Erratum: Effects of COVID-19-targeted non-pharmaceutical interventions on pediatric hospital admissions in North Italian hospitals, 2017 to 2022: a quasi-experimental study interrupted time-series analysis.

[This corrects the article DOI: 10.3389/fpubh.2024.1393677.].

National record and analysis of pharmaceutical interventions in critical care units: PHARMACRITIC study. / Registro nacional y análisis de intervenciones farmacéuticas en unidades de cuidados críticos: estudio FARMACRITIC.

OBJECTIVE: To design a homogeneous methodology for the registration and analysis of pharmaceutical interventions performed in Spanish critical adults' care units. METHOD: Observational, prospective and multicenter study. In the first stage, a national registry of pharmaceutical interventions will be agreed upon and subsequently all the pharmaceutical interventions performed on adult patients admitted to Spanish CCUs during eight weeks will be recorded. Variables related to the type of CCU, the drug involved in the intervention, type of intervention (indication, effectiveness, safety), recommendation made by the pharmacist and the degree of acceptance will be evaluated. Risk and incidence will be calculated for each of the medication errors detected. The χ2-squared test or Fisher exact test will be used for categorical variables and Mann-Whitney U or Kruskal-Wallis test for continuous variables. All tests will be performed with a significance level α = 0.05 and confidence intervals with confidence 1- α. DISCUSSION: The results obtained from this project will make it possible to obtain a homogeneous classification of the pharmaceutical interventions performed in CCU, a national record and an evaluation of the weak points with the aim of developing strategies for improvement in the pharmaceutical care of the critically ill patient.

Understanding the associations between information sources, sociodemographics, and views on public health measures: evidence from the COVID-19 pandemic in Austria.

BACKGROUND: Throughout the COVID-19 pandemic, it was a key priority for governments globally to ensure agreement with, and subsequently adherence to, imposed public health measures, specifically non-pharmaceutical interventions (NPIs). Prior research in this regard highlighted the role of COVID-19 information sources as well as sociodemographic and other personal characteristics, however, there is only limited evidence including both. To bridge this gap, this study investigated the associations of COVID-19 information sources such as social media and participant characteristics with agreement with and adherence to NPIs during the first lockdown in Austria. METHODS: An online survey was conducted in May 2020 among adult Austrian residents asking about their experiences during the first lockdown. Collected data included sociodemographic characteristics, main COVID-19-related information sources, agreement with/adherence to three NPIs (no physical contact to family members not living in the same household, leisurely walks restricted to members of the same household, mandatory face masks) and information about perceived social support using the Multidimensional Scale of Perceived Social Support (MSPSS), anxiety/depression levels using the Hospital Anxiety and Depression Scale (HADS), whether participants felt well advised by the government, and whether participants perceived the pandemic to threaten their income. Ordered and multinomial logistic regression models were employed to achieve the research aims. RESULTS: The cross-sectional sample consisted of 559 Austrian residents. Using social media as main COVID-19 information source was consistently associated with lower agreement with NPIs. A positive association with agreement with measures was found for higher educational backgrounds and higher anxiety levels. By contrast, higher levels of depression, not feeling well advised by the government, and perceiving the pandemic as an economic threat were negatively associated with agreement with measures. Moreover, the use of social media as main COVID-19 information source and not feeling well advised by the government were associated with lower adherence to NPIs. By contrast, higher levels of education were associated with higher adherence. CONCLUSIONS: This comprehensive analysis emphasizes the associations of COVID-19 information sources as well as sociodemographic and other participant characteristics with agreement with and adherence to NPIs, bearing important implications for future public health crisis communication strategies.

An innovative fractional-order evolutionary game theoretical study of personal protection, quarantine, and isolation policies for combating epidemic diseases.

This study uses imposed control techniques and vaccination game theory to study disease dynamics with transitory or diminishing immunity. Our model uses the ABC fractional-order derivative mechanism to show the effect of non-pharmaceutical interventions such as personal protection or awareness, quarantine, and isolation to simulate the essential control strategies against an infectious disease spread in an infinite and uniformly distributed population. A comprehensive evolutionary game theory study quantified the significant influence of people's vaccination choices, with government forces participating in vaccination programs to improve obligatory control measures to reduce epidemic spread. This model uses the intervention options described above as a control strategy to reduce disease prevalence in human societies. Again, our simulated results show that a combined control strategy works exquisitely when the disease spreads even faster. A sluggish dissemination rate slows an epidemic outbreak, but modest control techniques can reestablish a disease-free equilibrium. Preventive vaccination regulates the border between the three phases, while personal protection, quarantine, and isolation methods reduce disease transmission in existing places. Thus, successfully combining these three intervention measures reduces epidemic or pandemic size, as represented by line graphs and 3D surface diagrams. For the first time, we use a fractional-order derivate to display the phase-portrayed trajectory graph to show the model's dynamics if immunity wanes at a specific pace, considering various vaccination cost and effectiveness settings.

Promoción de la adherencia al tratamiento antihipertensivo a través de un servicio de atención farmacéutica apoyado en telefonía móvil / Promoting of Adherence to Antihypertensive Treatment through a Pharmaceutical Care Service Supported by Mobile Phones / Promoção da adesão ao tratamento anti-hipertensivo através de um serviço de assistência farmacêutica apoiado por telefonia móvel

ntroducción: la hipertensión arterial continúa siendo un desafío para la salud pública del Paraguay. La falta de adherencia a los tratamientos es un problema desde los puntos de vista médico, económico y psicosocial. Objetivo: promover la adherencia al tratamiento farmacológico antihipertensivo en pacientes con hiperten-sión que asisten a servicio de salud público, mediante un servicio de atención farmacéutica apoyado en el uso de telefonía móvil. Materiales y métodos: estudio cuasiexperimental en pacientes mayores de 18 años de ambos sexos con hipertensión arterial, en quienes se aplicaron intervenciones farmacéuticas apoyadas con el uso de telefonía móvil (llamada, mensajería sms y WhatsApp) y en quienes se evaluó la adherencia al tratamiento mediante el cuestionario de Morisky-Green, junto con preguntas complementarias para cono-cer las causas de no adherencia. Resultados: participaron 60 pacientes. Al inicio, el 68.3 % (n = 41) mostró adherencia al tratamiento según el cuestionario de Morisky-Green, y el 31.7 % (n = 19) no cumplió con la indicación. Después de las intervenciones se ha encontrado una mayor adherencia al tratamiento, al llegar al 96.7 % los cumplidores (p < 0.001). Entre las causas de no adherencia a la farmacoterapia están el olvido (28.3 %; n = 17), la falta de disponibilidad del medicamento en el hospital (20 %; n = 12) y el costo (10 %; n = 6). Conclusión: la utilización de telefonía móvil como apoyo a la atención farmacéutica podría constituirse en una herramienta para la promoción de la adherencia en pacientes con hipertensión arterial.

Introduction: Arterial hypertension remains a public health challenge in Paraguay; lack of adherence to treatment poses medical, economic, and psychosocial concerns. Information and communication tech-nologies (ICT) are valuable tools in monitoring patients and improving adherence to drug treatment. Objective: Promote adherence to antihypertensive drug treatment among hypertensive patients who attend a public health service by implementing a pharmaceutical care service supported by mobile phones. Materials and methods: A quasi-experimental study was conducted in male and female patients aged 18 years and older with arterial hypertension, in which pharmaceutical interventions supported by mobile telephony (calls, SMS messaging, and WhatsApp) were applied and adherence to treatment was assessed using the Morisky-Green questionnaire with complementary questions to identify the reasons for non-adherence. The research protocol was approved by a Research Ethics Committee of the FCQ-UNA (714/2021). Results: A total of 60 patients participated. Initially, 68.3% (n=41) showed adhe-rence to treatment according to the Morisky-Green questionnaire, while 31.7% (n=19) did not adhere to the indication. After the interventions, an increase in adherence to treatment was observed, with a compliance of 96.7% (p<0.001). Reasons non-adherence to pharmacotherapy included forgetfulness 28.3% (n=17), unavailability of drugs at the hospital 20% (n=12) and cost 10% (n=6).Conclusion: The use of mobile phones to support pharmaceutical care has the potential to serve as a tool for promoting adherence in patients with arterial hypertension

Introdução: A hipertensão arterial continua a ser um desafio para a saúde pública no Paraguai; a falta de adesão aos tratamentos é um problema do ponto de vista médico, econômico e psicossocial. Objetivo:Promover a adesão ao tratamento farmacológico anti-hipertensivo nos doentes com hipertensão que frequentam os serviços públicos de saúde, através de um serviço de assistência farmacêutica apoiado na utilização de telefonia móvel. Materiais e métodos: Estudo quase experimental realizado em pacientes maiores de 18 anos de ambos os sexos com hipertensão arterial; em que foram aplicadas intervenções farmacêuticas apoiadas no uso da telefonia móvel (chamada, mensagem sms e WhatsApp) e a adesão ao tratamento foi avaliada por meio do questionário Morisky-Green, juntamente com perguntas comple-mentares para determinar as causas da não adesão. Resultados. 60 pacientes participaram. No início, 68,3% (n = 41) apresentaram adesão ao tratamento conforme questionário de Morisky-Green e 31,7% (n = 19) não cumpriram a indicação. Após as intervenções constatou-se maior adesão ao tratamento, com adesão chegando a 96,7% (p < 0,001), as causas da não adesão à farmacoterapia foram esquecimento em 28,3% dos casos (n = 17), falta de disponibilidade de medicamentos no hospital 20% (n = 12) e custo 10% (n = 6). Conclusão: a utilização de telefonia móvel para apoio à assistência farmacêutica poderá tornar-se uma ferramenta para promover a adesão ao tratamento em pacientes com hipertensão.

The Changing Detection Rate of Respiratory Syncytial Virus in Adults in Western Australia between 2017 and 2023.

The incidence of respiratory syncytial virus (RSV) in adults is inadequately defined and the impact of SARS-CoV-2-related non-pharmaceutical interventions (NPIs) is underexplored. Using laboratory data, we described the detection rate of RSV in adults ≥16 years in Western Australia (WA) between 2017 and 2023. With the exception of 2020, RSV detections rose annually between 2017 and 2023, reaching 50.7 per 100,000 in 2023 (95% confidence interval [CI], 47.9-53.8). RSV testing expanded considerably across the study period, with the testing in 2023 more than five times the 2017 total. The detection rate was highest in adults ≥60 years between 2017 and 2019, particularly those ≥75 years. Following 2020, the detections in all age groups increased, with the highest detection rate in 2023 in those ≥75-years (199.5 per 100,000; 95% CI, 180.5-220). NPIs significantly impacted RSV seasonality; the preceding winter pattern was disrupted, resulting in an absent 2020 winter season and two major summer seasons in 2020/21 and 2021/22. The RSV season began to realign in 2022, reverting to a winter seasonal pattern in 2023 and the largest season in the study period. Ongoing surveillance will be required to understand the stability of these increases and to delineate the impact of new immunisation strategies.

Effects of COVID-19-targeted non-pharmaceutical interventions on pediatric hospital admissions in North Italian hospitals, 2017 to 2022: a quasi-experimental study interrupted time-series analysis.

Background: The use of Non-Pharmaceutical Interventions (NPIs), such as lockdowns, social distancing and school closures, against the COVID-19 epidemic is debated, particularly for the possible negative effects on vulnerable populations, including children and adolescents. This study therefore aimed to quantify the impact of NPIs on the trend of pediatric hospitalizations during 2 years of pandemic compared to the previous 3 years, also considering two pandemic phases according to the type of adopted NPIs. Methods: This is a multicenter, quasi-experimental before-after study conducted in 12 hospitals of the Emilia-Romagna Region, Northern Italy, with NPI implementation as the intervention event. The 3 years preceding the beginning of NPI implementation (in March 2020) constituted the pre-pandemic phase. The subsequent 2 years were further subdivided into a school closure phase (up to September 2020) and a subsequent mitigation measures phase with less stringent restrictions. School closure was chosen as delimitation as it particularly concerns young people. Interrupted Time Series (ITS) regression analysis was applied to calculate Hospitalization Rate Ratios (HRR) on the diagnostic categories exhibiting the greatest variation. ITS allows the estimation of changes attributable to an intervention, both in terms of immediate (level change) and sustained (slope change) effects, while accounting for pre-intervention secular trends. Results: Overall, in the 60 months of the study there were 84,368 cases. Compared to the pre-pandemic years, statistically significant 35 and 19% decreases in hospitalizations were observed during school closure and in the following mitigation measures phase, respectively. The greatest reduction was recorded for "Respiratory Diseases," whereas the "Mental Disorders" category exhibited a significant increase during mitigation measures. ITS analysis confirms a high reduction of level change during school closure for Respiratory Diseases (HRR 0.19, 95%CI 0.08-0.47) and a similar but smaller significant reduction when mitigation measures were enacted. Level change for Mental Disorders significantly decreased during school closure (HRR 0.50, 95%CI 0.30-0.82) but increased during mitigation measures by 28% (HRR 1.28, 95%CI 0.98-1.69). Conclusion: Our findings provide information on the impact of COVID-19 NPIs which may inform public health policies in future health crises, plan effective control and preventative interventions and target resources where needed.

The impact of quality-adjusted life years on evaluating COVID-19 mitigation strategies: lessons from age-specific vaccination roll-out and variants of concern in Belgium (2020-2022).

BACKGROUND: When formulating and evaluating COVID-19 vaccination strategies, an emphasis has been placed on preventing severe disease that overburdens healthcare systems and leads to mortality. However, more conventional outcomes such as quality-adjusted life years (QALYs) and inequality indicators are warranted as additional information for policymakers. METHODS: We adopted a mathematical transmission model to describe the infectious disease dynamics of SARS-COV-2, including disease mortality and morbidity, and to evaluate (non)pharmaceutical interventions. Therefore, we considered temporal immunity levels, together with the distinct transmissibility of variants of concern (VOCs) and their corresponding vaccine effectiveness. We included both general and age-specific characteristics related to SARS-CoV-2 vaccination. Our scenario study is informed by data from Belgium, focusing on the period from August 2021 until February 2022, when vaccination for children aged 5-11 years was initially not yet licensed and first booster doses were administered to adults. More specifically, we investigated the potential impact of an earlier vaccination programme for children and increased or reduced historical adult booster dose uptake. RESULTS: Through simulations, we demonstrate that increasing vaccine uptake in children aged 5-11 years in August-September 2021 could have led to reduced disease incidence and ICU occupancy, which was an essential indicator for implementing non-pharmaceutical interventions and maintaining healthcare system functionality. However, an enhanced booster dose regimen for adults from November 2021 onward could have resulted in more substantial cumulative QALY gains, particularly through the prevention of elevated levels of infection and disease incidence associated with the emergence of Omicron VOC. In both scenarios, the need for non-pharmaceutical interventions could have decreased, potentially boosting economic activity and mental well-being. CONCLUSIONS: When calculating the impact of measures to mitigate disease spread in terms of life years lost due to COVID-19 mortality, we highlight the impact of COVID-19 on the health-related quality of life of survivors. Our study underscores that disease-related morbidity could constitute a significant part of the overall health burden. Our quantitative findings depend on the specific setup of the interventions under review, which is open to debate or should be contextualised within future situations.

Oral anticancer medicine interventions: A cross-sectional study in French community pharmacies.

INTRODUCTION: The increasing number of oral anticancer medicines (OAMs) dispensed in community pharmacies and the associated challenges (misuse, management of side effects) give the community pharmacist (CP) a major role in the pharmacotherapeutic management of cancer patients. In France, as a response to these challenges, cancer outpatients can schedule a meeting with their CP to ensure the safe and effective use of OAMs. The objectives of this study were to evaluate the perspectives of these interventions regarding their implementation and the opinion of French CPs. METHODS: A declarative survey and semi-structured interviews were conducted with CPs that dispensed at least one OAM between January 2021 and March 2022. The study was conducted between April and August 2022. RESULTS: Eighty-five CPs completed the survey. Of these pharmacists, 21% (n = 18) had already performed OAM interventions and 91% (n = 61) wanted to implement them. Lack of time, knowledge and training were the main barriers to implementation. No correlations were identified between the characteristics of community pharmacies and the likelihood of implementing OAM interventions. CONCLUSIONS: Considering that CPs seem willing to implement them and the favourable context in France, this observational study highlights the potential of OAM interventions to improve the management of cancer patients. Though further studies are required to better evaluate the implementation and the potential effects of these interventions, OAM interventions could be relevant strategies in other healthcare systems to secure the management of cancer patients through the involvement of the CP.

Epidemiology of Escherichia coli bloodstream infection antimicrobial resistance trends across South West England during the first 2 years of the coronavirus disease 2019 pandemic response.

OBJECTIVES: Between 2016 and 2019, the proportion of Escherichia coli bloodstream infection (BSI) with resistance to at least one antibiotic increased nationally. Public health interventions implemented in response to the COVID-19 pandemic changed population contact patterns and healthcare systems, with consequent effects on epidemiological trends of numerous pathogens. We investigated the impact of COVID-19 restrictions on epidemiological trends of E. coli BSI antimicrobial resistance (AMR) across South West England. METHODS: We undertook a retrospective ecological analysis utilizing routine surveillance data of E. coli BSI cases reported to the UK Health Security Agency between 2016 and 2021. We analysed AMR trends for antimicrobial agents including amoxicillin-clavulanate, ciprofloxacin, piperacillin-tazobactam, gentamicin, third-generation cephalosporins and carbapenems before and after the implementation of COVID-19 restrictions (23 March 2020) using Bayesian segmented regression. RESULTS: We identified 19 055 cases. A total of 50.2% were male. Median age was 76 (interquartile range, 65-85 years). Piperacillin-tazobactam (-2.90% [95% highest density interval {HDI} -4.51%, -0.48%]) and ciprofloxacin (-2.40% [95% HDI -4.35%, 0.48%]) resistance demonstrated immediate step changes at the implementation of COVID-19 restrictions. Gentamicin (odds ratio [OR] 0.92 [95% HDI 0.76, 1.12]) and third-generation cephalosporins (OR 0.95 [95% HDI 0.80, 1.14]) exhibited decreasing annual resistance trends after the implementation of COVID-19 restrictions, with moderate evidence for a lower OR after restrictions as compared to the period before (gentamicin Bayes Factor = 5.10, third-generation cephalosporins Bayes Factor = 6.67). DISCUSSION: COVID-19 restrictions led to abrupt and longer term changes to E.coli BSI AMR. The immediate effects suggest altered transmission, whereas changes to resistant E. coli reservoirs may explain trend effects.

Factors associated with compliance with barrier gestures and social distancing measures in France.

BACKGROUND: The COVID-19 pandemic led many countries to drastically limit social activities. The objective of this study is to describe the factors associated with compliance with protective measures and social distancing in the general adult population in France, between March and December 2020 (first and second waves of the epidemic), before vaccination began at the end of December 2020. METHOD: The data come from the CoviPrev repeated cross-sectional descriptive survey, conducted between March 2020 and December 2022 in metropolitan France. The data collected from March to December 2020 (19 survey waves), from a panel representative of the general population, were used. Three periods were defined: the first epidemic wave (March-April), the inter-wave period (May-June) and the second epidemic wave (November-December). A compliance score was constructed to measure systematic compliance with the five main measures. The association between systematic compliance and different variables (sociodemographic, mental health, level of health literacy, perceived severity of COVID-19, confidence in government, perceived effectiveness of the measures) was described using bivariate and multivariate logistic regression models, using the statistical software R. RESULTS: Systematic compliance with the preventive measures changed over time. Regardless of the period, being a woman, being over 50, perceiving COVID-19 as severe, having a high level of health literacy or anxiety were positively associated with compliance. Having a child under 16 years of age and perceiving the measures as effective were positively associated with compliance with the protective measures during the epidemic waves; conversely, having a high level of depression, living alone, not working were negatively associated in the first epidemic wave. Finally, during the inter-wave period, living in an area heavily affected during the first wave and having a high level of education were positively and negatively associated with systematic compliance with the preventive measures, respectively. CONCLUSION: The factors associated with compliance with the protective measures and social distancing evolved during the epidemic. Monitoring this evolution, in order to adapt communication and awareness strategies, is essential in the context of pandemic response.

Enhancing Drug Management, Cost Savings, and Staff Satisfaction in Anesthesiology: A Quality Improvement Project in a Chinese Tertiary Hospital.

INTRODUCTION: In alignment with China's national directive for improved drug management in anesthesiology, the Affiliated Hospital of Qingdao University initiated a quality improvement project, aiming to tackle the prevailing challenges of inefficiencies in drug administration, escalating drug costs, and the notable communication gap between pharmacists and anesthesiologists. METHODS: We employed a Plan-Do-Study-Act methodology to establish a pharmacy team and execute a multidimensional pharmaceutical intervention. The interventions included the formulation of standard procedures, guidelines and regulations, assistance from an information system (including automatic dispensing cabinets and prospective prescription review system), communication feedback (via WeChat groups), and education for anesthesiology staff. The intervention spanned from April to September 2023, focusing on optimizing medication management, achieving cost savings, and enhancing the satisfaction of anesthesia team members, with an additional observation from October to December 2023. RESULTS: Following the interventions, improvements were observed in drug management practices. These enhancements included increased compliance with accounting procedures, more rigorous registration of controlled substances, and more effective disposal of liquid residues. There was no adverse events related to high-alert medications or look-alike drug usage errors. The introduction of automatic dispensing cabinets and a prospective prescription review system markedly improved work efficiency. The utilization of a WeChat group facilitated effective communication about unreasonable prescriptions and drug-related issues. Among the 29,061 patients who underwent surgery both before and after the interventions, significant reductions were observed both in the drug proportion and the per capita drug costs (P = 0.03, P = 0.014, respectively). The per capita drug cost decreased by 20.82%, from ¥723.43 to ¥572.78, consistently remaining below ¥600 throughout the 9-month observation period. The per capita cost of monitoring drugs including dezocine, butorphanol, haemocoagulase agkistrodon, penehyclidine, and ulinastatin experienced a significant reduction (P < 0.05). Additionally, in the satisfaction questionnaires returned, a remarkable 94.44% of anesthesiology staff expressed high satisfaction with the comprehensive pharmaceutical interventions. CONCLUSION: The quality improvement project has yielded remarkable positive outcomes, serving as a model worthy of reference and replication in similar healthcare settings.

Unlocking the importance of perceived governance: The impact on COVID-19 in NUTS-2 European regions.

In the immediate aftermath of the pandemic, governments implemented non-pharmaceutical interventions (NPIs). Previous literature suggests that NPI effectiveness is influenced by governance quality. The acceptance and perceived necessity of these measures by the public are crucial to their success, as NPIs cannot be easily enforced without public support. Does regional governance also play a role? This study examines the correlation between the quality of governance in European NUTS-2 regions and the spread of COVID-19. The findings indicate that overall perceived governance, and its perceived quality and corruption pillars, significantly impact the effectiveness of these interventions. This effect was pronounced during the first wave and then diminished in importance, disappearing before vaccines were available, suggesting that regional governance matters especially in the immediate aftermath of an exogenous shock.

The impact of non-pharmaceutical interventions on the spread of COVID-19 in Saudi Arabia: Simulation approach.

Objectives: This paper aims to measure the impact of the implemented nonpharmaceutical interventions (NPIs) in the Kingdom of Saudi Arabia (KSA) during the pandemic using simulation modeling. Methods: To measure the impact of NPI, a hybrid agent-based and system dynamics simulation model was built and validated. Data were collected prospectively on a weekly basis. The core epidemiological model is based on a complex Susceptible-Exposed-Infectious-Recovered and Dead model of epidemic dynamics. Reverse engineering was performed on a weekly basis throughout the study period as a mean for model validation which reported on four outcomes: total cases, active cases, ICU cases, and deaths cases. To measure the impact of each NPI, the observed values of active and total cases were captured and compared to the projected values of active and total cases from the simulation. To measure the impact of each NPI, the study period was divided into rounds of incubation periods (cycles of 14 days each). The behavioral change of the spread of the disease was interpreted as the impact of NPIs that occurred at the beginning of the cycle. The behavioral change was measured by the change in the initial reproduction rate (R0). Results: After 18 weeks of the reverse engineering process, the model achieved a 0.4 % difference in total cases for prediction at the end of the study period. The results estimated that NPIs led to 64 % change in The R0. Our breakdown analysis of the impact of each NPI indicates that banning going to schools had the greatest impact on the infection reproduction rate (24 %). Conclusion: We used hybrid simulation modeling to measure the impact of NPIs taken by the KSA government. The finding further supports the notion that early NPIs adoption can effectively limit the spread of COVID-19. It also supports using simulation for building mathematical modeling for epidemiological scenarios.

Development and partial validation of Be-CLIPSS: a classification system for hospital clinical pharmacy activities.

BACKGROUND: Documentation of drug related problems (DRPs) and pharmaceutical interventions (PIs) is essential for an objective evaluation of the pharmacist's contribution to pharmacotherapy. However, in Belgium, a nationally used classification system is not available, prohibiting structured and uniform documentation of DRPs and PIs. AIM: To develop and validate a national classification system for in-hospital clinical pharmacy activities, based on literature and field experience, specifically intended for routine registration. METHOD: Based on a literature review, a survey among Belgian hospital pharmacists and a stakeholder focus group, a first version of Be-CLIPSS (Belgian CLInical Pharmacy claSsification System) was developed. Inter-rater reliability of the DRPs and PIs was assessed. Additionally, its usability was reviewed. The system was further refined, followed by a second validation. RESULTS: Both the survey and focus group discussion revealed little use of validated DRP and PI classification systems in Belgium, although these were considered highly desirable if practical and minimally time-consuming. The final classification system encompassed seven clinical pharmacy activities, grouped into four activity classes. The inter-rater reliability for the second activity class was substantial for the DRPs (κ = 0.737) and almost perfect for the PIs (κ = 0.872). The interpretability (86.4%), user-friendliness (61.4%), user satisfaction (84.1%), interest for use in daily practice (68.2%) and difficulty in correctly classifying the DRP and PI (31.8%) were assessed. CONCLUSION: Be-CLIPSS, a newly developed and partially validated classification system for DRPs and PIs, was found to be user-friendly, with a good interpretability and user satisfaction, resulting in a high interest for use in daily practice.

Effectiveness of cloth face masks to prevent viral spread: a meta-analysis.

BACKGROUND: The effectiveness of cloth face masks to prevent viral spread has not yet been conclusively established. In this meta-analysis, we evaluate their effectiveness in comparison to standard medical/surgical and N95-typed masks against viral spread. METHODS: We identified literature through a systematic search in three databases and meta-analytically synthesized relevant studies by means of random-effects as well as multilevel modelling. RESULTS: Twelve studies comprising k = 28 effect sizes (N = 338) were included. Medical/surgical and N95-typed masks outperformed cloth masks, yielding a large effect (g = 1.40). This effect remained robust when data were grouped according to comparisons with medical/surgical masks (g = 1.25) and N95-typed masks (g = 1.29). However, effects were differentiated according to mask fit, indicating reversals of signs when cloth mask effects were compared with ill-fitting medical/surgical and N95-typed masks (gs = -12.50 and - 10.90, respectively). CONCLUSIONS: Cloth face masks were found to have significantly poorer filtering performance than medical/surgical masks and N95 masks, but only if non-cloth masks were properly fitted. Our results illustrate the necessity of using well-fitting medical/surgical or N95-typed masks to prevent viral spread, although some allowance should be made in circumstances where higher compliance with cloth mask mandates are expected.

Predicting the impact of COVID-19 non-pharmaceutical intervention on short- and medium-term dynamics of enterovirus D68 in the US.

Recent outbreaks of enterovirus D68 (EV-D68) infections, and their causal linkage with acute flaccid myelitis (AFM), continue to pose a serious public health concern. During 2020 and 2021, the dynamics of EV-D68 and other pathogens have been significantly perturbed by non-pharmaceutical interventions against COVID-19; this perturbation presents a powerful natural experiment for exploring the dynamics of these endemic infections. In this study, we analyzed publicly available data on EV-D68 infections, originally collected through the New Vaccine Surveillance Network, to predict their short- and long-term dynamics following the COVID-19 interventions. Although long-term predictions are sensitive to our assumptions about underlying dynamics and changes in contact rates during the NPI periods, the likelihood of a large outbreak in 2023 appears to be low. Comprehensive surveillance data are needed to accurately characterize future dynamics of EV-D68. The limited incidence of AFM cases in 2022, despite large EV-D68 outbreaks, poses further questions for the timing of the next AFM outbreaks.

Effect of Pharmaceutical Intervention in Pharmacologically Treated Hypertensive Patients-A Cluster-Randomized Clinical Trial: AFPRES-CLM Study.

BACKGROUND: Evaluate the effect of a community pharmaceutical intervention on the control of blood pressure in hypertensive patients treated pharmacologically. METHODS: A cluster-randomized clinical trial of 6 months was carried out. It was conducted in the Autonomous Community of Castilla-La Mancha (Spain). Sixty-three community pharmacies and 347 patients completed the study. Intervention patients received the community pharmaceutical intervention based on a protocol that addresses the individual needs of each patient related to the control of their blood pressure, which included Health Education, Pharmacotherapy Follow-up and 24 h Ambulatory Blood Pressure Measurement. Control patients received usual care in the community pharmacy. RESULTS: The pharmaceutical intervention resulted in better control of blood pressure (85.8% vs. 66.3% p < 0.001), lower use of emergencies (p = 0.002) and improvement trends in the physical components of quality of life, measured by SF-36 questionnaire, after 6 months of pharmaceutical intervention. No significant changes were observed for any of these variables in the control group. There were also detected 354 negative medication-related outcomes that were satisfactorily resolved in a 74.9% of the cases and 330 healthcare education interventions and 29 Ambulatory Blood Pressure Monitorings were performed in order to increase adherence to pharmacological treatment and minimize Negative Outcomes associated with Medication and prevent medication-related problems. CONCLUSIONS: Community pharmaceutical intervention can increase hypertensive patients with controlled blood pressure, after 6 months, compared with usual care.

Analysis of the effectiveness of non-pharmaceutical interventions on influenza during the Coronavirus disease 2019 pandemic by time-series forecasting.

BACKGROUND: Coronavirus disease 2019 (COVID-19) was first identified in South Korea during the 2019-2020 seasonal influenza epidemic. The social distancing measures, as effective non-pharmaceutical interventions (NPIs), adopted to mitigate the spread of COVID-19 might have influenced influenza activity. We evaluated IFV(influenza virus) activity during the COVID-19 pandemic and the effect of NPI intensity on influenza transmission. METHODS: IFV activity and epidemic duration during COVID-19 pandemic were predicted under a counterfactual scenario with no NPIs against COVID-19. The Seasonal Autoregressive Integrated Moving Average Model was used to quantify the effects of NPIs on the transmission of influenza virus. Influenza-like illness/1000 outpatients and IFV positivity rate from the 2011-2012 to 2021-2022 seasons were used in this study. RESULTS: Comparison of the 2020-2021 and 2021-2022 seasonal influenza activities with those in 2013-2019 showed that COVID-19 outbreaks and associated NPIs such as face mask use, school closures, and travel restrictions reduced the influenza incidence by 91%. Without NPIs against COVID-19, the rates of influenza-like illness and IFV positivity would have been high during the influenza epidemic season, as in previous seasons. NPI intensity decreased the transmission of influenza; the magnitude of the reduction increased as the intensity of social-distancing measures increased (weak social distancing; step-by-step daily recovery: 58.10%, strong social distancing; special quarantine measures: 95.12%). CONCLUSIONS: Our results suggest that NPIs and personal hygiene can be used to suppress influenza transmission. NPIs against COVID-19 may be useful strategies for the prevention and control of influenza epidemics.

Impact of Non-Pharmaceutical Interventions on the Incidence and Treatment of Chronic Rhinosinusitis during the COVID-19 Pandemic: A Nationwide Retrospective Cohort Study.

Many countries have implemented non-pharmaceutical interventions (NPIs) to prevent the spread of COVID-19. However, the impacts of NPIs on the epidemiology and treatment of chronic rhinosinusitis (CRS) remain unclear. We analyzed 671,216 patients to investigate changes in the incidence rate and treatment frequency of CRS using Korean nationwide health insurance data between 2017 and 2021. The incidence rate (p < 0.001) and the number of outpatients (p < 0.001), patients hospitalized (p < 0.001), and patients prescribed antibiotics (p < 0.001) or steroids (p = 0.024) were significantly lower in the pandemic period than in the pre-pandemic period; however, the number of patients who underwent surgery was not different (p = 0.205). Additionally, the frequency of surgeries per patient was significantly lower in patients during the pandemic period (p < 0.001). In the interrupted time series analysis, the trends in the number of outpatients (p < 0.001), patients hospitalized (p < 0.001), patients who underwent surgery (p < 0.001), and patients prescribed antibiotics (p < 0.001) or steroids (p < 0.001) significantly changed after the onset of the COVID-19 pandemic. In summary, NPI implementation during the COVID-19 pandemic was associated with a reduction in the incidence and treatment of CRS.