Background: Novel coronavirus (COVID-19) and subsequent quarantine could raise the risk of food inadequacy and nutrition deficiency crises. Objectives: This study aimed to assess the impacts of COVID-19 on household food security in Jordan, determined the percentage of food security and the levels of food insecurity during the quarantine, determined the associated factor with food insecurity, and determined main food groups associated with FINS during the quarantine. Design: A cross-sectional study was conducted using a Web-based validated questionnaire. The Food Insecurity Experience Scale was used to measure the food insecurity during the first four weeks of the quarantine, and a modified food consumption score was used to determine the number of times the household consumes each food group. Univariate and multiple logistic regression models were used to describe, explore, and predict risk factors correlated with food insecurity among Jordanians, during the first four weeks of the quarantine. Results: A total of 3129 Jordanians had responded to the assessment and fully answered the questionnaire. 23.1% of the total participants were severe food insecure, while 36.1% were moderate food insecure, 40.7% were food secure. The regression model demonstrated the monthly income per capita below the poverty line and a number of the family member (1e4 and 5e7) associated significantly with moderate food insecurity (OR: 5.
Aims To assess the knowledge and practices toward diabetes in the Jordanian community. Methods This study was conducted as a public based cross-sectional study in different cities in Jordan. A previously published validated questionnaire about knowledge, attitudes, and practices (KAP) toward diabetes mellitus (DM) was translated from the Arabic version and used in this study with very minor modification to be suitable for this study of the Jordanian population. Results A total of 1,702 participants were recruited in the present study. About half of the participants (53.3%) had good knowledge scores. The respondents’ knowledge scores were significantly correlated with attitudes ( p < 0.001). The education level (university or higher) and education related to a field were predictors for good knowledge and positive attitudes. About 46.3% of participants had positive attitudes toward the disease. As for practices, 37.7% of participants did not engage in regular exercise while more than half of the study subjects had never checked their blood glucose level on an annual basis. The factors influencing the practice of checking blood glucose level have been investigated. Conclusion This study has highlighted the need for more educational interventions to address negative attitudes and promote healthy lifestyle practices and regular health checks especially in certain subgroups of patients, such as those not having a degree related to the medical field and not having a first-degree relative with DM.
AIMSTo implement pharmacist-led, postdischarge telephone follow-up (TFU) intervention and to evaluate its impact on rehospitalization parameters in polypharmacy patients, via comparison with a well-matched control group. METHODPragmatic, prospective, quasi-experimental study. Intervention patients were matched by propensity score techniques with a control group. Guided by results from a pilot study, clinical pharmacists implemented TFU intervention, added to routine integrated medicines management service. RESULTSUsing an intention to treat approach, reductions in 30-and 90-day readmission rates for intervention patients compared with controls were 9.9% [odds ratio = 0.57; 95% confidence interval (CI): 0.36-0.90; P < 0.001] and 15.2% (odds ratio = 0.53; 95% CI: 0.36-0.79; P = 0.021) respectively. Marginal mean time to readmission was 70.9 days (95% CI: 66.9-74.9) for intervention group compared with 60.1 days (95% CI: 55.4-64.7) for controls. Mean length of hospital stay compared with control was (8.3 days vs. 6.7 days; P < 0.001). Benefit: cost ratio for 30-day readmissions was 29.62, and 23.58 for 90-day interval. Per protocol analyses gave more marked improvements. In intervention patients, mean concern scale score, using Beliefs about Medicine Questionnaire, was reduced 3.2 (95% CI: -4.22 to À2.27; P < 0.001). Mean difference in Medication Adherence Report Scale was 1.4 (22.7 vs. 24.1; P < 0.001). Most patients (83.8%) reported having better control of their medicines after the intervention. CONCLUSIONS Pharmacist-led postdischarge structured TFU intervention can reduce 30-and 90-day readmission rates. Positive impacts were noted on time to readmission, length of hospital stay upon readmission, healthcare costs, patient beliefs about medicines, patient self-reported adherence and satisfaction. British Journal of Clinical Pharmacology Br J Clin Pharmacol (2019) 85 616-625 616• Telephone follow-up (TFU) is a well-established and widely used approach for exchanging information with patients. It has been applied in continuity of care after hospitalization. • Mixed results have been reported when TFU was combined with predischarge and other postdischarge interventions. WHAT THIS STUDY ADDS• This study applied the Perceptions and Practicalities Approach, endorsed by the National Institute for Health and CareExcellence Medicines Guidelines, to tailor medication support to meet the needs of the individual. • We utilized propensity score matching to obtain a well-matched control group, to determine the impact of a pharmacistled postdischarge telephone intervention on readmission rate. • This is the first study to present the benefit-cost ratio of the impact of TFU on readmission rate. Continuityof patient care post-hospitalisation Br J Clin Pharmacol (2019) 85 616-625 617 Continuity of patient care post-hospitalisation Br J Clin Pharmacol (2019) 85 616-625 623
Background There is a major drive within healthcare to reduce patient readmissions, from patient care and cost perspectives. Pharmacist-led innovations have been demonstrated to enhance patient outcomes. Objective To assess the impact of a post-discharge, pharmacist-led medicines optimisation clinic on readmission parameters. Assessment of the economic, clinical and humanistic outcomes were considered. Setting Respiratory and cardiology wards in a district general hospital in Northern Ireland. Method Randomised, controlled trial. Blinded random sequence generation; a closed envelope-based system, with block randomisation. Adult patients with acute unplanned admission to medical wards subject to inclusion criteria were invited to attend clinic. Analysis was carried out for intention-to-treat and per-protocol perspectives. Main Outcome Measure 30-day readmission rate. Results Readmission rate reduction at 30 days was 9.6% (P = 0.42) and the reduction in multiple readmissions over 180-days was 29.1% (P = 0.003) for the intention-to-treat group (n = 31) compared to the control group (n = 31). Incidence rate ratio for control patients for emergency department visits was 1.65 (95% CI 1.05-2.57, P = 0.029) compared with the intention-to-treat group. For unplanned GP consultations the equivalent incident rate ratio was 2.00 (95% CI 1.18-3.58, P = 0.02). Benefit to cost ratio in the intention-to-treat and per-protocol groups was 20.72 and 21.85 respectively. Patient Health Related Quality of Life was significantly higher at 30-day (P < 0.001), 90-day (P < 0.001) and 180-day (P = 0.036) time points. A positive impact was also demonstrated in relation to patient beliefs about their medicines and medication adherence. Conclusion A pharmacist-led post-discharge medicines optimisation clinic was beneficial from a patient care and cost perspective.
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