Study of Inappropriate Medication Prescribed to the Elderly Hospitalized Patients Using the START Screening Tool

Objectives Aging population is of global concern and care for the health and quality of life for people over 65 years of major issues and problems of today and the future will be . Medication is an essential component of care for elderly patients, and optimizing the treatment for elderly patients is challenging. The aim of this study was to evaluate the state of appropriate non-prescribed drugs in 60 elderly patients hospitalized in teaching and non-teaching hospitals in the University of Medical Sciences by using screening tool START. Methods & Materials This cross-sectional study included 400 randomly selected elderly patients of Parts common (CCU, ENT, ICU General, Orthopedics, Surgery General, The Internal) hospitalized within six months (from June to December 2013). The data from the hospital records of the selected patients were collected to determine the appropriate medications prescribed by the criterion START. The data was analyzed using software Excel 2013 and SPSS 18, and the relationship between variables was determined by using the chi-square test, Mann-Whitney, Spearman correlation coefficient, and Kolmogorov-Smirnov test. Results The average age of the elderly patients was 73.4 years. Cardiovascular disease had the largest prevalence (21.6%) and diabetes (3.0) had the lowest prevalence among the elderly patients. The total number of drugs prescribed for patients was 4744; of which, 158 patients (39.6%) were not prescribed with at least one appropriate medication. The most appropriate medications that were not prescribed according to START were related to bisphosphonates category (11.7% vs. 13.3%) and anti-diabetic category (8.3% vs. 11.4%) in non-training and training hospitals. There was a significant relationship between the average appropriate medication not prescribed and the length of stay of patients in teaching hospitals. The number of appropriate medication not prescribed with the increasing number of prescribed medications has increased significantly. Conclusion Since issues relating to the appropriate medications prescribed among the elderly can be serious, the drugs prescribed for the elderly are very important. Supervising the prescription, supply, and rational use of drugs is very vital and effective and as part of the health budget allocated to the drug. Therefore, hospitals can take advantage of physicians with medical consultants and expert opinions of clinical pharmacists in handling this problem

Prediction of breast self-examination in a sample of Iranian women: an application of the Health Belief Model

<p>Abstract</p> <p>Background</p> <p>Iranian women, many of whom live in small cities, have limited access to mammography and clinical breast examinations. Thus, breast self examination (BSE) becomes an important and necessary approach to detecting this disease in its early stages in order to limit its resultant morbidity and mortality. This study examined constructs arising from the Health Belief Model as predictors of breast self examination behavior in a sample of women living in Bandar Abbas, Iran.</p> <p>Methods</p> <p>This study was conducted in eight health centers located in Bandar Abbas, Iran. The sample consisted of 240 eligible women who were selected from referrals to the centers. The inclusion criteria were as follows: aged 30 years and over; and able to read and write Farsi. Women with breast cancer, who were pregnant, or breast feeding, were excluded from the study. Data were collected by using a self administered questionnaire which included demographic characteristics and Champion's Health Belief Model Scale. This instrument measures the concepts of disease susceptibility (3 items), seriousness (6 items), benefits (4 items), barriers (8 items) and self-efficacy (10 items).</p> <p>Results</p> <p>The subjects' mean age was 37.2 (SD = 6.1) years. Just under a third of the subjects (31.7%) had performed BSE in the past and 7.1% of them performed it at least monthly. Perceived benefits and perceived self-efficacy of the women who performed BSE were significantly higher compared with women who did not practice BSE (p < 0.03). Furthermore, perceived barriers were lower among those who had performed BSE (p < 0.001). Logistic regression analysis indicated that women who perceived fewer barriers (OR: 0.70, 95% CI: 0.63-0.77, p < 0.001) and had higher self-efficacy (OR: 1.08, 95% CI: 1.02-1.13, p = 0.003) were more likely to perform BSE (R²= 0.52).</p> <p>Conclusion</p> <p>Findings from this study indicated that perceived barriers and perceived self-efficacy could be predictors of BSE behavior among the sample of women. Therefore, BSE training programs that emphasize self-efficacy and address perceived barriers are recommended.</p

Study of Inappropriate Medication Prescribed to Elderly Hospitalized Patients Using the Screening Tool to Alert Doctors to Right Treatment

Objectives:&nbsp;Medication is an essential component of care for elderly patients, and optimizing their process of treatment is often a challenging task. The aim of this study was to evaluate the status of appropriate non-prescribed drugs in 60 elderly patients hospitalized in the teaching and non-teaching hospitals in the University of Medical Sciences employing the START screening tool. Methods & Materials: This cross-sectional study included 400 elderly patients who were randomly selected from various divisions of the hospital (CCU, ENT, ICU General, Orthopedics, Surgery General, and Internal) and were hospitalized within six months duration (from June to December 2013). The data of the selected patients were collected from the hospital records in order to determine the appropriate medications prescribed based on the criterion START. The data was analyzed- using software Excel 2013 and SPSS 18, and the relationship between the variables was determined using the chi-square test, Mann-Whitney, and Spearman correlation coefficient. Results:&nbsp;The average age of the elderly patients was reported to be 73.4 years. Cardiovascular disease had the largest prevalence (21.6%) and diabetes (3.0) had the lowest prevalence among the elderly patients. The total number of drugs prescribed for patients was 4744, of which 158 patients (39.6%) were not prescribed with at least one appropriate medication. In non-training and training hospitals, the most appropriate medications that were not prescribed according to START were related to the bisphosphonates (11.7% vs. 13.3%) and anti-diabetic (8.3% vs. 11.4%) categories. A significant relationship was noted between the average numbers of non-prescribed appropriate medications and the length of stay of patients in teaching hospitals.&nbsp; Conclusion: Since issues relating to the appropriate medications prescribed among the elderly can have serious implications, the drugs prescribed for the elderly are very important. Supervising the prescription, supply, and rational use of drugs is very vital and effective and acts as an integral part of the health budget allocated to the drug. Therefore, hospitals need to readily consult with the trained physicians and consider the expert opinions of clinical pharmacists in handling this problem