Knowledge, attitude, behaviour, and influencing factors of home-based medication safety among community-dwelling older adults with chronic diseases: a cross-sectional study.

BACKGROUND: Older adults with chronic diseases require long-term medication. However, due to lack of drug knowledge and hypomnesia, older adults with chronic diseases are prone to adverse drug events and increased medical costs. This study aimed to explore the status and influencing factors of home-based medication safety among community-dwelling older adults with chronic diseases in China to provide a basis for follow-up to conduct targeted health education. METHODS: Overall, 427 community-dwelling older adults with chronic diseases participated in this study. The Knowledge, Attitude, and Behaviour of Medication Safety among Older Adults with Chronic Diseases Questionnaire was used to assess their home-based medication safety. Multivariate linear regression was used to identify the factors influencing knowledge, attitude, and behaviour regarding medication safety. RESULTS: The average score of home-based medication safety among older adults with chronic diseases was 68.26 ± 8.96, indicating that they had a moderate grasp of medication safety. The scoring rate of each subscale was ranked from high to low as follows: behaviour (84.51%), knowledge (63.33%), and attitude (47.39%). Stepwise linear regression analysis showed that medication safety knowledge, attitudes, and behaviours were significantly associated with higher monthly income, adverse drug events, and taking medicine several times a day (p < 0.05). Additional influencing factors included having fewer chronic diseases, being female, higher educational attainment, taking medicines multiple kinds a day, better self-care ability, and non-hospitalisation for chronic illnesses (p < 0.05). CONCLUSION: Medical staff and community workers should pay attention to the drug safety of older adults with different characteristics and mobilise their enthusiasm for participation to improve their medication self-management ability. TRIAL REGISTRATION: Chinese Clinical Trial Register: ChiCTR2200060987 ; reg. date: 15/06/2022.

Prevalence,antimicrobial resistance patterns and virulence gene analysis of Salmonella spp.originated from ducks in Chengdu area,China / 中国人兽共患病学报

We investigated the contamination,antimicrobial resistance and the virulence genes carriage of Salmonella spp. in duck slaughter chain.Suspected strains were isolated from slaughterhouse samples according to GB 4789.4-2010 and identi-fied by duplex PCR,and then the positive strains were used for serotype analysis.Subsequently,positive strains were tested against 10 different antimicrobial agents using Kirby-Bauer disk diffusion method,the results were determined on the basis of CLSI standard.Finally,9 virulence genes were detected among positive strains by PCR.The results showed that 9 9 Salmonella isolates were recovered from 343 samples and total isolation rate was 28.86%.The prevalence of Salmonella before slaughte-ring,at depilation stage,at evisceration stage,in duck meat and after slaughtering was 45.71%,22.68%,24.72%, 38.33% and 25.81%,respectively.Seven serotypes were de-tected and most of them were S.Indiana,S.Newlands,S. Anatum.The Salmonella isolates were most frequently re-sistant to nalidixic acid(91.92%),the resistance rates of tet-racycline (43.43%),ampicillin (42.42%),trimethoprim-sulfamethoxazole (34.34%),ciprofloxacin (29.29%),ceftri-axone (27.27%),gentamycin (24.24%),and kanamycin (22.22%)were at a medium level.The resistance rates of amoxicillin-clavulanic acid (9.09%)and minocycline (6.06%)were relatively low.The multi-drug resistance rate of Salmonella isolates,which was 47.47%,showed a high especially in S.Indi-ana,S.Typhi and S.Typhimurium.It was notable that the harboring rates of virulence gene spvR(94.95%),avrA (93.94%),ssaQ(90.91%),mgtC(87.88%),sopB(83.84%),bcfC(80.81%),siiD(77.78%)among Salmonella isolates were at high level,in contrast to the lower carriage rates of spvB(29.29%),spvC (11.11%).In summary,the results indica-ted that the duck slaughter chain was easily contaminated by Salmonella spp.with different serotypes,different antibiotic re-sistant patterns and high virulence genes harboring rate.Relevant slaughterhouse and departments should strengthen supervi-sion in sanitation and manage the use of antimicrobial agents,to guarantee food safety and public health．