Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review.

Background Oral anticoagulants (OAC) are widely used in patients with cardiovascular diseases. However, for optimal OAC self-care patients must have skills, among which health literacy (HL) is highlighted. We aimed to describe the relation between HL and self-care in cardiovascular patients on OAC treatment. Methods Electronic searches were carried out in the PubMed, Scopus, Embase, CINAHL, Web of Science, Cochrane Library, SciELO, IME-Biomedicina, CUIDEN Plus and LILACS databases, limited to Spanish and English language and between January 2000-December 2016. Papers reported on adults older than 18 years, taking OAC by themselves for at least three months. PRISMA guidelines were used for paper selection. Results We identified 142 articles and finally included 10; almost all of them about warfarin. Our results suggest that in patients taking OAC treatments there is a positive relationship between HL and the level of knowledge. In addition, a small percentage of participants on the selected papers recognized the side effects and complications associated with OAC treatment. Lower HL level was associated with greater knowledge deficits and less adherence to treatment. Conclusion There is a paucity of research evaluating the effect of HL on diverse aspects of OAC treatments. There is a need to expand the evidence base regarding appropriate HL screening tools, determinants of adequate knowledge and optimal behaviours related to OAC self-management

The use of social media in anatomical and health professional education: a systematic review

Social media is used by many students at universities, with sites such as Facebook, Twitter and YouTube being the most popular. Initially these social networking sites were mainly used for recreational purposes, but they have been increasingly used in an educational setting. Educators in the anatomical sciences and health professions have utilised many forms of technology to supplement and enhance a student’s learning. However, the true effectiveness of using social media in anatomical and health professions education has not been fully explored. It has been hypothesised that social media in anatomical sciences and health professional education could enhance learner engagement, raise morale, relieve anxieties and improve communication. However, the evidence is limited. Therefore, the purpose of this study is to undertake a comprehensive literature review to examine the effectiveness, or otherwise, of these tools when implemented. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method for reviewing the literature. By using specific keywords and using Google Scholar, PubMed, ERIC and OVID, we performed an extensive literature search to examine the use of social media in anatomical sciences and health professional education. A total of 155 studies were identified in this systematic review, with 99 studies investigating a variety of social networking sites being included. Overall, the evidence is supportive, with 79.8% of the studies supporting the use social media in education. Furthermore, when the use of social media in the anatomical sciences and health professional was investigated, the majority of studies advocated for its implementation. Despite this, there are some factors that limit the significance of these results, and the amount of evidence was indeed limited. Additional research must be carried out if social media is to influence modern pedagogical practices, with more focus on how the intervention affects academic achievement

Recommendations to Prescribe in Complex Older Adults: Results of the CRIteria to Assess Appropriate Medication Use Among Elderly Complex Patients (CRIME) Project

The occurrence of several geriatric conditions may influence the efficacy and limit the use of drugs prescribed to treat chronic conditions. Functional and cognitive impairment, geriatric syndromes (i.e. falls or malnutrition) and limited life expectancy are common features of old age, which may limit the efficacy of pharmacological treatments and question the appropriateness of treatment. However, the assessment of these geriatric conditions is rarely incorporated into clinical trials and treatment guidelines. The CRIME (CRIteria to assess appropriate Medication use among Elderly complex patients) project is aimed at producing recommendations to guide pharmacologic prescription in older complex patients with a limited life expectancy, functional and cognitive impairment, and geriatric syndromes, and providing physicians with a tool to improve the quality of prescribing, independent of setting and nationality. To achieve these aims, we performed the following: (i) Existing disease-specific guidelines on pharmacological prescription for the treatment of diabetes, hypertension, congestive heart failure, atrial fibrillation and coronary heart disease were reviewed to assess whether they include specific indications for complex patients; (ii) a literature search was performed to identify relevant articles assessing the pharmacological treatment of complex patients; (iii) A total of 19 new recommendations were developed based on the results of the literature search and expert consensus. In conclusion, the new recommendations evaluate the appropriateness of pharmacological prescription in older complex patients, translating the recommendations of clinical guidelines to patients with a limited life expectancy, functional and cognitive impairment, and geriatric syndromes. These recommendations cannot represent substitutes for careful clinical consideration and deliberation by physicians; the recommendations are not meant to replace existing clinical guidelines, but they may be used to help physicians in the prescribing process