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The Difference in Contributing Factors and Costs Associated with Outpatient Refusal to Accept Cardiovascular Medications or Analgesics During Dispensing Process.
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Background: Study looking into cardiovascular disorders (CVD) medicines or analgesics cost-saving activities during dispensing process is lacking.

Aim: To determine differences in factors and costs associated with refused CVD medicines or analgesics during dispensing process

Method: This study was approved by Medical Research and Ethics Committee (MREC) (Registration number: NMRR-20-177-53153(IIR)). Participants receiving CVD medicines or analgesics during dispensing process were recruited via convenience sampling technique between February and March 2020 at the Specialist Pharmacy Department of Jerantut Hospital, Malaysia. Refusal to medications and its reasons were asked based on the questionnaire developed by the researchers.

Results: Overall, 175 patients participated in this survey and CVD drugs contributed toward 58.9% of the refused medicines. Those who refused CVD drugs and analgesics were significantly different in terms of gender, medications dosing frequency, refusal reasons namely side effects, medications use, intentionally skipping dose and skipping the dose when feeling well. No associations were found between forgetfulness and age with refusal to CVD drugs or painkillers. Those who refused CVD medicines had a significantly higher total daily medicines, total daily pill burden, and total number of medicines refused per prescription compared to those who refused analgesics. Cost of CVD medicines refused per prescription was significantly higher compared to analgesics, median Ringgit Malaysia (RM) 10.50 (IQR, RM 15.00) versus median RM 6.00 (IQR, 15.00), P=0.01.

Conclusion: Refusal to CVD medicines and analgesics was associated with several medication’s and patient’s factors. However, higher cost-saving was observed in those refusing CVD medicines.

 

Keywords: cardiovascular disease, analgesics, dispensing, wastage

                                                                                                                              

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Publication Date
Sun Jun 22 2025
Journal Name
اكليل للدراسات الانسانية
Topic review article Britain and Iraq's book The Economic Status of Iraq during the era of the British administration 1914-1921 by Dr. Hussein Ali Falih Al-Khazraji
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: Summary Iraq suffered under the British administration during the First World War and its entry into an occupation of economic backwardness, and this economic backwardness was linked to the phenomenon of linking Iraq economically to the capitalist world by keeping it as a source of raw materials and a market for capitalist goods, and that the occupation authorities controlled Iraq's economic goods and wealth and mocked them to serve its interests and achieve their political and economic goals that it drew before the war.

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Publication Date
Fri Sep 01 2017
Journal Name
Journal Of Bridge Engineering
Novel Demountable Shear Connector for Accelerated Disassembly, Repair, or Replacement of Precast Steel-Concrete Composite Bridges
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A novel demountable shear connector for precast steel-concrete composite bridges is presented. The connector uses high-strength steel bolts, which are fastened to the top flange of the steel beam with the aid of a special locking nut configuration that prevents bolts from slipping within their holes. Moreover, the connector promotes accelerated construction and overcomes the typical construction tolerance issues of precast structures. Most importantly, the connector allows bridge disassembly. Therefore, it can address different bridge deterioration scenarios with minimum disturbance to traffic flow including the following: (1) precast deck panels can be rapidly uplifted and replaced; (2) connectors can be rapidly removed and replaced; and (

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
A solution to the Lifely Disobedience and its Effect to Stop Divorce
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Allah legislated marriage and made it dwelling, fellowship and mercy between
the two couples, Prophet Moh'd (peace of Allah and blessing be upon him) ordered a
husband to look after his wife, treat her with full charity and make love with here
every kindly. On the other hand, he ordered a wife to obey her husband and respect
him deeply, nevertheless, some obstacles may sometimes be appeared within the life
of their marriage, this may be caused by either a husband or a wife. This problem is
called lifely disobedience (AL-Noshooz).
In the other words, this means that a wife begins to hate her husband, refuse his orders
and not obey him.
In brief, they hate each other which leads to some marks appear in their
m

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Publication Date
Mon Dec 01 2014
Journal Name
Advances In Structural Engineering
CFRP Strengthening of RC Beams with Multiple Openings Subjected to Static and Impact Loads
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The provision of openings in serviceable reinforced concrete beams may result in a substantial decline in the beam's capacity and integrity, indicating the necessity of opening strengthening. The present study investigates the experimental response of reinforced concrete T-beams with multiple web-strengthened openings disposed in shear span to static and impact loads. Fourteen RC T-beams were tested in two groups, each of seven beams. The first group was tested under static loading up to failure, while the second group was tested under repeated impact loading until the width of shear cracks reached 0.3 mm. The residual static strengths of the beams subjected to impact loading were then determined. The test variables considered were

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Publication Date
Tue Jan 10 2017
Journal Name
International Journal Of Dynamics And Control
On local approximation-based adaptive control with applications to robotic manipulators and biped robots
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Publication Date
Thu Feb 28 2019
Journal Name
Political Sciences Journal
American Presidential Elections- Mechanism and campaign Issues with special reference to 2008-2012 elections
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Publication Date
Mon Dec 01 2014
Journal Name
Advances In Structural Engineering
CFRP Strengthening of RC Beams with Multiple Openings Subjected to Static and Impact Loads
...Show More Authors

The provision of openings in serviceable reinforced concrete beams may result in a substantial decline in the beam's capacity and integrity, indicating the necessity of opening strengthening. The present study investigates the experimental response of reinforced concrete T-beams with multiple web-strengthened openings disposed in shear span to static and impact loads. Fourteen RC T-beams were tested in two groups, each of seven beams. The first group was tested under static loading up to failure, while the second group was tested under repeated impact loading until the width of shear cracks reached 0.3 mm. The residual static strengths of the beams subjected to impact loading were then determined. The test variables considered were

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Publication Date
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Electrosorption of Hexavalent Chromium Ions by MnO2/Carbon Fiber Composite Electrode: Analysis and Optimization of the Process by Box-Behnken Design
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A nano manganese dioxide (MnO2) was electrodeposited galvanostatically onto a carbon fiber (CF) surface using the simple method of anodic electrodeposition. The composite electrode was characterized by field emission scanning electron microscopy (FESEM), and X-ray diffraction (XRD). Very few studies investigated the efficiency of this electrode for heavy metals removal, especially chromium. The electrosorption properties of the nano MnO2/CF electrode were examined by removing Cr(VI) ions from aqueous solutions. NaCl concentration, pH, and cell voltage were studied and optimized using the Box-Behnken design (BDD) to investigate their effects and interactions on the electrosorption process. The results showed that the

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Re-engineering management processes and its impact on the strategic decision-making process Field study on the College of Education / University of Mustansiriya / Iraq
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The aim of the research is to identify both the re-engineering of management processes and the strategic decision-making process in the research community and determine the nature of the correlation between the two variables and know the relationship between them to achieve the research goal. The researcher used a descriptive and analytical method. The research community consists of a group of professors and staff of the College of Education affiliated to the University of Mustansiriya in Baghdad, which their number were (45),  the researcher has distributed the forms to all members of the sample,  only (3) forms were excluded for invalidity and thus the number of forms approved in the analysis were (42) forms. The rese

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Publication Date
Thu Jun 30 2011
Journal Name
Al-khwarizmi Engineering Journal
The Effect of the Solution Heat Treatment on the Mechanical Properties of Aluminum-Copper Alloy (2024-T3) Using Rolling Process
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The effect of solution heat treatment on the mechanical properties of Aluminum-Copper alloy. (2024-T3) by the rolling process is investigated. The solution heat treatment was implemented by heating the sheets to 480 C° and quenching them by water; then forming by rolling for many passes. And then natural aging is done for one month. Mechanical properties (tensile strength and hardness) are evaluated and the results are compared with the metal without treatment during the rolling process. ANSYS analysis is used to show the stresses distribution in the sheet during the rolling process.  It has been seen that good mechanical properties are evident in the alloy without heat treatment due to the strain hardening and also the mechanical

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