Systematic Review of Medicine-Related Problems in Adult Patients with Atrial Fibrillation on Direct Oral Anticoagulants

New oral anticoagulant agents continue to emerge on the market and their safety requires assessment to provide evidence of their suitability for clinical use. There-fore, we searched standard databases to summarize the English language literature on medicine-related problems (MRPs) of direct oral anticoagulants DOACs (dabigtran, rivaroxban, apixban, and edoxban) in the treatment of adults with atri-al fibrillation. Electronic databases including Medline, Embase, International Pharmaceutical Abstract (IPA), Scopus, CINAHL, the Web of Science and Cochrane were searched from 2008 through 2016 for original articles. Studies pub-lished in English reporting MRPs of DOACs in adult patients with AF were in-cluded. Seventeen studies were identified using standardized protocols, and two reviewers serially abstracted data from each article. Most articles were inconclusive on major safety end points including major bleeding. Data on major safety end points were combined with efficacy. Most studies inconsistently reported adverse drug reactions and not adverse events or medication error, and no definitions were consistent across studies. Some harmful drug effects were not assessed in studies and may have been overlooked. Little evidence is provided on MRPs of DOACs in patients with AF and, therefore, further studies are needed to establish the safety of DOACs in real-life clinical practice

Engagement of men in group treatment programs

The goal of this paper is to arrive at a better understanding of the process of men’s engagement in treatment groups. Given the low perseverance rate of men in such groups, engagement is crucial to program continuance and results. A number of treatment factors and strategies that can influence engagement in group therapy programs are drawn from a review of the literature. To gain a better understanding of the factors and how they interrelate, the literature was reviewed from the perspective of Bronfenbrenner’s (1979) ecological model. The studies reviewed show that engagement is influenced by various factors associated with the characteristics of the participants, their family environment, treatment program, and cultural and social values. Current knowledge is discussed to highlight the main research and practice issues concerning men’s engagement in treatment groups. The review underscores the importance of exploring the influence of male socialization on men’s engagement, given that some traditional norms may curb their involvement and willingness to invest in group programs