Search results for “Feasibility

About 23 results in articles

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23 articles

Diabetic Foot and Leg Ulcer & Peri-wound Neuropathy Healing Feasibility Studies

Jan 2026 DOI 10.14302/issn.2640-6403.jtrr-25-5922

Diabetic foot and leg ulcers represent a significant global health burden and are frequently associated with peripheral neuropathy, vascular compromise, infection, and high rates of recurrence and amputation. Standard wound care often fails to achieve healing in chronic cases due to unaddressed underlying neuropathic and vascular pathology. This feasibility study evaluated the Hemastyl™ System in patients with long-standing diabetic foot and leg ulcers that had failed standard care and, in many cases, had been diagnosed for amputation. Two prospective feasibility cohorts comprising 39 chronic infected diabetic wounds were treated with the Hemastyl™ System. Outcomes included rapid microbe reduction, high wound closure rates, subjective improvement in neuropathy-related symptoms, and avoidance of amputation in all amputation-diagnosed cases. These findings suggest that targeting neuropathy, vasculature, and microbial burden concurrently may offer a promising approach for healing complex chronic wounds in high-risk populations.

A Study on the Feasibility and Utility of Continuous Glucose Monitors in Elite Football

Jan 2025 DOI 10.14302/issn.2694-2283.jsem-24-5363

Physiological performance may be limited by reduced systemic glucose availability to working muscles. Continuous glucose monitors (CGM) measure interstitial glucose every 1-15 minutes, offering a practical way to assess glucose during sporting activity. However, empirical research has predominantly focused on endurance-based sports, whereas glucose responses during professional competitive football matches remain unknown. This study evaluated the feasibility and utility of CGM in professional football. Eight professional, male outfield footballers from the English third tier participated in the study. Participants completed a 14-day food diary control period, followed by a 28-day observation period wearing CGM devices during six matches and sixteen training sessions. CGM devices remained in situ for 98% of training sessions and matches. Mean glucose concentrations were 6.5 ± 1.2 mmol/L during training sessions, 7.5 ± 2.1 mmol/L during match play, and 5.4 ± 0.3 mmol/L overnight. No significant differences were found between glucose concentrations during match play (p = 0.060) or training (p = 0.510), compared to overnight fasted glucose concentrations. There was also no difference between training and match-play glucose concentrations (p = 0.788). Glucose concentrations were highly individualised, with one player displaying minimal change throughout match play (-0.2 mmol/L) whereas another experienced increases of up to 5.8 mmol/L. Non-nutritional factors appeared to influence glucose concentrations; participants (n=3) who used nicotine pouches displayed an transient increase in blood glucose in the 10-55 minutes after administration. This study concludes that CGM use in professional football is feasible for assessing individual glucose responses to  training and match-play.

The Feasibility of Enzyme Immunoassay Tests in the Absence of a Conventional Source of Electricity

Oct 2020 DOI 10.14302/issn.2576-6694.jbbs-20-3517

Background of the Study African  countries are facing frequent blackout. Thus in sub Saharan region, due to frequent power cut, the laboratory professionals find sometimes difficulty to carry out earlier diverse diagnostic tests. Objective The  aim of this work is to evaluate the feasibility of enzyme immunoassay tests in the absence of a conventional source of electricity. Methods We  developed a battery-powered experimental device, which was then applied to diagnose measles. The samples included 45 sera randomly selected from non-haemolysed serum samples received and stored at the National Public Health Laboratory of Benin. The experimental device is composed of two devices (Devices 1 and 2). The Device 1 provided an average temperature of 34.47 °C, 20 min after starting. With Device 2 an average temperature of 20.32 °C is obtained 15 min after starting. Results With  the experimental device the same rate of measles antibody-positive sera (44.68%) was obtained as recorded from the test using the standard equipment of laboratory. The experimental device detected 18 negative and 8 intermediate results against respectively 19 and 7 by the standard equipment. The analysis of the results of both equipments shows a concordance rate of 93.33% with a kappa reproducibility coefficient of 0.89. Conclusion The  device conceived in our study is a simply equipment allowing the realization of the enzyme immunoassay tests, in this case the ELISA anti-measles test. The rate of concordance obtained shows that this device can be used with commercial kits and at temperatures close to those recommended by the manufacturer without altering the results.

Family Medicine Open Access

Using a Medication Plan as a Quality Indicator: Feasibility and Satisfaction Results from an Observational Study

Aug 2019 DOI 10.14302/issn.2640-690X.jfm-19-2989

Background Medication adherence remains a challenge for patient management. Changes in the drug regimen after a hospital stay can lead to confusion or misunderstandings. We implemented a structured patient-centered interview during which a computer-generated individualized medication plan was discussed and provided to patients at discharge. Objective To explore whether a medication plan can be a quality indicator, in terms of its content (quality) and its implementation in the resident’s workflow (feasibility). Methods An observational mixed method study with interviews of 174 patients from general internal medicine wards at 1 week and 1 month after discharge, and of 91 physicians at baseline. We report the quality of the medication plan in terms of content and state of completion. We describe feasibility for residents to complete this plan, as well as patient and resident satisfaction with the plan. Results 83% of participants received a medication plan. Physicians verified renal function (83%) to adapt doses but did not regularly assess for medication interactions (43%). Incomplete plans (61%), were due to blanks when physicians considered the information irrelevant for their patients. Error rate was <3%. Patients reported low use of their plan after discharge (64% found it useful after 1 week, whereas only 37% used it when taking their medication 1 week after discharge). Conclusion Although the plans were considered useful by both patients and physicians, their implementation could have been optimized by considering the overall process (creation to patient use). Mobile apps could help fill gaps in supporting patients for medication adherence.

Family Medicine Open Access

Exploring the Feasibility of Supporting UK Partners Living Alongside Veterans with PTSD: A Pilot Study of the Together Programme (TTP)

Apr 2019 DOI 10.14302/issn.2640-690X.jfm-19-2725

Background Romantic partners living alongside veterans with Post Traumatic Stress Disorder (PTSD) appear at increased risk of secondary traumatic stress (sPTSD) and common mental health difficulties (CMD) compared to the general population.  The severity of symptoms implies the need for structured, bespoke and evidence-based interventions. Objective The aim of this study was to explore the feasibility of offering a community support programme (The Together Programme, TTP) for military partners. TTP was developed based upon a number of US programmes and consisted of 10 hours of group-based support delivered over a five-week course. 56 participants engaged in TTP over a year at nine locations across the UK and were followed up three months later.   Methods Measures of CMD, sPTSD, alcohol use and relationship satisfaction were used to assess benefits. Data were also collected on attendance and participant feedback. Results Significant reductions were observed for symptoms of sPTSD and CMD at follow up. 51/56 (90.1%) participants completed TTP.  The majority of participants reported positive experiences. However, several individuals stated wanting more sessions and that barriers such as work, and family commitments made it difficult to attend. Conclusions Whilst limitations exist, the data presented suggests cautious optimism for the efficacy of offering a structured programme of support to address the needs of military partners living alongside PTSD.

A Feasibility Study of A Home-Based Program to Promote Perceived Adequate Milk

Mar 2019 DOI 10.14302/issn.2381-862X.jwrh-19-2617

Objective The purpose of this study was to evaluate the feasibility of a home-based educational skill building program to support exclusive breastfeeding for mothers in the early postpartum period. Specific aims were to: (1) evaluate the effectiveness of the study’s recruitment strategy, comparing the use of an intermediary with a direct approach, (2) examine intervention fidelity, (3) examine program adherence, and (4) assess the acceptability of the intervention to participants. Design and Sample A mixed methods within-group, three-occasion descriptive design, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. Intervention The program was implemented during three, 60-90 minute educational training sessions in the home, delivered at 6, 13, and 27 days postpartum. Results Mothers who adhered to the intervention protocol correctly attributed their infant’s crying behavior to factors other than the adequacy of the mother’s milk supply. All participants were recruited through direct approach. The program was delivered as planned with high fidelity, a high retention rate, and with a high rate of acceptability. Conclusions A fully scripted, at-home, nurse-delivered educational skill building program can be delivered with efficiency to breastfeeding mothers with full-term singleton infants; intervention fidelity, retention, and acceptability were high.

Giant Ileal Conduit Stone: Feasibility of Endoscopic Lithotripsy: A Case Report and Review of Literature

Jan 2018

Ileal conduit has been considered the urinary diversion of choice following radical cystectomy although orthotopic bladder substitution is gaining popularity. Urinary diversions are associated with complications including stone formation in up to 54%. We report the management of the largest ileal conduit stone reported in the literature.

Implementing Evidence-Based Occupational Therapy for Multiple Sclerosis Rehabilitation: Exploring Knowledge on Barriers, Facilitators and Strategies

Jun 2026

Background A persistent gap remains between evidence-based health care and its application in routine practice. This challenge is particularly prominent in allied health professions like occupational therapy (OT), where interventions are complex, individualized and centred on patients' daily functioning. Objective To identify barriers, facilitators, and implementation strategies for integrating evidence-based OT interventions in multiple sclerosis (MS) rehabilitation. Methods A mapping review was conducted using searches in five databases. Eligible studies included adults with MS, examined OT interventions, and reported on factors influencing implementation. Data were extracted and categorized using Grol’s framework for barriers/facilitators and Mazza’s taxonomy for implementation strategies. Results Fifteen studies met inclusion criteria. Barriers and facilitators were identified at multiple levels of Grol’s framework: 1-Innovation-level: accessibility, feasibility, and perceived attractiveness supported implementation, particularly when interventions incorporated holistic approaches, gamification, or printed manuals. 2-Professional-level: therapists’ competencies and alignment between interventions and patients’ priorities. 3-Patient-related: facilitators included motivation, readiness to change, and peer support, whereas fatigue, pain, and cognitive challenges served as barriers. 4-Social and organizational: effective teamwork, resource availability, and flexible scheduling facilitated successful adoption. 5-Economic or political: no studies. Implementation strategies focused on using manuals, patient empowerment, gamification, and organizational supports. No financial or structural policy-level strategies were identified. Conclusion Successful implementation of evidence-based OT for MS requires multifaceted, context-sensitive strategies addressing innovation, professional, patient, and organizational determinants. Practical approaches enhance uptake, while substantial gaps persist at economic and policy levels. Strengthening these areas may improve longterm integration and sustainability of evidence-based OT in MS rehabilitation.

Maxillary Sinus Lift Using the Lateral Window Technique with Hydroxyapatite and Beta-Tricalcium Phosphate (β-TCP) Graft

Dec 2025 DOI 10.14302/issn.2473-1005.jdoi-25-5870

This narrative literature review investigates the clinical feasibility of maxillary sinus lift using the lateral window (or traumatic) technique, employing a grafting material composed of hydroxyapatite associated with beta-tricalcium phosphate. The study is based on the premise that bone resorption and sinus pneumatization—common in edentulous posterior maxillae—pose a challenge to achieving primary stability during dental implant placement. Given the limitation imposed by reduced residual bone height, bone-grafting surgical techniques become necessary to enable implant-supported rehabilitation. The objective of this work is to analyze, through a literature review, the efficacy of combining synthetic biomaterials as an alternative to autogenous bone grafts, which are considered the gold standard in implant dentistry. A bibliographic search was conducted in the PubMed and LILACS databases and through the VHL portal, prioritizing articles addressing the biological properties of alloplastic grafts, the indications of the lateral window technique, and the clinical success rates of implants placed in previously grafted areas using such materials. The findings demonstrated that hydroxyapatite associated with beta-tricalcium phosphate exhibits favorable osteoconductive characteristics, such as adequate porosity and gradual resorption, while allowing the formation of viable bone within a clinically acceptable timeframe. The combination of these materials eliminates the need for a second surgical site, reduces morbidity, and maintains treatment predictability. It is concluded that the lateral window technique associated with synthetic biomaterials is a safe and effective alternative for patients with maxillary bone atrophy, capable of promoting suitable bone beds for dental implant placement and stabilization, with lower surgical risk and satisfactory clinical outcomes.

Barriers and Opportunities to Improve the Implementation of Patient Screening and Linkage to Pre-Exposure Prophylaxis in Primary Care

Dec 2022 DOI 10.14302/issn.2324-7339.jcrhap-22-4371

Although pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV infection, only around 25% of at-risk individuals in the United States have accessed a prescription. One way to increase PrEP uptake is through the sexual health screening of patients and linkage to PrEP in primary care settings. The objective of this analysis was to assess the barriers and implementation strategies during a screening and linkage to PrEP pilot intervention. Primary care patients were screened for PrEP indication during routine primary care visits. Of the 1,225 individuals screened, 1.8% (n=22) were eligible for PrEP and from those, 77.3% (n=17) attended the specialist appointment and were prescribed PrEP. Primary care patients (n=30) and providers (n=8) then participated in semi-structured interviews assessing their experience with the pilot intervention. Using an applied thematic analytic approach, patients and providers identified barriers and related improvement strategies that could be classified into four main categories: 1) Financial Barriers: Individual- vs. Clinic-level Considerations 2) The Role of Stigma, Discomfort, and Cultural Factors 3) Logistical Hurdles and Streamlining the Intervention, and 4) The Lack of PrEP Knowledge and the Need for Education. Findings support the accepatability and feasibility of screening for PrEP in primary care along with appropriate implementation strategies. This study suggests that because of the high volume of patients seen in primary care, sexual health screenings and linkage to PrEP interventions have the potential to reduce new incident HIV infections among diverse sexual minority men.

Pericardiocentesis Procedure: Anatomical Structures and Approaches

Dec 2021 DOI 10.14302/issn.2577-2279.ijha-21-4012

Knowledge of accurate surface anatomy is essential for safe clinical practice. Different views and opinions for clinically important surface markings exist between clinicians. Pericardiocentesis is performed as an emergency procedure in conditions aggravating cardiac tamponade. The approach of pericardiocentesis should be held by the hands of an experienced operator because of the surrounding relations. Nowadays, the introduction of imaging-guided procedures, especially echo-guided procedures, has significantly improved the safety and feasibility of pericardiocentesis and has provided the possibility of choosing the best anatomical approach among the apical, subcostal and parasternal approaches. This case report also emphasizes the importance of instillation of agitated saline as a supplementary technique while performing echo-guided pericardiocentesis in order to reduce the likelihood of cardiac chamber perforations.

The Current Chinese Global Supply Chain Monopoly and the Covid-19 Pandemic

Feb 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3720

Because of the ongoing Covid-19 crisis, supply chain management performance seems to be struggling. The purpose of this paper is to examine a variety of critical factors related to the application of contingency theory to determine its feasibility in preventing future supply chain bottlenecks. The study reviewed current online news reports, previous research on contingency theory, as well as strategic and structural contingency theories. This paper also systematically reviewed several global supply chain management and strategic decision-making studies in an effort to promote a new strategy. The findings indicated that the need for mass production of products within the United States, as well as within trading partners, is necessary to prevent additional Covid-19 related supply chain gaps. The paper noted that in many instances, the United States has become dependent on foreign products, where the prevention of future supply chain gaps requires the United States restore its manufacturing prowess.

Energy Conservation Open Access

The Interaction Model of Concentrated Solar Radiation with Materials

Oct 2020 DOI 10.14302/issn.2642-3146.jec-20-3551

The paper analyzes approaches to modeling the processes of interaction of concentrated solar radiation with materials. The experimental results obtained on the synthesis of materials from a melt in a solar furnace are presented. The features of the interaction of concentrated solar radiation with materials are analyzed. The mechanisms are described and a model for the interaction of concentrated solar radiation with materials is created. A feasibility study is proposed for the technology of glass-based glass materials obtained on the Big Solar Furnace.

The Nutrition Route following Esophagectomy

Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3488

Esophagectony remains a high-risk surgical procedure. Esophageal cancer is often associated with a weight loss. The best nutritional condition is crucial for successful oesophageal surgery. The increased septic complications and costs have limited the wide use of total parenteral nutrition. Currently, enteral nutrition is the preferred nutrition method following esophagectomy. However; jejunostomy-tube was associated with rare major complications that may lead to discontinuing nutrition. Choosing an enteral feeding route after esophagectomy depends greatly on the surgeon preference. The safety and benefits of early oral feeding on outcomes after major gastrointestinal surgery have been well documented. However, the surgical community is still reticent about initiating early oral feeding after esophageal surgery. Despite the limited number of published reports, comparative trials have clearly shown the feasibility, safety with no increase in morbidity rate.In this brief review, we tried to discuss the different routes of nutritional support after oesophagectomy with providing the current insights on early oral feeding.

Validated Analytical Spectrofluorimetric Method for Quantitation of Diphenhydramine HCl in Commercial Dosage Forms

Aug 2018 DOI 10.14302/issn.2377-2549.jndc-18-2220

Diphenhydramine HClis a weakly fluorescent drug having tertiary amine group forming ion pair complex with eosin Y in dichloromethane at pH 5 in disodium hydrogen phosphate-citric acid buffer solution. The complex formation was the basis for the development of new analytical method for determination of active diphenhydramine in pharmaceutical formulations. The stoichiometric ratio between diphenhydramine and eosin Y was studied by mole ratio method and found to be 2:1. The ion-pair complex showed maximum fluorescence emission intensity at 554 nm with excitation at 259 nm. The linear dynamic range was obtained in the concentration range of 2-22 µg mL-1 with a linear equation of FI = 0.361 + 13.675 C. The apparent Gibb’s free energy (ΔGº) was calculated and found to be -80.783 KJ mol-1, confirmed the feasibility of the reaction. The proposed method was successfully applied to the determination of diphenhydramine HCl in pharmaceutical formulations and in good agreement with the reference method.

Human Health Research Open Access

Oncopunt, a Video-Portal to Improve Oncological Skills of Home Care Nurses: Usability, User-Experience and Added Value for Clinical Practice

Dec 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1811

Homecare is very important in oncology care since cancer patients are discharged more and more earlier from the hospital and receiving ambulatory treatments. Homecare nurses have a more general broad educational background, with less specialization regarding specific care, like oncology care. The aim of this study is to develop and test a cross-platform application (named Oncopunt) for homecare nurses involved in oncology care to provide specific nurse-centred information via digital media about skill guidelines specific for oncology care. This study was set-up as a non-experimental feasibility and satisfaction study with one measurement moment to collect information about usability, user-experience and added value of Oncopunt using the System Usability Scale (SUS) and an additional questionnaire. The cross-platform application Oncopunt was build using Drupal and Vimeo and consists of a homescreen, filter/search function and watch-function (full video panel, chapter panel and FAQ). Seventeen homecare nurses completed all questionnaires. The mean SUS score was 83,8 (stdev 11,6) and Oncopunt was rated positively regarding video content, technical issues, website layout, quality of care and user satisfaction. Oncopunt is developed to provide homecare nurses specific nurse-centred information about skills specific for oncology care via digital media . It was rated good on usability, user-experiences and added value for clinical practice.

Ophthalmic Science Open Access

Eye Exam in the Virtual World: A Pilot Study

May 2017 DOI 10.14302/issn.2470-0436.jos-17-1479

This study investigated the feasibility of using three-dimensional (3D) technology as a multi-functional visual stimulus to assist the clinical eye exam. Specifically, we examined: (1) whether the receding movement of a 3D fixation target into distance could relax the accommodation of non-cycloplegic hyperopic subjects so that accurate refraction measurements could be achieved; (2) the feasibility of using the left-eye and right-eye images from the 3D monitor as the light source to perform swinging-flashlight pupil tests; and (3) the implementation of 3D technology to interrupt the binocular visual/motor fusion as required for the clinical cover test to identify strabismus. Using a 3D TV to provide visual stimuli and a photoscreening (PS) device, near-infrared (NIR) eye images were acquired and analyzed for each of the three objectives. The result of accommodation test showed that with visual stimuli, the maximal hyperopic refractions could more accurately suggest the patients’ true refractions and the more hyperopic patients responded more to the 3D projected distance. However the very mild hyperopia did not show significant response. The pilot tests also showed distinguishable normal and abnormal pupillary responses with 3D image illumination and also the difference in phoria and tropia in the ocular alignment test using 3D stimuli.

Cervical Medial Branch Blocks For The Diagnosis Of Somatosensory Tinnitus. A Pilot Study.

Dec 2016 DOI 10.14302/issn.2379-8572.joa-16-1369

The purpose was to discover if medial branch blocks (MBBs) of the cervical spine can be used as a diagnostic tool to identify patients with somatosensory tinnitus. MBBs are a diagnostic tool to confirm the diagnosis facet joint pain in patients with neck pain. It is not known, if MBBs are also suitable for testing other symptoms than pain. However, the existence of neural connections between the auditory system and the cervical region can be assumed. Included were 22 consecutive patients presenting with tinnitus, who had received MBBs in a ten years’ period. Patients were tested with a MBB with bupivacaine and triamcinolone. Injections were performed with fluoroscopic visualization using established techniques. The mean follow-up time was 6.2 weeks. Tinnitus was analyzed through the global clinical impression of the patient. Seven patients (31.8 %) experienced a significant improvement of the tinnitus. In one patient a thermal radiofrequency neurotomy was done after positive response to two MBBs. The pain relief and a significant reduction of the tinnitus sustained at the follow-up examination 20 weeks after the denervation. No statistically significant difference was found in age, gender, duration of symptoms, additional neck pain or vertigo, or side or level of the intervention. This pilot study shows the feasibility to identify patients with somatosensory tinnitus with MBBs. Further studies with the primary intention on tinnitus are necessary to prove the significance of MBBs. After a positive response to MBBs, treatment with radiofrequency neurotomy is the rational consequence.

COLLAGE 360: A Model of Person-Centered Care to Promote Health Among Older Adults

Jul 2016 DOI 10.14302/issn.2474-7785.jarh-16-1123

This article describes COLLAGE 360, a person‑centered care model for older adults that integrates comprehensive assessment, goal‑setting, and coordinated community services. The approach seeks to promote health and function while reducing fragmentation across medical and social supports. Early implementation experience outlines feasibility and pathways to measure outcomes and scale within aging networks.

Evaluating the Role and Efficacy of Plerixafor in Rescue Mobilization of Autologous Peripheral Blood Stem Cells

May 2015 DOI 10.14302/issn.2372-6601.jhor-14-493

In autologous hematopoietic stem cell transplantation patients for whom granulocyte-colony stimulating factor fails to mobilize a sufficient number of peripheral blood stem cells, plerixafor proposes an option for successful rescue mobilization. This paper evaluates the efficacy of plerixafor to mobilize peripheral blood stem cells (PBSCs) in patients who failed previous mobilization with G-CSF alone, by retrospectively analysing the PBSC results from lymphoma and myeloma (MM) patients between 2006 and 2011. Patients were classified according to the CD34+ cells/kg yield collected by apheresis: < 2 x 106 CD34+ cells/kg was considered collection failure, whereas ≥ 5 x 106 CD34+ cells/kg was considered good mobilization. 797 patients underwent one or more apheresis. The first mobilization success rate was 82%; 140 patients proved to be poor mobilizers. Suboptimal first mobilization was significantly associated with age >50 years (p=0.005) and the absence of chemotherapy in prior PBSCs stimulation (p=0.04). 149 rescue protocols were used in the 140 poor mobilizers, and 71 patients received plerixafor. In univariate analysis the remobilization rate without plerixafor was 42% and increased to 65% when plerixafor was added. In multivariate analysis, plerixafor administration reduced the PBSC remobilization failure risk by a half (OR=0.47). The median value of CD34+ cells/kg in transplants increased from 1.43 (range, 014.03) without plerixafor to 3.85 (range, 0–18.25; p=1 x 10-4) with plerixafor. There were more good mobilizers after plerixafor use (35% with plerixafor versus 15% without plerixafor; p=0.005). Plerixafor efficacy was similar for lymphoma (60% remobilization) and MM (80%; p=0.12). These data show that plerixafor was effective in poor mobilizers and that it synergized with G-CSF to improve the quantity of collected PBSCs. Plerixafor also increased transplant feasibility by 23%. While the clinical results of this study are promising, economic data were not taken into account and there is a need for real work concerning the cost-effectiveness of this treatment. We propose a subsequent study in which the economic efficacy of plerixafor’s use is evaluated based on the financial aspects of the treatments received by the cohort evaluated in this paper.

Hospital Episodes Due to Antidepressant Overdose: An Under-Utilised Source of Pharmacovigilance Data

Nov 2013 DOI 10.14302/issn.2328-0182.japst-13-185

Background: Antidepressant agents are commonly implicated in drug overdose, and the toxicological profile varies between agents. Clinical data concerning overdoses are not systematically sought or evaluated in pharmacovigilance. The present study sought to examine the feasibility of collecting Emergency Department data concerning antidepressant overdose. Methods : Presentations to York Hospital due to intentional antidepressant overdose were studied between 2010 and 2011. Data collected were the type of antidepressant, dose, co-ingested drugs, duration of hospital stay, and need for critical care. Community National Health Service prescription data were evaluated across York and North Yorkshire region. Results : There were 250 overdose episodes. These involved a selective serotonin reuptake inhibitor (SSRI) in 183 (73.2%), and a tricyclic in 45 (18.0%), equivalent to 24 episodes per 100,000 prescription items (95% CI 21-28 per 100,000) and 11 per 100,000 (8-15 per 100,000) respectively (P<0.0001). Citalopram was the most commonly prescribed, and associated with 22 overdose episodes per 100,000 (17-27 per 100,000). Fluoxetine was associated with 32 overdose episodes per 100,000 (24-41 per 100,000) (P=0.032 versus citalopram), whereas the lower rates were observed for amitriptyline (13, 9-17 per 100,000) (P=0.004) and dosulepin (2, 0-10 per 100,000) (P=0.001). Conclusions : A higher than expected number of overdose episodes involved an SSRI based on National Health Service primary care prescribing, and fewer episodes involved a tricyclic antidepressant. Clinical outcomes differed between agents, indicating the feasibility of using Emergency Department data to detect different patterns of toxicity between antidepressants. Further work is required to examine whether systematic collection of clinical toxicology data might enhance existing pharmacovigilance systems.

When and How Should we be Measuring Adherence to Antiretroviral Therapy in Resource-Limited Settings?

Jun 2013 DOI 10.14302/issn.2324-7339.jcrhap-13-edt.1.2

This perspective reviews practical approaches to measuring ART adherence in resource‑limited settings. It weighs self‑report, pill counts, pharmacy refill data, and biologic measures, emphasizing feasibility, bias, and programmatic integration to support sustainable HIV care.

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