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Medication Usage (medication + usage)

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Medical Sciences	100%

Selected Abstracts

Medication usage among young adult women: A comparison between Sweden, the USA, and Greece

NURSING & HEALTH SCIENCES, Issue 1 2008
Evy Lidell rn
Abstract This study evaluated whether or not medication usage among young adult women differed across three countries. An additional aim was to evaluate the association between medication use and sociodemographic factors and exercise habits. A sample of 1098 young adult women were selected in Sweden, the USA, and Greece. Consistent medication usage by young adult women in the three countries related to oral contraceptives and vitamins; nevertheless, there were differences. The main differences were found in the use of laxatives, iron supplements, analgesics, antidepressants, and antacid medication. The most outstanding differences were the frequent use of laxatives in Sweden and vitamins in the USA. Different association patterns were found between medication use and culture, sociodemographic factors, and exercise. The assessment of medication use among young adult women can be performed very easily and provides an immediate indication of their well-being and needs for preventative care. [source]

A new US,UK diagnostic project: mood elevation and depression in first-year undergraduates at Oxford and Stanford universities

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2008
R. A. Chandler
Objective:, To investigate differences in prevalence of mood elevation, distress and depression among first-year undergraduates at Oxford and Stanford universities. Method:, An online survey was sent to Oxford and Stanford first-year undergraduate students for two consecutive years in the winter of 2005 and 2006. Students completed a survey that assessed mood symptoms and medication use. Results:, Both universities had similar rates of distress by General Health Questionnaire (Oxford , 42.4%; Stanford , 38.3%), depression by Primary Care Evaluation of Mental Disorders (Oxford , 6.2%; Stanford , 6.6%), and psychotropic and non-psychotropic medication usage (psychotropic: Oxford , 1.5%; Stanford 3.5%; non-psychotropic: Oxford , 13.3%; Stanford , 18%). Oxford had higher rates of mood elevation by Mood Disorder Questionnaire (MDQ) (Oxford , 4%; Stanford , 1.7%). Conclusion:, Oxford and Stanford students have similar rates of mood distress, depression and general medication usage. Students at Oxford have a higher prevalence of MDQ scores that possibly indicate a bipolar disorder, while Stanford students are prescribed more psychotropics. [source]

Group therapy for somatization disorders in primary care: maintenance of treatment goals of short cognitive-behavioural treatment one-and-a-half-year follow-up

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2003
J. Lidbeck
Objective:, The objective of this study was to evaluate the maintenance of treatment goals of a short cognitive-behavioural group treatment programme for the management of somatization disorders in primary care. Method:, In a previous controlled 6-month follow-up study, patients with somatization disorders (n=32) improved with respect to illness and somatic preoccupation, hypochondriasis, and medication usage. In the present report the same group of patients were also investigated one-and-a-half year after initial treatment. Results:, The long-term follow-up manifested maintained improvement with respect to hypochondriasis. There was additional reduction of anxiety and psychosocial preoccupation, whereas somatization and depression-anxiety scores improved progressively. Conclusion:, A short cognitive-behavioural group treatment of psychosomatic patients can be useful in primary care and may manifest maintained or progressive beneficial outcome. [source]

Road traffic accidents and the elderly

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2009
Suzan Abou-Raya
Aim: To identify and evaluate the causes and characteristics of road traffic accidents (RTA) and to analyze injury patterns in elderly road traffic victims in order to apply appropriate measures for the prevention of RTA in the elderly. Methods: Two hundred and fifty-eight elderly road traffic victims admitted to the Emergency and Traumatology Departments of our institution were enrolled. Complete data about the circumstances surrounding the accident, mechanism of injury, specific injury, comorbid conditions and drug history were recorded. All subjects underwent a physical and mental function examination. Results: The majority of road traffic victims were pedestrians. Most elderly pedestrian accidents were due to falls. Accidents by elderly car drivers occurred frequently at intersections. Craniocerebral and extremity injuries formed the majority of the injuries in pedestrian and cyclist victims whereas chest injuries were commoner in car accident victims. Medical problems and medication usage was common among RTA victims. Conclusion: The fragility of elderly car occupants and pedestrians should be taken into consideration and strategies aimed at the road-user safety including periodic medical screening, improvement of road structure and facilities, and the improved design of motor vehicles should be implemented. [source]

Botulinum Toxin Type-A (BOTOX®) in the Treatment of Occipital Neuralgia: A Pilot Study

HEADACHE, Issue 10 2008
Martin Taylor DO
Objective., To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia. Background., Occipital neuralgia is a unilateral or bilateral radiating pain with paresthesias commonly manifesting as paroxysmal episodes and involving the occipital and parietal regions. Common causes of occipital neuralgia include irritation or injury to the divisions of the occipital nerve, myofascial spasm, and focal entrapment of the occipital nerve. Treatment options include medication therapy, occipital nerve blocks, and surgical techniques. BTX-A, which has shown promise in relief of other headache types, may prove a viable therapeutic option for occipital neuralgia pain. Methods., Botulinum toxin type-A (reconstituted in 3 cc of saline) was injected into regions traversed by the greater and lesser occipital nerve in 6 subjects diagnosed with occipital neuralgia. Subjects were instructed to report their daily pain level (on a visual analog pain scale), their ability to perform daily activities (on several quality of life instruments) and their daily pain medication usage (based on a self-reported log), 2 weeks prior to the injection therapy and 12 weeks following injection therapy. Data were analyzed for significant variation from baseline values. Results., The dull/aching and pin/needles types of pain reported by the subjects did not show a statistically significant improvement during the trial period. The sharp/shooting type of pain, however, showed improvement during most of the trial period except weeks 3-4 and 5-6. The quality of life measures exhibited some improvement. The headache-specific quality of life measure showed significant improvement by 6 weeks which continued through week 12. The general health- and depression-related measures showed no statistical improvement. No significant reduction in pain medication usage was demonstrated. Conclusions., Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain. [source]

Psychosocial Impact of Headache and Comorbidity with Other Pains among Swedish School Adolescents

HEADACHE, Issue 8 2002
Åsa Fichtel MSc
Background.,The psychosocial impact of headache combined with other pains has previously been insufficiently investigated. Objective., The present study examined the prevalence of headache, its comorbidity with other pains and psychosocial impact among adolescents. Methods., 793 adolescents in a sample recruited from 8 schools in the middle of Sweden were assessed. Results.,Forty-five percent of the adolescents reported ongoing pain during assessment and more than half of the adolescents reported at least one frequent pain during the previous 6 months. The most common pain among girls was headache (42%), but for boys muscle pain (32%) was most prevalent. Number of pains and perceived pain disability were also higher among girls than boys. One-third of the headache sufferers had headache only, while one-third reported one other frequent pain and the others had at least two other frequent pains. Overall, adolescents with frequent headaches had higher levels of anxiety or depressive symptoms, in addition to functional disability and usage of analgesic medication. Frequent headache sufferers reported more problems in everyday life areas than those with infrequent headaches. Conclusions.,It is recommended that adolescents suffering from recurrent headaches routinely should be asked about the presence of other pains, anxiety and depressive symptoms, medication usage, in addition to psychosocial consequences in their everyday life activities. Longitudinal research is also needed to delineate causal relationships between psychosocial factors and recurrent pains, in particular regarding possible sex differences. [source]

Ascertaining Health-Related Information on Adults With Intellectual Disabilities: Development and Field Testing of the Rochester Health Status Survey

JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008
Philip W. Davidson
Abstract, There is a growing need for researchers and service providers to ascertain and track health status and health care utilization among adults with intellectual disabilities as they pass through the lifespan. This paper reports the development and field testing of the Rochester Health Status Survey (RHSS), a survey instrument that identifies incidence, lifetime prevalence, and point prevalence of diseases common in adults, as well as functional abilities and medication usage. The instrument also provides information about health system access and utilization. The survey is designed to be completed from chart review. An initial version of the survey was developed in 1998, revised in 2003, and then validated on a cohort of adults ages 21 to 73 years living in supervised community residences in the U.S. The RHSS includes 51 questions and requires about 45 min to complete. In the present study, data were collected on each subject by 3 different respondents (a service coordinator, a nurse, and when available, a family member). Their responses were compared item by item with the responses of the second author, a developmental disabilities geriatrician, who also completed the survey on each subject. Correlations and Kappa statistics confirmed that the highest agreement scores occurred between nurses and the geriatrician. [source]

Follow-up to a Federally Qualified Health Center and Subsequent Emergency Department Utilization

ACADEMIC EMERGENCY MEDICINE, Issue 1 2010
Tara M. Scherer MD
Abstract Objectives:, Determine if 1) proximity of referral to a federally qualified health center (FQHC) improves initial follow-up rates for discharged emergency patients, 2) improved initial follow-up rates are associated with improved rates for an "ongoing relationship" with the FQHC, and 3) an ongoing relationship with an FQHC is associated with decreased subsequent emergency department (ED) utilization over a 2-year follow-up period. Methods:, An expedited referral system was initiated just prior to January 2004 for discharged ED patients referred to an FQHC. Referral categories were as follows: R1 = next-day; R2 = 2 to 7 days; R3 = 2 to 3 weeks; and R4 = follow-up as needed. The FQHC database for 2004,2006 was merged with the ED database from 2004 through 2006. The FQHC database contained all ED referrals, the referral category, whether the patient kept his or her initial ED referral appointment, all subsequent scheduled clinic appointments, and whether the patient kept any of the subsequent scheduled appointments. We compared initial referral follow-up rates and subsequent scheduled visits to the FQHC for each referral category, over a 2-year follow-up period. We evaluated the effects of age, sex, marital status, insurance status, initial triage score, race, comorbidities, and number of prescription medications on initial follow-up, and subsequent kept appointments with the FQHC. We defined an "ongoing relationship" as one or more kept scheduled appointments annually. Finally, we compared the number of subsequent ED visits over the follow-up period between patients who maintained an ongoing relationship with the FQHC and those who did not, before and after correcting for the demographic and clinical factors. Results:, There were 520 referrals over the study period. Follow-up rates ranged from 37.5% (95% confidence interval [CI] = 13.5% to 69.6%) for R1 to 9.0% (95% CI = 4.4% to 17.0%) for R4. The overall ongoing relationship rate was 7.1% (95% CI = 5.2% to 9.7%) and had weak association with temporal proximity of referral. On bivariate analysis, older age, female sex, white race, one or more comorbidities, and three or more medications were associated with increased rates of initial follow-up. These factors (with the exception of race) were also associated with increased rates of developing an ongoing relationship. Patients with an ongoing relationship with the FQHC had more repeat ED visits over the study period than did patients without (3.6 vs. 1.7, p = 0.003). However, this difference was no longer evident after adjusting for age, race, comorbidities, and medication usage. Conclusions:, Overall patient follow-up to an FQHC was low, but increased with next-day or same-week referral. The ongoing relationship rate was low, but increased with temporal proximity of ED referral. Increased comorbidities and medication usage were significantly associated with increased initial follow-up rates, development of an ongoing relationship, and subsequent ED utilization. Patients with an ongoing relationship with the FQHC had higher ED utilization over the 2-year follow-up period, likely due to a higher rate of comorbidities. ACADEMIC EMERGENCY MEDICINE 2010; 17:55,62 © 2010 by the Society for Academic Emergency Medicine [source]

Effects of a pseudoallergen-free diet on chronic spontaneous urticaria: a prospective trial

ALLERGY, Issue 1 2010
M. Magerl
Abstract Background:, Chronic spontaneous urticaria is a skin disorder that is difficult to manage and can last for years. ,Pseudoallergens' are substances that induce hypersensitive/intolerance reactions that are similar to true allergic reactions. They include food additives, vasoactive substances such as histamine, and some natural substances in fruits, vegetables and spices. Eliminating pseudoallergens from the diet can reduce symptom severity and improve patient quality of life. Aim:, To assess the effects of a pseudoallergen-free diet on disease activity and quality of life in patient's chronic spontaneous urticaria. Methods:, Study subjects had moderate or severe chronic spontaneous urticaria that had not responded adequately to treatment in primary care. For 3 weeks, subjects followed a pseudoallergen-free diet. They kept a clinical diary, which recorded their wheal and pruritus severity each day, to yield a clinical rating of chronic spontaneous urticaria severity (the UAS4 score). The subjects also completed the DLQI, a validated quality-of-life instrument. Use of antihistamines and glucocorticoids was minimized, recorded, and analysed. Subjects were classified into nine response categories, according to the changes in symptom severity (UAS4), quality of life (DLQI) and medication usage. Results:, From the 140 subjects, there were 20 (14%) strong responders and 19 (14%) partial responders. Additionally, there were nine (6%) subjects who made a substantial reduction in their medication without experiencing worse symptoms or quality of life. Conclusions:, Altogether the pseudoallergen-free diet is beneficial for one in three patients. The pseudoallergen-free diet is a safe, healthy and cost-free measure to identify patients with chronic spontaneous urticaria that will benefit from avoiding pseudoallergens. [source]

Medication usage among young adult women: A comparison between Sweden, the USA, and Greece

Emergency department visits attributed to selected analgesics, United States, 2004,2005,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 3 2009
Mary Willy PhD
Abstract Purpose To estimate the rate of emergency department (ED) visits attributed to selected analgesic-containing medications. Methods We used a nationally representative public health surveillance system to provide estimates of adverse events identified in EDs, and a national telephone survey to provide estimates of selected analgesic-containing medication usage in the US population, 2004,2005. Analysis was restricted to products containing acetaminophen, aspirin, ibuprofen, or naproxen. Types of adverse events and outcomes were compared. Estimated numbers and rates of ED visits were calculated by analgesic groupings and patient age groups. Results The estimated overall rate of ED visits attributed to analgesic-containing medications was 1.6 visits /100,000 users per week. The very old and very young had the highest rates; there were minimal differences in rates by patient gender. Acetaminophen was the attributed drug with the most estimated ED visits and generally had the highest rates of ED visits. The highest estimated rate for a specific product group was among subjects 18,64 years of age taking narcotic-acetaminophen products (8.9 ED visits /100,000 users per week). Overall, 12% of patients presenting to EDs with analgesic-attributed events were hospitalized. Conclusions Rates of ED visits due to analgesics vary depending on the age of the patient and the product; most do not result in hospitalization. Although the rate of emergency visits is relatively low, because of the wide use of the analgesics, public health impact is considerable. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Chronic Recurrent Rhinosinusitis: Disease Severity and Clinical Characterization

THE LARYNGOSCOPE, Issue 2 2005
Neil Bhattacharyya MD
Objectives/Hypothesis: The objective was to clinically characterize and determine disease severity parameters for chronic recurrent rhinosinusitis (CRRS). Study Design: Prospective. Methods: A consecutive series of adult patients undergoing evaluation for CRRS was prospectively evaluated. Patients with four or more acute rhinosinusitis episodes in the previous calendar year with an absence of symptoms between episodes were considered as manifesting CRRS. Symptom severity and disease data from the Rhinosinusitis Symptom Inventory was obtained, as well as Lund staging information from the paranasal sinus CT scan. The Lund staging scores for patients with CRRS were compared with a control group of patients without CRRS. Symptom domain scores and disease severity parameters were compared between the CRRS group and a third group of patients with chronic persistent rhinosinusitis. Results: In all, 30 patients met inclusion criteria for the diagnosis of CRRS. Mean age was 40.9 years with a 3:1 female preponderance. The mean Lund score for patients with CRRS was 3.79. Patients with CRRS failed to demonstrate a statistically different Lund score from control patients (mean Lund score, 4.26 [P = .538]). Symptom severity scores according to Rhinosinusitis Symptom Inventory domains were largely similar for the nasal, facial, and total symptom domains between patients with CRRS versus chronic persistent rhinosinusitis. However, patients with CRRS demonstrated statistically significant increases in oropharyngeal and systemic symptom domain scores. Patients with CRRS also had significant increases in number of antibiotic courses (4.8 vs. 2.9 [P < .001]) and number of missed workdays (8.8 vs. 4.6 d [P = .046]) attributable to rhinosinusitis. Conclusion: Chronic recurrent rhinosinusitis is a distinct form of chronic rhinosinusitis differing somewhat from chronic persistent rhinosinusitis. However, patients with CRRS still experience significant symptoms associated with this diagnosis, which results in significant medication usage and workplace impact. [source]

Botulinum injections for the treatment of bladder symptoms of multiple sclerosis

ANNALS OF NEUROLOGY, Issue 5 2007
MRCS, Vinay Kalsi MBBS
Objective Our objective was to demonstrate the efficacy and impact on quality of life of detrusor injections of botulinum neurotoxin type A in the treatment of bladder dysfunction in patients with multiple sclerosis. Methods Forty-three patients with multiple sclerosis suffering from severe urgency incontinence were treated with detrusor injections of botulinum neurotoxin type A. Data from cystometric assessment of the bladder, voiding diaries, quality-of-life questionnaires, and procontinence medication usage were collected before treatment and 4 and 16 weeks after injection. The same data were also collected after repeat treatments. Results Highly significant improvements (p < 0.0001) in incontinence episodes and urinary urgency, daytime frequency and nocturia, were the symptomatic reflection of the significant improvements in urodynamically demonstrated bladder function. Although 98% of patients had to perform self-catheterization after treatment, there were sustained improvements in all quality-of-life scores. The mean duration of effect was 9.7 months. Similar results were seen with repeat treatments. Interpretation Minimally invasive injections of botulinum neurotoxin type A have been shown to be exceptionally effective in producing a prolonged improvement in urinary continence in patients with multiple sclerosis. This treatment is likely to have a major impact on future management. Ann Neurol 2007 [source]

HP23 USE OF ANTI-REFLUX MEDICATION AFTER ANTI-REFLUX SURGERY

ANZ JOURNAL OF SURGERY, Issue 2007
B. P. L. Wijnhoven
Purpose It is thought that a substantial number of patients who undergo anti-reflux surgery use anti-reflux medication post operatively, despite no objective evidence of reflux. This study aims to determine the prevalence and underlying reasons for anti-reflux medication usage in patients after anti-reflux surgery. Methodology A questionnaire (13 questions) on the usage of anti-reflux medication was sent to 1016 patients from a prospective database of anti-reflux surgery patients. Results 852 patients (84%), (437 males & 415 females with a mean age 58 yrs) returned the questionnaire. Mean follow up was 5.9 yrs after surgery. A single or combination of medications was being taken by 319 patients (37%): 82% proton pump inhibitors, 9% H2-blockers and 34% antacids. 54 patients (18%) had never stopped taking medication, whereas 261 patients (82%) re-started medication at a mean of 2.4 yrs after surgery. Persistent or return of the same or different symptoms was the reason for taking medication by the vast majority (85%), whereas 15% were asymptomatic or had other reasons for medication use. A response of symptoms to the medication occurred for 30% of the patients, whereas 64% noticed some improvement. Postoperative 24-hour pH studies (while off medication) were abnormal in 17/62 patients (27%) on medication and in 5/73 patients (6%) not taking medication. Conclusions Anti-reflux medication is frequently taken by patients for symptoms after surgery, despite normal pH profiles in the majority. Strategies need to be employed to lower the inappropriate use of medications after surgery and to further evaluate the mechanisms underlying postoperative symptoms, which are non-responsive to anti-reflux medication. [source]