International Journal of Risk & Safety in Medicine - Volume 35, issue 1

Authors: Ziganshina, Liliya Eugenevna

Article Type: Editorial

DOI: 10.3233/JRS-246000

Citation: International Journal of Risk & Safety in Medicine, vol. 35, no. 1, pp. 1-3, 2024

Authors: Vittengl, Jeffrey R. | Jarrett, Robin B. | Ro, Eunyoe | Clark, Lee Anna

Article Type: Research Article

Abstract: BACKGROUND: Although antidepressant medication (ADM) has produced small advantages over pill placebo in randomized controlled trials, consuming ADM has predicted prospectively increasing depressive symptom severity in samples of community-dwelling adults. OBJECTIVE: We extended the community literature by testing ADM’s relations to changes in personality and quality of life that may underpin depression. METHOD: In this longitudinal, observational study, community-dwelling adults (N  = 601) were assessed twice, 8 months apart on average. Assessments included depressive symptoms, personality, life satisfaction and quality, and prescription medication consumption. RESULTS: Consuming ADM at time 1 predicted relative increases in depressive …symptoms (dysphoria), maladaptive traits (negative affect, negative temperament, disinhibition, low conscientiousness), personality dysfunction (non-coping, self-pathology), and decreases in life satisfaction and quality from time 1 to 2, before and after adjustment for age, gender, race, income, education, physical health problems, and use of other psychotropics. In no analysis did ADM use predict better outcomes. CONCLUSION: Among community-dwelling adults, ADM use is a risk factor for psychosocial deterioration in domains including depressive symptoms, personality pathology, and quality of life. Until mechanisms connecting ADM to poor outcomes in community samples are understood, additional caution in use of ADM and consideration of empirically supported non-pharmacologic treatments is prudent. Show more

Keywords: Antidepressant medications, personality, quality of life, risk, community

DOI: 10.3233/JRS-230016

Citation: International Journal of Risk & Safety in Medicine, vol. 35, no. 1, pp. 5-18, 2024

Authors: Ascenção, R. | Lopes Vaz, P. | Pereira Gomes, C. | Costa, J. | Broeiro-Gonçalves, P.

Article Type: Case Report

Abstract: BACKGROUND: Medication reconciliation is advocated to ensure the continuity, safety, and effective use of medicines across transitions of care. CASE REPORT: In this report, we describe the case of a 90-year-old female with previous diagnoses of atrial fibrillation and cutaneous metastatic breast cancer presenting with bilateral ulcerative lesions on the chest wall. The patient was diagnosed with Deep Vein Thrombosis at the Emergency Department and started on rivaroxaban, although the patient was already taking edoxaban. This therapeutic duplication was noticed only one week later, even though she was already experiencing significant bleeding managed through a prescribing cascade. Despite …the technical error (action-based), it is possible to identify several weaknesses in the organisation’s structure, which provided a trajectory of accident opportunity. CONCLUSION: Anticoagulants are ranked first for the highest priority to receive a medication reconciliation. To achieve an optimal level of medication reconciliation, we ought to recognise and correct latent failures. Show more

Keywords: Case report, medication reconciliation, medication errors, patient safety, continuity of patient care, anticoagulants

DOI: 10.3233/JRS-230002

Citation: International Journal of Risk & Safety in Medicine, vol. 35, no. 1, pp. 19-24, 2024

Authors: Kantemirova, B.I. | Bogorodskaya, E.M. | Poptsova, M.S. | Sychev, D.A. | Tsimbal, E.A. | Stepanova, N.A.

Article Type: Research Article

Abstract: BACKGROUND: There is currently no widespread implementation of pharmacogenetic testing (PGx) methods in the practice of phthisiology service. OBJECTIVE: The aim of this study is to determine how informed and prepared phthisiologists, residents, and postgraduate students of the Russian Medical Academy of Continuing Professional Education (RMACPE, Moscow) use PGx techniques in their work to improve treatment safety, predict the occurrence of adverse reactions (ADRs), and personalize therapy. METHODS: A survey was conducted among phthisiologists (n = 314) living in different regions of the Russian Federation and studying at RMACPE, such as residents and post-graduate students (n …= 185). The survey was developed on the Testograf.ru web platform and had 25 questions for physicians and 22 for residents and post-graduate students. RESULTS: More than 50% of respondents are ready to use PGx in clinical practice and thus are aware of the method’s possibilities. At the same time only a small part of participants were aware of the pharmgkb.org resource. The absence of PGx in clinical guidelines and treatment standards, according to 50.95% of phthisiologists and 55.13% of students of RMACPE, the absence of large-scale randomized clinical trials, according to 37.26% of phthisiologists and 43.33% of students, and the lack of physician knowledge on PGx, according to 41.08% of phthisiologists and 57.83% of students, are all factors that prevent the implementation of PGx in Russia. CONCLUSION: According to the survey, the overwhelming majority of participants recognize the importance of PGx and are willing to use the method in practice. However, there is a low level of awareness among all respondents about the possibilities of PGx and the pharmgkb.org resource. The implementation of this service could significantly increase patient compliance, lower ADRs, and enhance anti-tuberculosis (TB) therapy quality. Show more

Keywords: Respiratory tuberculosis, clinical practice, adverse drugs reactions, pharmacogenetics, physician opinions, survey

DOI: 10.3233/JRS-220028

Citation: International Journal of Risk & Safety in Medicine, vol. 35, no. 1, pp. 25-36, 2024

Authors: Sychev, Ivan V. | Denisenko, Natalia P. | Kachanova, Anastasiya A. | Lapshtaeva, Anna V. | Abdullaev, Sherzod P. | Goncharova, Ludmila N. | Mirzaev, Karin B. | Sychev, Dmitry A.

Article Type: Research Article

Abstract: BACKGROUND: Angioneurotic edema is the most dangerous complication in angiotensin-converting enzyme inhibitors (ACEIs) therapy. Based on the current data, the clinical and genetic predictors of angioedema development are still understudied, which demonstrates the relevance of this study. OBJECTIVE: To reveal the pharmacogenetic predictors of the angioedema as a secondary side effect to enalapril in patients with essential arterial hypertension. METHODS: The study enrolled 111 subjects randomized into two groups: study group, patients with the angioedema as a secondary side effect to enalapril; and control group, patients without adverse drug reaction. All patients underwent pharmacogenetic testing. …RESULTS: An association between the development of the angioneurotic edema and the genotypes AA rs2306283 of gene SLCO1B1 , TT rs4459610 of gene ACE , and CC rs1799722 of gene BDKRB2 in patients was revealed. CONCLUSION: The findings justify further investigations of the revealed genetic predictors of angioedema with larger-size patient populations. Show more

Keywords: ACE inhibitors, enalapril, adverse drug reaction, hypertensive disease, angioedema

DOI: 10.3233/JRS-230006

Citation: International Journal of Risk & Safety in Medicine, vol. 35, no. 1, pp. 37-47, 2024

Authors: Panggabean, Bungaran | Suharjo, Budi | Sumarwan, Ujang | Yuliati, Lilik Noor

Article Type: Research Article

Abstract: BACKGROUND: The global COVID-19 pandemic has forced people to obtain health products and services from home. Similar to other e-commerce, medicines are bought online and delivered using a courier service. OBJECTIVE: By being fully concerned to patient safety, this study aims to determine development strategies to increase intention in purchasing prescription drugs through e-pharmacy. METHODS: Two stages of measurement are employed in this study, namely confirmatory factor analyis using PLS-SEM and pairwise comparison using AHP method. To discover consumer perception in using e-pharmacy, the basic model of Theory of Planned Behavior (TPB) is employed with several …extensions. RESULTS: The results of PLS-SEM express that Trust has a major role as an intervening variable to enhance the indirect effect of Subjective Norms and Perceived Values on Purchase Intention. In general, PLS-SEM structural model is declared “fit” (GFI = 0.93 ≥ 0.90; RMSEA = 0.045 ≤ 0.08; SRMR = 0.033 ≤ 0.05). Measurement model test proves that all selected indicators are valid to represent their related constructs (Loading Factor ≥ 0.50), and all selected constructs are reliable to build the whole path model (CR ≥ 0.7; AVE ≥ 05). Meanwhile, the results of AHP indicate that strengthening government policies and regulations is prioritized to increase consumer intention of purchasing prescription drugs through e-pharmacy, followed by protection of user confidential data in the second place. Those two eigenvectors are 0.236 and 0.185 respectively. CONCLUSION: Future research is suggested to add perceived risk as latent variable in the study of consumer behavior for any high-risk products. Show more

Keywords: AHP, e-pharmacy, extended theory of planned behavior, PLS-SEM, prescription drugs

DOI: 10.3233/JRS-220067

Citation: International Journal of Risk & Safety in Medicine, vol. 35, no. 1, pp. 49-73, 2024

Authors: Mohammadpour, Ali | Bouraghi, Hamid | Khodaveisi, Taleb | Imani, Behzad | Ghazikhanlousani, Karim | Azmoonfar, Rasool | Khosravi, Hossein | Rafieemehr, Hassan

Article Type: Research Article

Abstract: BACKGROUND: Healthcare organizations are among high-risk organizations due to the nature of their work as well as structural, physical and technological complexities. Accordingly, it is important to use risk management and control programs in all departments of these organizations. OBJECTIVE: The present study was conducted for the first time to evaluate the risk management status of the operating room and laboratory departments of Hamadan hospitals in 2022. METHODS: In this descriptive-observational cross-sectional study, laboratory and operating room departments were selected as the research environment. To conduct this research, a valid and reliable questionnaire was used …to collect data, and the data were analyzed using SPSS 22 statistical software. RESULTS: The findings of the present study showed that the overall mean score of risk management status for the laboratory and operating room departments was 2.66 ± 0.15 and 2.89 ± 0.13, respectively. Furthermore, there was no statistically significant difference in the mean scores of the research components based on work experience, education level, and gender. CONCLUSION: It is suggested that the laboratory and operating room departments should focus more on adopting policies and solutions to improve the position of risk management, training and budget allocation for risk management. Show more

Keywords: Risk, laboratory, operating room, hospital, evaluation, assessment

DOI: 10.3233/JRS-220066

Citation: International Journal of Risk & Safety in Medicine, vol. 35, no. 1, pp. 75-89, 2024

Authors: Rodríguez-Ramos, Miguel Alejandro | Santos-Medina, Maikel | Dueñas-Herrera, Alfredo | Prohías Martínez, Juan Adolfo | Rivas-Estany, Eduardo

Article Type: Position Paper

Abstract: BACKGROUND: Data about performance measures (PM) in patients with ST segment Elevation Myocardial Infarction (STEMI) in low- and middle-income countries is really scarce. One of the reasons is the lack of appropriate measures for these scenarios where coronary intervention is not the standard treatment. OBJECTIVE: This study aimed to develop a set of PM and quality markers for patients with STEMI in these countries. METHODS: Two investigators systematically reviewed existing guidelines and scientific literature to identify potential PM by referring to documents searched through PubMed from 2010 through 2019, using terms “Myocardial Infarction”, “STEMI”, “quality indicator”, …and “performance measure”. A modified Delphi technique, involving multidisciplinary panel interview, was used. A 15-member multidisciplinary expert panel individually rated each potential indicator on a scale of 1 (lowest) to 5 (highest) during three rounds. All indicators that received a median score ≥4.5, in final round without significant disagreement were included as PM. RESULTS: Through the consensus-building process, 84 potential indicators were found, of which 10 were proposed as performance measures and 2 as quality metrics, as follows: Pre-Hospital Electrocardiogram; Patients with reperfusion therapy; Pre-hospital Reperfusion; Ischemic time less than 120 minutes; System delay time less than 90 minutes; In-hospital Mortality; Complete in-hospital Treatment; Complete in-hospital Treatment in patients with Heart Failure; 30 day-Re-admissions; 30 day-mortality; Patients with in-hospital stress test performed; and, Patients included in rehabilitation programs. CONCLUSION: This document provides the official set of PM of attention in ST segment Elevation Myocardial Infarction of the Cuban Society of Cardiology and Cuban National Group of Cardiology. Show more

Keywords: Performance measures, quality markers, STEMI, Cuba, low- and middle-income countries

DOI: 10.3233/JRS-220057

Citation: International Journal of Risk & Safety in Medicine, vol. 35, no. 1, pp. 91-100, 2024