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.
Toxoplasma gondii is an obligate intracellular protozoan parasite; it spreads via the circulatory system during infection and causes chronic infection in various organs. Toxoplasmosis affects nearly one third of people worldwide, especially immunocompromised people. This study aimed to determine the effect of toxoplasmosis on renal function in hemodialysis patients. Overall 300 patients referred to the Medical City, Al-Karama General Hospital, Baghdad, Iraq were enrolled from 2021 to 2022. All serum samples were tested for T. gondii immunoglobulins (IgG and IgM) antibodies, urea and creatinine levels. In patients undergoing hemodialysis, the results revealed a high positivity percentage for anti-Toxoplasma IgG. In hemodialysis patients infe
... Show Moreهدف البحث إلى بناء مقياسين تخصصين للنزاعات اللاشعورية وحرية الإرادة لمدربي بعض ألعاب القوى والتعرف على مستوى كل منهما لديهم، وإعداد برنامج إرشادي نفسي مستند لرفع مستوى الحالات اللاشعورية وحرية الإرادة للمدربين الذين يعانون من انخفاض مستوى النزاعات اللاشعورية وحرية الإرادة، والتعرف على تأثير البرنامج الإرشادي نفسي في النزاعات اللاشعورية وحرية الإرادة لدى مدربي بعض ألعاب القوى، لتفترض بذلك الباحثة بإ
... Show MoreBackground: Hemoglobin A1c (HbA1c) is a widely used test for glycemic control. It is done for chronic kidney disease (CKD) patients. Renal disease is accompanied by thyroid abnormalities, which affect HbA1c, especially in those taking erythropoiesis-stimulating agents (ESAs). We aimed to find the effect of thyroid dysfunction on HbA1c in hemodialysis patients taking ESAs and those who do not. Materials and Method: Fifty six patients were included in this study, which was done between September 2017 and June 2018, in Baghdad Teaching Hospital. Thyroid stimulating hormone, free T3, free T4 and HbA1c measurements were done. The patients were divided into 2 groups; those who took ESAs and those who did not, then they were subdivided into those
... Show MoreBackground: The excessive use and abuse of antibiotics contribute to bacterial resistance, raising the risk of complications and treatment failures. This study investigates adherence to antibiotic prescriptions among Iraqi dental patients, highlighting implications for antimicrobial resistance.Objective: To assess adherence levels and identify factors influencing antibiotic therapy compliance among dental patients.Methods: A cross-sectional survey was conducted in which adult dental patients aged 18 and older, who had been prescribed antibiotics within the past year, participated. The modified Morisky Medication Adherence Scale-8 items was used to evaluate adherence, and data were analyzed with IBM SPSS Statistics software V26.Results: Amon
... Show MoreAbstract Background Hemoglobin A1c (HbA1c) is a widely used test for glycemic control. It is done for chronic kidney disease (CKD) patients. Renal disease is accompanied by thyroid abnormalities, which affect HbA1c, especially in those taking erythropoiesis-stimulating agents (ESAs). We aimed to find the effect of thyroid dysfunction on HbA1c in hemodialysis patients taking ESAs and those who do not. Materials and Method Fifty six patients were included in this study, which was done between September 2017 and June 2018, in Baghdad Teaching Hospital. Thyroid stimulating hormone, free T3, free T4 and HbA1c measurements were done. The patients were divided into 2 groups; those who took ESAs and those who did not, then they were subdivided into
... Show MoreBackground: Uncontrolled hyperphosphatemia is the main difficulty facing staff treating patients with end-stage renal disease on hemodialysis. Sevelamer and calcium-containing phosphate binders have been associated with cost burden and tissue calcification, respectively. Therefore, the current trial was targeted to investigate the efficacy of a new phosphate binder, ferric citrate, in a sample of Iraqi patients with end-stage renal disease on hemodialysis. Keywords: Ferric citrate, Hemodialysis Phosphate binder
Dialysis is a stressful process and follows various psychological and social problems, which can lead to psychological disturbances. Patients on dialysis experience psychological distress, and the reduction of stress in patients provides psychological resources to cope with their physical condition. The study aimed to evaluate the effect of deep-breathing exercise training on the level of stress among maintenance hemodialysis patients.
This study is a randomized
Asthma is a chronic inflammatory disease of respiratory airways characterized by distinctive history of respiratory symptoms due to variable airflow obstruction which reverses either spontaneously or in response to certain medications. Acetylcholine is a parasympathetic neurotransmitter which plays fundamental roles in the development of persistent asthma. Treatment guidelines recommend using medium doses of inhaled corticosteroids in addition to another controller bronchodilator instead of using high doses inhaled steroid alone for treatment of moderate to severe persistent asthma. The inhaled long acting muscarinic antagonist, tiotropium, was approved recently to control unresponsive asthma to inhaled corticosteroid with or without a long
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