Evaluation of the Factors Associated with Prescribed and Non-Prescribed Medicine: A Population-Based Study.

OBJECTIVES: Several factors influence medication patterns. The purpose of this study was to look into the role of social determinants in the use of prescribed and non-prescribed medications in a population-based setting of people over 18 in a southern metropolis of Iran (Shiraz) for 2 years. STUDY DESIGN: Prospective population-based cross-sectional. METHODS: This descriptive and cross-sectional survey was done in 2018-2020. A total of 1016 participants were randomly selected based on their postal codes and recruited to the study. The demographic characteristics (age, sex, and education), social profiles (insurance, supplementary insurance, health status, and daily exercise plan), and outpatient visits (family/general physician or specialist/ subspecialist) were recorded by gathering sheets. Descriptive analyses and multinomial logistic analyses were carried out using SPSS software. RESULTS: The medication use pattern was classified into three categories: non-prescribed type I, non-prescribed type II, and prescribed. The mean age of participants was 45.54 ± 15.82 years. The results indicated that most of them took their medication without a prescription (non-prescribed type II). However, people who had insurance and referred to a family physician commonly used the prescribed medications. This study also found that patients who visited a family doctor or a general practitioner used fewer prescribed drugs than those who visited a specialist. CONCLUSION: This study describes social determinants as additional effective factors in health services that influence the use of prescribed and non-prescribed medications in Shiraz. These evidence- based findings can help policymakers to plan the best programs.

New Modification of Smell Identification Test for the Detection of Malingerers: A Pilot Experimental Study.

Background: A major problem with the University of Pennsylvania Smell Identification Test (UPSIT) is its poor sensitivity for malingering detection in a group of people familiar with the test mechanism. This study aimed to evaluate the modification of UPSIT to detect anosmia malingering. Methods: This was a pilot experimental study conducted in 2019 in Tehran. The participants were 60 healthy subjects classified into two groups of 30 people. The first group was requested to deliberately feign a negative result on the Iranian version of UPSIT, Iran Smell Identification Test (ISIT) (malingering group). The second group consisted of participants, who did not scratch the odorant part of ISIT during the tests (anosmia group). ISIT was modified in two steps. At each step, one incorrect option was deleted from the available choices. The number of each group's answers, altered away from the correct choice, was then calculated and compared. Results: The coached malingering group participants were able to feign anosmia in the original ISIT exam. In the modified ISIT, the number of answers changed from correct to wrong during the second stage (from three available choices to two choices) was significantly higher in the anosmia group (P<0.001). In the ROC analysis, the area under the curve was 0.92 (P<0.001). The cut-off of 4.5 for this test showed 93% sensitivity, 82% specificity, and 90% PPV and NPV. Conclusion: The ISIT is not capable of detecting malingering in the coached participants, yet by deleting the choices step-by-step, the sensitivity and specificity of the test increased.

Assessing the Performance of Community Pharmacies in Iran by Measuring Responsiveness to Non-Medical Needs: An Application of WHO Responsiveness Framework.

OBJECTIVE: Despite growing debates about the health systems' nonmedical performance, there has not been any empirical research on nonmedical performance and patients' rights consideration as a driver of human rights in the pharmaceutical sector. This study's main objective was to assess the nonmedical performance of community pharmacies of Shiraz, Iran. METHODS: A cross-sectional study was conducted using two self-administrated Likert-based questionnaires based on the World Health Organization (WHO) responsiveness framework and the legal charter communicated by the Ministry of Health and Medical Education of Iran. The population was patients older than 18 years who took a prescription from community pharmacies located in Shiraz and willing to answer the questions voluntarily, from 2018 to 2019. Considering the weights of subdimensions of responsiveness provided by the WHO framework, the total score of responsiveness was calculated ranging from 0 to 100. FINDINGS: The response rate was 80.5%. The mean (standard deviation) overall score of responsiveness was 57.18 (21.61), with a median of 56.71. The mean score of client orientation was lower in respondents with a high education level than those with a diploma and under diploma (P = 0.028). CONCLUSION: Nonmedical pharmacy performance was considered either medium or high in more than half of the cases based on the participants' views. Regarding client, orientation was seen less often in patients with high education level compared to those with a lower education level.

Pharmacological and Nonpharmacological Studies on Coronavirus Disease 2019: A Mini-review of the Recent Evidence.

Coronavirus 19 (COVID-19) is an extremely transmittable microbial infection that has emerged in Wuhan (China) in late 2019, leading to severe acute respiratory syndrome coronavirus 2 syndrome, and caused a pandemic all over the globe. This study is a systematic review of all 927 clinical trial studies performed worldwide from the beginning of the COVID-19 mysterious pandemic in China. These researches have registered in different databases. According to the best of our knowledge, China (74.82%), the United States (4.49%), and France (2.72%) have the most significant number of clinical trials, respectively. Clinical trials can be randomized or nonrandomized. Due to our results, 32.58% of studies were randomized, and 7.12% were not randomized. Most of the studies were open-labeled studies (22.44%), and double-blinded (4.42%) and quadruple blinded (2.48%) studies stand in second and third place regarding the number of trials, respectively. The direction and quantity of clinical trials attempted to identify a possible cure for COVID-19 demonstrates the depth of this crisis. As we are writing this article, a significant international endeavor will find a cure or vaccine for containing this devastating and mysterious disease.