Reviews on recent clinical trials最新文献

{"title":"Metformin: A Promising Radiosensitizer in Neoadjuvant Rectal Cancer Treatment.","authors":"Nikolaos S Georgopoulos,&nbsp;Maria Tolia,&nbsp;Davide Mauri,&nbsp;Konstantinos Kamposioras,&nbsp;Nikolaos Charalampakis,&nbsp;Nikolaos Tsoukalas,&nbsp;Areti Gkantaifi","doi":"10.2174/1574887118666230428114349","DOIUrl":"https://doi.org/10.2174/1574887118666230428114349","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemoradiotherapy (nCRT) decreases the risk of local recurrence after surgery in patients with locally advanced rectal cancer (LARC) and metformin is constantly gaining scientific interest due to its potentially radiosensitizing effect.</p><p><strong>Objective: </strong>This review article aims to better clarify the role of metformin as a radiosensitizer in patients with LARC undergoing neoadjuvant concurrent chemoradiotherapy.</p><p><strong>Methods: </strong>We used the PubMed database to retrieve journal articles and the inclusion criteria were all human studies that illustrated the effective role of metformin in the neoadjuvant setting of locally advanced rectal cancer.</p><p><strong>Results: </strong>Our search resulted in 17 citations, of which 10 eventually fulfilled the inclusion criteria of our study. Promising results (improved tumor and nodal regression as well as higher pathologic complete response rate) have been occasionally documented with metformin use in some of the included studies. However, regarding survival and all-cause mortality, no significant difference has been found.</p><p><strong>Conclusion: </strong>Metformin might constitute a highly promising radiosensitizer in neoadjuvant LARC treatment attracting much scientific interest. Due to the lack of studies with high evidence, further advanced research is required to enhance the existing knowledge about its potential value in this field.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 3","pages":"172-180"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Relationship between the Attitude Towards Infertility and Stress Coping Strategies among Couples undergoing Assisted Reproduction Treatment.","authors":"Fatemeh Anjom Rouz, Mona Rahnavardi, Vahideh Hafezi, Fatemeh Rafat, Ehsan Kazemnezhad Leili, Arezoo Shayan, Zahra Karami","doi":"10.2174/0115748871262224230919092032","DOIUrl":"10.2174/0115748871262224230919092032","url":null,"abstract":"<p><strong>Introduction: </strong>Infertility and its treatment methods among couples have psychological and social consequences. To encounter these consequences, coping strategies are commonly used, which are influenced by various factors, such as the attitude of couples toward infertility.</p><p><strong>Objective: </strong>This study aims to determine the relationship between attitudes toward infertility and stress-coping strategies among couples undergoing Assisted Reproduction Treatment, referring to the infertility clinic of Al-Zahra Educational Center.</p><p><strong>Methods: </strong>This study was a cross-sectional study performed on 153 couples referred to Al-Zahra Infertility Clinic in Rasht. Three instruments (demographic questionnaire, attitude, and Lazarus coping strategies questionnaire) were used with regard to the inclusion restrictions.</p><p><strong>Results: </strong>Between the two variables of individual and social information factors and the attitude of couples toward infertility, only the duration of infertility factor revealed a significant relationship (p <0.05); and in explaining the relationship between individual and social variables and coping strategies, the lack of insurance in both genders with an emotion-oriented strategy, the female infertility factor in women with the confrontational adjustment domain, and treatment in a discontinuous way in both genders have a significant relationship with the problem-oriented domain (p <0.05). Accountability and problem-solving strategies in women and an escapeavoidance strategy in infertile men have been identified as the most important predictors of attitude toward infertility.</p><p><strong>Conclusion: </strong>There is a relationship between attitudes toward infertility and coping strategies. However, the impact of community culture on the type of coping strategies used in this study has led to different results in some cases from other studies.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":" ","pages":"251-257"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Treatment Outcome and Clinical Profile among Guillain- Barre Syndrome Patients in South India.","authors":"Nitin Joseph, Soumya Shrigiri","doi":"10.2174/0115748871254419231019053136","DOIUrl":"10.2174/0115748871254419231019053136","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barre syndrome (GBS) is one of the principal causes of acute neuromuscular weakness and paralysis worldwide. Its clinic-epidemiological profile and factors influencing its treatment outcomes in developing countries are very minimally studied.</p><p><strong>Objective: </strong>The study aimed to find out the risk factors, clinical presentation, management, and predictors of treatment outcomes among GBS patients admitted in two tertiary care hospitals.</p><p><strong>Materials and methods: </strong>Medical records of 121 inpatients with GBS confirmed based on the Brighton criteria over the recent five-year period from June 2017 to May 2022 were examined. Assessment of the severity of GBS was done using the Hughes functional grading scale.</p><p><strong>Results: </strong>The mean age at onset was 36.8 ± 18.9 years. The majority of the patients [82 (67.8%)] were males. Antecedent illnesses within 1 month of onset of GBS were present among 34 (28.1%) patients. The majority of them developed respiratory tract illnesses [13 (38.2%)]. Recurrent history of GBS was observed among 4 (3.3%) patients. The median time gap between the onset of antecedent illnesses and the onset of GBS was 5 days (IQR 3, 10). The most common symptom among GBS patients was the weakness of the muscles of the extremities [117 (96.7%)]. The pattern of progression of weakness among 53 (45.3%) of these patients was from the lower to upper limbs. The most common sign noted was hypotonia [64(52.9%)]. Complications due to GBS were observed among 12 (9.9%) patients. The most common complication among them was respiratory distress in 11 (91.7%) patients, followed by autonomic dysfunctions in 8 (66.7%). Albuminocytological dissociation in cerebrospinal fluid was noted among 48 (39.7%) patients. The majority of patients in nerve conduction studies had acute inflammatory demyelinating polyneuropathy [61(50.4%)]. The majority of the GBS patients [68 (56.2%)] were treated using intravenous immunoglobulin (IVIG). 95 (78.5%) patients improved with treatment at the time of discharge. In multivariable analysis, the absence of antecedent illnesses (p =0.029), Brighton's diagnostic certainty levels 1 and 2 of GBS (p =0.024), and being on IVIG treatment (p =0.05) were associated with improvement in disease condition among the patients.</p><p><strong>Conclusion: </strong>Appropriate diagnosis of GBS using both clinical and laboratory evidence and providing appropriate treatment along with more supervision among GBS patients with a history of antecedent illnesses will help improve their prognosis at the time of discharge.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":" ","pages":"258-268"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Scapula Focused Interventions on Pain and Disability in Neck Pain with Mobility Deficits- Protocol for a Single Blinded Randomized Controlled Trial.","authors":"Nithin Prakash, Joshua Cleland, Karvannan Harikesavan","doi":"10.2174/1574887118666230519155631","DOIUrl":"10.2174/1574887118666230519155631","url":null,"abstract":"<p><strong>Background: </strong>Neck pain with mobility deficits is a common non-specific disorder often observed in younger individuals. The abnormal position of the scapula has also been identified as a risk factor in individuals with neck pain and mobility deficits. Though literature exists regarding the effects of scapular strengthening exercises, there is a lack of studies that have examined the effects of scapular strengthening exercises in individuals with neck pain and mobility deficits. This randomized controlled trial aims to examine the effects of scapula-focused exercises on pain and disability in individuals with neck pain and mobility deficits.</p><p><strong>Methods: </strong>A single-blind (assessor-blinded) randomized controlled trial will be performed. One hundred and eight participants will be recruited and randomly assigned into two groups. The intervention group will receive scapula-focused exercises, and the control group will receive neckspecific exercises. Both groups will receive supervised sessions 3 days per week for 6 weeks and unsupervised sessions for the remaining weeks. Disability, pain, range of motion, pain pressure threshold, muscle strength, EMG activity, and sensory-motor functions will be assessed at the baseline, the 6th week, and the 12th week.</p><p><strong>Results: </strong>This study aims to provide the effectiveness of scapular-focused exercises and its effect on neck pain with mobility deficits.</p><p><strong>Conclusion: </strong>Analyzing the results can provide insight into how effective scapular-focused exercises are when compared to neck exercises.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"1 1","pages":"282-287"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67990900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Telenursing on the Quality of Life of Caregivers of Older Patients with Stroke.","authors":"Fatemeh Mohammadi, Hoda Bani Ardalan, Leila Dehghankar, Seyedeh Ameneh Motalebi","doi":"10.2174/1574887118666230522163725","DOIUrl":"10.2174/1574887118666230522163725","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers of stroke patients suffer from a high caregiving burden that affects their quality of life. Telenursing can provide caregivers and patients with services at the lowest cost and full access. Therefore, the aim of this study was to investigate the impact of telenursing on the quality of life of caregivers of older stroke patients.</p><p><strong>Methods: </strong>A total of 79 family caregivers of older stroke patients participated in this randomized clinical trial. The samples were selected from caregivers of older stroke patients admitted to a teaching hospital in Qazvin, Iran. They were randomly divided into two groups. The intervention group participated in an educational intervention for 12 weeks through telephone follow-up and social media. The Barthel Scale and the 36-item Short Form Survey (SF-36) were used for data collection. The chi-square and independent and paired t-tests were used to analyze the data.</p><p><strong>Results: </strong>The mean age of 79 caregivers participating in the study was 46.16 ± 11.32 years. No significant differences were found between the two groups at baseline. However, the independent ttest showed significant differences in the psychological subscale (p <0.001) between the intervention and control groups after the intervention. In addition, the results of the paired t-test showed significant improvements in the intervention group in physical (p <0.001) and psychological (p <0.001) subscales.</p><p><strong>Conclusion: </strong>The results of the current study support the effectiveness of telenursing in improving the quality of life of caregivers of older stroke patients.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":" ","pages":"275-281"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9512307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Gastrointestinal Bleeding in the Emergency Department: High- Volume vs. Low-Volume Peg Bowel Preparation for Colonoscopy: A Randomized Trial.","authors":"Angela Saviano, Carmine Petruzziello, Maria Elena Riccioni, Marcello Di Pumpo, Martina Petrucci, Mattia Brigida, Christian Zanza, Marcello Candelli, Francesco Franceschi, Veronica Ojetti","doi":"10.2174/1574887117666220908152754","DOIUrl":"10.2174/1574887117666220908152754","url":null,"abstract":"<p><strong>Background: </strong>Lower Gastrointestinal Bleeding (LGIB) is a common cause of admission to the Emergency Department (ED). Early colonoscopy is the exam of choice for evaluating LGIB, and an adequate colon cleansing is essential. High-volume solution 4L-PEG is largely used, but it has some limitations. Low-volume solution 2L-PEG may improve patient's tolerability and compliance, reducing the time of administration and speeding up the exam.</p><p><strong>Patients and methods: </strong>We conducted a randomized 1:1, prospective observational monocentric study in 228 patients (144M/84F) with LGIB. 121 (69M/52F) received the High-Volume, while 107 (75M/32F) received Low-Volume. They completed a \"satisfaction questionnaire\" (taste and smell, mood, time of taking, general experience). We collected the results of the Boston Bowel Preparation Scale (BBPS) and the final diagnosis. The study was retrospectively registered on clinicaltrial.gov with protocol number NCT0536 2227.</p><p><strong>Results: </strong>A mean value of BBPS 6,3 was achieved by both groups (p=0.57). Regarding smell, taste, mood and time of taking (1 to 5), we do not find any statistically differences. The overall satisfaction between the two preparations was 2.90 for low-volume compared to 3.17 for Highvolume (p=0.06). No side effects were reported. The proportion of patients without an evident source of bleeding was higher in High volume preparations compared to Low-volume (39% vs. 30%, respectively).</p><p><strong>Conclusion: </strong>Low volume bowel preparation showed the same efficacy and tolerability with better satisfaction compared with high volume. Low-volume could represent an effective and more desirable preparation for patients in the ED.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 1","pages":"76-81"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9259280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Mechanical Ventilation in Traumatic Brain Injured Patients with Acute Respiratory Failure.","authors":"Fabrizio Racca,&nbsp;Cristina Geraci,&nbsp;Luca Cremascoli,&nbsp;Domenico Ruvolo,&nbsp;Fabio Piccolella,&nbsp;Tatsiana Romenskaya,&nbsp;Yaroslava Longhitano,&nbsp;Ermelinda Martuscelli,&nbsp;Angela Saviano,&nbsp;Gabriele Savioli,&nbsp;Christian Zanza","doi":"10.2174/1574887117666220826164723","DOIUrl":"https://doi.org/10.2174/1574887117666220826164723","url":null,"abstract":"<p><p>Patients with severe traumatic brain injury (TBI) need to be admitted to intensive care (ICU) because they require invasive mechanical ventilation (IMV) due to reduced consciousness resulting in loss of protective airway reflexes, reduced ability to cough and altered breathing control. In addition, these patients can be complicated by pneumonia and acute distress syndrome (ARDS). IMV allows these patients to be sedated, decreasing intracranial pressure and ensuring an adequate oxygen delivery and tight control of arterial carbon dioxide tension. However, IMV can also cause dangerous effects on the brain due to its interaction with intrathoracic and intracranial compartments. Moreover, when TBI is complicated by ARDS, the setting of mechanical ventilation can be very difficult as ventilator goals are often different and in conflict with each other. Consequently, close brain and respiratory monitoring is essential to reduce morbidity and mortality in mechanically ventilated patients with severe TBI and ARDS. Recently, recommendations for the setting of mechanical ventilation in patients with acute brain injury (ABI) were issued by the European Society of Intensive Care Medicine (ESICM). However, there is insufficient evidence regarding ventilation strategies for patients with ARDS associated with ABI. The purpose of this paper is to analyze in detail respiratory strategies and targets in patients with TBI associated with ARDS.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 1","pages":"3-11"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9634886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Efficacy of HPV Vaccines in Preventing Cervical Cancer from 2006 to 2018 in the US: A SEER Data Set Analysis.","authors":"Alexander Mattis,&nbsp;Hind Beydoun,&nbsp;Yuliya Dobrydneva,&nbsp;Rohini Ganjoo","doi":"10.2174/1574887118666230410093715","DOIUrl":"10.2174/1574887118666230410093715","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) is the most common sexually transmitted infection in the US.The first HPV vaccine was introduced in 2006. There are three different HPV vaccines that commonly target high-risk HPV types.</p><p><strong>Objective: </strong>This study compares HPV vaccine efficacy based on alternative endpoints with the most recently available cervical cancer incidence data from the Surveillance, Epidemiology and End Results (SEER) program and SEER*Stat statistical software.</p><p><strong>Methods: </strong>The incidence of cervical cancer, mined from the most recent April 2021 SEER data set, was stratified according to age and racial groups. Trend analysis reporting cervical cancer incidence percentage change (PC) and annual percentage change (APC) was calculated by SEER*Stat statistical software.</p><p><strong>Results: </strong>A total of 46,583 cases of cervical cancer were reported, with an average of about 3,580 incidents of cervical cancer per year, with an overall decrement of about 60 cases over the period of 12 years. The percentage change according to age and race groups varied between -15.9 among 40- 44 years old (yo) and +13.8 among 30-34 yo, and from -12 among non-Hispanic White women to +13 among Hispanic women. Statistically significant APC was observed for five of the nine age groups and four of the five racial groups.</p><p><strong>Conclusion: </strong>There seems to be little if any, correlation between cervical cancer incidence and the HPV vaccine program in the US. HPV vaccine efficacy based on alternative endpoints, such as nucleic acid testing and cytological, surgical, and seropositivity endpoints, is fair. Therefore, it is important to emphasize such alternative testing and surrogate endpoints.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 3","pages":"214-222"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10197045","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":"The Burden of Irritable Bowel Syndrome in Medical and Nurse Italian University Student Population: The VANVITELLI-IBS Survey.","authors":"Antonietta Gerarda Gravina,&nbsp;Raffaele Pellegrino,&nbsp;Mario Romeo,&nbsp;Giovanna Palladino,&nbsp;Marina Cipullo,&nbsp;Giorgia Iadanza,&nbsp;Simone Olivieri,&nbsp;Giuseppe Zagaria,&nbsp;Chiara Mazzarella,&nbsp;Tommaso Durante,&nbsp;Alessandro Federico","doi":"10.2174/1574887118666230508154027","DOIUrl":"https://doi.org/10.2174/1574887118666230508154027","url":null,"abstract":"<p><strong>Background: </strong>The increased prevalence of irritable bowel syndrome (IBS) among medical and nursing students is a global challenge. Unfortunately, data on the Italian medical and nurse student population are scarce. Therefore, this study was designed to assess the prevalence of IBS in this setting and to evaluate the demographic, university, Mediterranean diet adherence, and anxiety factors associated with its increased presence.</p><p><strong>Objective: </strong>To assess the prevalence of IBS, anxiety levels, and adherence to the Mediterranean diet in medical and nursing university students.</p><p><strong>Methods: </strong>An anonymous online questionnaire was sent to participants. Several demographic and educational variables were assayed, and the presence of symptoms associated with the definition of IBS (according to Rome IV criteria). In addition, anxiety levels and adherence to the Mediterranean diet were also assessed.</p><p><strong>Results: </strong>Of 161 students, 21.11% met the Rome IV criteria for IBS. Some subgroups, the out-ofcourse students or no scholarship recipients, were found to have a higher percentage of IBS (p < 0.05). Being out-of-course was shown to be associated with an increased and unreported risk of presenting IBS (OR: 8.403, p < 0.001). Levels of anxiety and adherence to the Mediterranean diet were significantly worse in the IBS group (p < 0.01). Adherence to the Mediterranean diet was associated with a reduced risk of presenting IBS in our setting (OR 0.258, p = 0.002).</p><p><strong>Conclusion: </strong>Our sample of Italian medical and nursing students recorded a non-negligible percentage of IBS. Therefore, screening and awareness campaigns could be suggested.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 3","pages":"206-213"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10203705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Implementation of the Hdc.DrApp.la and SIMDA Programs to Reduce Polypharmacy and Drug-drug Interactions in Patients Hospitalized in Internal Medicine.","authors":"Ricardo E Barcia,&nbsp;Guillermo Alberto Keller,&nbsp;Francisco Azzato,&nbsp;Roberto A Diez,&nbsp;Mathias Sielecki,&nbsp;Ricardo Klaine Samson,&nbsp;Juan Alberto Lescano,&nbsp;Guido Giunti","doi":"10.2174/1574887118666230208124744","DOIUrl":"https://doi.org/10.2174/1574887118666230208124744","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated polypharmacy and possible drug-drug interactions (p-DDIs) in hospitalized patients before and after using the SIMDA Computerized Medical Decision Support System (CMDSS).</p><p><strong>Materials and methods: </strong>We included the prescriptions of ≥ 18 years hospitalized patients in the internal medicine department. We developed and implemented the Hdc.DrApp Physician Order Entry System and the CMDSS SIMDA, which detects p-DDIs and signals dosage adjustment based on renal function. To evaluate the impact of the CMDSS, we made a comparison Before (Survey) / After (Intervention): Survey between Oct/22/2019, and Mar/21/2020, and Intervention between Apr/4/2020 and Sep/3/2020. We analyze prescriptions from the first day and after the first day. We compared the number of drugs, polypharmacy (≥ 5 drugs), excessive polypharmacy (≥ 10 drugs), and p-DDIs. We evaluated differences with the X2 test, Yates correction, Fisher's exact test, ANOVA, and post hoc tests according to their characteristics.</p><p><strong>Results: </strong>We evaluated 2,834 admissions: Survey 1,211 and Intervention 1,623. The number of drugs per patient was 6.02 (± 3.20) in Survey and 5.17 (± 3.22) in Intervention (p < 0.001) on the first day and 9.68 (± 5.60) in Survey and 7.22 (± 4.93) in Intervention (p < 0.001) throughout the hospitalization. Polypharmacy was present in 64% of the Survey and 53% of Interventions (RR: 0.83 (0.78-0.88); and excessive polypharmacy in 14% of the Survey and 10% of Intervention (RR: 0.73, 0.60-0.90). The frequency of total p-DDIs was 1.91/patient (± 4.11) in Survey and 0.35 (± 0.81) in the Intervention (p < 0.001).</p><p><strong>Conclusions: </strong>We developed and implemented the Hdc.DrApp and SIMDA systems that were easy to use and allowed us to quantify and reduce polypharmacy and p-DDIs.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":"18 2","pages":"156-166"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9562366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}