ABSTRACT
Background: Non-adherence to medication schedules by patients with chronic illnesses can have serious consequences, including poor clinical outcomes, higher hospitalization rates, and increased healthcare costs. Hypothyroidism is a chronic illness with simple treatment, yet non-compliance is common.
Aims: This study aimed to evaluate treatment adherence to levothyroxine therapy in Lebanese population by estimating the proportion of adherent hypothyroidism patients and assess factors affecting the adherence to treatment.
Methods: A cross-sectional survey between May and July 2015 included 337 patients. Patients were approached by a community pharmacist during their visit to buy their levothyroxine drug and were asked to fill the questionnaire.
Results: Among these patients, 14.5% showed high adherence, 30.6% medium adherence, and 54.9% low adherence to medication. The mean adherence score was 5.53 ± 1.86 points. The results of a logistic regression showed that age [ORa=1.036], visiting the endocrinologist once every month [ORa=27.77], and the fact that the physician gave the patient information about the disease [ORa=2.898] would significantly increase the adherence to the medication. In addition, having one [ORa=0.365] or two comorbidities [ORa=0.232] in addition to hypothyroidism, postponing/cancelling medical appointments at the last minute [ORa=0.358], the number of waterpipe smoked per week [ORa=0.621] and the number of alcohol glasses drunk per week [ORa=0.631] would significantly decrease the adherence score.
Conclusion: Educational programmes should be implemented, doctor-patient and pharmacist-patient relationship could be improved and new treatment regimens be considered in order to enhance patient adherence
ABSTRACT
Background: Venous thromboembolism (VTE) is a multifactorial disease with a preventable characteristic. The knowledge of its predictive risk factors will help in preventing it. Therefore, the aim of this study is to assess the predictive risk factors of VTE in the Lebanese population so that effective recommendations can be drawn out. Methodology: A retrospective case-control study was carried between the periods of March till June 2017 in two tertiary care hospitals in Beirut-Lebanon. Patients with a confirmed official diagnosis of VTE between the period going from 2008 till 2016 were taken as cases. Each case was randomly matched with 2 hospitalized controls. Questionnaires concerning VTE risk factors and symptoms were filled. Data were then entered into SPSS version 21 to explore the association between the risk factors and VTE. Bi-variate and multivariate logistic regression were done and a p-value less than 0.05 was considered. Results: 430 patients were included in our study. Among these, 140 were cases of deep vein thrombosis and/or pulmonary embolism and 290 were matched controls. The results of the bi-variate analysis was significant for history of VTE, active cancer, general surgery, thrombophilia, immobility, active/recent pneumonia, trauma, and hormone replacement therapy/contraceptives use (p-value<0.001). It was also significant for history of coronary artery disease/myocardial infarction (p-value=0.018), neurological disease (p-value=0.001), stroke (p-value=0.033) liver diseases and varicose veins (p-value=0.045) and spinal cord injury (p-value=0.034). In multivariate analysis, the probability of VTE was significant for: VTE history (OR=32.8; p-value<0.001), thrombophilia (OR=25.4; p-value<0.001), major trauma (OR=11.5; p-value<0.001), general surgery (OR=10.2; p-value<0.001), immobility (OR=6.9; p-value=0.003), history of stroke (OR=6.8; p-value=0.001), serious liver disease (OR=6.5; p-value=0.016), cancer (OR=5; p-value<0.001), central venous catheter or pacemaker implantation (OR=4.4; p-value=0.025), active/recent pneumonia (OR=3.2; p-value=0.023), neurological disorders (OR=3; p-value =0.047), coronary artery disease/myocardial infarction (OR=2.3; p-value=0.017) and chronic lung diseases (OR= 2.2; p-value=0.033). There was a lack of testing for thrombophilia in the Lebanese hospitals. Conclusion: The knowledge of these causative risk factors and their influence on VTE is crucial to initiate awareness in the population and strict prophylactic procedures for hospitalized patients. Furthermore, physicians must be more aware of the possible thrombophilic factors behind VTE cases by searching through thrombophilia testing. Larger studies must be done to investigate risk factors not detected in this study in order to further generalize the results.
ABSTRACT
The main objective of this study was to identify the risk factors of dyslipidemia and measure its impact on patients' quality of life [QOL]. Secondary objectives were to determine the percentage of dyslipidemia and assess the predictive factors affecting patients' QOL. A cross-sectional study was conducted in a sample of Lebanese population. A standardized questionnaire was developed to assess the QOL using the Short form-36 [SF-36] score. A total of 452 individuals were interviewed, of which 59.5% were females. The mean age was 43.3 +/- 15.6 years, and 24.8% had dyslipidemia. The results show a lower overall QOL score among dyslipidemic patients compared with controls [57.9% and 76.5%, respectively; p < 0.001]. Waterpipe smoking [adjusted odds ratio [OR[a]] = 4.113, 95% confidence interval [CI]: 1.696-9.971, p = 0.002], hypertension [OR[a] = 3.597, 95% CI: 1.818-7.116, p < 0.001], diabetes [OR[a] = 3.441, 95% CI: 1.587-7.462, p = 0.002], cigarette smoking [OR[a] = 2.966, 95% CI: 1.516-5.804, p = 0.001], and passive smoking [OR[a] = 2.716, 95% CI: 1.376- 5.358, p = 0.004] were significantly associated with dyslipidemia in individuals older than 30 years. A higher overall QOL score [p = 0.013] was observed in patients treated with statins in comparison with other lipid-lowering medications. In addition to clinical and economical consequences, dyslipidemia may have a significant impact on patients' QOL. Further research is needed to confirm the impact of treatment on dyslipidemic patients' QOL in order to maximize the overall benefits of therapy
ABSTRACT
Malnutrition represents an important issue in older adults; unfortunately, there is lack of data concerning this topic in Lebanon. This paper aims to provide a description of nutri-tional status and its correlates in older adults living in long stay institutions situated in Beirut. This cross-sectional study was conducted in three long stay institutions in Beirut in 2012. The study population was composed of people aged 65 years and above, having a score of Folstein Mini Mental State Examination [MMSE] greater than 14 and without renal failure requiring dialysis. Subjects meeting inclusion criteria filled out a questionnaire consisting of nutri-tional status scale [Mini Nutritional Assessment: MNA] and several other parts [demographic, self-assessment of the state health, smoking and alcohol, physical dependence, quality of life, frailty, depression, social isolation and loneliness]. Data were entered and analyzed using the statistical software SPSS [Statistical Package for Social Sciences], version 17.0 [Chicago, IL, USA]. Among 111 older adults [55 men and 56 women], 14 [12.6%] were malnourished, 54 [48.7%] were at risk of malnutrition and 43 [38.7%] had an adequate nutritional status. Multivari-ate analysis showed that physical exercise, depression, frailty and cognitive function were inde-pendent correlates of nutritional status of older adults. This model explained 42.2% [adjusted R2=0.422] of the older adults nutritional status variability. We found a moderate percentage of malnutrition in older adults living in long stay institutions situated in Beirut, and the correlates of malnutrition in older adults were low physical exercise, depression, frailty and low cognitive function.
ABSTRACT
Hip fractures are serious fall injuries that often result in long-term functional impairment and increased mortality. As the population ages, the number of hip fractures is likely to increase worldwide. The main objective of this pilot study was to evaluate the risk factors of hip fracture among the older adults in the Lebanese population. This pilot epidemiological, prospective, and case-control study was performed in 6 hospitals in Great Beirut and South Lebanon. Subjects who met the inclusion criteria filled out a questionnaire consisting on the socio- demographic characteristics, health status, drugs intake and cigarette smoking. Overall, 195 subjects were recruited, with 65 cases of hip fracture and 130 controls all aged over 50 yr. Females represented around two third of the studied population. The logistic regression, using adjusted odds ratio [OR[a]], showed a significant relationship between hip fracture and chronic diseases [OR[a]=3.02; 95% CI: 1.63, 6.66], antihypertensive drugs intake [OR[a]=2.72; 95% CI: 1.56, 6.42], fall [OR[a]=2.79; 95% CI: 1.82, 7.06] previous fracture [OR[a]=3.80; 95% CI: 1.57, 9.23] and family history of fracture [OR[a]=4.82; 95% CI: [2.29, 10.86]. Besides, smoking increased the risk of hip fracture [OR[a]=2.55; 95% CI: [1.96, 5.80]. Having a bow was associated with the highest risk for hip fracture [OR[a]=5.18; 95% CI: 2.30, 12.24]. Elderly people in Lebanon are exposed to many risk factors contributing to hip fracture. Our finding has implication in geriatric health improvement by preventing hip fracture in the Lebanese population