13 research outputs found
Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale
Get PDFPurposeKorean adolescents have severe nighttime sleep deprivation and daytime sleepiness because of their competitive educational environment. However, daytime sleep patterns and sleepiness have never been studied using age-specific methods, such as the pediatric daytime sleepiness scale (PDSS). We surveyed the daytime sleepiness of Korean adolescents using a Korean translation of the PDSS.MethodsWe distributed the 27-item questionnaire, including the PDSS and questions related to sleep pattern, sleep satisfaction, and emotional state, to 3,370 students in grades 5-12.ResultsThe amount of nighttime sleep decreased significantly with increasing age. During weekday nights, 5-6th graders slept for 7.95±1.05 h, 7-9th graders for 7.57±1.05 h, and 10-12th graders for 5.78±1.13 h. However, the total amounts of combined daytime and nighttime sleep during weekdays were somewhat greater, 8.15±1.12 h for 5-6th graders, 8.17±1.20 h for 7-9th graders, and 6.87±1.40 h for 10-12th graders. PDSS scores increased with age, 11.89±5.56 for 5-6th graders, 16.57±5.57 for 7-9th graders, and 17.71±5.24 for 10-12th graders. Higher PDSS scores were positively correlated with poor school performance and emotional instability.ConclusionKorean teenagers sleep to an unusual extent during the day because of nighttime sleep deprivation. This negatively affects school performance and emotional stability. A Korean translation of the PDSS was effective in evaluating the severity of daytime sleepiness and assessing the emotional state and school performance of Korean teenagers
Patterns of Cough Medication Prescribing among Patients with Chronic Cough in Florida: 2012–2021
Get PDFAmong patients with chronic cough (CC) in the 2012–2021 statewide OneFlorida Clinical Research Consortium database, we examined trends in cough medication (CM) prescribing prevalence over time in repeated cross-sectional analyses and identified distinct CM utilization trajectories using group-based trajectory modeling (GBTM) in a retrospective cohort study. Among eligible adults (≥18 years) without cancer/benign respiratory tumor diagnoses, we identified CC patients and non-CC patients with any cough-related diagnosis. In the GBTM analysis, we calculated the number of monthly prescriptions for any CMs (excluding gabapentinoids) during the 12 months from the first qualifying cough event to identify distinct utilization trajectories. From 2012 to 2021, benzonatate (9.6% to 26.1%), dextromethorphan (5.2% to 8.6%), and gabapentinoid (5.3% to 14.4%) use increased among CC patients, while opioid antitussive use increased from 2012 to 2015 and decreased thereafter (8.4% in 2012, 14.7% in 2015, 6.7% in 2021; all p < 0.001). Of 15,566 CC patients and 655,250 non-CC patients identified in the GBTM analysis, CC patients had substantial burdens of respiratory/non-respiratory comorbidities and healthcare service and concomitant medication use compared to non-CC patients. Among CC patients, GBTM identified three distinct CM utilization trajectories: (1) no CM use (n = 11,222; 72.1%); (2) declining CM use (n = 4105; 26.4%); and (3) chronic CM use (n = 239; 1.5%). CC patients in Florida had limited CM use with increasing trends in use of benzonatate, dextromethorphan, and gabapentinoids and a decreasing trend in opioid antitussive use. CC patients, particularly with chronic prescription CM use, experienced substantial disease burden
Trends in the Management of Headache Disorders in US Emergency Departments: Analysis of 2007–2018 National Hospital Ambulatory Medical Care Survey Data
Get PDFWe examined trends in management of headache disorders in United States (US) emergency department (ED) visits. We conducted a cross-sectional study using 2007–2018 National Hospital Ambulatory Medical Care Survey data. We included adult patient visits (≥18 years) with a primary ED discharge diagnosis of headache. We classified headache medications by pharmacological group: opioids, butalbital, ergot alkaloids/triptans, acetaminophen/nonsteroidal anti-inflammatory drugs (NSAIDs), antiemetics, diphenhydramine, corticosteroids, and intravenous fluids. To obtain reliable estimates, we aggregated data into three time periods: 2007–2010, 2011–2014, and 2015–2018. Using multivariable logistic regression, we examined medication, neuroimaging, and outpatient referral trends, separately. Among headache-related ED visits, opioid use decreased from 54.1% in 2007–2010 to 28.3% in 2015–2018 (Ptrend < 0.001). There were statistically significant increasing trends in acetaminophen/NSAIDs, diphenhydramine, and corticosteroids use (all Ptrend < 0.001). Changes in butalbital (6.4%), ergot alkaloid/triptan (4.7%), antiemetic (59.2% in 2015–2018), and neuroimaging (37.3%) use over time were insignificant. Headache-related ED visits with outpatient referral for follow-up increased slightly from 73.3% in 2007–2010 to 79.7% in 2015–2018 (Ptrend = 0.02). Reflecting evidence-based guideline recommendations for headache management, opioid use substantially decreased from 2007 to 2018 among US headache-related ED visits. Future studies are warranted to identify strategies to promote evidence-based treatment for headaches (e.g., sumatriptan, dexamethasone) and appropriate outpatient referral and reduce unnecessary neuroimaging orders in EDs
Evaluation of Cough Medication Use Patterns in Ambulatory Care Settings in the United States: 2003–2018
Get PDFUsing 2003–2018 National Ambulatory Medical Care Survey data for office-based visits and 2003–2018 National Hospital Ambulatory Medical Care Survey data for emergency department (ED) visits, we conducted cross-sectional analyses to examine cough medication (CM) use trends in the United States (US) ambulatory care settings. We included adult (≥18 years) patient visits with respiratory-infection-related or non-infection-related cough as reason-for-visit or diagnosis without malignant cancer or benign respiratory tumor diagnoses. Using multivariable logistic regressions, we examined opioid antitussive, benzonatate, dextromethorphan-containing antitussive, and gabapentinoid use trends. From 2003–2005 to 2015–2018, opioid antitussive use decreased in office-based visits (8.8% to 6.4%, Ptrend = 0.03) but remained stable in ED visits (6.3% to 5.9%, Ptrend = 0.99). In both settings, hydrocodone-containing antitussive use declined over 50%. Benzonatate use more than tripled (office-based:1.6% to 4.8%; ED:1.5% to 8.0%; both Ptrend < 0.001). Dextromethorphan-containing antitussive use increased in ED visits (1.8% to 2.6%, Ptrend = 0.003) but stayed unchanged in office-based visits (3.8% to 2.7%; Ptrend = 0.60). Gabapentinoid use doubled in office-based visits (1.1% in 2006–2008 to 2.4% in 2015–2018, Ptrend < 0.001) but was negligible in ED visits. In US office-based and ED ambulatory care settings, hydrocodone-containing antitussive use substantially declined from 2003 to 2018, while benzonatate use more than tripled, and dextromethorphan-containing antitussive and gabapentinoid use remained low (<3%)
Trends in the Management of Headache Disorders in US Emergency Departments: Analysis of 2007–2018 National Hospital Ambulatory Medical Care Survey Data
No full textWe examined trends in management of headache disorders in United States (US) emergency department (ED) visits. We conducted a cross-sectional study using 2007–2018 National Hospital Ambulatory Medical Care Survey data. We included adult patient visits (≥18 years) with a primary ED discharge diagnosis of headache. We classified headache medications by pharmacological group: opioids, butalbital, ergot alkaloids/triptans, acetaminophen/nonsteroidal anti-inflammatory drugs (NSAIDs), antiemetics, diphenhydramine, corticosteroids, and intravenous fluids. To obtain reliable estimates, we aggregated data into three time periods: 2007–2010, 2011–2014, and 2015–2018. Using multivariable logistic regression, we examined medication, neuroimaging, and outpatient referral trends, separately. Among headache-related ED visits, opioid use decreased from 54.1% in 2007–2010 to 28.3% in 2015–2018 (Ptrend < 0.001). There were statistically significant increasing trends in acetaminophen/NSAIDs, diphenhydramine, and corticosteroids use (all Ptrend < 0.001). Changes in butalbital (6.4%), ergot alkaloid/triptan (4.7%), antiemetic (59.2% in 2015–2018), and neuroimaging (37.3%) use over time were insignificant. Headache-related ED visits with outpatient referral for follow-up increased slightly from 73.3% in 2007–2010 to 79.7% in 2015–2018 (Ptrend = 0.02). Reflecting evidence-based guideline recommendations for headache management, opioid use substantially decreased from 2007 to 2018 among US headache-related ED visits. Future studies are warranted to identify strategies to promote evidence-based treatment for headaches (e.g., sumatriptan, dexamethasone) and appropriate outpatient referral and reduce unnecessary neuroimaging orders in EDs
Bipolar bozukluk tanısı almış hastalarda kardiyometabolik risklerin ve ilaç kaynaklı problemlerin saptanması
No full textBipolar Bozukluk Tanısı Almış Hastalarda Kardiyometabolik Risklerin ve İlaç Kaynaklı Problemlerin Saptanması
Seonkyeong Yang; Danışman: Yrd. Doç. Dr. Betul Okuyan, Klinik Eczacılık Anabilim Dalı.
Amaç: Çalışmamızda bipolar bozukluk tanısını alıp, en az üç aydır ilaç kullanan hastaların kardiyometabolik risklerinin, tanı ve tedavi rehberlerindeki kardiyovasküler hastalık ve metabolik sendrom tanı kriterleri kullanılarak ve çeşitli kardiyometabolik belirteçlerin serum düzeylerine bakılarak saptanması ve yine bipolar hastalarında ilaç kullanımının değerlendirilmesi ve olası ilaç kaynaklı problemlerin retrospektif saptanması amaçlanmıştır.
Gereç ve yöntem: Çalışmamız, 24 Nisan - 30 Temmuz 2014 tarihleri arasında psikiyatri polikliniğine başvuran, DSM-IV-TR kriterlerine göre bipolar bozukluk tanısı almış ve en az üç aydır ilaç tedavisi alan hastalar ile gerçekleştirilmiştir. Antipsikotik kullanan hastaların yan etkileri, ‘Liverpool Üniversitesi Antipsikotiklerin Yan Etkilerini Değerlendirme Ölçeği (LÜAYEDÖ)’; hastaların tedaviye uyuncu ‘Morisky İlaç Tedavisine Uyum Ölçeği (MMAS-8-Madde)’ ile restrospektif olarak değerlendirilmiştir.
Bulgular: Çalışmaya katılan 60 hastanın (39 kadın, 21 erkek) yaş ortalaması 41.8±14.3 olarak hesaplanmıştır. Çalışmamızda metabolik sendrom sıklığı %46.7 olarak belirlenmiştir. Yan etki şiddeti ile ilaç uyuncu arasında ters yönde ve istatistiksel olarak anlamlı bir korelasyon bulunmuştur (r=-0.441, p<0.01).
Sonuç: Klinik eczacıların ilaç danışmanı olarak ilaç ile ilgili problemlerin değerlendirilmesi ve önlenebilmesi için bipolar hastaların tedavisine iştirak etmesi gerektiği düşünülmektedir.
Anahtar Sözcükler: bipolar bozukluk, kardiyometabolik risk, antipsikotik, ilaç uyuncu, klinik eczacı
SUMMARY
Evaluation of Kardiometabolic Risk and Drug-related Problems in Patients with Bipolar Disorder
Seonkyeong Yang; Supervisor: Assist.Prof.Dr. Betul Okuyan, Clinical Pharmacy Department
Objective: The aim of the study is to evaluate cardiometabolic risk, medication use and potential drug-related problems in patients treated for at least 3 months for bipolar disorder using the Framingham 10 year coronary heart disease risk score and the revised NCEP ATP III metabolic syndrome criteria and measuring serum levels of multiple indicatiors of cardiometabolic risk.
Methods: The study was conducted at the psychiatry clinic of the Haydarpaşa Numune Training and Research Hospital on patients with bipolar disorder who fulfilled the DSM-IV-TR diagnostic criteria for bipolar disorder between April 24 and July 30, 2014. The Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS) was used to retrospectively assess the prevalence and intensity of side effects in antipsychotic treated patients and the Morisky Medication Adherence Scale (MMAS-8-Item) was used to retrospectively evaluate patients’ medication adherence.
Results: The mean age of 60 patients (39 female, 21 male) was 41.8±14.3. Metabolic syndrome was present in 46.7% of patients. There was a statistically significant negative correlation between medication adherence and the prevalence and intensity of side effects (r=-0.441, p<0.01).
Conclusion: Clinical pharmacists as a drug advisor, should involve in management of patients with bipolar disorder for detecting and preventing potential drug-related problems.
Key Words: bipolar disorder, cardiometabolic risk, antipsychotic, medication adherence, clinical pharmacist
Evaluation of Cough Medication Use Patterns in Ambulatory Care Settings in the United States: 2003–2018
No full textUsing 2003–2018 National Ambulatory Medical Care Survey data for office-based visits and 2003–2018 National Hospital Ambulatory Medical Care Survey data for emergency department (ED) visits, we conducted cross-sectional analyses to examine cough medication (CM) use trends in the United States (US) ambulatory care settings. We included adult (≥18 years) patient visits with respiratory-infection-related or non-infection-related cough as reason-for-visit or diagnosis without malignant cancer or benign respiratory tumor diagnoses. Using multivariable logistic regressions, we examined opioid antitussive, benzonatate, dextromethorphan-containing antitussive, and gabapentinoid use trends. From 2003–2005 to 2015–2018, opioid antitussive use decreased in office-based visits (8.8% to 6.4%, Ptrend = 0.03) but remained stable in ED visits (6.3% to 5.9%, Ptrend = 0.99). In both settings, hydrocodone-containing antitussive use declined over 50%. Benzonatate use more than tripled (office-based:1.6% to 4.8%; ED:1.5% to 8.0%; both Ptrend < 0.001). Dextromethorphan-containing antitussive use increased in ED visits (1.8% to 2.6%, Ptrend = 0.003) but stayed unchanged in office-based visits (3.8% to 2.7%; Ptrend = 0.60). Gabapentinoid use doubled in office-based visits (1.1% in 2006–2008 to 2.4% in 2015–2018, Ptrend < 0.001) but was negligible in ED visits. In US office-based and ED ambulatory care settings, hydrocodone-containing antitussive use substantially declined from 2003 to 2018, while benzonatate use more than tripled, and dextromethorphan-containing antitussive and gabapentinoid use remained low (<3%)
