Medicine recovery and reuse in a hospital setting: a lesson from Italy.

OBJECTIVES: In 2017, a new programme was created for recovering and reusing (i) unexpired Class A medicines (i.e. dispensed either by community pharmacies or by hospitals) in hospital settings and (ii) medicines for hospital use only (Class H). The aim of this study was to describe a three-year reuse programme and assess its impact on medicines cost savings. METHODS: The setting was AOU Città della salute e della Scienza-in Turin (Italy). All the collected data referred to packages of medicines collected by/assigned to AOU for reuse over the 1 December 2017/1 December 2020 period. Retail prices were used to calculate the financial value of the medication. Costs for the time required for the reuse programme (a working group comprising a pharmacist, an administrative and a warehouse worker) were estimated. KEY FINDINGS: A total of 10 450 boxes were recovered for reuse (corresponding to 52% of donated boxes). The total value was €1 300 000. Class H accounted for 73% (€952 000) of the total value of the recovered medicines, while they represented only 9% of the packages collected by/assigned to AOU. Estimated cost for the reuse programme was €75 806. CONCLUSIONS: Medicine recycling programmes with appropriate checks can be implemented to facilitate reuse of medications in hospital settings. This study provides evidence that a reuse programme reduced drug expenditures, especially regarding the Class H medications. These results contribute to the debate regarding opportunity for recycling and sustainability in medicines management.

Prevalence of Violence Perpetrated by Healthcare Workers in Long-Term Care: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to determine the prevalence of violence perpetrated by healthcare workers (HCWs) against patients in long-term care (LTC). For this purpose, five relevant databases were searched. Two reviewers extracted data from the included articles independently and assessed their quality. Overall and subgroup random-effects pooled prevalence meta-analyses were performed. A series of meta-analyses stratified by study quality were also performed due to high heterogeneity. Nineteen articles were included, physical restraint (22%; CI: 15-29), verbal abuse (22%; CI: 16-28), and neglect (20%; CI: 15-26) attained the highest overall prevalence, while sexual abuse was less reported (2%; CI: 1-3). The prevalence of witnessed violence is generally higher than those reported by HCWs, and patients and their relatives reported fewer cases of violence than HCWs. Differences in violence perpetrated among LTC settings were found. Neglect (64%; CI: 56-72) and financial abuse (7%; CI: 3-12) reported by HCWs were higher in home care, while verbal abuse (21%; CI: 7-39) reported by patients or their families was higher in nursing homes. Our findings highlight that violence perpetrated by HCWs toward patients represents a significant concern in LTC, suggesting the adoption of reliable monitoring approaches and provision of assistance to victims in reporting abuse.

Depression, Suicidal Ideation and Perceived Stress in Italian Humanities Students: A Cross-Sectional Study.

Mental health issues are common among university students. Nevertheless, few studies focused on Italian students. This study aimed to assess prevalence and associated factors of perceived stress (PS), depressive symptoms (DS) and suicidal ideation (SI) in an Italian sample. A cross-sectional study was conducted amongst a convenience sample of students in humanities field (2018). Questionnaires were self-administered. Outcomes were assessed through Beck Depression Inventory-II (DS, SI) and Perceived Stress Scale (PS). Multivariable regressions were performed (p-value < 0.05 significant; sample size = 203). DS and SI prevalence was 30.6% and 8.8%. PS median score was 20 (IQR = 11), 87.7% reported moderate/severe PS. DS likelihood was increased by psychiatric disorders family history and not attending first year of course and decreased by not thinking that university hinders personal activities. Chronic disease and higher stress score increased SI probability; good/excellent family cohesion reduced it. Being female, thinking that university hinders resting/relaxing, seeing a psychologist/psychiatrist were positively associated with PS; having no worries about future was negatively associated. A high prevalence of mental health issues was reported, with miscellaneous associated factors that were linked to both private and social aspects. Universities must be aware of this to provide efficient preventive measures.

Prevalence of Workplace Sexual Violence against Healthcare Workers Providing Home Care: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis sought to explore the prevalence of sexual violence including both sexual harassment and abuse, perpetrated by clients against home healthcare workers (HCWs), including professional and paraprofessional HCWs. To this end, we systematically searched five relevant databases. Two reviewers extracted data from the included studies independently and performed a quality appraisal. Overall and subgroup random-effects pooled prevalence meta-analyses were performed. Due to high heterogeneity, a more robust model using a quality effect estimator was used. Fourteen studies were included, and the prevalence of sexual violence was 0.06 (95% confidence interval (CI): 0.01-0.13). Paraprofessionals had a higher prevalence of sexual violence (0.07, 95% CI: 0.00-0.18 vs. 0.05, 95% CI: 0.00-0.12), and the prevalence of sexual abuse was lower than that of sexual harassment (0.04, 95% CI: 0.00-0.10 vs. 0.10, 95% CI: 0.03-0.18). This systematic review estimated the prevalence of sexual violence across home HCWs from different high-income countries, highlighting the presence of this phenomenon to a lesser but nevertheless considerable extent compared to other healthcare settings. Health management should consider interventions to prevent and reduce the risk of home HCWs from being subjected to sexual violence, as the home-care sector presents particular risks for HCWs because clients' homes expose them to a relatively uncontrolled work environment.