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.
There are different types of corruptions such as administrative, political, economic and financial corruption. The corruption forms also varied such as bribery, nepotism and extortion. All types and forms of corruption play significant role in the all economic variables generally and on investments in particular, and the corruption used to be an intermediate means in reducing the rate of economic growth. The corruption contributes in reducing the domestic investments via pay bribery by investors to officials’ persons for supplemental contracts and tenders which finally leads to reduction in the investment efficiency. The corruption also contributes in rise of operational costs for the investment projects. In additio
... Show MoreThe current research aims to test the relationship of the entrepreneurial leadership and its factors (strategic factors, communication factors, personal factors, motivational factors) in managing the organizational crisis and its stages (detection of warning signs, readiness and prevention, containment of damages, restoration of activity, learning) among a sample of companies of the Ministry Water resources (Al-Fao State Company for the implementation of irrigation projects, Al-Rafidain Company for the implementation of dams, Iraq Company for the implementation of irrigation projects), as well as standing at the level of interest of the research companies in the search variables and their factors and stages, there is no doubt tha
... Show MoreThe research aims to investigate the relationship and impact of e-governance as an independent variable in achieving creative performance as a dependent variable. These variables have been studied in the Directorate of Passports Affairs, and seek to come up with a set of recommendations that help in promoting e-governance in the researched organization, and the researcher adopted the descriptive-analytical approach, included The sample (122) of the total (194) individuals distributed in several administrative levels (officers, associates, and administrative staff). By adopting the questionnaire, which included (49) paragraphs as the main tool for the collection of data and information, as well as personal interviews and field obs
... Show MoreThe problem of the study is concerned with the work of The Iraqi Airways Company in political, economic, and social environment that suffers instability for many years. This has its negative outcomes regarding its decisions of providing services to its markets and customers as a result of the orientations, behavior, and marketing values the company management adopted. The aim of this study is to investigate the marketing philosophy adopted by the management and to identify the extent it suits the materialistic and the human capacities of the company and its current environmental circumstances within the marketing culture common to the thoughts and behaviors of the management and their employees. And in order to achiev
... Show MoreThe history of the impact of nuclear radiation on the environment, as illustrated by the Hiroshima bombing, reveals a multifaceted interplay of scientific, ecological, and ethical dimensions. From the historical context and immediate environmental consequences to long-term ecological effects and human health implications, the effects of nuclear radiation are pervasive. Comparatively analyzed with other nuclear incidents, case studies of affected ecosystems, and through education, ongoing challenges and opportunities toward nuclear technology are revealed. Moreover, it is through the echoes of past nuclear events that lessons were learned which until today guide current efforts on striking a balance between technological advancement
... Show MoreAl-Wasiti's drawings are the first attempt to document the Arab landscape more than 778 years ago. These drawings were associated with a fine literary material, and the relationships between words and poetic sentences are matched by artistic, aesthetic and color relations in drawing, as they are all outputs of a sense that agreed in creativity and differed in the language of expression. Al-Wasiti was creative in drawing these events. Islamic painting has a goal that differs from the goals of the painting arts that preceded it or its contemporary, as it tends to “beautification” only. This is achieved by true copying from nature, just as it is achieved by drawing what is transmitted from nature, transforming and refining it. The
... Show MoreThis research aims the effects of negative media on the educational identity of community. Whereas display the concept of educational identity and its basic components, as well as the role of educational institutions for example the school and the family in form it and reinforcing this identity to individuals. The study showcasing the harmful impact of both traditional and modern media on identity and values, spotlight several examples like the promotion of consumerism and materialism through television programs. which results in the young people to adopt materialistic values like simplicity. The study concludes that media is a double-edged weapon: it can instill virtues and support education if used duly, but it can also weaken the educat
... Show MorePharmaceutical care is a patient-centered, outcomes oriented practice that requires the pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. In addition, the presence of clinical pharmacists has led to a higher quality of patient education and provision of complete detailed information for patients. In developed countries Pharm D has become the professional degree for practice of Pharmacy. The graduates will be enrolled in a pharmacy residency program; admission to the residency programs is available to Pharm D graduates of an accredit
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