Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled in the deprescribing program. The median age was 51.5 years, 56.8% were males, and hypertension was the most common etiology for their chronic kidney disease (CKD); 78% had comorbidities. After deprescription, there was a significant reduction in the number of medications from 6.0 to 4.0 and a reduction in the number of pills from 7.0 to 5.0. Medication adherence accessed using the Arabic version of Morisky, Green, and Levine’s (MGL) adherence scale also had a significant reduction from 2.0 to 1.0. Conclusion: A pharmacist-led deprescribing program is a successful strategy for decreasing the number of medications and daily pills prescribed while simultaneously improving hemodialysis patients' adherence to their regimens without compromising the patient’s safety.
The world went through turmoil before the sixth century AD, and human societies were in conflict and rivalry, each strong state is a weak state-dependent, but the dominant societies made the slave societies to them .. And thus made many societies or civilizations system of classes, and differentiation between members of one community, Weakened its strength and go alone. As the Islamic society in the present weak and weak and falling to the lowest levels of civilizational underdevelopment in the organization of society and social security contrary to what it was Islamic civilization, because of our distance from the heavenly instructions, and this prompted many to walk behind Western ideas aimed at the demolition of Islamic civilization,
... Show MoreMercury is a heavy metal that is extremely toxic. There are three types of it: inorganic, organic, and elemental. Mercury in all its forms has been shown to have harmful effects on living things. It can multiply its concentration from lower to higher trophic levels and accumulate in the body's various tissues. Aquatic organisms bodies have been exposed to mercury mostly through various human activities. The largest source of mercury pollution in the air is thermal power plants that mostly use coal as fuel. It is carried to a body of water after being deposited on the ground surface from the air. The way it enters the food chain is through aquatic plants and animals. Mercury accumulations in the kidney, liver, gills, or gonadal tissu
... Show MorePraise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
We see human societies differ from one society to another in organizing social life, and each according to the foundations and rules prepared by the main thing in the welfare and prosperity.
That is why we see eastern societies differ from western societies in many patterns and various ways of reaching that sophistication, until Islam came and gave the proper model in raising society at that time to the best and highest social levels, because it is based on heavenly rules and foundations and not status as in previous civilizations.
And when the Islamic community has
Urban wetlands are one of the complex systems that provide many economic, social and environmental services to the city. In this research, the most important services provided by urban wetlands from the point of view of the urban planner were reviewed, and the types of these lands and their divisions according to the type of services provided by each type were presented. Environmental is represented in its ability to reduce the dangers of floods, mitigate the climate and reduce its negative impacts, purify water and deplete a lot of suspended impurities and pollutants, and social services such as recreational areas and beautiful landscapes that inspire joy and reassurance in the soul, as well as cultural areas and sports activities for m
... Show Moreكان لنهاية الحرب الباردة وعولمة العالم على وفق رؤية كونية تتجاوز حدود ومفاهيم السيادة الوطنية والقومية الاثر الواضح في ترتيب العلاقات الدولية , واصبحت تلك العلاقات تدور حول محورين الاول .. هو الاعتماد المتبادل بين الدول من اجل الوصول الى خطوط مشتركة للمصالح المختلفة بين هذه الدول . والآخر.. هو تبعية الدول الضعيفة للدول القوية لافتقار الاولى توفير الحاجيات الى مواطنيها . هذا يشير الى نشأة علا
... Show More. The concepts of structural flexibility became one of the important goals in the design phases to reach high performance in architecture. The pioneering projects and ideas that linked architecture with technologies and scientific innovations appeared, with the aim of reaching projects that mix the concepts of flexibility with the development of machine thought and modern technology to meet the functional, environmental, and aesthetic requirements for human wellbeing. The aim of this paper is to identify the mechanisms used in order to reach flexible structural systems capable of accommodating technological changes and developments. The research hypothesizes that the structural design according to the concepts of flexibility achieves high s
... Show MoreMercury is a heavy metal that is extremely toxic. There are three types of it: inorganic, organic, and elemental. Mercury in all its forms has been shown to have harmful effects on living things. It can multiply its concentration from lower to higher trophic levels and accumulate in the body's various tissues. Aquatic organisms bodies have been exposed to mercury mostly through various human activities. The largest source of mercury pollution in the air is thermal power plants that mostly use coal as fuel. It is carried to a body of water after being deposited on the ground surface from the air. The way it enters the food chain is through aquatic plants and animals. Mercury accumulations in the kidney, liver, gills, or gonadal tissues of sp
... Show MoreEmpirical research in the disciplines of art and design has started to escalate and gather consideration within the academic community over the past few decades. However, still, graphic design tends to be a topic extremely under-researched by scholarly persons. Profound research in the field of graphic design extends far beyond the works produced by the designer himself (Khoury, 2009, p.844). In order to develop a clear insight, one needs to delve deep into the subcategories that the diverse field of graphic design is comprised of, including illustration, typography, interaction design, branding and even the impact of notable, eminent institutes from around the world that have taken the budding artists for quite a long time (Walke
... Show MoreThe aim of this research is to demonstrate the impact of credit risk on the banks of the study sample on the granting of loans and credit facilities, and try to reduce the size of credit risk to banks as a result of granting loans and credit facilities, credit risk is the oldest form of risk in financial markets. Every financial institution takes a degree of risk when it gives loans and credit facilities to companies and customers, It is exposed to financial losses when some borrowers fail to repay their loans as agreed, and at the same time credit facilities are the most profitable operations of the bank as it is the most profitable banking operations than other operations, so it represents the research communit
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