Perception and the influence of information toward e-cigarette smoking behavior.

INTRODUCTION: Perceptions, personal perspectives, and public awareness of e-cigarette information have a significant impact on e-cigarette smoking behavior, and provide comprehensive information that can help reduce interest in e-cigarette smoking and reduce the number of new smokers. This study aimed to investigate the perceptions towards e-cigarettes related to e-cigarette use and how that information related to people's use of them. METHODS: The data for this cross-sectional study were collected via an online questionnaire. Thai nationals who were aged ≥18 years provided data between June 2021 and January 2022. Multivariable logistic regression and the chi-squared test were used to analyze the data. RESULTS: There were 340 respondents, 76 e-cigarette users, and 264 non-e-cigarette users. Most of the perceptions of information that differed statistically significantly between e-cigarette users and non-e-cigarette users included information on regulations, products, health effects, and the effectiveness of smoking cessation. The association between factors and e-cigarette smoking behavior revealed that the perception of the product information and male gender were associated with e-cigarette smoking behavior (AOR=13.59; 95% CI: 2.35-78.60, and AOR=5.19; 95% CI: 2.87-9.40, respectively). CONCLUSIONS: The perception of e-cigarette product information and male gender were associated with e-cigarette smoking behavior.

Effectiveness of telehealth on the glycemic control of patients with type 2 diabetes mellitus during the COVID-19 pandemic: A systematic review and meta-analysis of randomised controlled trials.

Background: During the COVID-19 pandemic, telehealth was employed to enhance clinical outcomes for patients with type 2 diabetes mellitus. However, the effectiveness of telehealth remains inconclusive. Objective: This study aimed to examine the impact of telehealth on the glycemic control of individuals with type 2 diabetes mellitus during the pandemic. Design: A systematic review and meta-analysis of randomized controlled trials. Setting: N/A. Participants: A total of 669 studies was sourced from electronic databases, including EMBASE, PubMed, and Scopus. Among these, twelve randomized controlled trials, comprising 1498 participants, were included. Methods: A comprehensive search was performed in electronic databases. The quality of the included studies was assessed using the Cochrane Risk of Bias tool, and statistical heterogeneity was assessed using I² and Cochran's Q tests. A random-effects model was utilized to combine the outcomes. Grading of Recommendations, Assessment, Development, and Evaluations was used to evaluate the certainty of the evidence. Results: The meta-analysis showed that participants receiving a telehealth intervention achieved a greater reduction in the glycated haemoglobin (HbA1C) compared to those receiving usual care, with a weighted-mean difference of -0.59 (95 % CI -0.84 to -0.35, p < .001, I² = 74.1 %, high certainty of evidence). Additionally, participants receiving telehealth interventions experienced better secondary outcomes, including a reduction in fasting blood sugar (16.06 %, 95 %CI -29.64 to -2.48, p = .02, high certainty of evidence), a decrease in body mass index (1.5 %, 95 %CI -1.98 to -1.02, p < .001, high certainty of evidence), and a decrease in low-density lipoprotein (7.8 %, 95 %CI -14.69 to -0.88, p = .027, low certainty of evidence). Conclusions: In our review, we showed telehealth's positive impact on glycaemic control in type 2 diabetes mellitus patients. Healthcare professionals can use telehealth in diabetes care. Caution is needed due to heterogeneity of the results. Further research should explore the long-term impacts of telehealth interventions. Registration: The study was registered with PROSPERO, CRD42022381879.

Effects of instructional video and community radio broadcasting interventions to improve knowledge and behavior of antibiotic use in the COVID-19 era.

BACKGROUND: Antibiotic overuse is a serious health issue. It has been demonstrated that improper antibiotic use is linked to a lack of knowledge in the public. To encourage judicious antibiotic use in the COVID-19 ERA, it is critical to provide accessible and secure therapies. OBJECTIVES: This study aimed to assess the effects of instructional video and community radio broadcasting interventions on knowledge and behavior of antibiotic use. METHODS: Adults over the age of 20 were enrolled in a quasi-experimental study. A total of 369 representatives were divided into two groups: 185 participants in the control group and 184 participants in the intervention group. Data were collected twice, before and after the educational program by community health workers. Both descriptive and inferential statistics were used to analyze the data. RESULTS: The participants' average age was 56.4 ± 0.6 years. Most of the respondents were female (264, 71.5%) and had only received an elementary education (186, 50.4%). A mean difference score was produced for the control and intervention groups. Both groups experienced a statistically significant gain in mean difference score of knowledge following the educational program (3.42 ± 4.18, [95% CI 2.81-4.02] vs 5.42 ± 4.97, [95% CI 4.69-6.14]) (P < 0.001). A mean difference score was produced with behavior (1.78 ± 3.45, [95% CI 1.28-2.28] vs 2.77 ± 3.06, [95% CI 2.28-3.27]) (P < 0.001). A mean difference in knowledge score between the groups was greater, with the intervention group scoring higher; all significant variables were controlled by multivariable regression analysis (1.31 [95% CI 0.53-2.09]) (P = 0.001). Similarly, a mean difference behavior score (1.34 [95% CI 0.82-1.86]) (P < 0.001). CONCLUSION: The integration of an educational poster, instructional video, and community radio broadcasting interventions about antibiotic use through CHWs in local communities is beneficial. This program should be implemented at the national level to promote rational drug use. Future studies should investigate how the educational program affects antibiotic use rates in the long term.

Effect of alcohol consumption on relapse outcomes among tuberculosis patients: A systematic review and meta-analysis.

Introduction: Tuberculosis (TB) is one of the major public health issues in every country. Alcohol consumption is one of the reasons associated with the severity of symptoms and death among TB patients. The impact of alcohol use on TB relapse outcomes is still debatable. This study aimed to conduct a systematic review and meta-analysis (SR/MA) to find the link between alcohol use and TB relapse outcomes. Methods: Data collection was performed from December 2021 to March 2022; and was obtained from electronic databases including CINAHL, PubMed, and Scopus. The researcher carefully searched and reviewed all the relevant research concerning drinking alcohol and relapse outcomes among TB patients. A set of inclusion and exclusion criteria was used to assess research publications. The methodological quality of eligible publications was assessed using the Newcastle-Ottawa Scale. Random meta-analysis was used to determine odds ratios (ORs) with a 95% confidence interval (CIs). The funnel plot, Begg's test, and Egger's test were employed to investigate publication bias. Results: There were a total of 2,113 studies found and reviewed, and eight publications were chosen for the analysis. It was found that among TB patients with a moderate appearance of heterogeneity, drinking alcohol increases the probability of relapse (OR = 3.64; 95% CI: 2.26-5.88, p < 0.001) and mortality (OR = 1.72; 95% CI: 1.40-2.12, p < 0.001). The funnel plot, Begg's test, and Egger's test all revealed that there was no indication of publication bias. Conclusions: Relapses and mortality among tuberculosis patients are considerably increased by alcohol drinking. More research into the causality of this link between the degree of alcohol use and the underlying processes is required. Systematic review registration: PROSPERO [CRD 42022295865].

Effects of home drug delivery on drug-related problems: preliminary evidence for improved patient outcomes during the COVID-19 pandemic in Thailand.

BACKGROUND: Drug-related problems cause severe disabilities, premature deaths, and unnecessary costs. Telepharmacy offer easier access to needed medications, preventing DRPs. Adoption has been slow, and it is unclear what aspects of telepharmacy are most important. The COVID-19 pandemic disrupted health services, forcing the rapid adoption of telepharmacy. In Phayao, Thailand, a program was implemented for home delivery of drugs for patients with chronic disease. OBJECTIVES: This study aimed to explore the prevalence and factors associated with DRPs of patients with chronic disease who received home drug-delivery services. METHODS: A cross-sectional study was undertaken in Phayao Province located in North Thailand. Simple random sampling was used to select patients from 6 public hospitals between July and August 2020. Logistic regression was used to analyze multivariate factors that might be related to DRPs. RESULTS: A total of 246 participants reported at least 1 DRP (49.30%). Most participants were female (58.32%) with elementary education (60.72%). Their mean age was 63.69 (SD = 12.97) years. The 5 most common DRPs were changes of drug packaging or drug brands (18.84%), leftover medications of more than 2 weeks (18.44%), nonadherence (17.43%), having conditions or diseases requiring additional medications (6.81%), and adverse drug reactions (5.21%). Univariate analysis identified number of chronic conditions, diabetes mellitus, dyslipidemia, chronic kidney disease, education level, and drug-delivery channel as predictors of DRPs. In multivariate analysis, predictors of DRPs were the number of drugs used per day (adjusted odds ratio [aOR] 1.11 [95% CI 1.03-1.19], P = 0.004) and dyslipidemia (aOR 1.83 [95% CI 1.18-2.84], P = 0.007). Nonadherence was associated with leftover medicines (aOR 4.22 [95% CI 2.44-7.28], P < 0.001) CONCLUSION: The present results indicate that home delivery caused no increase and may have caused a decrease in DRPs, and patients were highly satisfied. These promising results suggest that home delivery should be continued and further investigated even as the COVID-19-induced emergency subsides.

Community Health Workers Improve Smoking Cessation When They Recruit Patients in Their Home Villages.

INTRODUCTION/OBJECTIVE: Community health workers (CHWs) can play a vital role in many aspects of healthcare, particularly for underserved communities, but it is unclear what factors are most important in determining the success of CHW-based programs. We wanted to assess what factors contribute to the effectiveness of CHWs in a smoking cessation program. METHODS: We trained CHWs in 3 areas regarding smoking cessation: knowledge, attitude, and practice (KAP). The training program utilized the 5A's as approach. CHWs actively sought out people addicted to cigarettes to participate. Patients received support from CHWs and a team of medical professionals for a year. At the conclusion of the program, focus group discussions with a group of CHWs, a group of patients, and a group of medical professionals were conducted. RESULTS: On average, patients reduced their cigarettes/day by 7.2% and 29% of patients were completely cigarette free at a 1-year follow-up. Patients marginally decreased exhalation CO levels and increased lung capacity. CHWs gained a good understanding of health risks associated with smoking and common methods to help quit. Their attitude became more sympathetic and caring. CHWs exhibited patient-specific solutions to help with smoking cessation and actively sought out people to participate in the smoking cessation program. CONCLUSIONS: A smoking cessation program combining CHWs and pharmacists was effective. Key factors were having CHWs that are respected and established in their communities, using CHWs who know their patients and can provide individually tailored solutions, and empowering CHWs with intensive training.

Smoking and risk of negative outcomes among COVID-19 patients: A systematic review and meta-analysis.

INTRODUCTION: COVID-19 has major effects on the clinical, humanistic and economic outcomes among patients, producing severe symptoms and death. Smoking has been reported as one of the factors that increases severity and mortality rate among COVID-19 patients. However, the effect of smoking on such medical outcomes is still controversial. This study conducted a comprehensive systematic review and meta-analysis (SR/MA) on the association between smoking and negative outcomes among COVID-19 patients. METHODS: Electronic databases, including PubMed, EMBASE, Cochrane Library, Science Direct, Google Scholar, were systematically searched from the initiation of the database until 12 December 2020. All relevant studies about smoking and COVID-19 were screened using a set of inclusion and exclusion criteria. The Newcastle-Ottawa Scale was used to assess the methodological quality of eligible articles. Random meta-analyses were conducted to estimate odds ratios (ORs) with 95% confidence interval (CIs). Publication bias was assessed using the funnel plot, Begg's test and Egger's test. RESULTS: A total of 1248 studies were retrieved and reviewed. A total of 40 studies were finally included for meta-analysis. Both current smoking and former smoking significantly increase the risk of disease severity (OR=1.58; 95% CI: 1.16-2.15, p=0.004; and OR=2.48; 95% CI: 1.64-3.77, p<0.001; respectively) with moderate appearance of heterogeneity. Similarly, current smoking and former smoking also significantly increase the risk of death (OR=1.35; 95% CI: 1.12-1.62, p=0.002; and OR=2.58; 95% CI: 2.15-3.09, p<0.001; respectively) with moderate appearance of heterogeneity. There was no evidence of publication bias, which was tested by the funnel plot, Begg's test and Egger's test. CONCLUSIONS: Smoking, even current smoking or former smoking, significantly increases the risk of COVID-19 severity and death. Further causational studies on this association and ascertianing the underlying mechanisms of this relation is warranted.