Disclosure and adverse effects of complementary and alternative medicine used by hospitalized patients in the North East of England

Objectives: This study aimed to investigate the prevalence, disclosure and adverse effects of complementary and alternative medicine (CAM) use in hospitalised patients, and to explore the associations between patients’ perceived side-effects and relevant factors. Methods: Patients who were admitted to a district general hospital and met the eligibility criteria were interviewed using a semi-structured questionnaire. Their medications and pertinent details were verified from the medical notes. All quantitative and qualitative data were collated and analysed. A chi-squared test was performed to test the associations of the perceived CAM side-effects with the significance level determined at a=0.05. Results: A total of 240 in-patients completed the study. They were mostly white British (98.8%). The prevalence of CAM use within two years was 74.6% and one month 37.9%. Only 19 of 91 patients (20.9%) using CAM within one month disclosed their current CAM applications. Nearly half of patients (45.8%) who used CAM within two years experienced various CAM side-effects that tended to resolve after discontinuation. Slightly more than half (57.6%) perceived CAM side-effects and their perceptions were significantly associated with gender (P=0.048) and consideration for future CAM use (P=0.033). Potential interactions between herbal remedies/dietary supplements and prescribed drugs, such as garlic with lisinopril or aspirin, were assessed in 82 patients (45.8%). Conclusion: Most in-patients used CAM and experienced some adverse effects. The disclosure of CAM use and its adverse outcomes should be encouraged by healthcare professionals

Patients′ awareness of antibiotic use in Bahraini health centers and community pharmacies

Objective: Patients′ understanding and perceptions of antibiotic use and resistance are crucial for the public health. This study aimed to explore the awareness of antibiotic utilization in 12 aspects among Bahraini patients attending health centers and community pharmacies and to find the associations of their awareness. Materials and Methods: A cross-sectional survey study with questionnaire interviews was conducted in Bahraini patients attending five health centers or four community pharmacies during January - June 2013. All data were analyzed using descriptive statistics and a Chi-squared test was performed with a significance level set at 0.05. Results: A total of 306 patients (156 in health centers and 150 in community pharmacies) participated in the study. Female respondents (57.2%) were nearly equal to the male. Most were adults aged 16-29 (47.7%) and educated at the university or school levels (88.2%). The majority were aware of the use for colds and relevant resistance, including 10 other aspects. Approximately 35% misconceived the medicine intake in terms of concomitant use with milk, daily doses, stopping time and reusability. Patients′ education was associated with six aspects of awareness, that is, decision on antibiotic prescribing, drug administration, treatment duration, drug resistance, reusability, and perceived side-effects (all P < 0.05). Conclusion: Bahraini patients are mostly aware of 12 antibiotic aspects despite some misconceptions. The public awareness and their expectations warrant further studies on a large scale to understand their self-medication and demand for antibiotic prescriptions

Perceptions of Bruneian clients about online medicine information

Objectives: This study aimed to explore the perceptions ofclients in Brunei Darussalam about online medicineinformation and to investigate determinants for the use ofpreferred medicine-related websites.Methods: Bruneian clients who met the eligibility criteriawere purposively sampled and asked to fill out a structuredquestionnaire. An in-depth interview was also conducted totriangulate the survey data.Results: A total of 189 respondents completed the survey withthe response rate of 75.6%. Half of the medicine informationseekers (55.6%) were women and mostly between the age of18 and 49 years. The majority of the respondents (90.5%)accessed the Internet from home, and 49.2% spentapproximately 1 to 2 hours searching for the requiredmedicine information. They mostly perceived searching onlinemedicine information was speedy and convenient (84.7%).Information on side effects and indications of drugs (87.3%and 79.4%) was largely sought on the Internet. Mostrespondents (79.4%) were satisfied with the retrievedmedicine information. Determinants for the use of medicinerelatedwebsites were not detected.Conclusions: Clients conveniently obtained medicineinformation from the Internet aside from seeking advice fromphysicians and pharmacists. Their online medicineinformation needs and information reliability merit furtherstudies

Usefulness of Patient-Generated Index for HIV to Measure Individual Quality of Life: A Study from Thailand

AbstractObjectivesTo measure health-related quality of life (HRQOL) in Thai HIV patients using the patient-generated index for HIV (PGI-HIV) and to compare the psychometric properties of the PGI-HIV with those of the EuroQol five-dimensional (EQ-5D) questionnaire and the Medical Outcome Study HIV Health Survey in terms of practicality, reliability, validity, and responsiveness.MethodsIn this study, two rounds of interviews were carried out in HIV outpatients who met the eligibility criteria and attended the HIV Clinic of Warinchamrap Hospital between January and March 2010. The patients were interviewed using a data collection form and three HRQOL measures (the PGI-HIV, the EQ-5D questionnaire, and the Medical Outcome Study HIV Health Survey) to assess the practicality and validity. The second interview was performed to check the test-retest reliability and responsiveness.ResultsA total of 210 patients completed the study. They were mostly women (69.5%), with a mean age of 39.2 ± 11.1 years. The majority with the US Centers for Disease Control and Prevention clinical stage C took the current antiretroviral drugs within 1 year. The average PGI score was about 0.60, implying HIV/AIDS and antiretroviral drug therapy decreased the patients’ quality of life by 40% from their healthy life. Three mostly cited impact domains were hyperlipidemia, lipid maldistribution and lipodystrophy, and hepatitis. The PGI-HIV was considered as practical, with a mean difficulty score of 3.7 ± 0.8, highly reliable (intraclass correlation coefficient = 0.75; P < 0.001), and responsive to HRQOL changes (effect size = 0.81; standardized response mean = 0.99), but not valid when compared with CD4 levels and viral loads (all Pearson’ r < 0.2; P > 0.05).ConclusionsThe PGI-HIV was used to measure the individual HRQOL in a Thai sample of HIV-positive patients. It proves to be practical, highly reliable, and very responsive to changes in patients’ HRQOL

Determinants for zidovudine-induced anemia in HIV adult patients: A Thai multicenter study

Objectives: This study was aimed to analyze the prevalence of zidovudine (AZT)-induced anemia, severity and determinants for the anemia in Thai human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Materials and Methods: A cross-sectional, multicenter study was carried out in HIV/AIDS adult out-patients who were taking AZT as part of the highly active antiretroviral therapy regimens, met relevant eligibility criteria and attended the eight antiretroviral clinics of community hospitals in Chumphon Province during January 2010-May 2012. Data on the prevalence and anemia characteristics were collected and analyzed. A binary logistic regression was performed to determine relevant factors with a significance level (α) of 0.05. Results: A total of 303 patients were included and nearly 71.6% of these started AZT + lamivudine + nevirapine as the primary regimen. Nearly half were male (48.8%) and the mean age was 39.5 years (standard deviation [SD] =8.6). Of 303 patients, 34 developed anemia that clearly started from 4 to 24 weeks after AZT-based therapy; the prevalence rate was 11.2%. With the AZT-induced anemia, patients mostly had the baseline CD4 count lower than 200 cells/mm 3 ( 64.7%), baseline body mass index (BMI) >18.5 kg/m 2 ( 61.8%) and baseline hemoglobin (Hb) in the range of 8.0-9.5 g/dL (85.3%); the mean Hb change from the baseline was 4.5 g/dL (SD = 3.2). The severity of anemia was mainly classified as grade 1 (55.9%) or 4 (32.4%). Four risk factors, i.e. baseline CD4 levels, Hb, BMI and duration of AZT use, significantly attributed to the anemia (P = 0.018, 0.004, 0.009 and 0.002, respectively). The risk of anemia could be predicted by 33.3% using the equation: Logit P anemia = 6.186 + 1.666 × Baseline CD4 level-0.501 × Baseline Hb-0.225 × Baseline BMI + 2.338 × Duration of AZT therapy. Conclusion: HIV patients using AZT may experience mild-to-severe anemia with salient features. Four determining factors for the anemia should be closely monitored by pharmacists or health care professionals before altering the regimen