-
1دورية أكاديمية
المؤلفون: Japelj Nuša, Horvat Nejc, Knez Lea, Kos Mitja
المصدر: Acta Pharmaceutica, Vol 74, Iss 2, Pp 249-267 (2024)
مصطلحات موضوعية: deprescription, drug discontinuation, drug withdrawal, drug tapering, umbrella review, Pharmaceutical industry, HD9665-9675
الوصف: This umbrella review examined systematic reviews of deprescribing studies by characteristics of intervention, population, medicine, and setting. Clinical and humanistic outcomes, barriers and facilitators, and tools for deprescribing are presented. The Medline database was used. The search was limited to systematic reviews and meta-analyses published in English up to April 2022. Reviews reporting deprescribing were included, while those where depre-scribing was not planned and supervised by a healthcare professional were excluded. A total of 94 systematic reviews (23 meta--analyses) were included. Most explored clinical or humanistic outcomes (70/94, 74 %); less explored attitudes, facilitators, or barriers to deprescribing (17/94, 18 %); few focused on tools (8/94, 8.5 %). Reviews assessing clinical or humanistic outcomes were divided into two groups: reviews with deprescribing intervention trials (39/70, 56 %; 16 reviewing specific deprescribing interventions and 23 broad medication optimisation interventions), and reviews with medication cessation trials (31/70, 44 %). Deprescribing was feasible and resulted in a reduction of inappropriate medications in reviews with deprescribing intervention trials. Complex broad medication optimisation interventions were shown to reduce hospitalisation, falls, and mortality rates. In reviews of medication cessation trials, a higher frequency of adverse drug withdrawal events underscores the importance of prioritizing patient safety and exercising caution when stopping medicines, particularly in patients with clear and appropriate indications.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/1846-9558Test
-
2دورية أكاديمية
المؤلفون: Jazbar Janja, Locatelli Igor, Kos Mitja
المصدر: Acta Pharmaceutica, Vol 74, Iss 2, Pp 329-341 (2024)
مصطلحات موضوعية: sedative load, anticholinergic burden, older adults, pharmaco-therapy optimization, drug utilization study, pharmacoepidemiology study, Pharmaceutical industry, HD9665-9675
الوصف: This study investigates the 10-year trend in the sedative and anticholinergic burden among older adults in Slovenia, with the aim of identifying opportunities to optimize pharmacotherapy in this population. A retrospective drug utilization analysis was conducted based on a national anonymized database of dispensed prescriptions from 2009 to 2019. The study employed the sedative load model and the anticholinergic cognitive burden scale to assess the sedative and anti cholinergic burden, respectively. The findings indicate that in 2019, 45.6 % and 40.8 % of older adults (≥ 65 years) used sedative and anticholinergic medications, respectively. A high sedative load and a clinically significant anticholinergic burden were observed in a considerable proportion of older adults (13.2 % and 11.2 %, respectively, in 2019). The age-standardized prevalence of sedative load and anti-cholinergic burden significantly decreased over the 10-year study period by 5.6 % and 1.7 %, respectively (absolute difference), while the prevalence of clinically significant anticholinergic burden remained stable. Notably, the age groups 85–89 years and above 90 years had an increase in the proportion of individuals with a clinically significant anticholinergic burden over the years. These results emphasize the need for targeted interventions, particularly in the oldest age groups, to promote safe and effective medication use among older adults.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/1846-9558Test
-
3دورية أكاديمية
المؤلفون: Buhl, Caroline, Jacobsen, Ramune, Almarsdóttir, Anna Birna, Abtahi, Shahab, Andersen, Armin, Deligianni, Elena, Dermiki-Gkana, Foteini, Kontogiorgis, Christos, Oikonomou, Chara, Kursite, Mirdza, Poplavska, Elita, Hegger, Ingrid, Goot, Marloes van der, Ferreira, Paula Barão Sousa, Ribeiro-Vaz, Inês, Silva, Ana Marta, Kos, Mitja, Lipovec, Nanča Čebron, Vliet, Ella van, Alves, Teresa Leonardo
المساهمون: Afd Pharmacoepi & Clinical Pharmacology, PECP - Centre for Pharmacoepidemiology, Pharmacoepidemiology and Clinical Pharmacology
مصطلحات موضوعية: COVID-19 vaccines, National health policies, Public perception, Risk awareness, SARS-CoV-2 adenovirus vector vaccines, Thrombosis with thrombocytopaenia syndrome (TTS), General Veterinary, Public Health, Environmental and Occupational Health, Infectious Diseases, Molecular Medicine, General Immunology and Microbiology
الوصف: Objective: In 2021, thrombosis with thrombocytopenia syndrome (TTS) was confirmed by the European Medicines Agency (EMA) as a rare side effect of the COVID-19 adenovirus vector vaccines Vaxzevria® and Jcovden®. This study aimed to describe the public's knowledge of TTS and how it affected the willingness to be vaccinated with COVID-19 vaccines and other vaccines in six European countries. Methods: From June to October of 2022, a multi-country cross-sectional online survey was conducted in Denmark, Greece, Latvia, Netherlands, Portugal, and Slovenia. The minimum target of participants to be recruited was based on the size of the country's population. The results were analysed descriptively. Results: In total, 3794 respondents were included in the analysis; across the six countries, 33.3 %–68.3 % reported being familiar with signs and symptoms of TTS, although 3.1–61.4 % of those were able to identify the symptoms correctly. The reported changes in willingness to be vaccinated against COVID-19 and with other vaccines varied per country. The largest reported change in the willingness to be vaccinated with Vaxzevria® and Jcovden® was observed in Denmark (61.2 %), while the willingness to be vaccinated with other COVID-19 vaccines changed most in Slovenia (30.4 %). The smallest decrease in willingness towards future vaccination against COVID-19 was reported in the Netherlands (20.9 %) contrasting with the largest decrease observed in Latvia (69.1 %). Conclusion: Knowledge about TTS seemed to have influenced the public's opinion in Europe resulting in less willingness to be vaccinated with Vaxzevria® and Jcovden®. Willingness for vaccination against COVID-19 with other vaccines and widespread use of vaccines to prevent other diseases also differed and seemed to be determined by the approaches taken by national health authorities when reacting to and communicating about COVID-19 vaccination risks. Further investigation of optimal risk communication strategies is warranted.
وصف الملف: application/pdf
-
4دورية أكاديمية
المؤلفون: Buhl, Caroline, Jacobsen, Ramune, Almarsdóttir, Anna Birna, Abtahi, Shahab, Andersen, Armin, Deligianni, Elena, Dermiki-Gkana, Foteini, Kontogiorgis, Christos, Oikonomou, Chara, Kursite, Mirdza, Poplavska, Elita, Hegger, Ingrid, van der Goot, Marloes, Sousa Ferreira, Paula Barão, Ribeiro-Vaz, Inês, Silva, Ana Marta, Kos, Mitja, Lipovec, Nanča Čebron, van Vliet, Ella, Alves, Teresa Leonardo
المصدر: Buhl , C , Jacobsen , R , Almarsdóttir , A B , Abtahi , S , Andersen , A , Deligianni , E , Dermiki-Gkana , F , Kontogiorgis , C , Oikonomou , C , Kursite , M , Poplavska , E , Hegger , I , van der Goot , M , Sousa Ferreira , P B , Ribeiro-Vaz , I , Silva , A M , Kos , M , Lipovec , N Č , van Vliet , E & Alves , T L 2024 , ' Public's perspective on COVID-19 adenovirus vector vaccines after ....
مصطلحات موضوعية: COVID-19 vaccines, National health policies, Public perception, Risk awareness, SARS-CoV-2 adenovirus vector vaccines, Thrombosis with thrombocytopaenia syndrome (TTS)
الوصف: Objective: In 2021, thrombosis with thrombocytopenia syndrome (TTS) was confirmed by the European Medicines Agency (EMA) as a rare side effect of the COVID-19 adenovirus vector vaccines Vaxzevria® and Jcovden®. This study aimed to describe the public's knowledge of TTS and how it affected the willingness to be vaccinated with COVID-19 vaccines and other vaccines in six European countries. Methods: From June to October of 2022, a multi-country cross-sectional online survey was conducted in Denmark, Greece, Latvia, Netherlands, Portugal, and Slovenia. The minimum target of participants to be recruited was based on the size of the country's population. The results were analysed descriptively. Results: In total, 3794 respondents were included in the analysis; across the six countries, 33.3 %–68.3 % reported being familiar with signs and symptoms of TTS, although 3.1–61.4 % of those were able to identify the symptoms correctly. The reported changes in willingness to be vaccinated against COVID-19 and with other vaccines varied per country. The largest reported change in the willingness to be vaccinated with Vaxzevria® and Jcovden® was observed in Denmark (61.2 %), while the willingness to be vaccinated with other COVID-19 vaccines changed most in Slovenia (30.4 %). The smallest decrease in willingness towards future vaccination against COVID-19 was reported in the Netherlands (20.9 %) contrasting with the largest decrease observed in Latvia (69.1 %). Conclusion: Knowledge about TTS seemed to have influenced the public's opinion in Europe resulting in less willingness to be vaccinated with Vaxzevria® and Jcovden®. Willingness for vaccination against COVID-19 with other vaccines and widespread use of vaccines to prevent other diseases also differed and seemed to be determined by the approaches taken by national health authorities when reacting to and communicating about COVID-19 vaccination risks. Further investigation of optimal risk communication strategies is warranted.
وصف الملف: application/pdf
الإتاحة: https://doi.org/10.1016/j.vaccine.2023.12.065Test
https://curis.ku.dk/portal/da/publications/publics-perspective-on-covid19-adenovirus-vector-vaccines-after-thrombosis-with-thrombocytopenia-syndrome-tts-reports-and-associated-regulatory-actionsTest(9780cab1-d77f-4578-988f-93ba39d62ee6).html
https://curis.ku.dk/ws/files/381561845/1_s2.0_S0264410X23015116_main.pdfTest -
5دورية أكاديمية
المؤلفون: Jožef, Maj, Locatelli, Igor, Brecl Jakob, Gregor, Savšek, Lina, Šurlan Popovič, Katarina, Špiclin, Žiga, Rot, Uroš, Kos, Mitja
المساهمون: Grubić Kezele, Tanja, Javna Agencija za Raziskovalno Dejavnost RS
المصدر: PLOS ONE ; volume 19, issue 3, page e0294116 ; ISSN 1932-6203
الوصف: The 5-item Medication Adherence Report Scale (MARS-5) is a reliable and valid questionnaire for evaluating adherence in patients with asthma, hypertension, and diabetes. Validity has not been determined in multiple sclerosis (MS). We aimed to establish criterion validity and reliability of the MARS-5 in persons with MS (PwMS). Our prospective study included PwMS on dimethyl fumarate (DMF). PwMS self-completed the MARS-5 on the same day before baseline and follow-up brain magnetic resonance imaging (MRI) 3 and 9 months after treatment initiation and were graded as highly and medium adherent upon the 24-cut-off score, established by receiver operator curve analysis. Health outcomes were represented by relapse occurrence from the 1 st DMF dispense till follow-up brain MRI and radiological progression (new T2 MRI lesions and quantitative analysis) between baseline and follow-up MRI. Criterion validity was established by association with the Proportion of Days Covered (PDC), new T2 MRI lesions, and Beliefs in Medicines questionnaire (BMQ). The reliability evaluation included internal consistency and the test-retest method. We included 40 PwMS (age 37.6 ± 9.9 years, 75% women), 34 were treatment-naive. No relapses were seen during the follow-up period but quantitative MRI analysis showed new T2 lesions in 6 PwMS. The mean (SD) MARS-5 score was 23.1 (2.5), with 24 PwMS graded as highly adherent. The higher MARS-5 score was associated with higher PDC (b = 0.027, P< 0.001, 95% CI: (0.0134–0.0403)) and lower medication concerns (b = -1.25, P< 0.001, 95% CI: (-1.93-(-0,579)). Lower adherence was associated with increased number ( P = 0.00148) and total volume of new T2 MRI lesions ( P = 0.00149). The questionnaire showed acceptable internal consistency (Cronbach α = 0.72) and moderate test-retest reliability ( r = 0.62, P < 0.0001, 95% CI: 0.33–0.79). The MARS-5 was found to be valid and reliable for estimating medication adherence and predicting medication concerns in persons with MS.
-
6دورية أكاديمية
المؤلفون: Jošt, Maja, Kerec Kos, Mojca, Kos, Mitja, Knez, Lea
المصدر: Frontiers in Pharmacology ; volume 15 ; ISSN 1663-9812
مصطلحات موضوعية: Pharmacology (medical), Pharmacology
الوصف: Transitions of care often lead to medication errors and unnecessary healthcare utilization. Medication reconciliation has been repeatedly shown to reduce this risk. However, the great majority of evidence is limited to the provision of medication reconciliation within clinical trials and countries with well-established clinical pharmacy. Thus, this pragmatic, prospective, controlled trial evaluated the effectiveness of routine pharmacist-led medication reconciliation compared to standard care on medication errors and unplanned healthcare utilization in adult general medical patients hospitalized in a teaching hospital in Slovenia. All patients hospitalized in a ward where medication reconciliation was integrated into routine clinical practice were included in the intervention group and received admission and discharge medication reconciliation, coupled with patient counselling. The control group consisted of randomly selected patients from the remaining medical wards. The primary study outcome was unplanned healthcare utilization within 30 days of discharge, and the secondary outcomes were clinically important medication errors at hospital discharge and serious unplanned healthcare utilization within 30 days of discharge. Overall, 414 patients (53.4% male, median 71 years) were included—225 in the intervention group and 189 in the control group. In the intervention group, the number of patients with clinically important medication errors at discharge was significantly lower (intervention vs control group: 9.3% vs 61.9%). Multiple logistic regression revealed that medication reconciliation reduced the likelihood of a clinically important medication error by 20-fold, while a higher number of medications on admission was associated with an increased likelihood. However, no significant differences were noted in any and serious unplanned healthcare utilization (intervention vs control group: 33.9% vs 27.8% and 20.3% vs 14.6%, respectively). The likelihood of serious healthcare utilization increased with the age of ...
-
7مؤتمر
المؤلفون: Buhl, Caroline, Jacobsen, Ramune, Almarsdóttir, Anna Birna, van Vliet, Ella, Abtahi, Shahab, Poplavska, Elita, Ribeiro-Vaz , Inês, Kos, Mitja, Čebron Lipovec, Nanča, Dermiki-Gkana, Foteini, Oikonomou, Chara, Kontogiorgis, Christos, Silva , Ana Marta, Barão Sousa Ferreira, Paula, Deligianni, Elena, Kursite, Mirdza, van der Goot, Marloes, Hegger, Ingrid, Leonardo Alves, Teresa
المصدر: Buhl , C , Jacobsen , R , Almarsdóttir , A B , van Vliet , E , Abtahi , S , Poplavska , E , Ribeiro-Vaz , I , Kos , M , Čebron Lipovec , N , Dermiki-Gkana , F , Oikonomou , C , Kontogiorgis , C , Silva , A M , Barão Sousa Ferreira , P , Deligianni , E , Kursite , M , van der Goot , M , Hegger , I & Leonardo Alves , T 2023 , ' Public's perspective on COVID-19 adenovirus vector vaccines after Thrombosis with thrombocytopenia syndrome ....
الوصف: Objective: In 2021, thrombocytopenia syndrome (TTS) was confirmed by the European Medicines Agency (EMA) as a rare side effect of the COVID-19 adenovirus vector vaccines from AstraZeneca or Janssen. This study aimed to describe the public’s knowledge of TTS and how it affected the willingness to be vaccinated with COVID-19 and other vaccines. Methods: In 2022, a multi-country cross-sectional online survey was conducted in Denmark, Greece, Latvia, Netherlands, Portugal and Slovenia. The minimum target of participants to be recruited was linked to the country’s population. The results were analysed descriptively. Results: In total, 3794 respondents were included in the analysis. Many (33.3% to 68.3%) reported being aware about TTS and its association with the vaccines from AstraZeneca and Janssen, though most were not familiar with the exact symptoms. Changes in willingness to be vaccinated with COVID-19 and other vaccines varied by country. The largest change in the willingness to be vaccinated with AstraZeneca and Janssen vaccines was in Denmark (61.2%), while the largest change in the willingness to be vaccinated with other COVID-19 vaccines was in Slovenia (30.4%). Conclusion: Information about TTS seemed to be considered by the public in the European countries resulting in changed willingness to be vaccinated with the COVID-19 vaccines from AstraZeneca and Janssen. Willingness to be vaccinated against other COVID-19 vaccines and vaccines in general seemed to be determined by the approaches of the national health authorities to react to and communicate about the COVID-19 vaccination risks. Further investigation of risk communication strategies is warranted.
وصف الملف: application/pdf
الإتاحة: https://curis.ku.dk/portal/da/publications/publics-perspective-on-covid19-adenovirus-vector-vaccines-after-thrombosis-with-thrombocytopenia-syndrome-tts-reports-and-associated-regulatory-actionsTest(2d21df71-2ff6-489c-8fd4-a1a8dde4e0a1).html
https://curis.ku.dk/ws/files/359722602/PosterCitizenSurvey_cb.pdfTest -
8دورية أكاديمية
المؤلفون: Zerovnik Spela, Kos Mitja, Locatelli Igor
المصدر: Acta Pharmaceutica, Vol 72, Iss 1, Pp 147-157 (2022)
مصطلحات موضوعية: diabetes mellitus, insulin, metformin, sulfonylurea, Pharmaceutical industry, HD9665-9675
الوصف: The aim of the study was to assess the initiation of insulin therapy in patients with type 2 diabetes using health claims data on prescription medicines. The study evaluated time to insulin initiation and prescribing patterns of other anti-diabetic medicines before and after insulin initiation. Five years after starting non-insulin antidiabetic therapy, 6.4 % of patients were prescribed insulin, which is substantially lower compared to other similar studies. Among all patients who initiated insulin therapy in 2013, 30 % did not continue any other antidiabetic therapy. However, this proportion was lowered to 20 % in 2018. Before insulin initiation in 2018, metformin was prescribed in only 67 % of patients and sulfonylureas in 78 % of patients. Moreover, metformin and sulfonylureas were discontinued after insulin initiation in 26 and 37 % of patients, resp. More attention should be paid to the continuation of oral anti-diabetics, particularly metformin, after insulin initiation.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/1846-9558Test
-
9دورية أكاديمية
المؤلفون: Nabergoj Makovec, Urska, Tomsic, Tanja, Kos, Mitja, Stegne Ignjatovic, Tea, Poplas Susic, Antonija
المصدر: BMC Primary Care ; volume 24, issue 1 ; ISSN 2731-4553
مصطلحات موضوعية: Family Practice
الوصف: Background An advanced level medication review service (CMR) is systematically reimbursed and available nationwide in Slovenian primary care since 2016. CMR is performed by clinical pharmacists (CP). Close collaboration with general practitioner (GP) is required as they perform patient selection and make clinical decisions regarding patient’s medication. Methods A prospective observational study was conducted in 2018 aiming to evaluate the perspective of GPs on the implementation of pharmacist-led medication review service in Community Health Care Centre Ljubljana, Slovenia. GPs of the patients, who provided written informed consent were invited for the interviews. The semi-structured interview consisted of 5 open ended questions addressing reasons for referral of the patients, implementation of CP recommendations and the GPs’ perspective of the service in general. Interviews were audio recorded with GPs written consent, transcribed verbatim and inductive content analysis was performed in NVivo11 Pro. Results In total 38 interviews with 24 GPs were performed. The emerged themes were nested under 3 main domains representing Donabedian model of quality healthcare – structure, process, outcomes. The service structure is built on broad pharmacotherapy knowledge as the main CP competency, good accessibility, and complementarity of healthcare professions. Patients are mainly referred to the CMR due to polypharmacotherapy, however in majority there is a more in-depth reason behind (e.g., adverse events, etc.). Lack of time to recognize eligible patients and additional workload to study and implement the recommendations present the major challenges in the service process and therefore low number of referrals. CPs recommendations are mostly accepted, although the implementation time varies. When recommendation addresses medicines prescribed by a clinical specialist, the CMR report is forwarded to them for decision regarding implementation. The empowerment of the patients in medicines use was emphasized as the ...
-
10دورية أكاديمية
المؤلفون: Jazbar Janja, Pišek Špela, Locatelli Igor, Kos Mitja
المصدر: Slovenian Journal of Public Health, Vol 60, Iss 3, Pp 190-198 (2021)
مصطلحات موضوعية: frailty, older adults, share survey, prevalence, incidence, krhkost, starejši odrasli, raziskava share, razširjenost, pojavnost, Public aspects of medicine, RA1-1270
الوصف: Frailty is recognized as one of the most important global health challenges as the population is aging. The aim of this study was to evaluate prevalence and incidence of frailty, and associated factors, among the population of older adults in Slovenia compared to other European countries.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/1854-2476Test
النص الكامل