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 global health crisis resulting from the spread of the Corona virus, which the World Health Organization described on January 30, 2020 as a public health emergency of international concern, then returned to describe it as a pandemic on March 11, 2020, and the measures and procedures taken by government authorities in different countries of the world, whether at the highest level of imposing a comprehensive curfew or what is called globally home quarantine and thus disrupting all sectors and activities in the state, whether public or private (with the exception of some sectors such as the health, media and security sectors), or at a lower level than that, such as reducing work rates in different sectors by rates that vary from one country
... Show MoreObjective(s): To assess the adequacy of mediation program on medical attendants practice toward care of kids with diabetic's ketoacidosis. Methodology: A quasi-experimental design that applied at teaching hospitals for pediatric in AL Ramadi city to establish the Effectiveness of Intervention Program on Nurses` Practices about Care of Children with Diabetic Ketoacidosis from 3th of March 2022 till 20 of March 2023. Non-probability (purposive) sample of (50), likewise was alienated into the study (experimental) group. The study group included (50) nurses non-randomly selected from AL-Ramadi Teaching Hospital.
A preliminary study has conducted in AL-Ramadi Teaching Hospital The whole number of nurse
... Show MoreThis study provides valuable information on secondary microbial infections in H1N1 patients compared to Seasonal Influenza in Iraqi Patients. Nasopharynx swabs were collected from (12 ) patients infected with Seasonal influenza (11 from Baghdad and 1 Patient from south of Iraq) ,and ( 22 ) samples from patients with 2009 H1N1 ( 20 from Baghdad and 2 from south of Iraq). The results show that the patients infected with 2009 H1N1 Virus were younger than healthy subjects and those infected with seasonal influenza. And the difference reached to the level of significance (p< 0.01) compared with healthy subjects.Two cases infected with 2009 H1N1 virus (9.1%) were fro
... Show MoreThe research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen
... Show MoreThis research came with the aim of showing the impact of governance mechanisms on tax avoidance practices, and in light of this, the financial data of the joint stock companies (industrial, service, agricultural, and hotels) listed in the Iraq Stock Exchange amounting to (35) companies were collected during the period (2009-2020). Through the financial reports published on the market website, multiple linear regression analysis was used as a tool to study the relationship between variables, and (Eviews 12) program was used for analysis and hypothesis testing. To achieve the objectives of the research,(administrative ownership, board size, board independence, women's membership) was adopted as an indicator of the dimensions of governance, an
... Show MoreThe development of technology used in computerized programs is considered on of the most important topics that is responsible for creating tools that can be used in the business environment, the audit profession is one of those professions that received this development. In order for this profession to be more effective, there must be a tool based on sound (correct) scientific basis that can be based upon to enhance the quality of auditing. The research also aims to propose a computerized program to plan the auditing process according to the methods appropriate to the working environment in the audit offices and companies in Iraq. The computerized program was applied to the research sample and the hypothesis of the research has been prov
... Show MoreThe significant shift in the Fine Arts, who led the avant-garde movements and creative which appeared in the modern, specifically in the mid-nineteenth century and early twentieth century era path, embodied in a clear show of new aesthetic value rejects traditional methods put in shape and color qualities She described the movements subjectivity or no formal, was intended to determine the direct function of expression and speech language in the visual arts away from the representation and simulation of reality was accompanied by the appearance of those fine movements directed towards a global approach to design carries features and clear in its organizations formalism of the most important move away from the symmetry and the adoption of
... Show MoreUnlike fault diagnosis approaches based on the direct analysis of current and voltage signals, this paper proposes a diagnosis of induction motor faults through monitoring the variations in motor's parameters when it is subjected to an open circuit or short circuit faults. These parameters include stator and rotor resistances, self-inductances, and mutual inductance. The genetic algorithm and the trust-region method are used for the estimation process. Simulation results confirm the efficiency of both the genetic algorithm and the trust-region method in estimating the motor parameters; however, better performance in terms of estimation time is obtained when the trust-region method is adopted. The results also show the po
... Show MoreCountries have faced the challenges of high levels of public debt and seek to define the optimum limits to reduce risks to which the financial system can be exposed and its impact on the economy as a whole. Hence the importance of research in studying the impact of internal and external public debt components on indicators of stability of the financial system for the period 2005-2017 for the purpose of knowing the extent of the financial stability indicators response to the high level of the public debt from its optimum ratio, as the aim of the research is to estimate and analyze the dynamic relationship of short and long term between the components of public debt and indicators of financial stability using the (ARDL) model that
... Show MoreThe research problem stems from the suffering of organizations from the weakness of their organizing aspect and the weak influence of the leadership on the subordinates and their dispersion. Organizations today are in rapid development and therefore work relations are not dominated by the humanitarian aspect and the first goal has become productivity. The research aims to identify the influence of servant leadership and its dimensions as an independent variable on the effectiveness of work teams as an approved variable and their importance increases when these organizations are service organizations, and how their influence increases when this leadership is the servant leadership and its dimensions in the Health Depa
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