Evaluación del conocimiento y cumplimiento del tratamiento farmacológico en pacientes hipertensos y diabéticos tipo 2 en una unidad de salud de la familia / Evaluation of the knowledge and compliance with pharmacological treatment in hypertensive and type 2 diabetic patients in a family health unit

Introducción: El grado de conocimiento de los pacientes sobre sus medicamentos está altamente asociado a la mejora de su uso racional y de los resultados de la farmacoterapia. El objetivo fue evaluar el conocimiento y cumplimiento del trata-miento farmacológico en pacientes hipertensos y diabéticos tipo 2 en una unidad de salud de la familia de la ciudad de Luque. Método: Estudio observacional, descriptivo, de corte transverso. La selección se realizó por conveniencia y la información se obtuvo a través de entrevistas, durante las visitas domiciliarias de mayo a junio 2021, utilizando un cuestionario estructurado que incluía datos sociodemográficos, y preguntas de la metodología de Dáder y del test de Morisky-Green modificado. Resultados: De los 50 pacientes entrevistados, el 80 % fueron mujeres, con una edad promedio de 63,04 ± 11,39 años, y con un bajo nivel de estudios. El 100 % eran hipertensos y el 38 % también diabéticos. Los antihipertensivos más prescriptos, ya sea solo o combinados, fueron losartán potásico (50 %), y enalapril maleato (18 %). El 42 % de los diabéticos utilizaban antidiabéticos orales y el 58 % insulina. El 100 % de los pacientes desconoce su tratamiento, y el cumplimiento no superó el 22 %, para ambas patologías. Conclusiones: Los pacientes no son conocedores adecuados de su tratamiento, y el cumplimiento es muy bajo, por lo que es necesaria la intervención del farmacéutico y la implementación de estrategias educativas que puedan ayudar a mejorar el grado de conocimiento y la adherencia a su tratamiento. (AU)

Introduction: The level of patients’ knowledge about their medications is highly related to the improvement of their rational use and the results of the pharmacotherapy. The aim of this study was to assess the knowledge and the compliance with the pharmacological treatment in hypertensive and type 2 diabetic patients in a family health unit of the city of Luque.Method: It was carried out an observational, de-scriptive and cross-sectional study. The selection was done by convenience and the information was obtained through interviews which took place during the home visits from May to June, 2021. A structured questionnaire was used and included so-cial demographic data and questions of the Dader method and the Morisky-Green test modified. Results: Among the 50 interviewed patients, 80% were women, with an average age of 63,04 ± 11.39 years with a low level of education. 100% were hypertensive and 38% were diabetic too. The most prescribed antihypertensive, both, alone or com-bined, were Ioasartan Potassium (50%) and Enal-april Maleate (18%). 42% of the diabetic patients used oral antidiabetics and 58% insulin. 100% of the patients ignored their treatment and the compli-ance did not exceed 22% for both diseases.Conclusions: The patients do not know their treatment and the compliance is very low. Thus, it is necessary the intervention of a pharmacist and the implementation of educational strategies that can help to improve the level of knowledge and the adherence to treatment. (AU)

Four years later: Do South Africans know what pre-exposure prophylaxis for HIV is?

HIV incidence remains high among South Africans, with low uptake of preventative measures such as condom use. Pre-exposure prophylaxis (PrEP), which protects HIV-negative individuals from infection, was first introduced in SA in 2016. This study determined the knowledge of PrEP among university students (n = 282) and primary health care clinic users (n = 358) in KwaZulu-Natal, South Africa. Data were collected using a cross-sectional survey. The study population was at high-risk of HIV infection, with early age of sexual debut, multiple concurrent sexual partners and inconsistent condom usage. Only 12.3% (n = 79) stated that they had a full understanding of PrEP, which was higher among university students (9.8%; n = 63) than clinic users (2.5%; n = 16; p < 0.001). Specific PrEP knowledge was, however, low. Health Science students did not have a better knowledge than students from other faculties. Neither did users of clinics offering PrEP have a better knowledge than users of clinics not offering PrEP. Moreover, few participants (15%; n = 96) were aware of the availability of PrEP at their local clinic. Interventions to address the low level of PrEP knowledge within the population are required, to reduce the high HIV incidence.

Self-administration of medications in inpatient postnatal women: an opportunity to empower self-care, improved medicines knowledge and adherence utilising clinical pharmacists and midwifery workforce and use of a midwife formulary.

OBJECTIVES: To assess the impact of self-administration of medicines (facilitated by a midwife formulary) on postnatal women's knowledge of certain post-delivery medications, awareness of the Green Bag Scheme, factors contributing to constipation, pain satisfaction, adherence, and time released to midwives plus feedback from these women and their midwives. METHODS: The study was conducted in consented postnatal women, who self-administered medications from their bedside lockers. The mode of delivery and parity were recorded. Data were compared in women who self-administered to those who did not. Midwives used our established midwife formulary to write their essential unprescribed medications. Direct interview questionnaires were used to obtain their knowledge on chosen post-delivery medicines, pain satisfaction, the Green Bag Scheme and factors contributing to constipation. Regular medicines counts were used to check adherence. Midwives' time not administering these self-administered medications was estimated. Self-reported questionnaires were used to obtain feedback from participants and midwives. Responses were analysed proportionately and where appropriate by simple statistics. RESULTS: Women (n=203) who self-administered were compared with those (n=401) who did not. Greater medicines' knowledge and better (96% vs 79%) pain satisfaction were found in self-administering women. Knowledge of each contributing factor to constipation varied. Mode of delivery and parity had no impact on these outcomes. Adherence seemed high 96% (195/203). Awareness of the Green Bag Scheme was poor (66/604). Most women, 94% (191/203) found the service helpful and 89% (178/200) would take part again. At least 224 hours were released to midwives by these self-administering women. 164/203 (81%) midwives felt the scheme was beneficial. CONCLUSIONS: Self-administering women had better pain satisfaction, medication knowledge and adherence. The need to improve engagement in the Green Bag Scheme was flagged. This service, supported by use of a midwife formulary, can release time to midwives to do other tasks including care for women with more complex issues. A business case for this service is under review.

A survey of public perception, knowledge and factors influencing COVID-19 vaccine acceptability in five communities in Ghana

Objective: The present study assessed the public's perception and Knowledge about COVID-19 and factors that could affect vaccine acceptability in Ghana. Design: We carried out a cross-sectional population-based study. A structured questionnaire was used to capture data on socio-demographic information, knowledge, and the public's perception of COVID-19 infection, as well as COVID-19 vaccine acceptability from consented participants. Factors affecting vaccine acceptability in Ghana were explored. Robust ordinary least square linear regression analysis was adopted to assess factors associated with vaccine acceptability. Setting: Five communities (Labone, Lartebiorkoshie, Old Fadama, Chorkor, and Ashiyie) in Accra in the Greater Accra district were selected. Participants: WHO modified cluster-sampling method was applied to select households of 997 participants in the five communities. Results: Most respondents were males (57.6%), and the median age of participants was 30 years. The study participants demonstrated a good knowledge of COVID-19 and had high perceptions of the COVID-19 pandemic. The results revealed that the highest educational level, marital status, self-rated Knowledge of COVID-19, Knowledge of COVID-19 definition, Knowledge of COVID-19 symptoms, and perception of the COVID-19 pandemic were significantly associated with vaccine acceptability. Self-reported impact of COVID-19 lockdown/movement restrictions on agriculture and job as a source of livelihood was associated with vaccine acceptability. Conclusion: Higher subjective and objective knowledge of COVID-19 increases vaccine acceptability scores significantly thus, education on COVID-19 and the vaccination against SARS-CoV-2 infection must be intensified to improve vaccine acceptability in Ghana, especially among those with lower educational backgrounds

Status and influencing factors of medication literacy among Chinese caregivers of discharged children with Kawasaki disease.

Background: The information on medication literacy among Chinese caregivers of discharged children with Kawasaki disease (KD) is unknown. We aimed to investigate the status of medication literacy among caregivers of discharged children with KD and evaluate the influencing factors of medication literacy. Methods: From March 2020 to February 2021, 106 caregivers with a KD child were recruited for the present study. We collected the sociodemographic characteristics of the KD caregivers using structured interviews. The medication literacy of the KD caregivers was assessed by the Chinese version of Medication Literacy Assessment. KD patients' demographic and clinical data were obtained from the medical records. The multiple logistic regression was performed to identify factors associated with medication literacy. Results: (1) The average medication literacy score was 4.91 ± 1.51. (2) Most of the Chinese KD caregivers had insufficient medication literacy (≤ 5 scores), and only 39.2% of the caregivers had adequate medication literacy (>5 scores). (3) The multiple logistic regression shows that education level, monthly income, and duration of hospitalization are the independent influencing factors on the medication literacy of KD caregivers. Conclusion: There is preliminary evidence that medication literacy among KD caregivers is low and needs improvement. A higher level of education, higher income, and longer duration of hospitalization were influencing factors of adequate medication literacy.

[Comparison in the Recognition about Medication Education between People with Prelingual Hearing Loss and Pharmacists].

Providing medication information according to a patient's health literacy and communication ability is needed for safe and effective healthcare. Communication barriers due to hearing loss prevent pharmacists from providing medication information to patients with hearing loss. A questionnaire about the difficulty in understanding medication information and the feeling of inconvenience during medication education was conducted from September to October 2020 with 84 people with prelingual hearing loss and 346 pharmacists. The 84 hearing loss participants were divided into low- and high-scoring groups based on their understanding of medication use. Pharmacists did not realize that low-scoring group participants did not understand items with homonyms, abstract expressions about medication use and medical terminology. Pharmacists were also unaware that the low-scoring group felt the inconvenience in medication education because of the difficulty to communicate, inform not understanding medication information and consult about medication use with a pharmacist. Prior learning about hearing loss led to higher responses in recognition of the aforementioned issues. However, even pharmacists with prior experience of learning did not fully recognize that speaking out loud is not useful for effective communication and that hearing loss patients need contact methods other than the phone. This indicates the need to learn about hearing loss to improve provision of medication information and effective communication in medication education to people with hearing loss.

Family-integrated diabetes education for individuals with diabetes in South-west Nigeria

Objectives: This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C). Design: The design was a two-group Pretest Posttest quasi-experimental. Setting: The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria. Participants: People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively. Interventions: PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS). Main outcome measures: A1C and diabetes knowledge. Results: Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C. Conclusions: Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better

Stroke-related knowledge and attitudes among university students in Northeast Nigeria

te public knowledge of stroke, but the impact in Nigeria is notwell known. This study assessed stroke-related knowledge andattitudes among university students in Nigeria, where health stud-ies are parts of college curricula. This was a cross-sectional studyof students at three universities in Northeast Nigeria. Using ques-tionnaire survey, we assessed biographical data and participantknowledge of the primary site, warning signs and risk factors ofstroke. Responses were graded on a knowledge score, where ≥2.5points indicated adequate knowledge. Data were analyzed with theSPSS version 21 program. We studied 824 participants, 67.1%males. Males were older than females (mean age ± SD: 27.42±5.58years versus 26.27±5.31 years; P = 0.009; 95% CI: 0.29 ­ 1.99)and 14.5% participants had stroke lectures during general studies.Major sources of stroke knowledge were personal discussions(44.6%) and internet websites (24.5%). Only 15.7% participantscorrectly identified the brain as the primary site of stroke, whileknowledge of one or more stroke warning signs and risk factorswere noted in 42.2% and 49.6%, respectively. Mean knowledgescore was 1.08 ± 0.99. Adequate knowledge of stroke was noted in13.2% participants, and was higher in females (17.7% versus10.7%; P = 0.01). Logistic regression analysis showed significantassociations between adequate knowledge of stroke with femalesex (OR 1.8; 95% CI: 1.2 ­ 2.8; P = 0.008) and a history of strokein close relatives (OR 1.7; 95% CI: 1.1 ­ 2.6; P = 0.025) but notwith age, academic discipline or stroke lectures. University stu-dents in Northeast Nigeria have low knowledge of stroke, which isworse in males. Although health issues are taught at universities,little is taught on stroke, suggesting a need to prioritize strokeknowledge in the universities little is taught on stroke, suggeting a need to prioritize stroke knowlegde in the university curriculum .

COVID-19: Socio-demographic determinants of knowledge

Background:Knowledge on etiology, risk factors, mode of transmission, signs and symptoms of COVID-19 is an essential element in pandemic control. Assessing the level of knowledge and determining sources from which information were derived is a fundamental element of situation analysis imperative in COVID-19 control.Materials and method: The study is a cross sectional study. All eligible visitors who presented at the general out-patient department for Medicare were enlisted into the study until required sample size was achieved. Pre-tested interviewer administered questionnaire was used to elicit information from respondents. Statistical analysis was done with multinomial logistic regression analysis using SPSS version 23.1 with statistical significance set at 0.05. Ethical approval and permission for the study from relevant authorities were granted.Conclusion:Knowledge of COVID 19 was poor. Higher educational qualification enhances better knowledge. Females, public servants, married persons, respondents who attended tertiary institution and those aged 31-40 years had better knowledge score.Results:Over all composite score for good knowledge was 1037(35.4%) with predominant statistically significant difference in knowledge. There was better knowledge score for females, public servants, married persons, respondents aged 31-40 years and those who had tertiary education

Acenocumarol: uso, adherencia y conocimiento del usuario. Oportunidades para la Atención Farmacéutica / Acenocumarol: use, adherence and knowledge. Opportunities for Pharmaceutical Care

Objetivo: El acenocumarol se mantiene como terapia anticoagulante (TAO) de primera elección. El objetivo de este estudio es valorar y mejorar el conocimiento que sobre el medicamento tienen sus usuarios y favorecer la personalización de la Atención Farmacéutica. Método: 60 pacientes usuarios de acenocumarol de 6 farmacias de Tenerife han participado en una encuesta anónima para valorar el uso, la adherencia y el conocimiento del fármaco. Resultados: 16% de los usuarios desconoce la indicación para la que se les prescribe el anticoagulante, un 32% son pacientes sin adherencia terapéutica y existe un alto grado de desconocimiento (47%) sobre cómo actuar en caso de olvido de una toma. La duplicidad de dosis es un PRM (Problema Relacionado con el Medicamento) real para el 12% de los pacientes. El 87% usa otros tratamientos junto con el acenocumarol (antihipertensivos (24%), antihipercolesterolémicos (11%), ansiolíticos/sedantes (13%) y antiulcerosos (13%)) destacando el uso conjunto de acenocumarol y analgésicos/antiinflamatorios en el 11% de nuestros usuarios de acenocumarol lo que se identifica como un riesgo potencial grave de PRM por interacción. El 35% de los pacientes desconoce las interacciones del acenocumarol, un 70% afirma haber recibido información sobre el fármaco y sólo un 42% de los pacientes manifiesta no haber leído el prospecto. Conclusiones: Se pone de manifiesto la necesidad de mejorar el conocimiento sobre este fármaco por parte del paciente. La intervención farmacéutica mediante la dispensación activa e informada y el seguimiento fármaco terapéutico personalizado permitiría la detección y prevención de PRM durante el uso de acenocumarol.(AU)

Aims: Acenocoumarol remains the first-line anticoagulant therapy (OAT). The objective of this study is to assess and improve the knowledge that users have about this drug and advance in the personalization of pharmaceutical care. Method: 60 acenocoumarol patients from 6 Tenerife pharmacies have participated in an anonymous survey to assess the use, adherence and knowledge of the drug. Results: 16% of acenocoumarol users do not know the indication for which the anticoagulant is prescribed, 32% are patients without therapeutic adherence and there is a high degree of ignorance (47%) about how to act in case of forgetting a dose. Duplication of doses is a real DRP (Drug Related Problem) for 12% of patients. 87% of those surveyed use other treatments together with acenocoumarol (antihypertensive (24%), antihypercholesterolemic (11%), anxiolytic / sedative (13%) and antiulcer (13%)), highlighting the joint use of acenocoumarol and analgesic/anti-inflammatory in 11% of our acenocoumarol users this is identified as a potential serious risk of DRP by interaction. 35% of the patients admit that they are unaware of the possible interactions of acenocoumarol, 70% of the patients affirm that they have received information about the drug, and only 42% of the patients state that they have not read the package leaflet. Conclusions: The need to improve knowledge about this drug by the patient is highlighted. Pharmaceutical intervention through active and informed dispensing and personalized therapeutic drug monitoring would allow the detection and prevention of DRP during the use of acenocoumarol.(AU)

Research on the Health Literacy Status and Compliance Behavior of Patients with Acute Coronary Syndrome.

This study is aimed at assessing the current status of ACS patients' health literacy and medication compliance, analyzing the relationship between the two, and providing ideas for clinically improving the medication compliance of ACS patients and preventing the recurrence of cardiovascular events. ACS patients need long-term medication to prevent vascular restenosis after surgery, and bad living habits and mood swings will affect postoperative recovery, so clinical interventions are needed to help patients establish a healthy lifestyle. The effect of conventional care is not ideal. Therefore, this paper uses regression analysis to analyze the correlation between the health literacy status of ACS patients and the compliance behavior, combines the investigation and experiment to perform regression analysis and uses mathematical statistics to process data. The connection between health literacy level and compliance behavior is discovered via a study, providing a point of reference for future research.

Knowledge, Experience, and Perceptions of Generic Drugs among Middle-Aged Adults and their Willingness-to-Pay: A Nationwide Online Survey in Japan.

Promoting generic drugs can reduce the financial burden on patients and improve healthcare finances. The insurers have been conducting promotional efforts, such as direct-mail campaigns, but little is known about the public's perception of generic drugs and effective message strategies for promotion. In 2018, we conducted a web-based survey of middle-aged Japanese men and women that investigated: (i) their perceptions of generic drugs, (ii) the association between perceptions and willingness-to-pay for brand-name drugs relative to generic drugs, and (iii) potentially effective forms of information provision to alter individuals' perceptions. Of the 1,005 respondents, over half perceived generic drugs as having the same level of efficacy and safety as brand-name drugs. While willingness-to-pay was dispersed among respondents, two factors were associated with small willingness-to-pay: (a) perceiving generic drugs as having the same level of efficacy and safety as brand-name drugs and (b) perceiving that promoting the use of generic drugs is important for controlling medical expenditures. Moreover, presenting potential savings over five years by choosing generic drugs was a potentially effective tool for altering perceptions, relative to showing monthly savings. Our findings suggest that certain parts of the population still have high willingness-to-pay for brand-name drugs, and strategic communication to alter perception could be effective in promoting the use of generic drugs among those who are price-inelastic.

How do older patients with chronic conditions view reading open visit notes?

BACKGROUND: We examine the experiences with and perceptions of the effect of reading clinical outpatient visit notes on patients with multiple chronic conditions at three healthcare organizations with significant experience sharing clinical notes with patients. METHODS: A cross-sectional survey was conducted via patient portals at three diverse healthcare organizations in the United States: Beth Israel Deaconess Medical Center (Boston, MA), UW Medical Center (Seattle, WA), and Geisinger Health System (Danville, PA). Participants were aged 65 and older patient portal users who read at least one clinical note over the 12 months before the survey. We examined the effect of note reading on patient engagement and managing medications. RESULTS: The majority of respondents had read two or more clinical notes in the 12 months before the survey. Patients with more than two chronic conditions were more likely than those with fewer or none to report that reading their notes helped them remember their care plan, take their medications as prescribed, and understand and feel more in control of their medications. Very few patients reported feeling worried or confused about their health or medications due to reading their notes. CONCLUSIONS: Older patients with chronic conditions are particularly vulnerable to misremembering and mismanaging their care and medication plans. Findings from this study suggest that these patients and their care partners could receive important benefits from accessing their notes. Healthcare organizations should work to maximize patient's engagement with their health information both through the patient portal and through other methods to ensure that patients and the healthcare systems reap the full benefit of the increased transparency of medical records.

Pediatric and Parents' Attitudes Towards COVID-19 Vaccines and Intention to Vaccinate for Children.

BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccination is necessary to reach herd immunity and essential for mitigating the spread of the pandemic. In May 2021, the US FDA and the EU have expanded the emergency use authorization for a COVID-19 vaccine to children aged 12 to 15. The aim of this study was to investigate parental acceptability of COVID-19 vaccination for their children, factors affecting their acceptability, and children's perceptions of COVID-19 vaccines in Republic of Korea. METHODS: We conducted a questionnaire survey at two tertiary hospitals from May 25, 2021 to June 3, 2021. Subjects were parents having children under 18 years and children aged 10-18 years. RESULTS: Two hundred twenty-six parents and 117 children aged 10-18 years were included in the final analysis. Overall, 76.5% and 64.2% of parents intended to get vaccinated against COVID-19 and intended to have their children vaccinated, respectively. However, only 49.6% of children responded that they would get COVID-19 vaccination. In the multivariate analysis, high confidence in the safety of COVID-19 vaccines (adjusted odds ratio [AOR], 4.87; 95% confidence interval [CI], 1.32-24.12), parents' willingness to vaccinate themselves (AOR, 19.42; 95% CI, 6.85-64.00), and awareness of the need to vaccinate children against COVID-19 (AOR, 13.15; 95% CI, 4.77-41.27) were associated with positive factors intention to vaccinate their children. CONCLUSION: This study provides insight into how parents think about the COVID-19 vaccine for their children in South Korea. Our findings could be referenced in establishing a policy for childhood COVID-19 vaccination in the future.

A casemix study of patients seen within an urban Aboriginal Health Service dermatology clinic over a five-year period.

This is the largest study of Aboriginal and Torres Strait Islander dermatologic presentations to an urban specialist clinic within a community-controlled health organisation. It adds to our understanding of Aboriginal and Torres Strait Islander dermatoepidemiology. Patient files were reviewed over the five-year audit period, with age, gender, Indigenous status, diagnosis, disease category, 'new' or 'review consultation' and 'did not attend' (DNA) data recorded. Our study shows that eczema and benign, pre-malignant or malignant neoplasms are the most common presentations for urban Aboriginal and Torres Strait Islander patients. Lupus erythematosus and cutaneous infections were less prominent in comparison to data from rural and remote populations. Overall, a broad casemix of dermatologic presentations was observed. Similar to other studies, adult male patients were under-represented. Most skin malignancies were diagnosed in this cohort; this, therefore, identifies a possible target for public health intervention. A high ratio of new to review patients is consistent with the clinic offering a consultation model of care facilitated by primary health-care providers' support within Aboriginal Community-Controlled Health Service. DNA rates in this study were lower than hospital outpatient rates in a comparative study and may be attributed to specialist dermatology care being offered in a more culturally sensitive environment. The dermatology clinic at the Victorian Aboriginal Health Services (VAHS) provides a good breadth of specialist dermatology care. The community health-care model could be replicated in centres elsewhere, including interstate, to help overcome barriers to specialist dermatology care experienced by Aboriginal and Torres Strait Islander populations. Additionally, this model improves trainee exposure and understanding of Aboriginal and Torres Strait Islander health.

Lessons Learned: A Process Evaluation of the Rural Elder Awareness of Medication Safety (REAMS) Program.

This process evaluation of the Rural Elder Awareness of Medication Safety (REAMS) program provided identification of successful and unsuccessful elements along with barriers to and facilitators of this home-based pilot program. The REAMS program was developed to assist rural older adults aged >65 years and community health care organizations with strategies to improve health literacy related to medications. Recruitment of older adults, rurality of the program's setting, time constraints, and the onset of the COVID-19 pandemic were the greatest barriers. The collaborative relationship developed with community health care partners was the greatest facilitator. This relationship promoted shared ideas and adjustments in program design to achieve the outcome goals. The lessons learned from process evaluation may benefit future researchers or community health promotion planners with designing community-based programs for older adults in rural areas. Future research should focus on expanding recruitment opportunities in acute care, primary care, and home health with the inclusion of all established health care providers in the community. [Journal of Gerontological Nursing, 47(4), 7-12.].

Difficulties in reporting purpose and dosage of prescribed medications are associated with poor cognition and depression.

Knowledge on prescribed medication is important for medication adherence. We determined the presence of cognitive impairment in neurological patients who report not to know reasons and dosages of their medication. Data from 350 patients were collected: sociodemographic data, German Stendal Adherence to Medication Score (SAMS), Montreal Cognitive Assessment (MoCA), and Beck Depression Inventory-II (BDI-II). Eighty-eight (29.0%) patients did not know the reasons for taking their prescribed medication and 83 (27.4%) did not know the doses. Sixty-three (20.8%) knew neither reasons nor dosage. The latter were characterized by higher nonadherence, higher number of prescribed medication per day, lower MoCA, higher BDI, and had more often a lower education level compared with patients who knew the reasons. The MANOVA revealed a significant multivariate effect for not knowing the reasons and not knowing the dosages of medication on MoCA and BDI. Significant univariate effects for not knowing reasons were found for depressive mood, but not for cognitive performance. Significant univariate effects for not knowing dosages were found for cognitive performance, but not for depressive mood. Inaccurate medication reporting is not solely associated with cognitive problems, but also with depression, which has to be taken into account in daily practice and research.

Análise do nível de conhecimento das manifestações orais causadas pelo uso de anticonvulsivantes / Analysis of knowledge level of oral manifestations caused by the use of anticonvulsants

Analisar o nível de conhecimento dos usuários de anticonvulsivantes e dos cirurgiões-dentistas a res peito das manifestações orais ocasionadas pela medicação. Trata-se de um estudo transversal realizado no munícipio de Vitória de Santo Antão, em Pernambuco, no qual participaram 30 Odontólogos e 16 usuários de anticonvulsivantes das unidades de saúde da família do município. Foram aplicados questionários sobre o conhecimento dos profissionais e percepção dos usuários sobre as manifestações orais ocasionadas pela medicação. Para avaliar associação entre duas variáveis categóricas foi utilizado teste Exato de Fisher, quando a condição para utilização do teste Qui-quadrado não foi verificada. A análise dos dados demonstrou que 86,7% dos cirurgiões-dentistas conhecem os anticonvulsivantes e 50,0% dos usuários não receberam orientação do dentista sobre a medicação e os seus efeitos adversos. Há escassez de conhecimentos específicos sobre os efeitos adversos do uso de anticonvulsivantes na cavidade bucal por parte dos usuários e cirurgiões-dentistas... (AU)

To analyze the knowledge level of anticonvulsants users and the dental surgeons concerning the oral manifestations caused by the medication. A cross-sectional study conducted in Vitória de Santo Antão, Pernambuco, Brazil, with participation of 30 dentists and 16 anticonvulsants users from the city's family health units. Questionnaires about the knowledge of professionals and users' perception of manifestations in the oral cavity caused by the medication. Fisher's Exact test was used to assess the association between two categorical variables when the condition for using the chi-square test was not verified. The data analysis showed that 86,7% of dental surgeons know the anticonvulsants and 50,0% of users do not receive orientation from the dentist about the medication and its adverse effects. There is a shortage of specific knowledge about the adverse effects of the use of anticonvulsants in the oral cavity, by users and dental surgeons... (AU)

Can educational videos reduce opioid consumption in trauma inpatients? A cluster-randomized pilot study.

BACKGROUND: Opioids are often used to treat pain after traumatic injury, but patient education on safe use of opioids is not standard. To address this gap, we created a video-based opioid education program for patients. We hypothesized that video viewing would lead to a decrease in overall opioid use and morphine equivalent doses (MEDs) on their penultimate hospital day. Our secondary aim was to study barriers to video implementation. METHODS: We performed a prospective pragmatic cluster-randomized pilot study of video education for trauma floor patients. One of two equivalent trauma floors was selected as the intervention group; patients were equally likely to be admitted to either floor. Nursing staff were to show videos to English-speaking or Spanish-literate patients within 1 day of floor arrival, excluding patients with Glasgow Coma Scale score less than 15. Opioid use and MEDs taken on the day before discharge were compared. Intention to treat (ITT) (intervention vs. control) and per-protocol groups (video viewers vs. nonviewers) were compared (α = 0.05). Protocol compliance was also assessed. RESULTS: In intention to treat analysis, there was no difference in percent of patients using opioids or MEDs on the day before discharge. In per-protocol analysis, there was no different in percent of patients using opioids on the day before discharge. However, video viewers still on opioids took significantly fewer MEDs than patients who did not see the video (26 vs. 38, p < 0.05). Protocol compliance was poor; only 46% of the intervention group saw the videos. CONCLUSION: Video-based education did not reduce inpatient opioid consumption, although there may be benefits in specific subgroups. Implementation was hindered by staffing and workflow limitations, and staff bias may have limited the effect of randomization. We must continue to establish effective methods to educate patients about safe pain management and translate these into standard practices. LEVEL OF EVIDENCE: Therapeutic, Level IV.

Spatial variations and associated factors of knowledge of ORS packet or pre-packaged liquids for the management of diarrhea among women of reproductive age in Ethiopia: A spatial and multilevel analysis.

BACKGROUND: Even though diarrhea is not lethal by itself, the lack of knowledge about its management results in devastating complications such as dehydration and lastly death. Using an oral rehydration solution (ORS) is an easy, inexpensive, and most reliable way of treating dehydration and reducing diarrhea-related mortalities. The literature revealed that Knowledge of ORS packet or pre-packaged liquids is a very important and critical factor for the utilization of ORS during the management of diarrhea. METHODS: We used the 2016 Ethiopian Demographic and Health Survey data, which is the fourth survey conducted by the Central Statistical Agency. A total weighted sample of 7590 reproductive-age women who gave birth within five years preceding the survey was used. Multilevel logistic regression analysis was done to assess factors associated with knowledge of ORS packet or pre-packaged liquids. Arc GIS version 10.3 and Kuldorff's SaTScan version 9.6 software were used for the spatial analysis. RESULTS: In the multilevel analysis maternal education, media exposure, residence, community illiteracy level, and region were significantly associated with knowledge of ORS packet or pre-packaged liquids. Besides, knowledge of ORS packet or pre-packaged liquids for the management of diarrhea was not random in Ethiopia (with Moran's Index = 0.46 and p-value <0.001), and the primary clusters spatial window was located in SNNPR, most parts of the Oromia region, and eastern parts of the Gambela region. CONCLUSION: In this study knowledge of ORS packet or pre-packaged liquids was not random across the country. Lack of formal education, lack of media exposure, being from a rural area, and being from communities with a higher illiteracy level was associated with lower odds of knowledge of ORS packet or pre-packaged liquids. Therefore, special emphasis should be given to these high-risk groups and the hot spot regions (SNNPR, most parts of the Oromia region, and eastern parts of the Gambela region). Moreover, distributing information through different media regarding ORS packet or pre-packaged liquids is necessary.