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.
Abstract:
The six Arab Gulf states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, UAE) play a vital role, especially with its geographical location and natural resources (oil and gas) as well as other cultural and civilizational elements, in achieving global economic balance and more specifically global energy security, naturally because of these countries have a comparative advantage in the field of fossil energy (oil and gas), thus this sector becomes more attractive for local and international investments alike. Being the energy sector a leader sector in the economic development process, and the basic factor to achieve savings and financial surpluses in thes
... Show Moret-Self-Compacting Concrete (SCC) reduces environmental noise and has more workability. This research presents an investigation of the behavior of SCC under mechanical loading (impact loading). Two types of cement have been used to produce SCC mixtures, Ordinary Portland Cement (OPC) and Portland Limestone Cement (PLC), which reduces the emission of carbon dioxide during the manufacturing process. The mixes were reinforced with Carbon Fiber Reinforced Polymer (CFRP) which is usually used to improve the seismic performance of masonry walls, to replace lost steel reinforcements, or to increase column strength and ductility. Workability tests were carried out for fresh SCC. Prepared concrete slabs of 500×500×50mm were tested for lo
... Show MoreThe objective of the research is to determine the nature of the strategic direction of the institution and its impact on enhancing the indicators of institutional performance. The strategic direction is the main purpose for which it was found. Therefore, it is the main engine for all activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. The promotion of corporate performance indicators is one of the major challenges that senior management must address in order to help the organization invest its human resources in the best possible way.
The research problem was determined by means of the intentional sample, consisting of (33) members
... Show Moreإن استخدام النظم الالكترونية في القطاع المصرفي وبالخصوص نظام مقاصة الصكوك الالكترونية (ACH) في عمليات التحويل الالكتروني للاموال بين المصارف تتضمن تحويلات مالية عالية القيمة بين المصارف المشاركة بهذا النظام, وان اي خلل قد يحدث بالنظام يؤدي الى حالات تلاعب في مقاصة الصكوك الالكترونية في المصارف المشاركة وبالتالي حدوث عملية اختلاس, ومن هذا المنطلق تبرز مشكلة البحث في اهمية توافر برنامج تدقيق مقترح ياخ
... Show MoreThe current study introduces a novel method for calculating the stability time by a new approach based on the conversion of degradation from the conductivity curve results obtained by the conventional method. The stability time calculated by the novel method is shorter than the time measured by the conventional method. The stability time in the novel method can be calculated by the endpoint of the tangency of the conversion curve with the tangent line. This point of tangency represents the stability time, as will be explained in detail. Still, it gives a clear and accurate envisage of the dehydrochlorination behavior and can be generalized to all types of polyvinyl chloride compared to the stability time measured by conventional ones based
... Show MoreTh paper scientifically deals with the Syrian crisis events erupted in 2011 using the historical descriptive and analytical approaches. The importance of the paper comes from the serious crisis that occurred in a region rich of historical crises, and natural resources attracting the attention of the major countries. The paper aims to show the Syrian crisis, its importance to Russia, the United States, and the regional countries, its impact on Russia economically and politically after the intervention, and Russia’s achievements on a global level holding the influential power on international decisions and other global events. The new Russian strategy has proven its worth in preserving its strategic interests as it could help the Syrian
... Show MoreIn the present time, radioactive contamination is considered one of the most dangerous types of environmental pollution. It usually takes place because of a leakage of radioactive materials to one of the environment natural components, such as, water, air, and soil. Iraq is considered one of the most contaminated environments in the world; this is closely associated with the wars Iraq had suffered from; especially, in 1991 and 2003. Considering the importance of the radioactive contamination and its different health impacts on the population, the current paper is interested in studying this type of environmental contamination and its impact on the birth defects depending on the data available in the annual reports issued by the Iraqi min
... Show MoreThe topic of the research tagged (narrative structure and its impact on building open and closed endings in the fictional film) is summarized by studying the mechanism of employing closed and open endings in the fictional film. novelist, then the need for it, as well as the objectives of the research and clarifying its limits as well as its importance. Then moving to the theoretical framework, which included three topics, where the first topic was entitled (the cinematic construction of the film narrative), either the second topic (the structure of complexity and narrative solutions), or the third topic dealt with the subject (the structure of the end and its relationship to the construction of the narrative). After completing the theore
... Show MoreThe research aims to a statement of specificity of the Controller of (academic achievement, specialty, job title, length of service, Gender) and its impact on performance, Through a proposed appraisal form includes three main axes and each axis including several specialized elements in the supervisory work in form (check list). as is the importance of research to enable officials of oversight bodies financial identify and diagnose performance Controller through what has this observer of the process of scientific properties when performing supervisory work. Be summarized problem of the research that the lack of regulatory institution with the Controller interesting in terms of the necessary characteristics and requirements and inv
... Show MoreZinc oxide (ZnO) nanostructures were synthesized through the hydrothermal method at various conditions growth times (6,7 and 8 hrs.) and a growth temperature (70, 90, and 100 ºC). The prepared ZnO nanostructure samples were described using scanning electron microscopy (SEM) and X-ray diffractometer to distinguish their surface morphologies and crystal structures. The ZnO samples were confirmed to have the same crystal type, with different densities and dimensions (diameter and length). The obtained ZnO nanostructures were used to manufacture gas sensors for NO2 gas detection. Sensing characteristics for the fabricated sensor to NO2 gas were examined at different operating temperatures (180, 200, 220, and 240) ºC with a low gas concentrati
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