Identification of Drug-Related Problems and Investigation of Related Factors in Patients with COVID-19: An Observational Study

Objective:Clinical prognosis of coronavirus disease-19 (COVID-19) may be severe and unexpected. Patients may quickly progress to respiratory failure, infections, multiple organ dysfunction, and sepsis. The main objective of this study is to investigate the drug-related problems of patients with COVID-19 and related factors.Method:A prospective observational study was conducted on patients with COVID-19 between September 2020 and May 2021. Patients’ demographics, comorbid diseases, prescribed medicines and laboratory findings were recorded. Drug-related problems (DRPs) were identified by a clinical pharmacist according to recent guidelines, UpToDate® clinical decision support system and evidence-based medicine.Results:The median age of 107 patients was 64 and 50.46% of them were male. The median number of comorbidities was 3 (2-4) per patient. The majority of the patients had at least one comorbidity (88.79%) other than COVID-19 and the most frequent comorbidities were hypertension, diabetes mellitus and coronary artery disease. The total number of DRPs was recorded as 201 and at least one DRP was seen in 75 out of 107 patients. The median number of DRPs was 2 (0-8). In multivariate model, number of comorbidities (odss ratio (OR)=1.952; 95% confidence interval (CI)=1.07-3.54, p<0.05, number of medications (OR=1.344; 95% CI=1.12-1.61, p<0.001), and serum potassium levels (OR=5.252; 95% CI=1.57-17.56, p<0.001) were the factors related with DRPConclusion:This study highlights the DRPs and related factors in patients with COVID 19 in hospital settings. Considering unknown features of the infection and multiple medication use, DRPs are likely to occur. It would be beneficial to consider the related factors in order to reduce the number of the DRPs

Effects of body position on sleep architecture and quality in subsyndromal adults without apparent obstructive sleep apnea

There is a well-known relationship between sleep quality and body position during sleep in patients with obstructive sleep apnea (OSA). In this study, we aimed to investigate the effects of body position on sleep architecture and sleep quality in subjects without sleep apnea. One hundred and one subjects between 24 and 77 years of age, who had undergone polysomnography and had a respiratory disturbance index (RDI) below 5 were included in the study. Sleep stages and sleep parameters in the right, left, supine and prone positions were examined. Mean sleep duration in S2, S3 and rapid eye movement (REM) were 110, 39 and 20.7min in supine position and 61, 28 and 17min in right position, respectively. Mean RDI at supine position was higher than other positions. Mean minimal oxygen saturation at supine position was significantly lower than other positions. Maximal heart rate and mean arousal index were significantly higher in the supine position. Duration of sleep was highest in the right position in those older than 60 years. Subjects with 40-60 years age had higher duration of sleep in right and supine positions. Female subjects slept more in supine position whereas male ones slept more in right position. Stages of sleep may change according to position. Deteriorations in the parameters of sleep quality (RDI, lowest saturation, arousal index, heart rate) occur in individuals with RDI < 5 as well as in patients with OSA in the supine position

COPD: eine unterdiagnostizierte Erkrankung. Ergebnisse einer Screeningstudie in der Umgebung eines Spitals

Background and Aim Chronic obstructive pulmonary disease (COPD) is a serious disease with morbidity and mortality due to delayed diagnosis until significant symptoms arise. We aimed to assess the utility of spirometry and COPD Assessment Test (CAT) in detecting undiagnosed COPD patients in a localized area