Association between oral fluoroquinolone use and the development of retinal detachment: a systematic review and meta-analysis of observational studies

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Drug wastage among the elderly living in old aged homes in Hong Kong

The extend of drug wastage among elderly living in old aged homes was never investigated. Upon the completion of the previous study on pharmaceutical services provided to elderly living in old aged homes, the amount of drugs wasted from 3,020 residents in one of the delegated pharmacies over a 4-month period were counted and their costs were calculated. The total cost of wasted drugs amounted to be HKD$96,924, with drugs acting on the central nervous system contributed to the highest cost of HKD$26,872 (27.7%), followed by respiratory drugs of HKD$23,875 (24.6$22,965 (23.7%). The results showed that for health institutes dispensing prescriptions of long duration to the elderly could lead to considerable amount of drug wastage and this issue should be addressed.link_to_subscribed_fulltex

The pharmaceutical services to the elderly in the old aged homes in Hong Kong: a scope exercise

Various models of pharmaceutical services have been provided by pharmacists to old aged home residents, however, these models have never been summarised and compared. The aim of this scoping exercise is to identify different kinds of pharmaceutical services currently available to the old aged home residents, by means of systemic literature review, qualitative in-depth interviews with service providers in order to understand their models and qualitative semi-structured interviews with non-pharmaceutical service users in an attempt to investigate reasons why some homes do not subscribe to these services. The results showed that none of the pharmaceutical services currently available can uproot the causes of medication errors, and there is a need to elaborate the roles of pharmacists in a primary care setting.link_to_subscribed_fulltex

Exposure to selective serotonin reuptake inhibitors during pregnancy and risk of autism spectrum disorder in children: A systematic review and meta-analysis of observational studies

postprin

Improving medication safety and diabetes management in Hong Kong: A multidisciplinary approach

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Experiences of adolescents and young adults with ADHD in Hong Kong: treatment services and clinical management

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The impact of ischemic stroke on atrial fibrillation-related healthcare cost: a systematic review

Aim: To summarize healthcare costs incurred by patients with atrial fibrillation (AF) who developed ischemic stroke, explore factors associated with increased cost and highlight the importance of anticoagulation therapy for stroke prophylaxis. / Methods: A systematic literature search of PubMed, EMBASE, Web of Science and the health economic evaluation database was conducted up to December 2015. Studies focused on the cost and/or resource utilization of ischemic stroke in patients with AF were included. Reported costs were converted to international dollars (I$) and adjusted to 2015 values. Alongside the narrative review of included studies, Spearman’s correlation, independent-samples t-test and one-way ANOVA were used to explore factors associated with cost differences between studies. / Results: Sixteen studies published from nine countries were identified. Based on currency conversion rates in 2015, ischemic stroke related healthcare costs were estimated to be I$41,420, I$12,895 and I$8,184 for high-income, upper middle-income and lower middle-income economies respectively. Local GDP per capita accounted for approximately 50% of the healthcare cost variation among countries. Major component of overall cost was from hospitalization. Ischemic stroke incurring in patients with AF ≥75 years were 2.3 times that of their younger peers (p=0.049). / Conclusions: The economic burden from ischemic stroke in patients with AF is considerable with positive association to country income. Clinicians and stakeholders should be aware of the importance of anticoagulation therapies in stroke prophylaxis, the occurrence of stroke and the downstream economic burden on an increasingly aging population

Metformin Use and Gastric Cancer Risk in Diabetic Patients After Helicobacter pylori Eradication

Background: Although prior studies showed metformin could reduce gastric cancer (GC) risk in patients with diabetes mellitus (DM), they failed to adjust for Helicobacter pylori infection and glycemic control. We aimed to investigate whether metformin reduced GC risk in H. pylori -eradicated diabetic patients and its association with glycemic control. Methods: This was a territory-wide cohort study using hospital registry database, recruiting all diabetic patients who were prescribed clarithromycin-based triple therapy for H. pylori infection from 2003 to 2012. Subjects were observed from H. pylori therapy prescription until GC diagnosis, death or end of study (December 2015). Exclusion criteria included GC diagnosed within first year of H. pylori therapy, prior history of GC or gastrectomy, and failure of H. pylori eradication. The hazard ratio (HR) of GC with metformin (defined as at least 180-day use) was estimated by Cox model with propensity score adjustment for covariates (age, sex, comorbidities, medications [including insulin], and time-weighted average hemoglobin A1c [HbA1c]). All statistical tests were two-sided. Results: During a median follow-up of 7.1 years (IQR:4.7–9.8), 37 (0.51%) of 7,266 diabetic patients developed GC at a median age of 76.4 years (IQR: 64.8–81.5 years). Metformin use was associated with a reduced GC risk (adjusted HR:0.49; 95% CI:0.24–0.98). There was a trend towards a lower GC risk with increasing duration (ptrend =0.01) and dose of metformin (ptrend=0.02) HbA1c level was not an independent risk factor for GC. Conclusions: Metformin use was associated with a lower GC risk among H. pylori -eradicated diabetic patients in a duration- and dose-response manner, which was independent of HbA1c level

ACE (Angiotensin-Converting Enzyme) Inhibitors/Angiotensin Receptor Blockers Are Associated With Lower Colorectal Cancer Risk: A Territory-Wide Study With Propensity Score Analysis

Whether ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers modify colorectal cancer risk remains controversial. We aimed to determine association between their use and colorectal cancer risk after a negative baseline colonoscopy. This is a territory-wide retrospective cohort study recruiting patients aged ≥40 who had undergone colonoscopy between 2005 and 2013. Exclusion criteria included colorectal cancer detected 3years (adjusted hazard ratio, 1.18 [95% CI, 0.88-1.57]); every single year increase in the drug use was associated with 5% reduction in adjusted hazard ratio risk. ACE inhibitors/angiotensin receptor blocker were associated with a lower colorectal cancer risk in a duration-response manner