Objective: To investigate the association of concurrent use of oral anticoagulants (OACs) and sul... more Objective: To investigate the association of concurrent use of oral anticoagulants (OACs) and sulfonylureas and the risk of hypoglycemia in individuals with type 2 diabetes mellitus (T2DM). Research Design and Methods: A retrospective cohort study was conducted between 2001 and 2017 using electronic primary healthcare data from the IQVIA Medical Research Data (IMRD) that incorporates data supplied by The Health Improvement Network (THIN), a propriety database of Cegedim SA. Individuals with T2DM who received OAC prescription and sulfonylureas were included. We compared the risk of hypoglycemia with sulfonylureas and OACs using propensity score matching and Cox regression. Results: 109,040 individuals using warfarin and sulfonylureas and 77,296 using direct oral anticoagulants (DOACs) and sulfonylureas were identified and included. There were 285 hypoglycemia events in the warfarin with sulfonylureas group (incidence rate = 17.8 per 1,000 person-years), while in the sulfonylureas only, 304 hypoglycemia events were observed (incidence rate = 14.4 per 1,000 person-years). There were 14 hypoglycemic events in the DOACs with sulfonylureas group (incidence rates = 14.8 per 1,000 person-years), while in the sulfonylureas alone group, 60 hypoglycemia events were observed (incidence rate =23.7 per 1,000 person-years). Concurrent use of warfarin and sulfonylureas was associated with increased risk of hypoglycemia compared with sulfonylureas alone (HR 1.38; 95%
Introduction: We aimed to determine trends and patterns of symptomatic medication used against de... more Introduction: We aimed to determine trends and patterns of symptomatic medication used against dementia in 66 countries and regions. Methods: This was a cross-sectional study that used the wholesale data from the IQVIA-Multinational Integrated Data Analysis System database. Sale data for symptomatic medication against dementia from 66 countries and regions from 2008 to 2018 were analyzed, and stratified by income level (Low/Middle-income countries (LMICs), n=27; High-income countries (HICs), n=37; regions, n=2). The medication use volume was estimated by Defined Daily Dose per 1000 inhabitants per day (DDDTID)(WHO DDD, harmonized the size, strength and form of each pack and reflects average dosing). Changes in medication use over time were quantified as percentage changes in compound annual growth rates (CAGR). Results: Total symptomatic medication against dementia sales increased from 0.85 to 1.33 DDDTID between 2008 and 2018 (LMICs: 0.094 to 0.396; HICs: 3.88 to 5.04), which is an increase of CAGR of 4.53% per year. The increase was mainly driven by the LMICs (CAGR=15.42%) in comparison to the HICs (CAGR=2.65%). The overall medication use from 2008 to 2018 increased for all four agents: memantine (CAGR=8.51%), rivastigmine (CAGR=6.91%), donepezil (CAGR=2.72%), and galantamine (CAGR=0.695%). In 2018, the most commonly used medications globally was donepezil contributed to 49.8% of total use volume, followed by memantine (32.7%), rivastigmine (11.24%) and galantamine (6.36%). 4 Conclusion: There was an increasing trend in use of symptomatic medications against dementia globally, but the use remained low in LMICs. Interventions may be needed to support the medication use in some countries.
Background: Few studies have shown that an increased risk of dementia is associated with diabetes... more Background: Few studies have shown that an increased risk of dementia is associated with diabetes mellitus. Objective: To estimate the prevalence and incidence of dementia in people with diabetes in primary care in the UK. Methods: We conducted a descriptive study using the UK The Health Improvement Network (THIN) database. People diagnosed with diabetes from 2000 to 2016 were included in the study. Prevalence and incidence rates of dementia were calculated annually, stratified by age and gender. Results: The prevalence of dementia was 0.424% [95%CI (0.420%-0.427%)] in 2000 and 2.508% [95% CI (2.501%-2.515%)] in 2016. The highest prevalence was in those aged 85+ from 2.9% [95%CI (2.890%-2.974%)] in 2000 to 11.3% [95% CI (11.285%-11.384%)] in 2016. The incidence of dementia increased 3.7 times, from 0.181 cases per 100 persons [95% CI (0.179-0.183)] in 2000 to 0.683 cases per 100 persons [95%CI (0.679-0.686)] in 2016, respectively. Women had a higher prevalence and incidence of dementia than men 3.138% [95% CI (3.127%-3.150%)] vs 2.014% [95% CI (2.006%-2.022%)] and 0.820 [95% CI (0.814-0.826)] vs 0.576 cases per 100 persons [95%CI (0.571-0.580)] in 2016, respectively. Conclusion: There was a trend of increasing prevalence and incidence of dementia in people with diabetes over the period of 2000 to 2016. This study adds to the evidence on dementia prevalence and incidence, particularly in the diabetic population.
Diabetes Research and Clinical Practice, Dec 1, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
BackgroundHypoglycaemia commonly occurs in patients diagnosed with diabetes mellitus (DM) and dem... more BackgroundHypoglycaemia commonly occurs in patients diagnosed with diabetes mellitus (DM) and dementia. The impact of dementia on hypoglycaemic events is controversial. Thus, we evaluated whether dementia increases the risk of hypoglycaemic events in older patients diagnosed with DM.DesignA retrospective cohort study.SettingWe used the IQVIA Medical Research Data (IMRD-UK) database (formerly known as the THIN database).ParticipantsAll patients aged ≥55 years and diagnosed with DM who were prescribed at least two prescriptions of antidiabetic medication between 2000 and 2017. Two groups of patients, dementia and non-dementia group, were propensity-score (PS) matched at 1:2. The risk of hypoglycaemia was assessed through a Cox regression analysis.Main outcome and measuresHypoglycaemic events were determined during the follow-up period by Read codes.ResultsFrom the database, 133,664 diabetic patients were identified, with a mean follow-up of 6.11 years. During the study period, 7,762 d...
ObjectiveTo evaluate the attitudes of undergraduate pharmacy students towards patient safety in s... more ObjectiveTo evaluate the attitudes of undergraduate pharmacy students towards patient safety in six developing countries.DesignA cross-sectional study.SettingParticipants were enrolled from the participating universities in six countries.ParticipantsUndergraduate pharmacy students from the participating universities in six developing countries (Jordan, Saudi Arabia, Kuwait, Qatar, India and Indonesia) were invited to participate in the study between October 2018 and September 2019.Primary outcomeAttitudes towards patient safety was measured using 14-item questionnaire that contained five subscales: being quality-improvement focused, internalising errors regardless of harm, value of contextual learning, acceptability of questioning more senior healthcare professionals’ behaviour and attitude towards open disclosure. Multiple-linear regression analysis was used to identify predictors of positive attitudes towards patient safety.ResultsA total of 2595 students participated in this stud...
As of 14 th July 2020, 12,964,809 confirmed cases of coronavirus (COVID-19) and 570,288 deaths ha... more As of 14 th July 2020, 12,964,809 confirmed cases of coronavirus (COVID-19) and 570,288 deaths had been reported globally. In Kuwait, the numbers stood at 55,508 confirmed cases and 393 deaths. The disease seems to be hitting hard on the country despite the measures that have been put in place. The current study sought to examine healthcare workers HCWs awareness and perceptions of coronavirus disease in Kuwait hospitals. A prospective study design was used to examine the development of the disease among 28 HCWs between mid-May and the start of June 2020. The primary findings were as follows; most of the study participants had attended lectures/ discussions on COVID-19, only few HCWs could identify the incubation period of the novel coronavirus. However, the majority could identify the most common symptoms of the disease as fever, cough, headache, sore throat, runny nose, and skin rashes. Most of the HCWs were aware that the virus transmitted through contact. A good number of the study participants also identified pneumonia, respiratory failure and death as complications associated with coronavirus disease. The study recommends running health education programs in Kuwait to promote knowledge on the coronavirus and help the HCWs develop positive attitudes and uphold important practices.
International Journal of Pharmaceutical Research, 2020
Introduction: The WHO announced on 30 January 2020 the respiratory tract infection outbreak cause... more Introduction: The WHO announced on 30 January 2020 the respiratory tract infection outbreak caused by Coronavirus 2019 (COVID-19) that was first recognized in China to be a global public health emergency. Objective: To investigate healthcare professional's knowledge and awareness about COVID-19. Methods: The study was conducted across four hospitals in Saudi Arabia and two hospitals in Kuwait. The questionnaire was completed between 18 th May and the end of June 2020. Results: A total of 460 healthcare professionals completed the questionnaire, 37.8%(n=174) were males. The age of the participants ranged from 18 to 64 and 80.4% (n=370) of the participants were aged 34 or below. Official government websites 54.8% (n=252) and social media 43.3% (n=199) were the major reliable information sources related to COVID-19. only 37% (n=170) mentioned that the coronavirus disease could transmit through contact. In addition, only 42% (n=191) of the study participants had the correct knowledge about the incubation period of the disease. Moreover, 43.5% (n=200) of the participants were able to identify the symptoms of COVID-19. Conclusion: The study recommended the need to focus more on educational and awareness programs targeting all healthcare professionals to ensure the best practice and provide the optimal care.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Background: Few studies have shown that an increased risk of dementia is associated with diabetes... more Background: Few studies have shown that an increased risk of dementia is associated with diabetes mellitus. Objective: To estimate the prevalence and incidence of dementia in people with diabetes in primary care in the UK. Methods: We conducted a descriptive study using the UK The Health Improvement Network (THIN) database. People diagnosed with diabetes from 2000 to 2016 were included in the study. Prevalence and incidence rates of dementia were calculated annually, stratified by age and gender. Results: The prevalence of dementia was 0.424% [95%CI (0.420%-0.427%)] in 2000 and 2.508% [95% CI (2.501%-2.515%)] in 2016. The highest prevalence was in those aged 85+ from 2.9% [95%CI (2.890%-2.974%)] in 2000 to 11.3% [95% CI (11.285%-11.384%)] in 2016. The incidence of dementia increased 3.7 times, from 0.181 cases per 100 persons [95% CI (0.179-0.183)] in 2000 to 0.683 cases per 100 persons [95%CI (0.679-0.686)] in 2016, respectively. Women had a higher prevalence and incidence of dementia than men 3.138% [95% CI (3.127%-3.150%)] vs 2.014% [95% CI (2.006%-2.022%)] and 0.820 [95% CI (0.814-0.826)] vs 0.576 cases per 100 persons [95%CI (0.571-0.580)] in 2016, respectively. Conclusion: There was a trend of increasing prevalence and incidence of dementia in people with diabetes over the period of 2000 to 2016. This study adds to the evidence on dementia prevalence and incidence, particularly in the diabetic population.
Objective: To investigate the association of concurrent use of oral anticoagulants (OACs) and sul... more Objective: To investigate the association of concurrent use of oral anticoagulants (OACs) and sulfonylureas and the risk of hypoglycemia in individuals with type 2 diabetes mellitus (T2DM). Research Design and Methods: A retrospective cohort study was conducted between 2001 and 2017 using electronic primary healthcare data from the IQVIA Medical Research Data (IMRD) that incorporates data supplied by The Health Improvement Network (THIN), a propriety database of Cegedim SA. Individuals with T2DM who received OAC prescription and sulfonylureas were included. We compared the risk of hypoglycemia with sulfonylureas and OACs using propensity score matching and Cox regression. Results: 109,040 individuals using warfarin and sulfonylureas and 77,296 using direct oral anticoagulants (DOACs) and sulfonylureas were identified and included. There were 285 hypoglycemia events in the warfarin with sulfonylureas group (incidence rate = 17.8 per 1,000 person-years), while in the sulfonylureas only, 304 hypoglycemia events were observed (incidence rate = 14.4 per 1,000 person-years). There were 14 hypoglycemic events in the DOACs with sulfonylureas group (incidence rates = 14.8 per 1,000 person-years), while in the sulfonylureas alone group, 60 hypoglycemia events were observed (incidence rate =23.7 per 1,000 person-years). Concurrent use of warfarin and sulfonylureas was associated with increased risk of hypoglycemia compared with sulfonylureas alone (HR 1.38; 95%
Introduction: We aimed to determine trends and patterns of symptomatic medication used against de... more Introduction: We aimed to determine trends and patterns of symptomatic medication used against dementia in 66 countries and regions. Methods: This was a cross-sectional study that used the wholesale data from the IQVIA-Multinational Integrated Data Analysis System database. Sale data for symptomatic medication against dementia from 66 countries and regions from 2008 to 2018 were analyzed, and stratified by income level (Low/Middle-income countries (LMICs), n=27; High-income countries (HICs), n=37; regions, n=2). The medication use volume was estimated by Defined Daily Dose per 1000 inhabitants per day (DDDTID)(WHO DDD, harmonized the size, strength and form of each pack and reflects average dosing). Changes in medication use over time were quantified as percentage changes in compound annual growth rates (CAGR). Results: Total symptomatic medication against dementia sales increased from 0.85 to 1.33 DDDTID between 2008 and 2018 (LMICs: 0.094 to 0.396; HICs: 3.88 to 5.04), which is an increase of CAGR of 4.53% per year. The increase was mainly driven by the LMICs (CAGR=15.42%) in comparison to the HICs (CAGR=2.65%). The overall medication use from 2008 to 2018 increased for all four agents: memantine (CAGR=8.51%), rivastigmine (CAGR=6.91%), donepezil (CAGR=2.72%), and galantamine (CAGR=0.695%). In 2018, the most commonly used medications globally was donepezil contributed to 49.8% of total use volume, followed by memantine (32.7%), rivastigmine (11.24%) and galantamine (6.36%). 4 Conclusion: There was an increasing trend in use of symptomatic medications against dementia globally, but the use remained low in LMICs. Interventions may be needed to support the medication use in some countries.
Background: Few studies have shown that an increased risk of dementia is associated with diabetes... more Background: Few studies have shown that an increased risk of dementia is associated with diabetes mellitus. Objective: To estimate the prevalence and incidence of dementia in people with diabetes in primary care in the UK. Methods: We conducted a descriptive study using the UK The Health Improvement Network (THIN) database. People diagnosed with diabetes from 2000 to 2016 were included in the study. Prevalence and incidence rates of dementia were calculated annually, stratified by age and gender. Results: The prevalence of dementia was 0.424% [95%CI (0.420%-0.427%)] in 2000 and 2.508% [95% CI (2.501%-2.515%)] in 2016. The highest prevalence was in those aged 85+ from 2.9% [95%CI (2.890%-2.974%)] in 2000 to 11.3% [95% CI (11.285%-11.384%)] in 2016. The incidence of dementia increased 3.7 times, from 0.181 cases per 100 persons [95% CI (0.179-0.183)] in 2000 to 0.683 cases per 100 persons [95%CI (0.679-0.686)] in 2016, respectively. Women had a higher prevalence and incidence of dementia than men 3.138% [95% CI (3.127%-3.150%)] vs 2.014% [95% CI (2.006%-2.022%)] and 0.820 [95% CI (0.814-0.826)] vs 0.576 cases per 100 persons [95%CI (0.571-0.580)] in 2016, respectively. Conclusion: There was a trend of increasing prevalence and incidence of dementia in people with diabetes over the period of 2000 to 2016. This study adds to the evidence on dementia prevalence and incidence, particularly in the diabetic population.
Diabetes Research and Clinical Practice, Dec 1, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
BackgroundHypoglycaemia commonly occurs in patients diagnosed with diabetes mellitus (DM) and dem... more BackgroundHypoglycaemia commonly occurs in patients diagnosed with diabetes mellitus (DM) and dementia. The impact of dementia on hypoglycaemic events is controversial. Thus, we evaluated whether dementia increases the risk of hypoglycaemic events in older patients diagnosed with DM.DesignA retrospective cohort study.SettingWe used the IQVIA Medical Research Data (IMRD-UK) database (formerly known as the THIN database).ParticipantsAll patients aged ≥55 years and diagnosed with DM who were prescribed at least two prescriptions of antidiabetic medication between 2000 and 2017. Two groups of patients, dementia and non-dementia group, were propensity-score (PS) matched at 1:2. The risk of hypoglycaemia was assessed through a Cox regression analysis.Main outcome and measuresHypoglycaemic events were determined during the follow-up period by Read codes.ResultsFrom the database, 133,664 diabetic patients were identified, with a mean follow-up of 6.11 years. During the study period, 7,762 d...
ObjectiveTo evaluate the attitudes of undergraduate pharmacy students towards patient safety in s... more ObjectiveTo evaluate the attitudes of undergraduate pharmacy students towards patient safety in six developing countries.DesignA cross-sectional study.SettingParticipants were enrolled from the participating universities in six countries.ParticipantsUndergraduate pharmacy students from the participating universities in six developing countries (Jordan, Saudi Arabia, Kuwait, Qatar, India and Indonesia) were invited to participate in the study between October 2018 and September 2019.Primary outcomeAttitudes towards patient safety was measured using 14-item questionnaire that contained five subscales: being quality-improvement focused, internalising errors regardless of harm, value of contextual learning, acceptability of questioning more senior healthcare professionals’ behaviour and attitude towards open disclosure. Multiple-linear regression analysis was used to identify predictors of positive attitudes towards patient safety.ResultsA total of 2595 students participated in this stud...
As of 14 th July 2020, 12,964,809 confirmed cases of coronavirus (COVID-19) and 570,288 deaths ha... more As of 14 th July 2020, 12,964,809 confirmed cases of coronavirus (COVID-19) and 570,288 deaths had been reported globally. In Kuwait, the numbers stood at 55,508 confirmed cases and 393 deaths. The disease seems to be hitting hard on the country despite the measures that have been put in place. The current study sought to examine healthcare workers HCWs awareness and perceptions of coronavirus disease in Kuwait hospitals. A prospective study design was used to examine the development of the disease among 28 HCWs between mid-May and the start of June 2020. The primary findings were as follows; most of the study participants had attended lectures/ discussions on COVID-19, only few HCWs could identify the incubation period of the novel coronavirus. However, the majority could identify the most common symptoms of the disease as fever, cough, headache, sore throat, runny nose, and skin rashes. Most of the HCWs were aware that the virus transmitted through contact. A good number of the study participants also identified pneumonia, respiratory failure and death as complications associated with coronavirus disease. The study recommends running health education programs in Kuwait to promote knowledge on the coronavirus and help the HCWs develop positive attitudes and uphold important practices.
International Journal of Pharmaceutical Research, 2020
Introduction: The WHO announced on 30 January 2020 the respiratory tract infection outbreak cause... more Introduction: The WHO announced on 30 January 2020 the respiratory tract infection outbreak caused by Coronavirus 2019 (COVID-19) that was first recognized in China to be a global public health emergency. Objective: To investigate healthcare professional's knowledge and awareness about COVID-19. Methods: The study was conducted across four hospitals in Saudi Arabia and two hospitals in Kuwait. The questionnaire was completed between 18 th May and the end of June 2020. Results: A total of 460 healthcare professionals completed the questionnaire, 37.8%(n=174) were males. The age of the participants ranged from 18 to 64 and 80.4% (n=370) of the participants were aged 34 or below. Official government websites 54.8% (n=252) and social media 43.3% (n=199) were the major reliable information sources related to COVID-19. only 37% (n=170) mentioned that the coronavirus disease could transmit through contact. In addition, only 42% (n=191) of the study participants had the correct knowledge about the incubation period of the disease. Moreover, 43.5% (n=200) of the participants were able to identify the symptoms of COVID-19. Conclusion: The study recommended the need to focus more on educational and awareness programs targeting all healthcare professionals to ensure the best practice and provide the optimal care.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Background: Few studies have shown that an increased risk of dementia is associated with diabetes... more Background: Few studies have shown that an increased risk of dementia is associated with diabetes mellitus. Objective: To estimate the prevalence and incidence of dementia in people with diabetes in primary care in the UK. Methods: We conducted a descriptive study using the UK The Health Improvement Network (THIN) database. People diagnosed with diabetes from 2000 to 2016 were included in the study. Prevalence and incidence rates of dementia were calculated annually, stratified by age and gender. Results: The prevalence of dementia was 0.424% [95%CI (0.420%-0.427%)] in 2000 and 2.508% [95% CI (2.501%-2.515%)] in 2016. The highest prevalence was in those aged 85+ from 2.9% [95%CI (2.890%-2.974%)] in 2000 to 11.3% [95% CI (11.285%-11.384%)] in 2016. The incidence of dementia increased 3.7 times, from 0.181 cases per 100 persons [95% CI (0.179-0.183)] in 2000 to 0.683 cases per 100 persons [95%CI (0.679-0.686)] in 2016, respectively. Women had a higher prevalence and incidence of dementia than men 3.138% [95% CI (3.127%-3.150%)] vs 2.014% [95% CI (2.006%-2.022%)] and 0.820 [95% CI (0.814-0.826)] vs 0.576 cases per 100 persons [95%CI (0.571-0.580)] in 2016, respectively. Conclusion: There was a trend of increasing prevalence and incidence of dementia in people with diabetes over the period of 2000 to 2016. This study adds to the evidence on dementia prevalence and incidence, particularly in the diabetic population.
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