group and 1423 in the CP (carboplatin plus paclitaxel) group. It was found that pooled OS demonstrated no significant differences between the CD group and CP group (HR = 1.02, 95% CI = 0.89–1.18, <i>P</i> = 0.340), and the differences were not statistically significant in progression-free survival (HR = 0.84, 95% CI = 0.71–0.99, <i>P</i> = 0.140), thrombocytopenia (OR = 0.23, 95% CI = 0.09−0.58, <i>P</i> = 0.775), and grade II alopecia between the two groups (OR = 9.41, 95% CI = 6.57–13.47, <i>P</i> = 0.215). <i>Conclusion</i>. Current evidence suggests that paclitaxel and carboplatin do not produce more satisfactory results with respect to overall survival and reduction of side effects in treating platinum-sensitive ovarian cancer, and further studies are needed.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1951412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41349736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Antioxidant Supplementation on Graves’ Disease: A Meta-Analysis","authors":"Qi Song,&nbsp;Xiaoxue Ji,&nbsp;Ying Xie","doi":"10.1155/2023/5587361","DOIUrl":"10.1155/2023/5587361","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. The main objective of this study is to evaluate the clinical efficacy of antithyroid drugs combined with antioxidant supplementation represented by selenium in the treatment of Graves’ disease. <i>Methods</i>. Relevant randomized controlled trials (RCTs) were searched in PubMed, MEDLINE, Embase, the Cochrane Library databases, and the Chinese Medical Association. The search was conducted from the time of library construction to December 20, 2022. Three writers gradually examined, evaluated, and graded the literature and then used RevMan 5.3 to analyze the data and develop conclusions. <i>Results</i>. A total of seven papers were screened according to the search requirements. The results showed that free triiodothyronine (FT3) (WMD = −2.29, 95% CI: −3.55 to −1.02, <i>P</i> = 0.0004), free thyroxine (FT4) (WMD = −0.62, 95% CI: −1.05 to −0.18, <i>P</i> = 0.0005), thyrotropin receptor antibody (TRAb) (WMD = −1.31, 95% CI: −1.63 to −0.99, <i>P</i> &lt; 0.00001), and thyroid peroxidase antibody (TPOAb) (WMD = −9.8, 95% CI: −16.57 to −3.03, <i>P</i> = 0.005) in the observation group (selenium supplementation combined with antithyroid drugs) were significantly lower than those in the control group (antithyroid drugs combined with or without placebo). In addition, selenium supplementation can increase serum selenium (WMD = 33.29, 95% CI: 30.7 to 35.87, <i>P</i> &lt; 0.00001), selenoprotein levels (WMD = 1.3, 95% CI: 0.8 to 1.8, <i>P</i> &lt; 0.00001), and blood lipid levels (WMD = 32.3, 95% CI: 17.87 to 46.74, <i>P</i> &lt; 0.0001). It cannot be excluded that the process of selenium supplementation treatment will affect the patient’s lipid levels. <i>Conclusion</i>. Selenium is a trace mineral that is crucial for human health. In patients with Graves’ disease, the use of antithyroid medications along with selenium supplementation can considerably enhance thyroid function. It has the potential to drastically lower TPOAb and TRAb levels as well as FT3 and FT4 levels, which is crucial for the treatment, recovery, and prognosis of hyperthyroid patients. Further research is required to determine whether the impact of antioxidant supplementation on blood lipids will restrict the use of this medication.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5587361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45518661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Effectiveness of S-Ketamine Combined with Sufentanil versus Sufentanil Alone for Postoperative Pain Management in Elderly Patients Undergoing Laparoscopic Radical Resection of Gastrointestinal Cancer: A Randomized Controlled Trial","authors":"Ji Wang,&nbsp;Yu Du,&nbsp;Yue-Shuang Tan,&nbsp;Yu Liu,&nbsp;Ai-Ping Wen","doi":"10.1155/2023/1327019","DOIUrl":"10.1155/2023/1327019","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The optimal analgesic dose of S-ketamine after laparoscopic gastrointestinal malignancy surgery remains unclear. This study aimed to evaluate the effect of S-ketamine combined with sufentanil in patient-controlled intravenous analgesia (PCIA) on postoperative pain relief in elderly patients undergoing laparoscopic surgery for gastrointestinal tumors. <i>Methods</i>. Elderly patients undergoing laparoscopic radical resection of gastrointestinal cancer were randomly assigned to one of three postoperative analgesia groups: F group received 2 ug/kg sufentanil in PCIA, LSF group received 0.5 mg/kg S-ketamine and 1.5 ug/kg sufentanil, and SF group received 1 mg/kg S-ketamine and 1 ug/kg sufentanil. The PCIA also contained 0.15 mg/kg of butorphanol and 0.02 mg/kg of ramosetron. Study drugs were administered via PCIA for 48 hours postoperatively. The primary outcome was the accumulated parecoxib sodium requirements within 48 hours after surgery. <i>Results</i>. A total of 105 patients were randomized, and 95 completed the trial (F group: <i>n</i> = 32, LSF group: <i>n</i> = 32, and SF group: <i>n</i> = 31). The cumulative consumption of parecoxib sodium within 48 hours postoperatively was lower in the SF group compared to that in the F group (median difference: −40 mg; 95% confidence interval: −40 to 0; <i>P</i> = 0.0028). The number of PCIA compressions within 48 hours after surgery was smaller in the SF group compared to that in the F group. NRS pain scores at 6 h and 12 h postoperatively were reduced in the SF group compared to that in the F group, both at rest and during movement. Compared to the F group, the incidence of postoperative mild depression was lower, the time to first flatus and time to first defecation were shorter, and the incidence of postoperative vomiting was lower in the SF group. The mechanical pain threshold, hyperalgesia area, and sedation scores were similar between the SF and F groups. No differences were observed in the abovementioned parameters between the LSF group and the F group. <i>Conclusion</i>. This trial demonstrated that 1.0 mg/kg S-ketamine combined with 1 ug/kg sufentanil in PCA decreased cumulative parecoxib sodium consumption within 48 hours after laparoscopic radical resection of gastrointestinal cancer in elderly patients.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1327019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44534456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Improvement of the Rational Use of Central Nervous System Disease-Related Drugs in Elderly Inpatients","authors":"Fang Li,&nbsp;Yingli Zhu,&nbsp;Min Li,&nbsp;Yinpeng Xu,&nbsp;Yahui Cui,&nbsp;Ying Yang,&nbsp;Yaling Wang,&nbsp;Hong Hao","doi":"10.1155/2023/1634743","DOIUrl":"10.1155/2023/1634743","url":null,"abstract":"<div>\u0000 <p><i>What Is Known</i>? In elderly inpatients, potential inappropriate medication (PIM) is a prominent prescription challenge. However, there is limited information available regarding PIM in patients with central nervous system (CNS) diseases in China. <i>Objective</i>. To evaluate and improve the rational use of drugs for the treatment of CNS diseases in elderly inpatients. <i>Method</i>. A retrospective, cross-sectional study was conducted among elderly inpatients (≥65 years) admitted to the Ninth People’s Hospital of Zhengzhou in China from March 2020 to March 2021. PIM was identified based on the 2019 Beers criteria at admission and discharge. The patients recruited in March 2020 were considered a baseline group, which was used as a comparison to evaluate PIM of CNS disease-related drugs in June 2020, September 2020, December 2020, and March 2021. <i>Results</i>. A total of 1500 patients were included in the evaluation. There was a statistically significant difference in the number of average hospitalization days, drug varieties used, and PIM detection (<i>p</i> &lt; 0.05), as determined by <i>X</i>² test. A total of 332 cases of PIM were identified, and 226 cases were detected for the interaction with CNS disease dementia. Multifactor logistic regression analysis showed that male, length of stay ≥15 days, and &gt;10 medication types were risk factors for the occurrence of PIM (<i>p</i> &lt; 0.05). After clinical supervision and training based on the High-Risk Drug Replacement Program for the Elderly, the rate of irrational medication under medical advice decreased from 34.67% in March 2020 to 14.0% (<i>p</i> &lt; 0.001) in March 2021. <i>What Is New and Conclusion</i>. There was certain rationality based on the High-Risk Drug Replacement Program for the Elderly, and the rates of selective serotonin reuptake inhibitor, 5-hydroxylamine/norepinephrine re-intake inhibitor, rotenone, quetiapine, and proton pump inhibitor use were improved. These results provide a reference for the continuous improvement of the PIM catalog for elderly patients.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1634743","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49603738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probiotics for Preventing Necrotizing Enterocolitis: A Meta-Analysis with Trial Sequential Analysis","authors":"Yang Zhang,&nbsp;Qiong Xu,&nbsp;Feng Zhang,&nbsp;Chunlei Sun","doi":"10.1155/2023/8626191","DOIUrl":"10.1155/2023/8626191","url":null,"abstract":"<div>\u0000 <p><i>What is Known and Objective.</i> The role of probiotics, especially the different genera of probiotics, in managing necrotizing enterocolitis (NEC) is controversial. Thus, we performed a meta-analysis with trial sequential analysis (TSA) to determine the efficacy and safety of probiotics for preventing NEC. <i>Methods</i>. Medline, Embase, CENTRAL, WorldCat, TROVE, DART-Europe, and CBM were searched from inception to May 2022. Two investigators independently screened the literature, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4, and TSA was conducted using TSA 0.9 beta. <i>Results and Discussion</i>. Fifty-five studies involving 12897 newborns were eligible. The use of probiotics for preventing NEC reduced the incidence of NEC (RR 0.48, 95% CI 0.41 to 0.57, and <i>P</i> &lt; 0.05) and sepsis (RR 0.77, 95% CI 0.64 to 0.94, and <i>P</i> &lt; 0.05), the risk of mortality (RR 0.69, 95% CI 0.58 to 0.84, and <i>P</i> &lt; 0.05), and shortened the average days of hospitalization (MD −3.12, 95% CI −4.98 to −1.26, and <i>P</i> &lt; 0.05). However, subgroup analysis revealed that different genera of probiotics gave rise to different outcomes. In addition, TSA indicated that the cumulative <i>z</i>-curve crossed the traditional and trial sequential monitoring boundaries for benefit, providing firm evidence that multiple strains and <i>Lactobacillus</i> species of probiotics decreased the incidence of NEC. However, the current evidence was inconclusive for <i>Bifidobacterium</i> and <i>Saccharomyces</i> species. <i>What is New and Conclusions</i>. Probiotics are effective in preventing NEC and sepsis and could provide added benefits, including decreasing mortality and the number of days of hospitalization. However, considering the heterogeneity of probiotics regimens and the risk of selective reporting of RCTs, more high-quality clinical trials targeting different genera of probiotics with suitable doses and timing to prophylactic use of probiotics are needed to avoid overestimating the role of probiotics in preterm infants.</p>\u0000 </div>","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8626191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46734738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}