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2.
Afr J AIDS Res ; 19(4): 269-275, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33337976

RESUMO

Aim: Globally, there were over 250 000 new HIV infections among adolescents in 2017, with a higher proportion of these in sub-Saharan Africa. In Cameroon, UNICEF estimated over 4 200 new HIV infections in adolescents in 2015; by 2016, there were over 40 000 adolescents who had HIV. Given that the number of adolescents living with HIV in Cameroon is on the increase, there is a need to better understand the factors influencing adherence to treatment. The objective of this study was to assess the factors associated with adherence among adolescents in Cameroon. Methods: A cross-sectional study was conducted. A total of 460 HIV+ adolescents who were receiving antiretroviral therapy were sampled randomly from nine health facilities. Questionnaires and data extraction forms were used to collect data. Descriptive (frequencies and proportions) and inferential (chi-square and multivariate logistic regression) statistical analyses methods were used to analyse the data. Statistical significance was set at p = 0.05 and 95% confidence level. Results: The level of adherence to antiretroviral therapy among the adolescents was 83%. Twelve out of 30 independent variables examined showed significant statistical association with adherence at the bivariate level. In the multivariable logistic regression analyses, however, only two variables significantly predicted adherence - experiencing side effects (AOR = 2.63; 95% CI = 1.14, 6.09; p = 0.02), and internalized stigma (AOR = 2.51; 95% CI = 1.04, 6.04; p = 0.04). Conclusion: Adherence to treatment among adolescents in Cameroon was found to be suboptimal. There is a need for more individualized, targeted medication counselling for adolescents and their guardians as well as strategies to reduce internalized stigma and improve adherence to antiretroviral treatment.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Adolescente , Camarões/epidemiologia , Criança , Estudos Transversais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Estigma Social , Inquéritos e Questionários , Adulto Jovem
3.
PLoS One ; 15(8): e0237781, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857798

RESUMO

BACKGROUND: Drug therapy problems (DTPs) are major concerns of healthcare and have been identified to contribute to negative clinical outcomes. The occurrence of DTPs in heart failure patients is associated with worsening of outcomes. The aim of this study was to assess DTPs, associated factors and patient satisfaction among ambulatory heart failure patients at Tikur Anbessa Specialized Hospital (TASH). METHODS: A hospital based prospective cross-sectional study was conducted on 423 heart failure patients on follow up at TASH. Data was collected through patient interview and chart review. Descriptive statistics, binary and multiple logistic regressions were used for analyses and P < 0.05 was used to declare association. RESULTS: Majority of the patients were in NYHA class III (55.6%) and 66% of them had preserved systolic function. DTPs were identified in 291(68.8%) patients, with an average number of 2.51±1.07.per patient. The most common DTPs were drug interaction (27.3%) followed by noncompliance (26.2%), and ineffective drug use (13.7%). ß blockers were the most frequent drug class involved in DTPs followed by angiotensin converting enzyme inhibitors. The global satisfaction was 78% and the overall mean score of treatment satisfaction was 60.5% (SD, 10.5). CONCLUSION: Prevalence of DTPs as well as non-adherence among heart failure patients on follow up is relatively high. Detection and prevention of DTPs along with identifying patients at risk can save lives, help to adopt efficient strategies to closely monitor patients at risk, enhance patient's quality of life and optimize healthcare costs.


Assuntos
Antagonistas Adrenérgicos beta/efeitos adversos , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Insuficiência Cardíaca/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Adolescente , Antagonistas Adrenérgicos beta/farmacocinética , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidores da Enzima Conversora de Angiotensina/farmacocinética , Estudos Transversais , Interações Medicamentosas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Etiópia/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Ambulatório Hospitalar/estatística & dados numéricos , Prevalência , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Adulto Jovem
4.
Medicine (Baltimore) ; 99(23): e20510, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32501998

RESUMO

Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy is the primary treatment option for patients with non-small cell lung cancer (NSCLC). However, one of the major adverse effects associated with this therapy is skin toxicity, which impacts the patient's quality of life. This study aimed to describe the severities and locations of skin toxicity, and to analyze their association with the quality of life in patients with advanced NSCLC who received EGFR-TKI therapy as first-line treatment.This cross-sectional and correlation study was conducted at a tertiary medical center in northern Taiwan between July 2015 and March 2016. Skin toxicity was assessed and graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.03). The Skindex-16 scale was used to measure the skin disease-related quality of life.A total of 146 NSCLC patients who received EGFR-TKI therapy within the first 3 months of diagnosis were included in this study; 93.2% of these patients experienced skin toxicities. Approximately 70% of the patients developed xerosis and pruritus, while 50% had papulopustular eruptions and paronychia. The mean skin symptom impact score was 5.38 (standard deviation = 2.65). The skin-related quality of life varied widely among the participants but remained acceptable (mean score = 13.96, standard deviation = 16.55). Skin symptoms correlated significantly with poor quality of life (r = 0.50, P < .001). Younger patients and those treated with afatinib were the most affected, reporting the poorest quality of life. Patients who required EGFR-TKI dose reduction had experienced more severe skin symptoms than had patients who did not require it (7.35 vs 5.01, P < .001).Skin toxicity related to EGFR-TKI treatment impacts the quality of life in patients with NSCLC. During the treatment period, skin assessment and tailored management should be incorporated into the daily care plan.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Inibidores de Proteínas Quinases/efeitos adversos , Inibidores de Proteínas Quinases/normas , Pele/efeitos dos fármacos , Afatinib/efeitos adversos , Afatinib/normas , Afatinib/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/psicologia , Correlação de Dados , Estudos Transversais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/fisiopatologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Cloridrato de Erlotinib/efeitos adversos , Cloridrato de Erlotinib/normas , Cloridrato de Erlotinib/uso terapêutico , Feminino , Gefitinibe/efeitos adversos , Gefitinibe/normas , Gefitinibe/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores de Proteínas Quinases/uso terapêutico , Qualidade de Vida/psicologia , Pele/fisiopatologia , Inquéritos e Questionários , Taiwan/epidemiologia
5.
Eur J Oncol Nurs ; 45: 101730, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32169687

RESUMO

PURPOSE: To investigate the experiences of adults living with chronic myeloid leukaemia and treated with tyrosine kinase inhibitors, with particular reference to factors influencing adherence. METHODS: A thematic synthesis of all published qualitative studies examining adults with chronic myeloid leukaemia, receiving tyrosine kinase inhibitors. Eligible publications were identified by searching five electronic databases using defined criteria. The synthesis involved complete coding of extracted data and inductive theme development. RESULTS: Nine studies were included and three overarching themes defined. Overarching themes were: 1) Disease impacts whole life; 2) Disease management strategies; and 3) Valued aspects of care. Side-effects often required physical and psychological adaptation. Patients developed individual decision-making processes to promote adherence and manage side effects. Unintentional non-adherence occurred due to forgetfulness and system failures. Intentional omission also occurred, which together with side effects, was unlikely to be reported to healthcare professionals (HCPs). HCP reassurance about missed doses could reinforce non-adherence. Information needs varied over time and between individuals. Knowledge among patients about treatment was often lacking and could lead to misunderstandings. Patients valued psychological support from HCPs and suggested an individualised approach, facilitating discussion of symptoms, adherence and their perspectives about living with chronic myeloid leukaemia, would improve care. CONCLUSIONS: Patients with chronic myeloid leukaemia experienced significant side-effects from treatment and changes to their psychological and physical well-being. They developed their own strategies to manage their disease and treatment. This should be recognised in interventions to improve education, support and the delivery of care that is compassionate and adequately resourced.


Assuntos
Adaptação Psicológica , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Inibidores de Proteínas Quinases/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
6.
BMC Womens Health ; 20(1): 2, 2020 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-31896349

RESUMO

BACKGROUND: Implanon is one of the cost - effective long acting reversible contraceptive methods used for spacing and limiting births in Ethiopia. Despite the scaling up initiative undertaken by the Ethiopian Government, Implanon uptake is very low compared to short acting contraceptive methods. There is low utilization of Implanon with high level of discontinuation in Ethiopia. Therefore, this study was conducted to explore the reasons for early removal of Implanon among users in Arba Minch town, South Ethiopia. METHODS: A community-based qualitative exploratory study using phenomenological approach was conducted. In-depth and key informant interviews were used to collect data from April 20-27, 2018 in Arba Minch town. Convenient sampling was employed to recruit participants from the households of targeted villages. A total of 10 in-depth interviews with women who recently removed Implanon and 5 key informant interviews with health extension workers were conducted. The sample size was determined based on the concept of saturation. The collected data were analyzed using thematic content analysis technique. Data coding and analysis were facilitated by using Open code version 4.0 software. RESULTS: This study revealed that majority of participants were able to mention at least three types of contraceptive methods available in the nearby health facilities. The study underlined that side effect of the method, husband opposition, seeking more children, and method failure were the common reasons for early removal of Implanon, in which side effect of the method was the main reason. Among various forms of side effects of Implanon identified by users, heavy and irregular bleeding was mentioned as the most frequently occurring side effect. CONCLUSION: Our result indicated that heavy and irregular bleeding was the main reason for early removal of Implanon. Therefore it suggests improvement in the service delivery system. Improving client's education and counseling service program could contribute much to avoid unreasonable and untimely removal of Implanon.


Assuntos
Desogestrel , Contracepção Reversível de Longo Prazo , Adulto , Anticoncepcionais Femininos/efeitos adversos , Anticoncepcionais Femininos/uso terapêutico , Estudos Transversais , Desogestrel/efeitos adversos , Desogestrel/uso terapêutico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Etiópia/epidemiologia , Serviços de Planejamento Familiar/métodos , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Humanos , Contracepção Reversível de Longo Prazo/psicologia , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Adesão à Medicação , Pesquisa Qualitativa , Falha de Tratamento
8.
J Patient Saf ; 16(1): 65-72, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-29112025

RESUMO

Unanticipated patient adverse events can also have a serious negative impact on clinicians. The term second victim was coined to highlight the experience of health professionals with these events and the need to effectively support them. However, there is some controversy over use of the term second victim. This article explores terminology used to describe the professionals involved in adverse events and services to support them. There is a concern that use of the term victim may connote passivity or stigmatize involved clinicians. Some patient advocates are also offended by the term, believing that it deemphasizes the experience of patients and families. Despite this, the term is now coming into widespread use by clinicians and health care managers as well as policy makers. As the importance of emotional support for clinicians continues to gain visibility, the terminology surrounding it will undoubtedly change and evolve. At this time, it may be most appropriate to label this important phenomenon in a way that local leaders are comfortable with-in a way that promotes its recognition and adoption of solutions. For example, for policy makers and health care managers, the term second victim may have value because it is memorable and connotes urgency. For support programs that appeal directly to health care workers, different language may attract more users. Debate concerning the benefits and drawbacks to this terminology will enhance and further drive its evolution, while helping retain our industry's focus on the importance of developing and evaluating programs to support clinicians in need.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Pessoal de Saúde/psicologia , Humanos
9.
Support Care Cancer ; 28(8): 3605-3615, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31828488

RESUMO

PURPOSE: Due to advances in anticancer treatment and supportive care, patients increasingly complained about nonphysical side effects of chemotherapy and targeted therapy in recent years. Therefore, continuous assessment of side effects and patients' perceptions is important. The aim of this study was to evaluate the identification and severity of side effects perceived by ovarian cancer (OC) and breast cancer (BC) patients undergoing contemporary anticancer therapy. METHODS: Between 2015 and 2017, consecutive chemo-naïve OC and BC patients were enrolled in this prospective cohort study. Interviews were performed 12 ± 3 weeks after start of anticancer therapy, and patients were asked to select and rank, according to severity, 72 physical or nonphysical symptoms potentially related to their treatment. Data were analyzed with descriptive statistics. RESULTS: Forty-five OC patients and 98 BC patients completed the interview. Sleeping difficulties were ranked as the most troublesome symptom, followed by concerns about family or partner, and loss of hair. Alopecia was the most predominant side effect for BC patients, whereas OC patients were highly afflicted by numbness in limbs. Chemotherapy alone or in combination with targeted therapy caused pronounced sleep disturbances. Prolonged taxane treatment led to shortness of breath and numbness in limbs. Vomiting was ranked by one and nausea by eight women among the five most bothersome symptoms. CONCLUSIONS: Sleep disturbances have lately emerged as the most severe problem in women with OC or BC receiving anticancer therapy. Concerns about family and partner were ranked second in the current study and first in previous investigations.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Alopecia/induzido quimicamente , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bevacizumab/administração & dosagem , Bevacizumab/efeitos adversos , Neoplasias da Mama/psicologia , Hidrocarbonetos Aromáticos com Pontes/administração & dosagem , Hidrocarbonetos Aromáticos com Pontes/efeitos adversos , Carboplatina/administração & dosagem , Carboplatina/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Neoplasias Ovarianas/psicologia , Percepção , Estudos Prospectivos , Transtornos do Sono-Vigília/induzido quimicamente , Taxoides/administração & dosagem , Taxoides/efeitos adversos , Trastuzumab/administração & dosagem , Trastuzumab/efeitos adversos , Vômito/induzido quimicamente , Adulto Jovem
10.
Aliment Pharmacol Ther ; 51(1): 121-128, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31664732

RESUMO

BACKGROUND: Proton pump inhibitors (PPI) are among the most commonly prescribed medications and studies are reporting potentially harmful PPI-related adverse events. While these studies' findings are controversial, their impact on patients and physicians remains unknown. AIM: To determine patient and physician awareness of PPI-related adverse events, source of information, and subsequent effect on patient behaviour and physician practice. METHODS: A 20-item questionnaire was administered to English speaking adult patients and physicians in primary care and specialty clinics about topics including knowledge of PPI-related adverse events, change in behaviour of patients on PPIs and physician management of patients on PPIs. RESULTS: Of 277 patients surveyed, 45% reported knowledge of side effects related to PPIs. Patients were more likely to hear about PPI side effects from non-physician sources (66%) than physicians (38%). Of patients who had heard about PPI side effects, bone fractures and osteoporosis were the most common concerns, 42% and 44% respectively. Of PPI users, 38% changed their behaviour based upon concerns about PPI-related adverse events. Change in patient behaviour due to concern about PPI side effects was associated with age ≥ 65 years (odds ratio [OR] 4.07 [1.19-13.94]; P = 0.03) and concern about long-term side effects (OR 2.31 [1.03-5.17]; P = 0.04). Of 83 physicians surveyed, 60% reported concern about PPI-related adverse events, with bone fractures (46%) and osteoporosis (49%) being the most frequently reported. Overall, 37% of physicians reported changing their practice based upon their concerns. CONCLUSIONS: Nearly half of patients reported knowledge of PPI-related adverse events, most often from non-physician sources, and general concern regarding their impact. PPI users are changing their behaviour based upon these concerns, without physician input, and care providers are changing behaviour based on relatively weak evidence.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Conhecimentos, Atitudes e Prática em Saúde , Percepção , Inibidores da Bomba de Prótons/efeitos adversos , Adulto , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Feminino , Fraturas Ósseas/induzido quimicamente , Fraturas Ósseas/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Médicos/psicologia , Médicos/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários
11.
BMC Neurol ; 19(1): 335, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864345

RESUMO

BACKGROUND: Myasthenia gravis is a chronic, autoimmune, neuromuscular junction disorder characterized by skeletal muscle weakness. Current therapies for myasthenia gravis are associated with significant side effects. The objective of this study was to characterize the side effects, and associated health-related quality of life and treatment impacts, of traditional myasthenia gravis treatments. METHODS: This study had two phases; a Phase 1 interview and a 2-part web-based survey in Phase 2 that included brainstorming (Step 1) and rating (Step 2) exercises using group concept mapping. In Phase 1, all 14 participants reported experiencing side effects from myasthenia gravis treatments which had significant impacts on daily life. In Phase 2, 246 participants contributed to Step 1; 158 returned for Step 2. RESULTS: The brainstorming exercise produced 874 statements about side effects and their impact, which were reduced to 35 side effects and 23 impact-on-daily life statements. When rating these statements on severity, frequency, and tolerability, blood clots, infections/decreased immunity, weight gain, and diarrhea were the least tolerable and most severely rated. The most frequent and severe impacts were sleep interference and reduced physical and social activities. CONCLUSIONS: Based on these findings, there appears to be a need for better and more tolerable treatments for myasthenia gravis patients.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Imunoterapia/efeitos adversos , Miastenia Gravis/tratamento farmacológico , Adulto , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Feminino , Humanos , Imunoterapia/métodos , Masculino , Adesão à Medicação , Qualidade de Vida , Inquéritos e Questionários
12.
Rev Soc Bras Med Trop ; 53: e20190207, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31859946

RESUMO

INTRODUCTION: Adverse drug reactions can develop when using anti-tuberculosis medication, and the effects of the drugs can also significantly hinder the treatment of patients. METHODS: A cross-sectional survey was conducted in 73 patients using two standardized questionnaires and the World Health Organization Quality of Life-Bref. RESULTS: All patients reported the presence of adverse drug reactions, 71.6% of which are minor and 28.3% both major and minor. The global quality of life analysis showed that patients with tuberculosis have a good average (67.3%). CONCLUSIONS: There is an association between quality of life and adverse drug reaction, educational level, and vulnerability.


Assuntos
Antituberculosos/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Qualidade de Vida/psicologia , Tuberculose/tratamento farmacológico , Idoso , Antituberculosos/administração & dosagem , Estudos Transversais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Centros de Atenção Terciária , Tuberculose/psicologia
13.
Eur Ann Allergy Clin Immunol ; 51(6): 258-265, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31594299

RESUMO

Summary: The nocebo reaction, namely the undesirable effect of an inert substance (placebo), is a phenomenon rarely investigated in literature. A better knowledge of this reaction may help clinicians in the management of these patients in clinical practice. Patients with drug adverse reactions (ADR) undergoing the drug challenge test are an ideal model for studying the nocebo effect, and the study aims to investigate their clinical and psychological features. One hundred and twenty patients (Mage = 46.59, SD = 15.5; 82% female), of which 90 non responders and 30 with nocebo reactions (25%) were recruited, and completed a battery of psychological measures: State-Trait Anxiety Inventory X1-X2, Beck Depression Inventory II, Symptoms Checklist-90-R, Difficulties in Emotion Regulation Scale, Toronto Alexithymia Scale. Clinical features (individual characteristics and ADR clinical history) were collected by clinicians. The results show that older age (p = 0.002), low level of education (p = 0.039) and a depressive tendency (p = 0.030) appear to be potential risk factors for nocebo effects. Although none of the features related to the previous clinical history appear to represent a risk factor for the nocebo reactions (p minor 0.05), significant correlations between some of the clinical and psychological characteristics considered (p values from 0.005 to 0.042) help to better delineate the profile of these reactive patients. A specific training of the sanitary team about psychological aspects is recommendable.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Efeito Nocebo , Placebos/efeitos adversos , Adulto , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
15.
Psychol Addict Behav ; 33(6): 529-539, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31343200

RESUMO

The college years are a period of peak vulnerability for sexual victimization (SV) and substance misuse. During college, students with SV histories report riskier substance use patterns, yet little is known about the influence of SV on substance use behaviors as students begin to transition away from the college environment. This was the purpose of the present study. College seniors (N = 480; 61% female) reported on their alcohol and drug use behaviors across 5 time points spanning 1 calendar year. For many, this year included the transition out of college. Latent growth curve analysis was used to determine whether trajectories for alcohol and drug use as well as alcohol and drug consequences differed based on SV histories (no SV, precollege SV, college SV, precollege + college SV). Results revealed that at the start of senior year, young adults with SV histories reported greater substance use and consequences relative to nonvictimized peers. Over the year, SV histories were associated with steeper declines in substance use and consequences. Despite the declines, those who were revictimized across developmental time periods (precollege + college SV) consistently reported higher alcohol use and consequences across the transitional year, although this did not replicate for other drugs. In sum, although alcohol and other drug involvement among those with SV histories decreased over time, precollege + college SV histories continued to be a persistent risk factor for heavier alcohol use behaviors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos Relacionados ao Uso de Álcool/psicologia , Alcoolismo/psicologia , Vítimas de Crime/psicologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Delitos Sexuais/psicologia , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Alcoolismo/epidemiologia , Vítimas de Crime/estatística & dados numéricos , Estudos Transversais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Grupo Associado , Fatores de Risco , Delitos Sexuais/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Universidades , Adulto Jovem
16.
Epilepsy Behav ; 97: 22-28, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31181425

RESUMO

OBJECTIVE: The objective of the study was to investigate the relationship between sociodemographic, seizure-related, behavioral health, and antiepileptic drug (AED) adverse effect variables. The aim of this study was to examine whether there were significant differences on AED adverse effects between youth with normative and subclinical/clinical depressive and/or anxiety symptoms. METHODS: As part of a larger multisite validation study, 231 youth age 5 to 18 years diagnosed with epilepsy and their caregivers were recruited to participate for the current study. Youth ages 8 and older and caregivers of all youth completed the Behavior Assessment System for Children-2 (BASC-2). Caregivers also completed the Pediatric Epilepsy Side Effects Questionnaire (PESQ) and a Background Questionnaire. Medical chart review provided information regarding epilepsy diagnosis and treatment. RESULTS: No differences were observed in the mean scores on AED adverse effects between the group with subclinical/clinical BASC-2 Depressive symptoms and those with average/low depressive symptoms. In contrast, the proportion of youth with subclinical/clinical versus average/low depressive symptoms via caregiver report was significantly different for the cognitive, behavioral, general neurological, and total scale of the PESQ. There was also a larger proportion of youth with self-reported subclinical/clinical depressive symptoms who experienced general neurological adverse effects compared with youth with average/low depressive symptoms who experienced general neurological adverse effects. Findings were consistent for anxiety symptoms. SIGNIFICANCE: Identifying potentially modifiable behavioral health symptoms that exacerbate the expression of AED adverse effects could provide alternative solutions for improved AED tolerability to achieve optimum treatment outcomes.


Assuntos
Anticonvulsivantes/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Epilepsia/tratamento farmacológico , Adolescente , Anticonvulsivantes/uso terapêutico , Ansiedade/complicações , Cuidadores/psicologia , Criança , Pré-Escolar , Depressão/complicações , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Epilepsia/psicologia , Feminino , Humanos , Masculino , Convulsões/tratamento farmacológico , Fatores Socioeconômicos
17.
Cancer Med ; 8(9): 4454-4464, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31190442

RESUMO

INTRODUCTION: Objectives were used to describe guardian proxy-report and child self-report quality of life (QoL) during chemotherapy for pediatric acute myeloid leukemia (AML) patients. METHODS: Patients enrolled on the phase 3 AML trial AAML1031 who were 2-18 years of age with English-speaking guardians were eligible. Instruments used were the PedsQL Generic Core Scales, Acute Cancer Module, and Multidimensional Fatigue Scale. Assessments were obtained at the beginning of Induction 1 and following completion of cycles 2-4. Potential predictors of QoL included the total number of nonhematological grade 3-4 Common Terminology Criteria for Adverse Event (CTCAE) submissions. RESULTS: There were 505 eligible guardians who consented to participate and 348 of their children provided at least one self-report assessment. The number of submitted CTCAE toxicities was significantly associated with worse physical health summary scores (ß ± standard error (SE) -3.00 ± 0.69; P < 0.001) and general fatigue (ß ± SE -2.50 ± 0.66; P < 0.001). Older age was significantly associated with more fatigue (ß ± SE -0.58 ± 0.25; P = 0.022). Gender, white race, Hispanic ethnicity, private insurance status, risk status, bortezomib assignment, and duration of neutropenia were not significantly associated with QoL. DISCUSSION: The number of CTCAE toxicities was the primary factor influencing QoL among children with AML. Reducing toxicities should improve QoL; identifying approaches to ameliorate them should be a priority.


Assuntos
Bortezomib/administração & dosagem , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Leucemia Mieloide Aguda/tratamento farmacológico , Qualidade de Vida/psicologia , Sorafenibe/administração & dosagem , Adolescente , Bortezomib/efeitos adversos , Criança , Pré-Escolar , Tratamento Farmacológico/psicologia , Feminino , Humanos , Leucemia Mieloide Aguda/psicologia , Masculino , Autorrelato , Sorafenibe/efeitos adversos
19.
Int J Clin Pharm ; 41(4): 1062-1073, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31140162

RESUMO

Background Higher incidence of adverse drug reactions (ADRs) remain a major cause of morbidity and mortality. Most targeted ADR reporting activities are mainly professional-centered with less attention to patients' knowledge, perception and selfreporting of experienced ADRs. Objectives To comprehensively evaluate patients' knowledge, awareness, perception and reporting of experienced ADRs. Setting Three public healthcare facilities in Ibadan, southwestern Nigeria. Method A questionnaire-guided cross-sectional interview of 1190 consented ambulatory adult patients consecutively recruited from various clinics of the selected hospitals between February and June 2018. The 32-item pretested questionnaire comprised open- and closed-ended questions, as well as open-ended questions with relevant prompts. Data were summarised using descriptive statistics, while Chi square was used to investigate association between relevant categorical variables at p < 0.05. Main outcome measure Knowledge, awareness, perception and reporting of experienced ADRs among patients. Results Response rate was 99.1%. Mean age was 40.6 ± 14.9 years. Forty-nine (4.1%) patients were aware of pharmacovigilance. A total of 964 (81.0%) correctly understood what can be regarded as serious adverse drug reactions (ADRs), 444 (37.3%) had previously experienced ADRs, while 77 (6.5%) experienced reactions with current medication(s). Of this, 64 (83.1%) made a report largely to physician (52; 81.3%). Summarily, reported reactions were more with antimalarials (214; 49.1%), with itching (168; 78.5%) constituting the most frequently occurring reaction. Use of text message (276; 27.2%) and filling of ADR report form (248; 24.4%) were topmost on the list of suggested methods for ADR reporting. There was a significant association between patient's age and awareness of pharmacovigilance (p = 0.015), while educational qualification (p = 0.001) significantly influenced tendency to make a report of experienced ADRs. Conclusion Approximately four percent of patients were aware of pharmacovigilance, while more than three-quarters correctly understood the concept of serious adverse drug reactions. A little above one-quarter had previously experienced one form of reaction or the other, with majority reporting such reactions to physician. Continuous education of stakeholders in pharmacovigilance activities is advocated, while patient's active involvement in spontaneous reporting of ADRs should be carefully considered.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pacientes Ambulatoriais/psicologia , Farmacovigilância , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Autorrelato , Inquéritos e Questionários , Adulto Jovem
20.
Int J Clin Pharm ; 41(3): 804-812, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31028593

RESUMO

Background Little is known about patients' Perceived Sensitivity to Medicines (PSM), "the belief that one is especially sensitive to the actions and side effects of medicines". Objective (i) To explore the extent of and factors associated with high Perceived Sensitivity to Medicines in a Norwegian population of chronic medicine users; (ii) to assess the psychometric characteristics of the tool to measure PSM. Setting Community pharmacies in the Oslo area, Norway. Method A cross-sectional, questionnaire-based study was conducted between October 2015 and January 2016. Patients filling prescriptions for chronic disorders were recruited. Main outcome measure Perceived sensitivity to medicines. Results The study population included 214 patients (response rate 36.7%). In total 20.1% of the patients reported low, 61.7% moderate and 18.2% high perceived sensitivity to medicines. Factors positively associated with high perceived sensitivity were female gender (Adjusted Odds Ratio (aOR) 5.33, 95% CI 1.52 to 18.72, p < 0.001) and having a non-native language (aOR 4.76, 95% CI 1.48 to 15.30, p < 0.001); lower educational level (aOR 0.43, 95% CI 0.17 to 1.07, p < 0.001) and using generic medicines (aOR 0.12, 95% CI 0.03 to 0.57, p < 0.001) were negatively associated with high perceived sensitivity to medicines. There was no association between the perceived sensitivity and the number of prescription medicines taken. The Norwegian version of the Perceived Sensitivity to Medicines tool demonstrated good psychometric characteristics. Conclusion Almost one out of five patients in this study reported high sensitivity to medicines. Female gender, having a non-native language, lower educational level and using generic medicines were important factors related to the perceived sensitivity. Health care providers should be aware of the impact negative expectations about medicines can have on health behaviors and treatment outcomes, and seek to elicit and address patients' beliefs about their personal sensitivity to medicines.


Assuntos
Doença Crônica/epidemiologia , Doença Crônica/terapia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Autorrelato , Adulto , Idoso , Idoso de 80 Anos ou mais , Serviços Comunitários de Farmácia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Medicamentos Genéricos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medicamentos sem Prescrição/efeitos adversos , Noruega/epidemiologia , Medicamentos sob Prescrição/efeitos adversos , Adulto Jovem
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