Safety of Using Traditional Chinese Medicine Injections in Primary Medical Institutions: Based on the Spontaneous Reporting System 2016-2020 in Henan Province, China.

Objective: Traditional Chinese medicine (TCM) injection is widely used, but its adverse drug reaction (ADR) may be a serious public health concern in primary medical institutions. This research will explore the safety of TCM injections and provide clinical recommendations at the primary medical institutions. Method: ADR data were collected by the Henan Adverse Drug Reaction Monitoring Center from 2016 to 2020 were analized Descriptive statistics, chi-square analysis, binary logistic regression, and Mantel-haenszel hierarchical analysis were used to identify the risk factors associated with the rational use of TCM injections in primary medical institutions. Results: A total of 30,839 cases were collected in this study, 4905 cases (15.90%) were SADRs. Patients using TCM injections in primary medical institutions were more likely to cause SADRs (OR = 1.149, 95% CI: 1.061-1.245). Aged over 60 years (OR = 1.105, 95% CI: 1.007-1.212), non-essential drugs (OR = 1.292, 95% CI: 1.173-1.424), autumn (OR = 1.194, 95% CI: 1.075-1.326) and TCM injections with safflower (OR = 1.402, 95% CI: 1.152-1.706), danshen (OR = 1.456, 95% CI: 1.068-1.984) and medication reasons with chemotherapy (OR = 2.523, 95% CI: 1.182-5.386) and hypertension (OR = 1.495, 95% CI: 1.001-2.233) were more likely to suffer SADR in primary medical institutions. Conclusion: In general, the number of reported cases of TCM injection was declining over time, but the proportion of SADRs in primary medical institutions increased. In the future, it is necessary to continue to restrict TCM injections at the macro policy level, and vigorously promote the varieties in the essential drug list. At the micro level, it is necessary to intervene in specific populations, specific diseases and specific drugs, first start with them, step by step, and effectively prevent SADR occurrences in primary medical institutions.

The Survey on Adolescents' Cognition, Attitude, and Behavior of Using Analgesics: Take Sichuan and Chongqing as an Example.

Objectives: To explore the current situation of knowledge, attitude, and behavior about the correct use of analgesics among adolescents in Western Sichuan and Chongqing and its related factors and to provide a reference for health promotion schools to promote correct medication education and relevant policy-making. Methods: A questionnaire survey was conducted among senior high school students in Sichuan and Chongqing by stratified random sampling. A total of 48 classes were surveyed and 2,280 valid questionnaires were obtained. Descriptive analysis, mean value comparison, and multiple regression analysis were conducted for the data using SPSS17.0 statistical analysis software. Results: (1) It showed that 65.5% of the students used methods other than drugs to deal with pain, 52.9% of the students took analgesics prescribed by doctors, more than 60% of the students got information about pain treatment from medical professionals or their families members, 71.6% of the students read the use label when using drugs, and only about 20% of the students knew the dosage and side effects of analgesics. (2) The higher the grade, the higher the proportion of students who often take analgesics prescribed by doctors, the higher the proportion of students who use methods other than drugs to relieve pain, the higher the proportion of students who read the label of analgesics, and the more information sources are introduced by family members. The better the knowledge, attitude, efficacy, and accomplishment of using analgesics, the better the behavior of using analgesics correctly. (3) Students who had taken analgesics provided by their family or friends and who had taken anti-inflammatory analgesics did not perform well in the correct use of analgesics. Conclusion: The key factors that influence the correct drug use behavior of middle school students are their correct drug use literacy, efficacy, attitude, and reading of analgesics. Therefore, schools should strengthen cooperation with pharmacists and encourage the promotion of parent-child education activities of correct drug use.

Knowledge, attitude, and practice of medication among Haikou residents.

BACKGROUND: Our study aims to explore the knowledge, attitude, and practice (KAP) and its influencing factors of medication among residents in Haikou, the capital city of Hainan Province, and inform the development of interventions to reduce residents' medication errors. METHODS: A cross-sectional questionnaire survey was conducted to investigate the KAP of medication among Haikou residents and its influencing factors from March to September 2019. RESULTS: A total of 471 valid questionnaires were collected (245 online and 226 offline), with an effective recovery rate of 94.2%. The average score of KAP of medication were 52.2±13.08, 27.34±8.14, and 51.54±9.22, respectively. The knowledge score reached "good" in the evaluation criteria of the questionnaire, and the attitude and practice scores were "fair". Multiple linear regression analysis revealed the medication knowledge increased with age; a lower education degree was associated with less knowledge and more medication errors, and a higher education level was associated with more access to medication knowledge. CONCLUSIONS: Education on rational drug use should be performed via multiple ways to promote rational drug use and reduce risky medication behaviors, particularly among residents with low education degrees, e.g., drug counseling and guidance, regularly push medication science popularization, public welfare lecture on rational drug use, organize and compile popular science books.

Association between health literacy, general psychological factors, and adherence to medical treatment among Danes aged 50-80 years.

BACKGROUND: Understanding behavioral factors associated with low health literacy (HL) is relevant for health care providers to better support their patients' health and adherence to preventive treatment. In this study, we aim to study associations between low HL and socio-demographic characteristics, medication-related perceptions and experience, as well as general psychological factors among patients aged 50-80 years. METHODS: We used a cross-sectional survey design based on a representative group of 6,871 Danish citizens aged 50-80 years returning a web-based questionnaire with socio-demographic data added from a national registry. Chi-square tests were conducted to analyze associations between low HL and daily use of medication and self-rated health. Chi-square tests and binary logistic regression were conducted for analyzing data from respondents using prescribed medicines daily (N = 4,091). RESULTS: Respondents with low HL were more often on daily medications (19 % [777/4,091] vs. 16 % [436/2,775]; P < 0.001) and were more likely to have poorer self-rated health (P < 0.001). Among patients on daily medications, low HL was significantly higher among men and those with lower educational attainment and lower family income. Low HL was independently and positively associated with perceptions that taking prescribed medicines daily is difficult and time-consuming, with forgetting to take prescribed medicines, and with lower satisfaction with life and poor self-assessed health. CONCLUSIONS: Our study provides information that patients aged 50-80 years with low HL are challenged on their adherence to treatment plans which is not only related to traditional sociodemographic factors but also on perceptions related to taking medication per se.

Medication adherence among patients with gout: A systematic review and meta-analysis.

OBJECTIVE: In the management of chronic gout, a large proportion of patients need long-term management with urate lowering therapy (ULT). This study reviews medication adherence to ULT and summarizes factors associated with adherence. METHODS: We performed a systematic literature search for studies on adherence to ULT among gout patients in PubMed, Embase, CINAHL, and PsycINFO. We conducted meta-analysis, with a random effect model, for the studies reporting the proportion of patients considered adherent to at least 80% of prescribed medication or time taken. We explored potential sources of heterogeneity, including geographic area and measure of adherence. Narrative summaries were made for data on adherence assessed/defined by Medication Event Monitoring System (MEMS)/pill-count or patient-reported, occurrence of a gap in therapy ≥30 days (non-persistence), and factors associated with adherence. RESULTS: Of the 24 studies, 16 assessed adherence using prescription/claims data, two by the MEMS or pill count, and six by patient-reported data. The pooled proportion of adherent patients (n = 13) was 46% (95% CI: 41-51); 45% across studies conducted in the USA (n = 8) and 48% in other countries (n = 5). Adherence assessed by MEMS/pill count and patient-reported was much higher than by studies using prescription/claims data. Non-persistence (n = 6) ranged from 54% to 87%. Factors associated with adherence were investigated in 18 studies. Strong evidence for a positive association with older age, more comorbidities, and the presence of diabetes or hypertension was found. CONCLUSION: Medication adherence to ULT among gout patients was poor. Better insight into reasons and consequences or poor adherence is needed.

Investigation and Analysis of Medication Knowledge and Behavior of Undergraduates in 9 Non-medical Colleges in Beijing / 中国药房

OBJECTIVE:To provide reference for improving rational drug use in undergraduates from non-medical college. METHODS:By questionnaire survey,9 non-medical colleges were collected according to college entrance examination admission batches and school types stratification sampling. The questionnaires were issued among 860 college students by encounter sampling. The survey included medication knowledge,medication behavior,personal basic information three aspects. Single factor analysis and Logistic regression analysis were conducted for their influential factors. RESULTS:A total of 860 questionnaires were sent out, and 812 valid questionnaires were collected with effective recovery rate of 94.4%. In respect of medication knowledge,4.2% of college students answered all of the five questions correctly,the correlation of correct rate with monthly disposable income was maximal(P=0.007);correct rate of the minority students with monthly disposable income more than 6 000 yuan was higher. In respect of medication behavior,14.4% of college students answered all of the seven questions correctly,the correlation of correct rate with whether the family had long-term(more than half a year)medication experience was maximal(P=0.035);the students whose family had no long-term(more than half a year)medication experience member and had medical personnel used drugs more standardly. CONCLUSIONS:The non-medical college students in Beijing lack of medication knowledge and have poor compliance;medication behavior is also unreasonable. Society,universities and families should strengthen the health education of students,and guide students to standardize the self-medicine therapy.

Analysis behavior of patients with serious adverse drug reaction using statins leading to rhabdomyolysis / 中国基层医药

Objective To analyze the behavior of patients with serious adverse drug reactions and look for risk factors leading to serious adverse drug reactions .Methods Patient medication behavior evaluation method was established,which was used in cases of serious adverse reaction caused by stains in recent three years in Beijing Chuiyangliu Hospital .Clinical pharmacists participated in field survey .Medication behavior of patients was analyzed from three aspects of knowledge ,attitude and ability .Results Three patients had serious adverse reactions occurred in recent 3 years,drugs were suspected of simvastatin and atorvastatin .The score of medication knowledge was lower than 20%.The score of health attitude was lower than 20%.The score of taking ability was lower than 20%. Conclusion In the investigation of serious adverse reaction ,pharmacists found the risk behavior of patients with daily medication is an important cause of patients with serious adverse reaction .Pharmacists should strengthen the drug education and publicity ,especially in patients with risk factors of medication behavior such as knowledge ,attitude and ability in their daily work .

Personality and reasons for not using asthma medication in young adults.

OBJECTIVES: To identify young adults' stated reasons for not taking asthma medication and to determine the significance of personality, asthma control and health-related quality of life in relation to these stated reasons. BACKGROUND: Reasons for non-adherence to asthma medication treatment have previously been studied, but research on the significance of personality in relation to stated reasons for not taking asthma medication is limited. METHODS: Young adults with asthma (age 22 years; n = 216) stated their most common reasons for not taking asthma medication and completed postal questionnaires on personality, asthma control and health-related quality of life (HRQL). RESULTS: The most common reason for non-adherence was "No perceived need" (n = 141). Participants giving this reason for not taking asthma medication scored lower on the personality trait Negative Affectivity and reported both higher asthma control and higher mental HRQL. "Insufficient routines" was the second most common reason (n = 66), and participants stating it scored higher on Negative Affectivity and reported lower asthma control. An increase in asthma control increased the odds of stating "No perceived need" as the reason for not taking asthma medication. An increase in Negative Affectivity was associated with an increase in the odds of giving "Insufficient routines" as a reason. CONCLUSIONS: The personality trait Negative Affectivity and perceived asthma control played a role in the young adults' stated reasons for not taking asthma medication, which indicates that these parameters are of importance to young adults' medication management.

Recent educational interventions for improvement of asthma medication adherence.

Poor adherence to asthma medication treatment is a dilemma as it decreases the chance of achieving and maintaining a proper asthma control. Another dilemma is that there seems to be a small range of functional interventions that enhance adherence to long-term medication treatments. The aim was to review the last five years of published educational interventions for improving adherence to asthma medication. Through systematic database searches 20 articles were identified, which matched the inclusion criteria and described educational interventions to improve asthma self-management including adherence. The current review showed that addressing unintentional non-adherence in terms of incorrect inhaler technique by recurrent education improved the technique among many patients, but not among all. Phoning patients, as a means to remove medication beliefs as adherence barriers, seemed to be an effective educational strategy, shown as increased adherence. Involving patients in treatment decisions and individualising or tailoring educational support also seemed to have favourable effect on adherence. To conclude, addressing specific adherence barriers such as poor inhaler technique or medication beliefs could favour adherence. To change adherence behavior, the current review proposes that educational adherence support should be a collaborative effort between the patient and the health-care professional based on each individual patient's needs and patient factors, including elements such as personality traits.

Recent educational interventions for improvement of asthma medication adherence

Poor adherence to asthma medication treatment is a dilemma as it decreases the chance of achieving and maintaining a proper asthma control. Another dilemma is that there seems to be a small range of functional interventions that enhance adherence to long-term medication treatments. The aim was to review the last five years of published educational interventions for improving adherence to asthma medication. Through systematic database searches 20 articles were identified, which matched the inclusion criteria and described educational interventions to improve asthma self-management including adherence. The current review showed that addressing unintentional non-adherence in terms of incorrect inhaler technique by recurrent education improved the technique among many patients, but not among all. Phoning patients, as a means to remove medication beliefs as adherence barriers, seemed to be an effective educational strategy, shown as increased adherence. Involving patients in treatment decisions and individualising or tailoring educational support also seemed to have favourable effect on adherence. To conclude, addressing specific adherence barriers such as poor inhaler technique or medication beliefs could favour adherence. To change adherence behavior, the current review proposes that educational adherence support should be a collaborative effort between the patient and the health-care professional based on each individual patient's needs and patient factors, including elements such as personality traits.