Risultati per: Benzodiazepine a lunga durata di azione

‘Ricaduta positiva sugli italiani. nel mondo disparità di cure per gli immigrati’. Il presidente alle Giornate dell’etica aiom

Ricaduta positiva sugli italiani. Nel mondo disparità per le cure agli immigrati

Objective
Guidelines recommend deprescribing benzodiazepine receptor agonists (BZRA) in older adults, yet implementation in clinical practice remains limited. Adapting effective, evidence-based interventions to a new context is a resource-saving strategy. In Canada, the D-PRESCRIBE intervention comprised a patient educational brochure and a pharmaceutical opinion inviting physicians to revise BZRA prescribing and consider safer alternatives. Due to its effectiveness on BZRA deprescribing among Canadian older adults, we aimed to adapt the D-PRESCRIBE intervention to the Belgian community setting.

Design
Recommendations from the ADAPT guidance, that provides a systematic approach for adapting interventions to new contexts, were followed. We conducted a mixed-methods study that comprised (1) group discussions and cognitive interviews to assess the acceptability and need for adaptation of the intervention’s components and (2) a survey on the adapted pharmaceutical opinion. A research committee involving stakeholders’ representatives decided on the adaptations, respecting the core functions of both tools. Changes in intervention components were reported following the Model for Adaptation Design and Impact framework.

Setting
Belgian French-speaking community setting.

Participants
Six older adults (≥65 years), six general practitioners (GPs) and seven pharmacists participated in the group discussions or interviews. 46 GPs and 91 pharmacists responded to the survey.

Results
Participants welcomed the brochure positively. Still, some changes in the vocabulary, wording, photos and icons were made for several purposes including making the patient feel concerned about the brochure and softening the use of fear. The pharmaceutical opinion aroused mixed perceptions. Its name, layout and content were adapted to enhance its acceptability and fit with our healthcare system, practices and national guidelines. The survey highlighted several enablers and barriers to its use from the perspectives of GP and pharmacist.

Conclusions
The Canadian D-PRESCRIBE intervention was adapted to the Belgian setting following a thorough and transparent process. Its feasibility will be tested in a future pilot study (NCT:05929417).

La presidente dell’Associazione americana ricerca sul cancro, ‘vedremo grandi cambiamenti’

This case-time-control study evaluates the association between benzodiazepine use during pregnancy and risk of miscarriage.

Per il mantenimento, è somministrato bimestralmente

Ricerca di team Università, prevenzione con test su 120 bambini

Objective
To investigate the association between opioid replacement therapy (ORT) and benzodiazepine (BZD) coprescription and all-cause mortality compared with the prescription of ORT alone.

Design
Population-based cohort study.

Setting
Scotland, UK.

Participants
Participants were people prescribed ORT between January 2010 and end of December 2020 aged 18 years or above.

Main outcome measures
All-cause mortality, drug-related deaths and non-drug related deaths.

Secondary outcome
ORT continuous treatment duration.

Analysis
Cox regression with time-varying covariates.

Results
During follow-up, 5776 of 46 899 participants died: 1398 while on coprescription and 4378 while on ORT only. The mortality per 100 person years was 3.11 during coprescription and 2.34 on ORT only. The adjusted HR for all-cause mortality was 1.17 (1.10 to 1.24). The adjusted HR for drug-related death was 1.14 (95% CI, 1.04 to 1.24) and the hazard for death not classified as drug-related was 1.19 (95% CI, 1.09 to 1.30).

Conclusion
Coprescription of BZDs in ORT was associated with an increased risk of all-cause mortality, although with a small effect size than the international literature. Coprescribing was also associated with longer retention in treatment. Risk from BZD coprescription needs to be balanced against the risk from illicit BZDs and unplanned treatment discontinuation. A randomised controlled trial is urgently needed to provide a clear clinical direction.

Trial registration number
NCT04622995.

Esperta, lontani dai livelli pre-pandemia. Il 15 marzo ricorre la siamo Giornata nazionale

Dieta ipocalorica rallenta processo di invecchiamento del 2-3%

Più di 85 mila famiglie sfollate in tutto il paese

Cattolica, difendono raccolto e consumatore, riducono pesticidi

«Quello che ad un occhio poco attento potrebbe sembrare un semplice accorgimento tecnico – sostiene Silvestro Scotti, segretario generale Fimmg – è invece un intervento legislativo che valorizza migliaia di professionisti (si stima più di 7.000 medici di medicina generale) e avrà un impatto positivo su milioni di cittadini»

Objectives
The aim of this study was to investigate physician benzodiazepine (BZD) self-use pre-COVID-19 pandemic and to examine changes in BZD self-use during the first year of the pandemic.

Design
Population-based retrospective cohort study using linked routinely collected administrative health data comparing the first year of the pandemic to the period before the pandemic.

Setting
Province of Ontario, Canada between March 2016 and March 2021.

Participants

Intervention
Onset of the COVID-19 pandemic in March 2020.

Outcomes measures
The primary outcome measure was the receipt of one or more prescriptions for BZD, which was captured via the Narcotics Monitoring System.

Results
In a cohort of 30 798 physicians (mean age 42, 47.8% women), we found that during the year before the pandemic, 4.4% of physicians had 1 or more BZD prescriptions. Older physicians (6.8% aged 50+ years), female physicians (5.1%) and physicians with a prior mental health (MH) diagnosis (12.4%) were more likely than younger (3.7% aged

Per gli adulti, agisce in 15 minuti su dolore e altri sintomi