Surveying Over the Counter and Prescription Only Medication Misuse in Treatment Services During COVID-19

BACKGROUND: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. AIM: To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England. METHODS: In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables. RESULTS: Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed. CONCLUSION: OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified

‘It's a horrible situation for everyone’: The impact of over the counter and prescription medication misuse on friends and family

Introduction: Over the counter and prescription-only medication misuse is of concern. Little is known about the impact on friends/family who provide individuals with support. It is important to increase understanding to identify how substance misuse services (SMS) and others can better meet their needs. The aim is to explore the impact of over the counter and prescription-only medication misuse on friends/family and improve an understanding of how this may be reduced. Methods: Ethical approval was obtained and confidential semi-structured interviews were undertaken with a modified grounded theory approach. Participants were recruited from community adult SMS in England. Verbatim transcripts underwent thematic analysis using NVIVO, and findings are reported in line with COREQ. Results: Eight telephone interviews (62.5% female) included a variety of different friend/relative relationships. Data saturation was felt to have been achieved, and identified that friends/family were significantly impacted, in long-standing and varying negative ways. Five themes were identified: impact on finances; impact of managing side-effects/withdrawal symptoms; impact on relationships; treatment interventions and personal support. Especially due to the psychological burden, friends/family benefit from holistic support, including improved awareness of over the counter and prescription-only medication misuse and interventions from healthcare/SMS providers, social services, affected others and their personal support network. Relationships where honesty and openness are encouraged, enable friends/family to provide more support and advocacy. Conclusions: Care providers should include friends/family when delivering holistic interventions. They should be vigilant for safeguarding issues and the impact on children, and improve approaches to withdrawal symptom/side-effect management, medicines optimisation and service responsiveness. Future research should include more participants and other SMS

The effect of job-stress on patient-safety in hospitals affiliated to Alborz University of Medical Sciences, Iran

BACKGROUND: Patient-safety is one of the main pillars of healthcare. Given that nurses are the largest group associated with patients, so with safety harms, job-stress among then can reduce patient-safety in hospitals. The aim of this article was to investigate the effects of job-stress on patient-safety in hospitals affiliated to Alborz University of Medical Sciences, Karaj, Iran.METHODS: In this cross-sectional study, data gathering tools consisted of a reliable researcher-made job-stress questionnaire, and a patient-safety checklist. 320 nurses in hospitals affiliated to Alborz University of Medical Sciences, who were selected using simple randomized sampling method, completed the questionnaire, and the checklist was filled by the researcher. Data were analyzed at two levels of inferential and descriptive statistics.RESULTS: Job-stress and also patient-safety were at average levels in studied hospitals. Among the demographic factors, only the relationship between job-stress and marital status was statistically significant (P < 0.050). There were no significant relationships between different aspects of job-stress among nurses and patient-safety.CONCLUSION: According to average level of job-stress among studied nurses, the quality of offered services would decrease and patient-safety would become undermined, if no action take place to reduce the job-stress among them. Therefore, it is necessary to increase nurses’ physical, psychological, and social health to increase patient-safety

Nutrition Counseling Position in Reducing the Duration of Admission for Patients with Type 2 Diabetes Undergoing Cataract Surgery

Background and Aim: Cataract is one of the most common ocular diseases caused by various causes including congenital, resulting from trauma, drug or radiation, diabetes, or aging. Diabetes type 2, as a common metabolic disorder, is one of the main reasons for cataracts. we aimed to study nutritional counseling's status on the correction of glucose and urea and creatinine patterns and blood pressure of patients undergoing cataract surgery and reducing the pre-operative hospitalization time. Methods: In this study, 60 women with type 2 diabetes and 39 male participants aged 25 to 65 (aged 25 to 65) were randomly assigned into two groups (control without diet and nutritional counseling). The target group (presentation of diabetic diet and nutrition counseling) went under investigation two weeks before cataract surgery. Blood sampling proceeded from the arm vein in a sitting way one day before and after the diet (12 hours of fasting). Results: Fasting blood glucose, body weight, waist circumference, urea, creatinine, blood pressure, and hospitalization period were significantly decreased after surgery (p≤0.05). Conclusion: The results showed that receiving nutrition counseling and diet before cataract surgery can improve fasting blood glucose, 2-hour blood glucose, body weight, urea, creatinine, blood pressure, and thus hospitalization and recovery be reduced after surgery. *Corresponding Author: Fariba Mohammadi Tahroodi; Email: [email protected] Please cite this article as: Vaziri Javid R, Safizadeh F, Lotfi F, Pouriamehr S, Khonakdar-Tarsi A, Akbari Javar A, Zarpou S, Mohammadi Tahroodi F. Nutrition Counseling Position in Reducing the Duration of Admission for Patients with Type 2 Diabetes Undergoing Cataract Surgery. Arch Med Lab Sci. 2019;5(4): 37-43. https://doi.org/10.22037/amls.v5i4.3008

Effects of Pomegranate Juice with and without Aerobic Training on Glycemic Control and Lipid Profile in Women with Type 2 Diabetes

Background and Aim: Type 2 diabetes is a common metabolic disease, which is associated with obesity and inactivity. Plant-based dietary patterns are recommended for the treatment of type 2 diabetes. On the other hand, the effect of aerobic training on the improvement of type 2 diabetes is also highly emphasized. The purpose of this study was to investigate the effects of 2-months of pomegranate juice consumption with and without aerobic training on the levels of HbA1c, fasting blood glucose (FBG), lipid profile in women with type 2 diabetes. Methods: In this study, 58 women with type 2 diabetes who were referred to Tehran Lorzadeh clinic were randomly divided into four groups: control, pomegranate juice, aerobic training, combined pomegranate juice with aerobic training. The aerobic training plan consisted of 2-months and three times per week (training time from 20 minutes to 45 minutes). Three days before and after this interventional study, serum levels of FBG, total cholesterol (TC), triacylglyceride (TG), and low-density lipoprotein (LDL) were measured by colorimetric methods. Results: Results showed that combined pomegranate extract consumption with aerobic exercise training significantly decreased the levels of FBG, HbA1c, and TG in women with type 2 diabetes compared to the control group after the intervention (P<0.01), while TC, LDL-c, and BMI remained unchanged. There was no statistically significant difference in the levels of TC, TG, HbA1c, and FBG in pomegranate extract or aerobic training groups compared to the control group after intervention. Conclusion: The results of this study indicate that combined pomegranate juice with aerobic training has beneficial effects on type 2 diabetes and could be recommended in their therapeutic program. *Corresponding Author: Fariba Mohammadi Tahroodi; Email: [email protected] Please cite this article as: Vaziri Javid R, Safizadeh F, Rastegary M, Nabi Afjadi M, Khonakdar-Tarsi A, Zare Z, Zarpou S, Mohammadi Tahroodi F. Effects of Pomegranate Juice with and without Aerobic Training on Glycemic Control and Lipid Profile in Women with Type 2 Diabetes. Arch Med Lab Sci. 2020;6.1-6 (e17). https://doi.org/10.22037/amls.v6.3038

Construction and Validation of the Narcissism and Vulnerable Narcissism Scale in a Non-clinical Sample in Iran

Background: This study was carried out to construct and validate Narcissism and Vulnerable Narcissism Scale (NVS) in a non-clinical sample in Iran. Methods: Through a review of literature, the affecting factors for narcissism and vulnerable narcissism were identified. Items for them were designed and their face validity and content validity were assessed via consultation with 5 psychoanalysts. 804 students, recruited through stratified sampling, completed the designed scale and Maladaptive Covert Narcissism Scale (MCNS). Principal Component Analysis (PCA) was applied for factor analysis. Cronbach alpha was used to confirm the reliability of factors. The difference between two genders was investigated using t test. The frequency of narcissism and vulnerable narcissism were estimated based on the z-scores. Results: Three factors of “grandiosity”, “devaluation”, and “social detachment” for narcissism part (24 items) and four factors of “negative emotions”, “fear of defect”, “low and fluctuating self-esteem”, and “withdrawal” for vulnerable narcissism part (27 items) of the scale showed reasonable validity and reliability. Pearson correlation coefficient between the two parts of narcissism and vulnerable narcissism and MCNS was estimated 0.42 and 0.47, respectively. Based on the score of 2 standard deviation (SD) above the mean, 2.0% of men, and 2.6% of women had narcissism, among which, 14.2% and 45.4% showed vulnerable narcissism, respectively. Conclusion: This scale showed suitable validity and reliability for screening narcissism and vulnerable narcissism. It needs to be replicated in other clinical and non-clinical samples with various demographic characteristics. Keywords Narcissism; Self report; Surveys; Scale

Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group

Objective Alcohol-related liver disease (ALD) is the most common cause of liver-related ill health and liver-related deaths in the UK, and deaths from ALD have doubled in the last decade. The management of ALD requires treatment of both liver disease and alcohol use; this necessitates effective and constructive multidisciplinary working. To support this, we have developed quality standard recommendations for the management of ALD, based on evidence and consensus expert opinion, with the aim of improving patient care.Design A multidisciplinary group of experts from the British Association for the Study of the Liver and British Society of Gastroenterology ALD Special Interest Group developed the quality standards, with input from the British Liver Trust and patient representatives.Results The standards cover three broad themes: the recognition and diagnosis of people with ALD in primary care and the liver outpatient clinic; the management of acutely decompensated ALD including acute alcohol-related hepatitis and the posthospital care of people with advanced liver disease due to ALD. Draft quality standards were initially developed by smaller working groups and then an anonymous modified Delphi voting process was conducted by the entire group to assess the level of agreement with each statement. Statements were included when agreement was 85% or greater. Twenty-four quality standards were produced from this process which support best practice. From the final list of statements, a smaller number of auditable key performance indicators were selected to allow services to benchmark their practice and an audit tool provided.Conclusion It is hoped that services will review their practice against these recommendations and key performance indicators and institute service development where needed to improve the care of patients with ALD

Surveying over the counter and prescription only medication misuse in treatment services during COVID-19.

BACKGROUND: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. AIM: To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England. METHODS: In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables. RESULTS: Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed. CONCLUSION: OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified

sj-docx-1-sat-10.1177_11782218221135875 – Supplemental material for Surveying Over the Counter and Prescription Only Medication Misuse in Treatment Services During COVID-19

Supplemental material, sj-docx-1-sat-10.1177_11782218221135875 for Surveying Over the Counter and Prescription Only Medication Misuse in Treatment Services During COVID-19 by Rosalind Gittins, Roya Vaziri and Ian Maidment in Substance Abuse: Research and Treatment</p