Leukotriene-modifying agents may increase the risk of depression: A cross-sectional study.

INTRODUCTION: Post-market monitoring has shown a potential link between the use of leukotriene-modifying agents (LTRAs) and an increased risk of neuropsychiatric events, such as depression. However, observational studies have produced inconsistent findings, offering no definitive conclusions. OBJECTIVE: To assess the potential correlation between LTRAs exposure and depression in US adults. METHOD: This cross-sectional study, based on population data from the National Health and Nutrition Examination Survey (NHANES) 2007-2016 cycle. The Patient Health Questionnaire-9 was used to assess depression. Multivariable regression was used to evaluate the association between LTRAs exposure and depression. Sensitivity and subgroup analyses were conducted, with the calculation of the E-value. Network pharmacology was employed to investigate the influence of LTRAs on mechanisms of depression. RESULTS: Among the 9414 participants, 595 (6.3 %) were classified as having depression. LTRAs exposure was associated with a higher prevalence of depression (16.9 % vs. 6.0 %). The multivariable logistic regression results showed that LTRAs use increased the risk of depression (OR = 1.70; 95 % CI, 1.05-2.75). An association between LTRAs exposure and depression was found in sensitivity analyses conducted regardless of multivariable linear regression with the PHQ-9 score as a continuous variable (ß = 0.97; 95 % CI, 0.44-1.50) or multivariable logistic regression with the PHQ-9 cut-off of 5 (OR = 1.52; 95 % CI, 1.08-2.14). The association between LTRAs and depression was stable in the different subgroups. CONCLUSION: LTRAs exposure is positively associated with depression in US adults. Therefore, the risk for depression in patients receiving long-term LTRAs treatment should be considered.

Adverse drug reaction reporting quality among different health professionals and the contribution of clinical pharmacists: A pilot study.

WHAT IS KNOWN AND OBJECTIVE: Adverse drug reaction (ADR) reporting is generally of poor quality, which may delay post-marketing regulatory actions. Here, we evaluated the quality of ADR reporting at our institution and examined the roles of clinical pharmacists in this process. METHODS: We retrospectively reviewed ADR reports at our hospital between 2017 and 2019 to assess the number, source, drugs, and routes of administration. The quality assessment of ADR case reports form issued by the China Adverse Drug Reaction Monitoring Centre was used to assess the quality of ADR reports. Quality scores of ADR reports from pharmacists and nonpharmacists were assessed before and after review by clinical pharmacists. RESULTS AND DISCUSSION: Reports of adverse drug reaction reporting by healthcare professionals increased annually, with 59, 77 and 82 reports submitted in 2017, 2018 and 2019, respectively. The numbers of new or serious ADR reports by healthcare professionals in 2017, 2018, and 2019 were 5 (8.47%), 77 (11.69%) and 82 (10.98%), respectively. New or serious ADR reports accounted for approximately 10% (23/218) of all reported cases, and more than 70% (158/218) of the reports were from pharmacists. Systemic administration accounted for more than 80% (233/265) of adverse reactions, whereas ADRs due to topical drug use were rarely reported. The drugs that reportedly triggered ADRs were mainly antibacterial and patented Chinese medicines and accounted for more than half of all reported cases. The scores of ADR reports from pharmacists and nonpharmacists before modification by clinical pharmacists were 86.69 ± 8.12 and 68.36 ± 5.94, respectively, and the scores of ADR reports from pharmacists and nonpharmacists after modification by clinical pharmacists were 91.14 ± 6.64 and 90.02 ± 5.63, respectively. WHAT IS NEW AND CONCLUSION: In a real-world setting, pharmacists are commonly responsible for most ADR reports. The quality of ADR reports from pharmacists and nonpharmacists before review did not reach the standard of excellence. An audit of clinical pharmacists may improve the overall quality of ADR reports. However, under-reporting of adverse reactions still occurs.

The use of fixed dose drug combinations for glaucoma in clinical settings: a retrospective, observational, single-centre study.

BACKGROUND: The aim of study was to understand anti-glaucoma fixed dose drug combination use in real-world settings, focussing on drug selection, repeated prescription of the same active ingredient, and administration of fixed dose combinations, thus providing a reference for doctors during prescription and pharmacists during prescription review, ultimately educating patients on medication. METHODS: A retrospective, observational, single-centre study was conducted. Outpatient prescriptions for anti-glaucoma eye drops from 01 January to 31 March 2021 were extracted. The prescriptions containing anti-glaucoma fixed dose combinations were analysed, and the rationale for each prescription was reviewed. RESULTS: There were 10,947 ophthalmic patients with anti-glaucoma eye drop prescriptions in the study period. Of these, 4002 (36.5%) were prescribed anti-glaucoma fixed dose drug combinations. Approximately 80% of the patients were prescribed brinzolamide/timolol, while about 10% received prostaglandin analogues/timolol eye drops. Less than 40% of prescriptions were for monotherapy with fixed dose combinations. The most commonly duplicated drug class was ß-receptor antagonists. An increase in prescribing drugs containing the same ingredient was observed for regimens containing various medicines. CONCLUSION: More than 60% of the combinations were used together with other anti-glaucoma drugs. The advantages of these fixed dose combinations in improving patient compliance need to be reassessed in real-word settings. Prescriptions containing duplicated ingredients were common. However, they were not necessarily considered unreasonable because the dosage forms were administered at different times. For prescriptions containing repetitive ingredients, pharmacists should judge the rationale by evaluating the dosing frequency and drug indications and explain the appropriate administration to patients.

The role of entrepreneurial education in determining actual entrepreneurial behavior: Does TESOL amplified communication apprehension matter?

Since the impression of innovation is at the fundamental of commercial standing, therefore, Industries estimate innovation as their competitive advantage. Resultantly, industries devote a lot of resources understanding the versatile and dynamic nature of innovations and also keep on progressing innovation techniques and strategies. To meet the objectives of the study, we collected data from the students studying in Chinese universities. A survey questionnaire was designed to collect data from university students who were part of the TESOL program. A total of 224 valid questionnaires were used to proceed with the analysis, where descriptive statistics were calculated using SPSS 21, while hypothesis testing was carried out using Mplus 8. Results revealed the facts that both formal and informal education significantly predicted entrepreneurial behavior, while entrepreneurial intention was also found to mediate the relationship between formal and informal education and entrepreneurial behavior. Similarly, as per prediction, TESOL amplified communication apprehension also significantly moderated the relationships of formal and informal education with entrepreneurial behavior.

Survey about the use of clarithromycin in an ENT outpatient department of a tertiary hospital.

We undertook this survey about the use of clarithromycin in the Ear, Nose, and Throat (ENT) Outpatient Department of Fudan University Hospital to understand its utilization patterns and rational use. A survey of prescriptions given to outpatients was carried out, and detailed information of the patients, including age, sex, diagnosis, combined medication, and other information, was recorded in Excel spreadsheets. The rationale for each prescription was evaluated retrospectively. Based on our analysis, 82.5% of the clarithromycin prescriptions were for the treatment of rhinosinusitis. It was found that the parameters for the diagnosis of this condition were surprisingly broad and should have been more specific. In addition, the clarithromycin dosage regimen varied in clinical practice. For chronic rhinosinusitis, the duration of treatment was between 8 and 16 days, which was not sufficient. Moreover, clarithromycin was prescribed along with considerable numbers of pharmacotherapeutic anti-allergic drugs. Our survey indicated that improvements in the quality of clarithromycin prescriptions in otolaryngology outpatients should be made. Furthermore, the importance of medical education to patients should be emphasized. In addition, the interaction between clarithromycin and other anti-allergic drugs requires further investigation.