A cross-sectional study to assess medication safety,knowledge,attitude,and practices regarding nutrition and medication among pregnant women

Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guidelines.Methods:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members.The validated questionnaire was then translated into regional languages,Kannada and Malayalam.The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP questionnaire.The safety of the medication was assessed using the FDA drug safety classification for pregnancy.Results:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,respectively.Among 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during pregnancy.Counselling pregnant women regarding diet and medication usage is crucial in maternal care.

Informing policy makers in developing countries:Practices and limitations of geriatric home medication review in Malaysia-A qualitative inquiry

Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.

Advancements in Medication Rule for Pulmonary Nodules: A Review of Current Research Progress

This paper reviewed the literature on medication rule of pulmonary nodules in recent years. It is found that contemporary doctors pay more attention to regulating Qi, clearing heat and detoxifying, eliminating phlegm, dissolving phlegm and dissipating masses. They use mild drugs, cold and warm treatments in parallel, combining the tastes of pungent, bitterness, and sweetness at the same time. The treatment focuses on the five viscera with emphasis on the lung meridian while also considering the spleen and stomach functions as well as soothing liver stagnation. This information aims to provide some reference for clinical treatment of pulmonary nodules.

Research Progress of Measuring Tools for Patient Medication Compliance

This paper introduced the content, compilation process, reliability and validity, scoring method of the evaluation tool for patients’ medication compliance at home and abroad, and reviewed the research progress of the tool. The evaluation method, dimension, scoring method, evaluation content and application scope of the tool were compared, so as to provide reference for nurses to comprehensively and accurately evaluate patients’ medication status.

Correlation of Hamstring Tendon Size in Pre-Operative MRI Measurement with Intra-Operative Graft Size in Primary Anterior Cruciate Ligament (ACL) Reconstruction

Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in Hospital Pakar Sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction.

Clinical effects of detailed nursing management interventions on medication adherence and disease perception in patients with drugresistant tuberculosis

BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.

Metabolic complications of psychotropic medications in psychiatric disorders:Emerging role of de novo lipogenesis and therapeutic consideration

Although significant advances have been made in understanding the pathophysiology of psychiatric disorders(PDs),therapeutic advances have not been very convincing.While psychotropic medications can reduce classical symptoms in patients with PDs,their long-term use has been reported to induce or exaggerate various pre-existing metabolic abnormalities including diabetes,obesity and non-alcoholic fatty liver disease(NAFLD).The mechanism(s)underlying these metabolic abnormalities is not clear;however,lipid/fatty acid accumulation due to enhanced de novo lipogenesis(DNL)has been shown to reduce membrane fluidity,increase oxidative stress and inflammation leading to the development of the aforementioned metabolic abnormalities.Intriguingly,emerging evidence suggest that DNL dysregulation and fatty acid accumulation could be the major mechanisms associated with the development of obesity,diabetes and NAFLD after long-term treatment with psychotropic medications in patients with PDs.In support of this,several adjunctive drugs comprising of anti-oxidants and antiinflammatory agents,that are used in treating PDs in combination with psychotropic medications,have been shown to reduce insulin resistance and development of NAFLD.In conclusion,the above evidence suggests that DNL could be a potential pathological factor associated with various metabolic abnormalities,and a new avenue for translational research and therapeutic drug designing in PDs.

Analysis of the Effect of Family-Centered Empowerment Model(FCEM)Health Education Through WeChat on Medication Compliance and Blood Pressure of Elderly Hypertensive Patients in Rural Areas

Objective: To validate the effectiveness of a Family-Centered Empowerment Model (FCEM) health education through WeChat on medication compliance and blood pressure among elderly hypertensive patients in rural areas. Methods: One hundred and two rural elderly hypertensive patients aged 65-80 years were selected and randomly divided into an experimental and control group of 51 each. The control group implemented conventional health education, and the experimental group implemented FCEM health education through WeChat platform for 4 consecutive weeks. The Therapeutic Adherence Scale for Hypertensive Patients (TASHP) scores and blood pressure measurements were compared between and within the two groups. Results: After the intervention, there were significant differences in medication compliance and blood pressure between the two groups (P < 0.001). In the control group, before and after the intervention, there was a significant difference in medication compliance (P < 0.001), but no significant difference in blood pressure (P > 0.05). In the experimental group, there were significant differences in medication compliance and blood pressure before and after the intervention (P < 0.001). Conclusion: The FCEM health education through an online social platform significantly improved medication compliance and led to effective blood pressure control in rural elderly hypertensive patients. Therefore, as an effective, safe, and economical model, it is also necessary to explore its effectiveness in improving health problems in other chronic diseases and other age groups.

Evaluation of the Effectiveness of Community Pharmacy Services on Rational Medication Use in Elderly Patients with Hypertension and Diabetes

Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.

Prevalence and clinical implications of polypharmacy and potentially inappropriate medication in elderly patients with heart failure: results of six months' follow-up

OBJECTIVES To investigate the prevalence of polypharmacy and potentially inappropriate medication(PIM)in elderly patients with heart failure(HF)and their impact on readmission and mortality.METHODS We conducted a study of 274 participants aged 60 years or older with HF.The prevalence of polypharmacy(defined as the use of five or more medications)was calculated,and the 2019 American Geriatrics Society Beers criteria were applied to access PIMs.Medications and PIMs were characterized at admission and discharge,and changes in prescriptions during hospitalization were compared.The impact of polypharmacy and PIM on readmission and mortality were investigated.RESULTS The median age of this study population was 68 years old.The median number of prescribed drugs was 7 at admission and 10 at discharge.At discharge,99.27%of all patients were taking five or more drugs.The incidence of composite endpoint and cardiovascular readmission increased with the number of polypharmacy within 6 months.The use of guideline-directed medical therapy reduced the incidence of composite endpoint events and cardiovascular readmission,while the use of noncardiovascular medications increased the composite endpoint events.The frequency of PIMs was 93.79%at discharge.The incidence of composite endpoint events increased with the number of PIMs.“PIMs in older adults with caution”increased cardiovascular readmission and“PIMs based on kidney function”increased cardiovascular mortality.Several comorbidities were associated with cardiovascular mortality or non-cardiovascular readmission.CONCLUSIONS Polypharmacy and PIM were highly prevalent in elderly patients with HF,and their use was associated with an increased risk of composite endpoint events,readmission and mortality.Non-cardiovascular medications,“PIMs in older adults with caution”,“PIMs based on kidney function”and several comorbidities were important factors associated with hospital readmission and mortality.Our findings highlight the importance of medication optimization in the management of HF in elderly patients.

Assessment of knowledge,cultural beliefs,and behavior regarding medication safety among residents in Harbin,China

BACKGROUND Medication misuse or overuse is significantly associated with poor health outcomes.Information regarding the knowledge,cultural beliefs,and behavior about medication safety in the general population is important.AIM To conduct a survey on medication habits and explored the potential factors impacting medication safety.METHODS The current survey included adults from 18 districts and counties in Harbin,China.A questionnaire on medication safety was designed based on knowledge,cultural beliefs,and behavior.Both univariate and multivariate analyses were used to explore the factors that impacted medication safety.RESULTS A total of 394 respondents completed the questionnaires on medication safety.The mean scores for knowledge,cultural beliefs,and behavior about medication safety were 59.41±19.33,40.66±9.24,and 60.97±13.69,respectively.The medication knowledge score was affected by age(P=0.044),education(P<0.001),and working status(P=0.015).Moreover,the cultural beliefs score was significantly affected by education(P<0.001).Finally,education(P=0.003)and working status(P=0.011)significantly affected the behavior score.CONCLUSION The knowledge,cultural beliefs,and behavior about medication safety among the general population was moderate.Health education should be provisioned for the elderly,individuals with a low education level,and the unemployed to improve medication safety in Harbin,China.

Drug utilization evaluation of medications used in the management of neurological disorders

Background and object:The burden of neurological disorders in India is expected to increase due to the rapid demographic and epidemiological transition,with irrational drug use,which is also a global concern.Thus,drug utilization evaluation is designed to ensure appropriate medicine use within the healthcare settings.The aim of the study was to assess the rate and pattern of drug utilization in the management of neurological disorders.Materials and methods:A hospital-based cross-sectional drug utilization evaluation study on neurological drugs was carried out at the Department of Neurology over a span of six months.All legible prescriptions consisting neurological medications irrespective of patient's gender,aged≥18 years were included for the study.The World Health Organization(WHO)core drug use indicators were used to assess the drug prescribing and utilization patterns.Results:A total of 310 prescriptions were reviewed,where male predominance was found to be 56.45%.Out of 310 prescriptions,drugs belonging to 26 neurological classes were prescribed for the management of various neurological disorders.The majority of patients were diagnosed with epilepsy and the most prescribed drugs per patient were phenytoin(14.8%)and valproic acid(6.45%).By following the WHO core drug prescribing indicators,65.47%of drugs prescribed from the India National List of Essential Medicines,2022,followed by 29.83%of drugs prescribed in generic name and 10.86%of prescriptions including injections.Conclusion:The study findings showed that the prescribing pattern in the Department of Neurology was in accordance with the WHO core prescribing indicators.But,the extent of polypharmacy prescriptions was very high.Therefore,interventions are very necessary to promote rational drug prescribing patterns and thus clinical pharmacists can contribute to assess and review the drug utilization pattern to optimize the drug therapy and improvement in patient safety.

Prescription patterns of antidiabetic and cardiovascular preventive medications in community-dwelling older adults with type 2 diabetes mellitus:a cross-sectional study

OBJECTIVE To describe trends in antidiabetics drug prescription patterns in community-dwelling older adults with type 2 dia-betes mellitus(T2DM)and to evaluate the use of cardiovascular preventive medications among those diagnosed with atheroscler-otic cardiovascular disease(ASCVD).METHODS This cross-sectional,face-to-face interview study that comprised community-dwelling older adults(≥65 years)dia-gnosed with T2DM.The study questionnaire included the patients’demographics,clinical data,and current medication use.Pati-ents with established ASCVD were further classified into low(i.e.,not receiving evidence-based therapy or only one)and high(i.e.,receiving at least two evidence-based therapies)composite score groups.Bivariate analysis followed by multivariable logistic re-gression analysis were performed to evaluate the demographic/clinical characteristics associated with the use of antidiabetic mo-notherapy/polytherapy and evidence-based pharmacotherapy.RESULTS A total of 500 older adults were enrolled.The mean age of included participants was 73±7 years,310 participants(62%)were males,and 385 participants(77.0%)had established ASCVD.Antidiabetic monotherapy was reported in 251 partici-pants(50.2%),with metformin followed by sulfonylureas being the most commonly prescribed drugs as monotherapy.The results of the multivariable analysis showed that age[odds ratio(OR)=0.89,95%CI:0.85-0.94,P<0.001],obesity(OR=4.18,95%CI:1.63-10.36,P=0.003),hypertension(OR=4.2,95%CI:1.22-7.66,P=0.04),and dyslipidemia(OR=4.1,95%CI:1.28-8.30,P=0.01),were significantly associated with the prescription of cardiovascular preventive medications.CONCLUSIONS Only one in twenty-one participant with T2DM and ASCVD collectively received three guideline-recommen-ded therapies,indicating a deficiency of utilization of cardiovascular preventive drugs.

Analysis on the medication rule of traditional Chinese medicine in the treatment of COVID-19 patients:Erratum

In the article entitled“Analysis on the medication rule of traditional Chinese medicine in the treatment of COVID-19 patients”[1]which published in Volume 2,Issue 2 of Acupuncture and Herbal Medicine,the following details of methods were omitted:“The‘two hospitals in Wuhan’means Zhongnan Hospital,Wuhan University,and Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology.

Initial medication adherence in newly diagnosed glaucoma patients:three adherence measures

AIM:To determine initial medication adherence in newly diagnosed glaucoma patients treated with anti-glaucoma drugs.METHODS:This retrospective and observational study included all patients diagnosed with glaucoma in the Primary Health Care units in Portugal during the years 2012 and 2013,which in consequence received a first prescription for anti-glaucoma drugs.Data was collected from electronic prescribing records of the primary care units and from pharmacy claims records.Initiation of glaucoma treatment and early discontinuation were measured,and the combination of(non)-initiation and early discontinuation accounted for initial medication(non)-adherence.RESULTS:A total of 3548 new glaucoma patients(40.1%male;59.9%female)were included.The 1133(31.9%)patients were initially classified as non-users,since there was no pharmacy claim found for their first prescription for glaucoma treatment.Additionally,277(11.5%)patients early discontinued their treatment,acquiring only their first prescription.Overall,the initial medication non-adherence rate was 39.7%since 1410 patients either didn’t initiate treatment or discontinued it early.CONCLUSION:This study,reveals a major opportunity to improve glaucoma treatment and its control,since a large proportion of patients fail to engage with their prescribed therapy,which implies that implementation of individual or group strategies that enable patients with glaucoma to correctly perform their treatment is still needed.

A Comparison of Quality of Life, Medication Side-Effect and Adherence among Schizophrenia Patients on Conventional versus Atypical Antipsychotics

Quality of life (QoL) is becoming a widely accepted schizophrenia management outcome. But it is still not very clear if there are any significant differences between the conventional and atypical antipsychotics in terms of QoL improvement among people with schizophrenia (PWS). It is also imperative that antipsychotic drug-related factors, such as medication adherence and side-effect, which could directly or indirectly affect the QoL of PWS, are determined and compared among PWS on different classes of the drugs. Data were collected on Socio-demographic Characteristics, Quality of Life and Medication adherence using Socio-demographic and Schizophrenia Clinical Characteristics questionnaire, World Health Organization Quality of Life (WHOQoL)-Brief, and Morisky Medication Adherence Scale (MMAS) respectively from 250 respondents attending a tertiary health center’s Psychiatric clinic in Kano, Nigeria. Although PWS on the two classes of antipsychotic drugs showed inequalities in different aspects and domains of QoL, as well as in the levels of adherence and side-effects, the differences were all insignificant. However, presence of drug side effects was significantly associated with lower health-related QoL in the conventional antipsychotics group (p = 0.001), and lower score in the physical domain of QoL in the atypical antipsychotics group (p = 0.044). Medication adherence was found to be associated with better scores in different domains of QoL in both groups of PWS. There are no significant differences in terms of QoL, medication side-effect and adherence among PWS on the two classes of antipsychotics. However, drug side-effects and adherence were significantly and respectively associated with lower and higher scores in different domains of QoL in both groups.

Efficacy of ripasudil in reducing intraocular pressure and medication score for ocular hypertension with inflammation and corticosteroid

·AIM:To investigate the efficacy of ripasudil,a Rho kinase inhibitor,in reducing intraocular pressure(IOP)and medication scores of anti-glaucoma drugs in patients with ocular hypertension with inflammation and corticosteroid.·METHODS:The study included 11 patients diagnosed with ocular hypertension with inflammation and corticosteroid,all of whom were prescribed ripasudil eye drops and followed up for at least 2y after the initiation of treatment.IOP was measured using a non-contact tonometer before enrollment and at each follow-up visit.The medication score of glaucoma eye drops was calculated for each patient.·RESULTS:The mean IOP(26.4±2.9 mm Hg before treatment)significantly decreased after ripasudil therapy(13.7±3.3 mm Hg at 3mo)and remained stable in the low-teens during the 2-year follow-up period(P<0.0001).A significant decrease in the medication score was observed at 12mo or later after the initiation of ripasudil therapy(P<0.05).Both baseline medication scores and glaucomatous optic disc change rates were significantly higher in the five eyes that required glaucoma surgery during the 2-year observation period than the 10 eyes that did not require surgery.·CONCLUSION:Our results demonstrate the efficacy of ripasudil,in reducing IOP and the medication score over a 2-year treatment period in patients with ocular hypertension with inflammation and corticosteroid.Our findings also suggest that ripasudil could reduce the IOP in uveitic glaucoma patients with both lower baseline medication score and lower glaucomatous optic disc change rate.

Study on Yan-Xin Wang’s medication experience and regularity in treating Insomnia from the liver based on data mining

Background:Professor Yan-Xin Wang has been committed to the use of traditional Chinese medicine formulas to treat insomnia from the liver for many years,and has achieved excellent clinical results.In order to better inherit Yan-Xin Wang’s academic thoughts.The purpose of this study is to use clinical data to explore the clinical experience of Prof.Yan-Xin Wang in the application of Chinese medicine to treat insomnia patients from the liver,explore the compatibility and medication rules of traditional Chinese medicine,and give more clinical treatment ideas for insomnia.Methods:The general data and prescription information of insomnia patients treated with Chinese herbal medicine by Prof.Yan-Xin Wang from January 1,2021,to December 31,2021,were summarized according to the inclusion and exclusion criteria,and the data were subjected to frequency statistics and drug association rules,complex network diagram analysis and cluster analysis.Results:A total of 159 patients and prescriptions were included in the study,of which 81.1%were women and 18.9%were men,containing 128 herbs;the highest frequency of use was 91.8%for Bupleuri Radix.Six Chinese herbs were used more than 70%of the time,namely Bupleuri Radix,Scutellariae Radix,oyster shell,Glycyrrhizae Radix,Os Draconis,and Ziziphi Spinosae Semen.The top 20 herbs in terms of frequency of use were analyzed in terms of the four Qi,five flavours,and their attributions.The four Qi were mainly calm and warm,the five flavours were mainly bitter and acrid,followed by sweet,and the attributions were mainly to the liver,spleen,and heart meridians.The Chinese medicine association rules set the confidence level>80%and the support level>10%,resulting in 10 two-herb and three-herb associations with the highest confidence level,such as Os Draconis is associated with oyster shell,Platycodonis Radix is associated with Achyranthis Bidentatae Radix,Scutellariae Radix is associated with Bupleuri Radix,Os Draconis,Bupleuri Radix is associated with oyster shell,Os Draconis,Scutellariae Radix is associated with oyster shell,etc.Cluster analysis yielded 3 classes of drug formulas.The complex network diagram shows that the core prescription drugs are composed of Bupleuri Radix,Chuanxiong Rhizoma,Pseudostellariae Radix,Jujubae Fructus,Os Draconis,Coptidis Rhizoma,Scutellariae Radix,Ziziphi Spinosae Semen,Smilacis Glabrae Rhizoma,Cinnamomi Cortex,White Moutan Cortex,Atractylodis Rhizoma,Glycyrrhizae Radix,oyster shell,Rehmanniae Radix Praeparata,Tritici Levis Fructus,Pinelliae Rhizoma Praeparatum,and Cinnamomi Ramulus.Conclusion:Prof.Yan-Xin Wang believes that the main treatment for patients with insomnia is based on the liver,by tonifying the deficiency and supporting the righteousness,mutually regulating the liver and spleen,and calming the mind and nourishing the heart,while adding and subtracting appropriate herbs according to the patient’s co-morbidities,which can significantly improve the patient’s insomnia symptoms.

Knowledge,attitude,and practices related to medication errors among nursing professionals:a questionnaire-based study in a tertiary care hospital

Objective:To evaluate the level of understanding(knowledge),beliefs(attitude),and behavior(practice)of staff nurses toward medication errors(MEs).Methods:Self-administered questionnaires were distributed to nursing professionals who had at least 1 year of work experience.Each questionnaire contained 19 items assessing“knowledge,”“attitude,”and“practice”attributes toward MEs.Results:Responses from 47 nursing respondents were included for the final analysis.The mean knowledge score was 3.8±1.1(out of 6);66%and 79%of the respondents had awareness of medication repor ting systems and interventions in preventing MEs,respectively.Lack of adequate knowledge in recognizing MEs(P=0.003),or presuming MEs are not as important enough to be reported(P=0.002),was considered as the major reason for under-repor ting of MEs.Nurses with higher knowledge score were against administration of medication through a different route than that prescribed by the physician(P=0.023),and tried to rectify an ME(P=0.020)and stayed with the patient until an oral medication had been swallowed(P=0.037).Conclusions:The nursing professionals were aware of the ME repor ting system and methods to prevent the occurrence of MEs.They also exhibited a positive attitude and followed optimal practices in controlling MEs.