The International journal of risk & safety in medicine最新文献

{"title":"An analysis of Russian-produced clinical practice guidelines using the RIGHT reporting checklist: The case of direct oral anticoagulants for coronavirus disease 2019.","authors":"Elena A Baybulatova, Mikhail S Chenkurov, Elina A Korovyakova, Sergey K Zyryanov, Dmitry A Sychev, Irina V Poddubnaya, Yaolong Chen, Janne Estill, Liliya E Ziganshina","doi":"10.1177/09246479251375246","DOIUrl":"10.1177/09246479251375246","url":null,"abstract":"<p><p>ObjectiveThe objective of the study was to compare the results of quality assessment of Russian-produced clinical practice guidelines on the use of direct oral anticoagulants in the treatment and prophylaxis of coronavirus disease 2019 using the RIGHT checklist and AGREE II instrument.MethodsWe assessed six relevant clinical practice guidelines published between 2020 and 2023 in Russian databases using the RIGHT checklist. We compared the results of using the RIGHT tool with the results obtained using the AGREE II instrument.ResultsAll six clinical guidelines received high scores in the sections \"Basic information\" (range: 56.2%-70.8%) and \"Background\" (48.4%-74.0%). The lowest results were obtained in the sections on RIGHT: \"Review and quality assurance\" (0%-4.2%) and \"Funding and declaration management of interests\" (14.6%-19.8%).ConclusionThe RIGHT checklist was proven applicable and usable for evaluating Russian-produced clinical practice guidelines. The use of RIGHT reporting tool enriched the depth and breadth of quality assessment to identify more areas that are problematic and to critically appraise details of the problems. More efforts are needed to further improve Russian clinical practice guidelines and their implementation into clinical practice to ensure better patient care and rational use of direct oral anticoagulants.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"49-66"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025212","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":"Effects of using a mobile app to improve medication adherence and glycated hemoglobin in type 2 diabetes: A before-after study.","authors":"Fatemeh Bakhtiari, Firozeh Sajedi, Maryam Etminaniesfahani, Maryam Rangchian","doi":"10.1177/09246479251377937","DOIUrl":"10.1177/09246479251377937","url":null,"abstract":"<p><p>BackgroundAlthough medication adherence is an important factor affecting treatment outcomes, many diabetic patients have yet to achieve acceptable adherence.ObjectiveMeasuring the potential of a mobile application to improve medication adherence and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, consuming oral medicines to control diabetes.MethodsThirty cases in the control group received routine services. Thirty patients in the intervention group received a mobile application that provided audio alarms and a cartoon animation showing four gestures at the time of the medicine consumption, with three repeats after 10, 20, and 30 min. The measured outcomes were medication adherence and HbA1c.ResultsThe medication adherence in the intervention group was significantly higher than the control group in all time points after starting the intervention (mean rank of 35.3 vs 25.7 at month 1; 37.0 vs 21.1 at month 2; 37.7 vs 20.5 at month 3, all <i>p</i>-values = 0.00). 0.28% reduction of the HbA1c was obtained for the intervention group (<i>p</i>-value = 0.02).ConclusionsIt is plausible to propose the utilization of the studied application as a means to improve medication adherence in patients with type 2 diabetes. Clinically meaningful reduction of HbA1c was not observed in this study.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"78-86"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042958","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":"Current status of pheniramine misuse among substance use disorder patients: A narrative review of extent, patterns, and clinical implications.","authors":"Raja Babu Ramawat, Omar Afroz, Rizwana Quraishi, Siddharth Sarkar","doi":"10.1177/09246479251370587","DOIUrl":"10.1177/09246479251370587","url":null,"abstract":"<p><p>BackgroundThere is growing concern about the misuse of Over-the-counter (OTC) medications around the world. Pheniramine is a first-generation antihistamine, which is widely available and is commonly used for allergic conditions. Initially considered to be a safe anti-allergic agent, growing evidence suggests its potential for misuse and dependence. Notably, it is reported that pheniramine is being used to mix other substances such as opioids during injection drug use. However, pheniramine misuse is not adequately studied in existing literature.ObjectiveThis review aims to synthesize the literature on pheniramine misuse, and summarize the published case reports on pheniramine misuse to understand its clinical implications.MethodsA comprehensive literature search was conducted using PubMed, Google Scholar, and MedSearch to identify case reports, epidemiological data, and clinical studies regarding pheniramine misuse. We included articles in English language, published in peer- review journals, and indexed in PubMed. The keywords for the search included 'Pheniramine use', 'misuse' 'abuse', 'dependence', 'harmful use', 'substance use disorder', 'opioid use disorder', and 'injecting drug user'.ResultsPheniramine has misuse potential comparable to Lorazepam. It is often combined with opioids and/or diazepam and used through injection route, commonly in South Asian region. Studies on extent of its use are mainly from South Asia, which report comorbid use of pheniramine ranging from around 15% to 80% in injection drug users. Use of pheniramine is often under-reported by patients. In literature, more than 8 case reports describe the misuse/dependence of pheniramine and associated complications such as seizures, psychosis, and life-threatening toxicity. Easy accessibility might be one of the contributing factors for pheniramine misuse.ConclusionPheniramine misuse is an emerging challenge and clinicians should remain vigilant about its signs, especially in those with substance use and psychiatric comorbidities.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"16-22"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986775","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":"Misguided medical insurance and government policies in the opioid epidemic: A chart review and NARX score analysis.","authors":"Leon Margolin, Juscelino F Colares, Sanford Lefkowitz, Richard Ancowitz, Sanford Rosenblum","doi":"10.1177/09246479251360693","DOIUrl":"10.1177/09246479251360693","url":null,"abstract":"<p><p>BackgroundDespite the investment of significant effort and resources, our country remains exposed to an alarming risk of opioid overdoses due to opioid addiction.ObjectiveThis study demonstrates the impact of misguided medical insurance and government policies on the opioid epidemic.MethodsThis is a retrospective chart review study of 142 patients who were denied access to care by insurance companies (CareSource, Molina, Aetna, government regulators, and contractors). The study provides a systematic analysis of the risk stratification of these patients based on the NARX score, prescribed medications, and OARRS report analysis.ResultsPatients who were denied access to care by the major insurance carriers in Ohio, CareSource, Aetna, and Molina had an average high NARX score of 309.8-310.5 range. The review of the prescribing provider lists on Ohio Automated RX Reporting System reports showed that, in most occasions, patients had significant difficulty in finding a qualified pain provider for 3 months or more.ConclusionReview of denied-care patient NARX scores shows, conclusively, that very high-risk patients were affected the most. These misguided medical insurance and government policies have exposed the most vulnerable and high-risk patients to significant risk of mortality and morbidity.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"31-39"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254463","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":"Artificial intelligence: Medical journalism and medical science.","authors":"David Healy, Liliya Eugenevna Ziganshina","doi":"10.1177/09246479251381515","DOIUrl":"10.1177/09246479251381515","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"3-4"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133400","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":"Does psychiatry need alternatives to ECT?","authors":"David Healy","doi":"10.1177/09246479251381512","DOIUrl":"10.1177/09246479251381512","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"8"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133410","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":"Interpreting Cortrak™ feeding tube position: Safety assessment of manufacturer training guides.","authors":"Stephen J Taylor, Kaylee R Sayer, Jules Brown","doi":"10.1177/09246479251377592","DOIUrl":"10.1177/09246479251377592","url":null,"abstract":"<p><p>BackgroundExpert Cortrak™ guided-tube placement attains near-zero pneumothorax risk versus 0.52% in 'blind' tube placement. Conversely, in low-use Cortrak centres, insufficient training and misinterpretation results in undetected lung misplacement and pneumothorax in 0.10% versus 0.013% for blind placement.ObjectiveDetermine whether manufacturer training guides enable safe interpretation of tube position.MethodsManufacturer guidance was compared to the evidence-based lung-oesophagus, gastrointestinal flexure system (LOGIFS). Manufacturer text and figures were analysed to determine whether it is possible to objectively interpret tube position by organ or its position within an organ.ResultsManufacturer descriptions are subjective, precluding definitive interpretation of tube position: 1. Lung: No information on the trace angle and distance of deviation from the sagittal midline or receiver or expected trace pattern to warn of misplacement; 2: Stomach: Gastric flexures are not described therefore a tube's entry, safe position and exit are unknown; 3. Intestine: Manufacturer terms cannot differentiate tube passage into the intestine from retroflexion back to the stomach. Failure to describe the superior- and inferior-duodenal or duodeno-jejunal (DJ) flexures means that intestinal position is not known. Guides only partially describe artefact traces caused by receiver misalignment but not how to correct the receiver position based on the trace.ConclusionsLack of objective information to interpret traces and correct for artefacts, combined with mandating tube withdrawal, risks misinterpreting tube position and repeated or failed tube placement, respectively. Manufacturer guides should be substituted with published, evidence-based guides.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"67-77"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133427","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":"Assessment of nanomedicines and nanosimilars: Clinical pharmacists' knowledge and regulatory gaps.","authors":"Courtney Fella, Mike Isles, John Hertig","doi":"10.1177/09246479251382360","DOIUrl":"10.1177/09246479251382360","url":null,"abstract":"<p><p>BackgroundNon-Biological Complex Drugs (NBCDs), including nanomedicines, are characterized by complex manufacturing processes. The slightest change in this process can lead to changes in the efficacy, safety, and quality of the product. New legislation to be adopted in the EU will help ensure a proper regulatory assessment which will improve patient safety. Meanwhile, there is currently no robust integrated curriculum on the use and interchangeability of nanomedicines and their respective follow-on medicine, commonly referred to as nanosimilars. Nanomedicines have been available in the EU since 1996. As the patents of these medicines expire, it is important that healthcare professionals are suitably prepared for future interchangeability programs.ObjectivesTo analyze clinical pharmacists' understanding of nanomedicines, nanosimilars, and the requirements needed to prepare the clinical ground to ensure safe and optimum interchangeability.MethodsA fourteen-question survey was constructed for clinical pharmacists in Germany, Italy, and Portugal, comprising a variety of hospital sizes and specializations. A combination of numerical ranking, yes/no, and open-ended questions was utilized.Results20 pharmacists in Germany, 9 in Italy, and 20 in Portugal completed the survey in entirety. On a scale ranging from 0 to 10, the three countries combined indicated an understanding of nanomedicines as 3.69 and their understanding of nanosimilars as 2.92. Open-ended prompts contained statements indicating the lack of clinical familiarity, regulations/policies provided, and the additional resources they would like to receive.ConclusionThe survey confirmed the need for more guidance from health-system institutions, medical agencies, and pharmaceutical manufacturers. Respondents desired opportunities to learn from webinars, newsletters, guidelines, and/or informational sessions.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"87-94"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133377","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":"Comment on \"Rates of successful conceptions according to COVID-19 vaccination status: Data from the Czech Republic\".","authors":"Chiaki Suda","doi":"10.1177/09246479251377034","DOIUrl":"10.1177/09246479251377034","url":null,"abstract":"","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"152-153"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025130","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":"Follow-up on test referrals and results: Whose responsibility is it?","authors":"Yael Keshet, Ariela Popper-Giveon, Tamar Adar","doi":"10.1177/09246479251401360","DOIUrl":"10.1177/09246479251401360","url":null,"abstract":"<p><p>BackgroundInadequate test follow-up is a major patient safety concern which can have implications for missed or delayed diagnosis and treatment. The community medicine setting poses challenges for test follow-up, which involves ensuring patient performance, receiving information about abnormal results, and informing patients.ObjectiveThis research aimed to learn how community physicians perceive and cope with test follow-up.MethodsIn-depth interviews were conducted with 20 community physicians: 10 family physicians and 10 other specialists.FindingsThe potential for inadequate follow-up on tests emerged from the interviews as a significant risk factor for patients. According to interviewees, inadequate follow-up includes both ensuring that referred tests are performed and receiving and informing patients about abnormal results. It stems from heavy workloads, poor communication between family physicians and specialists, and patients being treated by multiple physicians. The coping strategies employed by physicians, such as encouraging patients to perform tests, contacting patients, documenting follow-ups, and using the healthcare organization's information technology alert system, are described as insufficiently effective.ConclusionsSuggestions are made for enhancing the responsibility of all parties in order to improve the management of test referrals follow-up, ensure that physicians receive the test results, and thus reduce the incidence of adverse events.</p>","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"120-130"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644800","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}