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Ghamar-Shooshtari A, Rahimian Z, Poustchi H, Mohammadi Z, Mesgarpour B, Akbari M, Kamalipour A, Abdipour-Mehrian SR, Hashemi ES, Zare P, Lankarani KB, Malekzadeh R, Malekzadeh F, Vardanjani HM. Polypharmacy and pattern of medication use among patients with gastroesophageal reflux disease: results from Pars Cohort study. BMC Gastroenterol 2023; 23:439. [PMID: 38097949 PMCID: PMC10720105 DOI: 10.1186/s12876-023-03086-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/09/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Gastroesophageal Reflux Disease (GERD) is a common chronic condition. Its chronic nature may affect the pattern of medication use. This study aimed to investigate the prevalence, associated factors, and patterns of polypharmacy and medication use among GERD patients in southwestern Iran. METHODS We used data from the Pars Cohort Study. We classified drugs using the Anatomical Therapeutic Chemical classification system. The Lexicomp® database was used to assess potential drug-drug interactions. Multivariable Poisson regression was applied. Adjusted prevalence ratio (PR) and its 95% confidence interval (CI) were estimated. RESULTS A total of 9262 participants were included. Among 2,325 patients with GERD, age-standardized prevalence of polypharmacy was 9.5% (95% CI: 7.5%, 11.6%) in males, and 19.3% (95% CI: 17.2%, 21.4%) in females. The PR of experiencing Polypharmacy by GERD patients compared to non-GERD patients was 1.82 (95% CI: 1.61, 2.05%). Multimorbidity (PR: 3.33; CI: 2.66, 4.15), gender (PR: 1.68; CI: 1.30, 2.18), and metabolic syndrome (PR: 1.77; CI: 1.45, 2.15) were associated with polypharmacy among GERD patients. Drugs for acid-related disorders were the most common used drugs among men, women and elders. We found that 13.9%, 4.2%, and 1.1% of GERD patients had type C, D and X drug interactions, respectively. CONCLUSION GERD is correlated with a higher prevalence of polypharmacy. Among GERD patients, females, those with multi-morbidities, and those with metabolic syndrome may be affected more by polypharmacy. Considering the fairly high rate of interactions identified, a review of the medication list is essential when approaching GERD patients, and physicians must check for medications that may worsen GERD.
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Affiliation(s)
- Arash Ghamar-Shooshtari
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Ophtalmology Resident of Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Rahimian
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- Vice Chancellery for Research and Technology, National Institute for Medical Research and Development (NIMAD), Tehran, Iran
| | - Mohammadreza Akbari
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Kamalipour
- Department of Ophthalmology, Shiley Eye Institute, Hamilton Glaucoma Center, University of California, San Diego, CA, USA
| | | | - Elham-Sadat Hashemi
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pooria Zare
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Pathology Resident of Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Malekzadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Molavi Vardanjani
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Research Center for Traditional Medicine and History of Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Lopes LC, Moga DC, Da Silva Dal Pizzol T, Gisev N, Mesgarpour B, Bérard A. Editorial: Women in pharmacoepidemiology: 2021. Front Pharmacol 2023; 14:1278768. [PMID: 37771724 PMCID: PMC10523565 DOI: 10.3389/fphar.2023.1278768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Affiliation(s)
- Luciane Cruz Lopes
- Pharmaceutical Science Graduate Course, University of Sorocaba, Sorocaba, Brazil
| | - Daniela C. Moga
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, United States
| | - Tatiane Da Silva Dal Pizzol
- Graduate Program of Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Production and Control of Medicines, School of Pharmacy, UFRGS, Porto Alegre, Brazil
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Bita Mesgarpour
- National Institute for Medical Research and Development, Tehran, Iran
| | - Anick Bérard
- CHU Sainte Justine Research Center, Faculty of Pharmacy, University of Montreal, Montréal, QC, Canada
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Sofi-Mahmudi A, Shamsoddin E, Ghasemi P, Nasser M, Mesgarpour B. Assessing Google Searches for Toothache during COVID-19 Lockdowns. Med J Islam Repub Iran 2023; 37:36. [PMID: 37284693 PMCID: PMC10240547 DOI: 10.47176/mjiri.37.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Indexed: 06/08/2023] Open
Abstract
Background Lockdowns due to the coronavirus disease 2019 (COVID-19) pandemic forced many dental offices to be closed. This study aims to investigate the association between COVID-19 imposed lockdowns and online searches for toothache using Google Trends (GT). Methods We investigated GT online searches for the term "toothache" within the past 5 years. The time frame for data gathering was considered as the initiation and end dates of national/regional lockdowns in each country. We used 1-way analysis of variance to identify statistical differences in relative search volumes (RSVs) between 2020 and 2016-2019 for each country. Results Overall, 16 countries were included in our analyses. Among all countries, Indonesia (n = 100), Jamaica (n = 56), Philippines (n = 56), Iran (n = 52), and Turkey (47) had the highest RSVs for toothache in the specified period. Compared with the previous 4 years, higher RSVs were seen in the world (as a whole) (2020 RSVs, 94.4; vs 2019 RSVs, 77.8 [ P < 0.001]) and 13 countries (81.3% of the included countries). Conclusion Generally, searching for the term "toothache" showed an increase during the COVID-19 lockdowns in 2020 compared with the past 4 years. This can imply the importance of dental care as urgent medical care during public health emergencies such as COVID-19.
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Affiliation(s)
- Ahmad Sofi-Mahmudi
- Cochrane Iran Associate Centre, National Institute for Medical Research
Development, Tehran, Iran
| | - Erfan Shamsoddin
- Cochrane Iran Associate Centre, National Institute for Medical Research
Development, Tehran, Iran
| | - Peyman Ghasemi
- Department of Health Economics, School of Public Health, Tehran University of
Medical Sciences, Tehran, Iran
| | - Mona Nasser
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and
Dentistry, Plymouth, UK
| | - Bita Mesgarpour
- Cochrane Iran Associate Centre, National Institute for Medical Research
Development, Tehran, Iran
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4
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Akbari MR, Kamalipour A, Pakroo M, Mesgarpour B, Poustchi H, Mohammadi Z, Gandomkar A, Molavi Vardanjani H. Prevalence and Correlates of Polypharmacy, and Drug Utilization Pattern in a Semi-urban Population: Results from the Pars Cohort Study. Arch Iran Med 2023; 26:156-165. [PMID: 37543938 PMCID: PMC10685724 DOI: 10.34172/aim.2023.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/20/2022] [Indexed: 08/08/2023]
Abstract
BACKGROUND Although polypharmacy is considered a major predictor of irrational use of drugs, little is known about polypharmacy in developing regions. We aimed to indicate the prevalence and correlates of polypharmacy and to determine the medication profile at the population level in southern Iran. METHODS In this cross-sectional study, we analyzed data from participants of the Pars Cohort Study (PCS) (aged above 40 years, N=9269). Polypharmacy was defined as using five or more medications concurrently. A Poisson multivariable model was applied to estimate the adjusted prevalence ratios (APRs) of various risk factors. The Anatomical Therapeutic Chemical (ATC) classification system was used for classifying medications. RESULTS Prevalence of polypharmacy was 10.4%, (95% CI: 9.75; 11.08) and it was higher among females (15.0%), older adults (age≥65 years) (16.0%), and individuals with more than two chronic conditions (31%). Being female, educated, married, and not having a low socio-economic class were independently associated with a higher likelihood of polypharmacy. The most prevalent medications among female participants were sex hormones and modulators of the genital system (58.4%), drugs for acid-related disorders (14.6%), and anti-anemic preparations (13.6%,). On the other hand, males were using acid-related disorders (14.6%), anti-inflammatory and anti-rheumatic products (7.8%), and beta-blocking agents (6.3%). CONCLUSION The prevalence of polypharmacy in our sample was relatively low, especially among males. Cardiovascular drugs, acid suppressants, hormonal contraceptives, and anti-anemic preparations are drug classes with the highest contribution to polypharmacy.
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Affiliation(s)
- Mohammad Reza Akbari
- MD-MPH Department, School of Medicine, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, United States
| | - Mahsa Pakroo
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Hossein Poustchi
- Digestive Disease Research Center, Digestive Research Institute, Shariati Hospital, Tehran University of medical Science, Tehran, Iran
| | - Zahra Mohammadi
- Digestive Disease Research Center, Digestive Research Institute, Shariati Hospital, Tehran University of medical Science, Tehran, Iran
| | - Abdullah Gandomkar
- Non-communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- MD-MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Shahraz S, Shahin S, Farzi Y, Modirian M, Shahbal N, Azmin M, Mohebi F, Naderian M, Amin-Esmaeili M, Ahmadi N, Seyfi S, Zokaei H, Samadi R, Mohajer B, Sherafat-Kazemzadeh R, Balouchi A, Mesgarpour B, Parsaeian M, Gorgani F, Rahimi S, Saeedi Moghadam S, Khezrian M, Amin A, Baheshmat S, Beyranvand MR, Haghjoo M, Mahdavi-Mazdeh M, Mehrpour M, Moradi G, Peiman S, Rahimi B, Rahimi-Movaghar A, Rikhtegar R, Roshani S, Saadatnia M, Samimi Ardestani SM, Khatibzadeh S. Iran Quality of Care in Medicine Program (IQCAMP): Design and Outcomes. Arch Iran Med 2023; 26:126-137. [PMID: 37543935 PMCID: PMC10685727 DOI: 10.34172/aim.2023.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/08/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Assessment of quality and cost of medical care has become a core health policy concern. We conducted a nationwide survey to assess these measures in Iran as a developing country. To present the protocol for the Iran Quality of Care in Medicine Program (IQCAMP) study, which estimates the quality, cost, and utilization of health services for seven diseases in Iran. METHODS We selected eight provinces for this nationally representative short longitudinal survey. Interviewers from each province were trained comprehensively. The standard definition of seven high-burden conditions (acute myocardial infarction [MI], heart failure [HF], diabetes mellitus [DM], stroke, chronic obstructive pulmonary (COPD) disease, major depression, and end-stage renal disease [ESRD]) helped customize a protocol for disease identification. With a 3-month follow-up window, the participants answered pre-specified questions four times. The expert panels developed a questionnaire in four modules (demographics, health status, utilization, cost, and quality). The expert panel chose an inclusive set of quality indicators from the current literature for each condition. The design team specified the necessary elements in the survey to calculate the cost of care for each condition. The utilization assessment included various services, including hospital admissions, outpatient visits, and medication. RESULTS Totally, 156 specialists and 78 trained nurses assisted with patient identification, recruitment, and interviewing. A total of 1666 patients participated in the study, and 1291 patients completed all four visits. CONCLUSION The IQCAMP study was the first healthcare utilization, cost, and quality survey in Iran with a longitudinal data collection to represent the pattern, quantity, and quality of medical care provided for high-burden conditions.
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Affiliation(s)
- Saeid Shahraz
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, Massachusetts, USA
| | - Sarvenaz Shahin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahbal
- School of Agriculture and Food Science, The University of Queensland, Brisbane, Australia
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Haas School of Business, University of California, Berkeley, CA, USA
| | - Mohammadreza Naderian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoume Amin-Esmaeili
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahedeh Seyfi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Samadi
- Psychiatry and Behavioral Sciences Research Center, Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bahram Mohajer
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sherafat-Kazemzadeh
- Institute for Global Health and Development, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Abbas Balouchi
- Nursing Department, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Bita Mesgarpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Fatemeh Gorgani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saral Rahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghadam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khezrian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Amin
- Cardiogenetics Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shahab Baheshmat
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Beyranvand
- Department of Cardiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Haghjoo
- Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Mahdavi-Mazdeh
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Mehrpour
- Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, Florida, USA
| | - Besharat Rahimi
- Advanced Thoracic Research Centre, Tehran University of Medical Science, Tehran, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Rikhtegar
- Institute for Diagnostic and Interventional Radiology, Alfried Krupp Hospital Ruttenscheid, Essen, Germany
| | - Shahin Roshani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saadatnia
- Isfahan Neurosciences Research Centre, Alzahra Research Institute, Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Mehdi Samimi Ardestani
- Departments of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahab Khatibzadeh
- Heller School of Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
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Mesgarpour B, Sadeghirad B. Cochrane in CORR® : Reducing Medication Errors for Adults in Hospital Settings. Clin Orthop Relat Res 2023; 481:17-24. [PMID: 36473112 PMCID: PMC9750574 DOI: 10.1097/corr.0000000000002497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Bita Mesgarpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Sadeghirad
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
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Mohsenzadeh P, Ardekani A, Poustchi H, Mohammadi Z, Abdipour Mehrian SR, Bazrafshan Drissi H, Rahimian Z, Taherifard E, Nabavizadeh A, Kamalipour A, Mesgarpour B, Malekzadeh F, Molavi Vardanjani H. Population-based pattern of medication use and prevalence of polypharmacy among patients with cardiovascular diseases: results of the Pars cohort study from Iran. BMC Cardiovasc Disord 2022; 22:435. [PMID: 36203125 PMCID: PMC9536013 DOI: 10.1186/s12872-022-02872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Polypharmacy in patients with cardiovascular diseases (CVDs) has been linked to several adverse outcomes. This study aimed to investigate the pattern of medication use and prevalence of polypharmacy among CVDs patients in Iran.
Method We used the baseline data of the Pars cohort study (PCS). The participants were asked to bring their medication bags; then, the medications were classified using the Anatomical Therapeutic Chemical classification. Polypharmacy was defined as using five or more medications concurrently. Poisson regression modeling was applied. The adjusted prevalence ratios (PR) and its 95% confidence interval (CI) were estimated. Results Totally, 9262 participants were enrolled in the PCS, of whom 961 had CVDs. The prevalence of polypharmacy in participants with and without CVDs was 38.9% and 7.1%, respectively. The highest prevalence of polypharmacy (51.5%) was among obese patients. Abnormal waist-hip ratio (PR: 2.79; 95% CI 1.57–4.94), high socioeconomic status (PR: 1.65; 95% CI 1.07–2.54), tobacco-smoking (PR: 1.35; 95% CI 1.00–1.81), patients with more than three co-morbidities (PR: 1.41; 95% CI 1.30–1.53), high physical activity (PR: 0.66; 95% CI 0.45–0.95), use of opiate ever (PR: 0.46; 95% CI 0.26–0.82), and healthy overweight subjects (PR: 0.22; 95% CI 0.12–0.39) were associated with polypharmacy. Cardiovascular drugs (76.1%), drugs acting on blood and blood-forming organs (50.4%), and alimentary tract and metabolism drugs (33.9%) were the most frequently used drugs. Agents acting on the renin-angiotensin system were the mostly used cardiovascular system drugs among men and those above 60 years old, while beta-blocking agents were mostly prevalent among cardiovascular system drugs in women with CVDs. Conclusion Given the high prevalence of polypharmacy among CVDs patients, and subsequent complications, programs to educate both physicians and patients to prevent this issue is crucial.
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Affiliation(s)
- Pooran Mohsenzadeh
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Ardekani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Reza Abdipour Mehrian
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Bazrafshan Drissi
- Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Rahimian
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Erfan Taherifard
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Nabavizadeh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Kamalipour
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA, USA
| | - Bita Mesgarpour
- Vice Chancellery for Research and Technology, National Institute for Medical Research and Development (NIMAD), Tehran, Iran
| | - Fatemeh Malekzadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Molavi Vardanjani
- MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Khalili M, Sharifi H, Mesgarpour B, Kheirandish M, Olsson S, Javidnikou N, Haghdoost AA. Evaluation of Pharmacovigilance System in Iran. Int J Health Policy Manag 2022; 11:990-1000. [PMID: 33590736 PMCID: PMC9808195 DOI: 10.34172/ijhpm.2020.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/28/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Evaluating a pharmacovigilance system helps identify its deficiencies and could facilitate measures to remedy and improve the quantity and quality of adverse drug reaction (ADR) reports and other opportunities for pharmacovigilance systems strengthening. This study aimed to evaluate the status of pharmacovigilance in Iran using the World Health Organization (WHO) pharmacovigilance indicators with the prospect of identifying the gaps and areas for improvement. METHODS This study was conducted in 2 parts. The first part included a secondary analysis of the national data obtained from the Iranian National Pharmacovigilance Center (PVC) using a structured data collection form based on WHO core pharmacovigilance indicators. In the second part, a 3-month prospective study was carried out to investigate 2 outcome indicators, ie, length of stay and costs of medicine-related hospitalization in all patients of 2 main referral hospitals in the southeast and north of Iran. RESULTS Iran has a PVC with national policy, trained staff, and a statutory budget. In 2017, the number of ADR reports was 15.0 per 100 000 population, and 262 signals were detected during the preceding 5 years. The average length of stay and costs of medicine-related hospitalization were 5 days and US$817.2 in Afzalipour hospital and 6.6 days and US$306.7 in Razi hospital, respectively. The status of pharmacovigilance in the Iranian public health programs (PHPs) is unknown, and most of the indicators could not be assessed. CONCLUSION A robust pharmacovigilance system is a pivotal part of the overall medicines regulatory system. The Iranian pharmacovigilance system has relatively the proper structural condition. Though the underreporting of ADRs, especially medicine-related deaths, is an important issue, and some indicators' status was unclear. The Iranian pharmacovigilance program requires a higher prioritization, particularly in the PHPs, a greater allocation of resources, and cross-sectoral cooperation to bolster and achieve the pharmacovigilance objectives.
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Affiliation(s)
- Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development, Tehran, Iran
| | - Mehrnaz Kheirandish
- Department for Assessment and Control of Prescribing and Use of Medicines and Health Products, Food and Drug Administration, Tehran, Iran
| | - Sten Olsson
- International Society of Pharmacovigilance, London, UK
- Pharmacovigilance Consulting, Uppsala, Sweden
| | | | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Hatami H, Sotgiu G, Bostanghadiri N, Abadi SSD, Mesgarpour B, Goudarzi H, Migliori GB, Nasiri MJ. Bedaquiline-containing regimens and multidrug-resistant tuberculosis: a systematic review and meta-analysis. J Bras Pneumol 2022; 48:e20210384. [PMID: 35649043 PMCID: PMC8836629 DOI: 10.36416/1806-3756/e20210384] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/30/2021] [Indexed: 12/01/2022] Open
Abstract
Objective: Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening infectious disease. Treatment requires multiple antimicrobial agents used for extended periods of time. The present study sought to evaluate the treatment success rate of bedaquiline-based regimens in MDR-TB patients. Methods: This was a systematic review and meta-analysis of studies published up to March 15, 2021. The pooled treatment success rates and 95% CIs were assessed with the fixed-effect model or the random-effects model. Values of p < 0.05 were considered significant for publication bias. Results: A total of 2,679 articles were retrieved by database searching. Of those, 29 met the inclusion criteria. Of those, 25 were observational studies (including a total of 3,536 patients) and 4 were experimental studies (including a total of 440 patients). The pooled treatment success rate was 74.7% (95% CI, 69.8-79.0) in the observational studies and 86.1% (95% CI, 76.8-92.1; p = 0.00; I2 = 75%) in the experimental studies. There was no evidence of publication bias (p > 0.05). Conclusions: In patients with MDR-TB receiving bedaquiline, culture conversion and treatment success rates are high even in cases of extensive resistance.
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Affiliation(s)
- Hossein Hatami
- . Department of Public Health, School of Public Health and Safety; Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Giovanni Sotgiu
- . Unità di Epidemiologia Clinica e Statistica Medica, Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università degli Studi di Sassari, Sassari, Italia
| | - Narjess Bostanghadiri
- . Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sahel Shafiee Dolat Abadi
- . Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- . Department of Public and International Affairs, National Institute for Medical Research Development - NIMAD - Tehran, Iran
| | - Hossein Goudarzi
- . Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Javad Nasiri
- . Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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10
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Kabir A, Sofi-Mahmudi A, Karimi Behnagh A, Eidkhani V, Baradaran HR, Kabiri P, Haghdoost A, Mesgarpour B. Risk of Bias in Iranian Randomized Trials Included in Cochrane Reviews. Arch Iran Med 2022; 25:375-382. [PMID: 35943017 DOI: 10.34172/aim.2022.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 09/15/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Among interventional studies, randomized controlled trials (RCTs) provide the highest level of evidence. However, RCTs can be susceptible to the risk of bias (RoB). Systematic reviews can be performed to appraise RoB in the included articles using evaluative tools. This study aimed to describe the main characteristics and focus on the RoB of RCTs conducted in Iran and included in Cochrane Reviews (CRs). METHODS We searched "Iran" by selecting the "Search All Text" and "Review" fields in the Cochrane Database of Systematic Reviews within Ovid. CRs that included the RCTs conducted in Iran were retrieved. A trial was selected only if it was included in CRs, described as a controlled clinical trial, involved human subjects and CR authors assessed its RoB. The trials were characterized by investigating the relevant articles and the table "Characteristics of included studies" in each CR. The RoB was investigated by collecting the review authors' judgments based on RoB assessment tables in the CRs. RESULTS Out of 1166 Iranian RCTs included by 571 CRs, low RoB was found in 44.9% for random sequence generation, 20.8% for allocation concealment, 32.3% for blinding of participants/personnel, 36.5% for blinding of outcome assessors, 56.3% for incomplete outcome data, 41.3% for selective outcome reporting and 53.8% for other sources of bias. CONCLUSION The RoB in Iranian RCTs was found to be mostly high or unclear. While this is similar to the global situation, it is recommended that the methodological quality of conducting and reporting RCTs be addressed in Iran.
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Affiliation(s)
- Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Ahmad Sofi-Mahmudi
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Arman Karimi Behnagh
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Eidkhani
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Payam Kabiri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - AliAkbar Haghdoost
- Social Determinants of Health Research Centre, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Bita Mesgarpour
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
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11
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Yazdizadeh B, Ehsani-Chimeh E, Zendehdel K, Mobinizadeh M, Mesgarpour B, Fakoorfard Z. Knowledge gaps and national research priorities for COVID-19 in Iran. Health Res Policy Syst 2022; 20:25. [PMID: 35236369 PMCID: PMC8889392 DOI: 10.1186/s12961-021-00805-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the present COVID-19 crisis, one of the greatest challenges for research funding at both the international and national level is selecting the best research topic to achieve efficiency and equity in health research and to address the knowledge gap urgently raised due to the event. Despite international recommendations, countries should consider their context-specific situation and define local research priorities. We aimed to exercise a priority-setting activity to identify the knowledge gaps and suggest research priorities in response to the COVID-19 epidemic in Iran. METHODS First, we tried to identify the contextual knowledge gaps based on an online survey, performing key informant interviews (i.e. health professionals, policy-makers and managers) and media analysis. We also performed a literature review and considered international research priorities for COVID-19. Subsequently, we prepared a list of research questions and challenges to respond to the COVID-19 crisis in Iran using a systems approach. Then we mapped approved COVID-19 research projects in the country to research questions. Finally, we compared the identified research questions (not challenges) with the prioritized research from international organizations and then prioritized them for Iran. RESULTS We found risk factors and epidemiological dissemination patterns of the virus and its consequences in an epidemiology domain, implementation of clinical and hygiene in a clinical management domain, genetic studies for targeting prevention and treatment in a candidate treatment and vaccine research and development (R&D) knowledge domain, examination of the manifestations of ethics in society instead of ethics in research in an ethics domain, "care, access and health system" and "public health and participation in response to public health and clinical research" as two sub-domains of a social sciences domain, and finally, no new questions in either the virology, transmission, diagnosis or animal and environmental domain. CONCLUSIONS In the event of global health crises like COVID-19, prioritization of research questions can be done globally, but some of the research priorities are context-specific and may vary by regional needs. To better manage research resources, researchers must respond to the challenges faced in each country based on its political, economic, social and cultural characteristics, and to make evidence-informed decisions, global knowledge gaps must be customized in each country.
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Affiliation(s)
- Bahareh Yazdizadeh
- Epidemiology, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ehsani-Chimeh
- Health Services Management, National Institute for Health Research, Tehran University of Medical Science, Tehran, Iran.
| | - Kazem Zendehdel
- Epidemiology, Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Mobinizadeh
- Health Services Management, National Institute for Health Research, Tehran University of Medical Science, Tehran, Iran
| | - Bita Mesgarpour
- Pharmacoepidemiology, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Zeinab Fakoorfard
- Health Economics, National Institute for Health Research, Tehran University of Medical Science, Tehran, Iran
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12
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Dehghani M, Kahouei M, Akhondzadeh S, Mesgarpour B, Ferdousi R. Expectations of Health Researchers From Academic Social Network Sites: Qualitative Study. J Med Internet Res 2021; 23:e24643. [PMID: 34878993 PMCID: PMC8693187 DOI: 10.2196/24643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/29/2020] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Today, academic social network sites' role in improving the quality of education and how investigators conduct their research has become more critical. OBJECTIVE This study aimed to investigate Iranian health researchers' requirements for academic social network sites from a low-income country perspective. METHODS This qualitative study with a phenomenological approach was done in 2020. In this study, 23 researchers in the health system were selected by purposive sampling. Semistructured interviews were used to collect data. Data were analyzed by MaxQDA-10 software and the content analysis method. RESULTS We identified 2 categories of functional and technical characteristics in the study participants' expectations. Functional characteristics included facilitating communication and team activities, managing scientific publications, enhancing the process of conducting research, being informative, and sharing and trading laboratory materials and equipment. Technical characteristics of an academic social network include user management capabilities, high security and privacy, being user-friendly, and other technical features. CONCLUSIONS Health researchers emphasized 2 functional and technical characteristics required to meet academic social network sites' expectations.
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Affiliation(s)
- Mohammad Dehghani
- Department of Health Information Technology, Khomein University of Medical Sciences, Khomein, Iran
| | - Mehdi Kahouei
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Reza Ferdousi
- Department of Health Information Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Sofi-Mahmudi A, Iranparvar P, Shakiba M, Shamsoddin E, Mohammad-Rahimi H, Naseri S, Motie P, Tovani-Palone MR, Mesgarpour B. Quality Assessment of Studies Included in Cochrane Oral Health Systematic Reviews: A Meta-Research. Int J Environ Res Public Health 2021; 18:ijerph18147284. [PMID: 34299733 PMCID: PMC8306360 DOI: 10.3390/ijerph18147284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/03/2021] [Accepted: 07/04/2021] [Indexed: 01/02/2023]
Abstract
Objectives: To assess the Risk of Bias (RoB) and other characteristics of published randomised clinical trials within Cochrane oral health systematic reviews. Materials and methods: All the published clinical trials within Cochrane oral health systematic reviews until 1 June 2020 were identified and examined. RoB was assessed for all the included clinical trials according to the Cochrane review standards. The Overall Risk of Bias (ORoB) was defined in this study using Cochrane’s RoB tool-v2. Descriptive analyses were carried out to determine the frequency of each variable in the study sample. Results: Out of a total of 2565 included studies, the majority (n = 1600) had sample sizes of 50 or higher. Regarding blinding, 907 studies were labelled as double-blind. Among the various domains of bias, the performance bias showed the highest rate of high risk (31.4%). Almost half of the studies had a high ORoB, compared to 11.1% with a low ORoB. The studies that used placebos had a higher percentage of low ORoB (14.8% vs. 10.7%). Additionally, the double- and triple-blind studies had higher percentages of low ORoB (23.6% and 23.3%, respectively), while the studies with a crossover design had the highest percentage of low ORoB (28.8%). Conclusion: The RoB of oral health studies published as Cochrane reviews was deemed high.
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Affiliation(s)
- Ahmad Sofi-Mahmudi
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran 1419693111, Iran; (A.S.-M.); (P.I.); (M.S.); (E.S.)
| | - Pouria Iranparvar
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran 1419693111, Iran; (A.S.-M.); (P.I.); (M.S.); (E.S.)
| | - Maryam Shakiba
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran 1419693111, Iran; (A.S.-M.); (P.I.); (M.S.); (E.S.)
| | - Erfan Shamsoddin
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran 1419693111, Iran; (A.S.-M.); (P.I.); (M.S.); (E.S.)
| | - Hossein Mohammad-Rahimi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran;
| | - Sadaf Naseri
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran; (S.N.); (P.M.)
| | - Parisa Motie
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran; (S.N.); (P.M.)
| | - Marcos Roberto Tovani-Palone
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
- Correspondence: (M.R.T.-P.); (B.M.)
| | - Bita Mesgarpour
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran 1419693111, Iran; (A.S.-M.); (P.I.); (M.S.); (E.S.)
- Correspondence: (M.R.T.-P.); (B.M.)
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14
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Shamsoddin E, Torkashvand-Khah Z, Sofi-Mahmudi A, Janani L, Kabiri P, Shamsi-Gooshki E, Mesgarpour B. Assessing research misconduct in Iran: a perspective from Iranian medical faculty members. BMC Med Ethics 2021; 22:74. [PMID: 34154574 PMCID: PMC8215315 DOI: 10.1186/s12910-021-00642-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/10/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Research misconduct is a global concern in biomedical science. There are no comprehensive data regarding the perception and situation of scientific misconduct among the Iranian medical faculty members. We conducted a nationwide survey to assess the research misconduct among the medical faculty members in Iran. METHODS We used the Persian version of the research misconduct questionnaire (PRMQ) on the Google Forms platform. We sent the survey link to a systematic random sample of medical faculty members in Iran (N = 4986). Descriptive analyses were performed on the individual items of the PRMQ, with frequencies and percentages for categorical and Likert-type response items, and means and standard deviation (S.D.) for continuous variables. Chi-square analysis was conducted to test hypotheses examining differences in the frequency of responses related to factors influencing misconduct. We also defined four tenure categories (TC) based on the working years of the participants as tenured faculty members. All the analyses were performed using R 3.6.0. RESULTS The response rate was 13.8% (692 responses). Nearly 70% of the respondents agreed that their publication output would be of higher quality if there were no publication pressure. Approximately three-quarters (N =499, 72.1%) of the respondents had been aware of some instances of research misconduct during the previous year according to their understanding of misconduct. Among the participants, 18.5% perceived the effectiveness of their associated organisation's rules for reducing research misconduct to be high or very high. Pressure for tenure was identified as the item most frequently perceived with a strong behavioural influence on engaging in research misconduct (80.2%). CONCLUSIONS This study confirms that research misconduct needs to be actively addressed among the medical faculty members. Making policies with a focus on boosting awareness regarding the occasions of scientific misconduct and its management seems to be indispensable in the future in Iran.
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Affiliation(s)
- Erfan Shamsoddin
- National Institute for Medical Research Development (NIMAD), West Fatemi St., Tehran, Tehran, 1419693111, Iran
| | - Zahra Torkashvand-Khah
- National Institute for Medical Research Development (NIMAD), West Fatemi St., Tehran, Tehran, 1419693111, Iran
| | - Ahmad Sofi-Mahmudi
- National Institute for Medical Research Development (NIMAD), West Fatemi St., Tehran, Tehran, 1419693111, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Payam Kabiri
- Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Shamsi-Gooshki
- Department of Medical Ethics, Faculty of Medicine/Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), West Fatemi St., Tehran, Tehran, 1419693111, Iran.
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15
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Khalili M, Mesgarpour B, Sharifi H, Golozar A, Haghdoost AA. Estimation of adverse drug reaction reporting in Iran: Correction for underreporting. Pharmacoepidemiol Drug Saf 2021; 30:1101-1114. [PMID: 33772938 DOI: 10.1002/pds.5235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/22/2021] [Accepted: 03/24/2021] [Indexed: 12/17/2022]
Abstract
PROPOSE Underreporting of Adverse Drug Reactions (ADRs) reduces the sensitivity of pharmacovigilance systems. We described ADR reporting and its trend from 1999 to 2017 and estimated the ADR underreporting in the Iranian Pharmacovigilance Center. METHODS We expressed the number of ADR reporting per inhabitants and admissions and their possible trends. Finally, ADR underreporting percentages were estimated by three approaches: prospective studies, literature review, stratification of the country; and the trend of the proportion of ADR per inhabitants was corrected. RESULTS The proportion of ADR reporting was 15.3 per 100 000 inhabitants (95% CI: 15.2, 15.8) and 10.0 per 100 000 admissions (95% CI: 9.8, 10.2) in 2017, and its trend was increasing with 16.3% average change per annum during 19 years. The median of estimated percentages of underreporting was 76.0% (IQR: 64.32-81.35). After the correction, the mean proportion of ADR reporting for 19 years reached from 5.87 to 10.33 per 100 000 inhabitants. CONCLUSIONS The trend of ADRs reporting has been increasing over the 19 years but is still low. This study showed a considerable underreporting of ADR, and about one of four detected ADRs were reported to the pharmacovigilance center from 1999 to 2017.
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Affiliation(s)
- Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bita Mesgarpour
- Department of Public and International Affairs, National Institute for Medical Research Development, Tehran, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Asieh Golozar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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16
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Dehghani M, Mesgarpour B, Akhondzadeh S, Azami-Aghdash S, Ferdousi R. How the US Sanctions Are Affecting the Health Research System in Iran? Arch Iran Med 2021; 24:101-106. [PMID: 33636976 DOI: 10.34172/aim.2021.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/08/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND In November 2018, the United States withdrew from the Joint Comprehensive Plan of Action (JCPOA), known commonly as the Iran nuclear deal, and imposed severe sanctions on Iran. This study explores the impact of US sanctions in Iran's health research system. METHODS This phenomenological study interviewed 24 Iranian health science scholars through purposeful sampling to learn about their experiences and thoughts regarding the impact of US sanctions on Iran's health research system. RESULTS The impact of sanctions on Iran's health research system were classified into five categories: (a) financial issues, (b) difficulty in supplying laboratory materials and (c) equipment, (d) disruption in international research collaboration and activities, and (e) other issues (e.g., increased stress and workload). CONCLUSION This study indicated that since research centers in Iran are highly dependent on governmental budgets, sanctions have greatly affected the health research system in Iran. Financial and economic problems, restrictions in transferring funds, and the disruption in political and international relations have created many challenges for supplying medical laboratory materials and equipment for medical and health research centers in Iran.
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Affiliation(s)
- Mohammad Dehghani
- Department of Health Information Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Ferdousi
- Department of Health Information Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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17
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Yazdizadeh B, Majdzadeh R, Ahmadi A, Mesgarpour B. Health research system resilience: lesson learned from the COVID-19 crisis. Health Res Policy Syst 2020; 18:136. [PMID: 33339524 PMCID: PMC7747187 DOI: 10.1186/s12961-020-00667-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 12/06/2020] [Indexed: 12/28/2022] Open
Abstract
Producing evidence in epidemics is crucial to control the current epidemic and prevent its recurrence in the future. Data must be collected and analyzed rapidly to recognize the most efficient and feasible methods with proper timelines. However, there are many challenges a research system may encounter during a crisis. This article has presented lessons learned from the COVID-19 pandemic for health research system (HRS) to deal with current and future crises. Therefore, a HRS needs to produce and use evidence in such a situation. The components Knowledge Translation Self-Assessment Tool for Research Institutes (SATORI) framework was used to review the actions required and respond to the COVID-19 pandemic in a national HRS. This framework consists of four categories of defining the research question, conducting research, translating the research results, and promoting the use of evidence. The work is proposed actions in response to the COVID-19 crisis and improving a HRS's resilience. While COVID-19 has serious harm to the health and broader socio-economic consequences, this threat should be accounted for as an opportunity to make research systems more accountable and responsible in the timely production and utilization of knowledge. It is time to seriously think about how HRS can build a better back to be resilient to potential shock and prepare for unforeseen emerging conditions.
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Affiliation(s)
- Bahareh Yazdizadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community-based Participatory Research Center, Knowledge Utilization Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ayat Ahmadi
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), Tehran, Iran
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18
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Affiliation(s)
- Mohammad Dehghani
- Scientific and Educational Center for Health Management of Iran, Tabriz, Iran.,Student Research Committee, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Reza Ferdousi
- Department of Health Information Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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19
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Shamsoddin E, Janani L, Ghamari K, Kabiri P, Shamsi Gooshki E, Mesgarpour B. Psychometric properties of Persian version of the research misconduct questionnaire (PRMQ). J Med Ethics Hist Med 2020; 13:18. [PMID: 33552451 PMCID: PMC7838887 DOI: 10.18502/jmehm.v13i18.4826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/01/2020] [Indexed: 12/05/2022] Open
Abstract
Assessment of scientific misconduct is considered to be an increasingly important topic in medical sciences. Providing a definition for scientific research misconduct and proposing practical methods for evaluating and measuring it in various fields of medicine discipline are required. This study aimed at assessing the psychometric properties of Scientific Research Misconduct-Revised (SMQ-R) and Publication Pressure Questionnaires (PPQ). After translation and merging of these two questionnaires, the validity of the translated draft was evaluated by 11-member expert panel using Content Validity Index (CVI) and Content Validity Ratio (CVR). Reliability of the final questionnaire, completed by 100 participants randomly chosen from medical academic members, was assessed by calculating Cronbach’s alpha coefficient. The final version was named Persian Research Misconduct Questionnaire (PRMQ) and consisted of 63 question items. The item-level content validity indices of 61 questions were above 0.79, and reliability assessment showed that 6 out of 7 subscales had alpha values higher than 0.6. Hence, PRMQ can be considered an acceptable, valid and reliable tool to measure research misconduct in biomedical sciences researches in Iran.
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Affiliation(s)
- Erfan Shamsoddin
- Research Assistant, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Leila Janani
- Associate Professor, Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Kiandokht Ghamari
- Research Assistant, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Payam Kabiri
- Senior Research Fellow, Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Shamsi Gooshki
- Assistant Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- Assistant Professor, National Institute for Medical Research Development (NIMAD), Tehran, Iran
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Mesgarpour B, Aghababa S, Baradaran HR, Kabiri P, Kabir A, Sofi-Mahmudi A, Haghdoost AA. Achievements of the Cochrane Iran Associate Centre: Lessons Learned. Int J Health Policy Manag 2020; 9:222-228. [PMID: 32613789 PMCID: PMC7382907 DOI: 10.15171/ijhpm.2019.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/23/2019] [Indexed: 11/09/2022] Open
Abstract
Healthcare decision-making is a process that mainly depends on evidence and involves increasing numbers of stakeholders, including the consumers. Cochrane evidence responds to this challenge by identifying, appraising, integrating and synthesizing high-quality evidence. Recently, a collaborative effort has been initiated in Iran with Cochrane to establish a representative local entity. A variety of multifaceted interventions were conducted according to Cochrane’s strategy to 2020, such as producing evidence, making Cochrane evidence accessible, advocating for evidence and building an effective and sustainable organization. In this report, the authors present the two and half year performance and achievements of Cochrane Iran based on a comprehensive and systematic approach. This case might be an example of health diplomacy, which is initiated by a successful international collaboration and proceed with recognizing the importance of adherence to the strategic action plans and goals.
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Affiliation(s)
- Bita Mesgarpour
- Cochrane Iran Associate Centre, National Institute for Medical research Development (NIMAD), Tehran, Iran
| | - Sara Aghababa
- Cochrane Iran Associate Centre, National Institute for Medical research Development (NIMAD), Tehran, Iran
| | - Hamid Reza Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Payam Kabiri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Sofi-Mahmudi
- Cochrane Iran Associate Centre, National Institute for Medical research Development (NIMAD), Tehran, Iran
| | - Ali Akbar Haghdoost
- Social Determinants of Health Research Centre, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Khalili M, Mesgarpour B, Sharifi H, Daneshvar Dehnavi S, Haghdoost AA. Interventions to improve adverse drug reaction reporting: A scoping review. Pharmacoepidemiol Drug Saf 2020; 29:965-992. [DOI: 10.1002/pds.4966] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 12/19/2019] [Accepted: 01/03/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development Tehran Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Samira Daneshvar Dehnavi
- Rajaie Cardiovascular Medical and Research Center Iran University of Medical Sciences Tehran Iran
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
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Moazen-Zadeh E, Bayanati S, Ziafat K, Rezaei F, Mesgarpour B, Akhondzadeh S. Vortioxetine as adjunctive therapy to risperidone for treatment of patients with chronic schizophrenia: A randomised, double-blind, placebo-controlled clinical trial. J Psychopharmacol 2020; 34:506-513. [PMID: 32122230 DOI: 10.1177/0269881120909416] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION AND OBJECTIVES Vortioxetine, a novel antidepressant, may be an interesting candidate for adjunctive therapy of schizophrenia. Our primary objective was to investigate the effect of vortioxetine on negative symptoms, with the assessment of positive, general psychopathology and total symptoms as our secondary goal. METHODS This was an eight-week randomised, double-blind, placebo-controlled, parallel-group clinical trial, in which 78 inpatients with chronic schizophrenia were stabilised with risperidone (4-6 mg/day) for two months before being assigned to adjunctive vortioxetine (10 mg b.i.d.) or placebo. The patients were assessed using the Positive and Negative Syndrome Scale (PANSS), Extrapyramidal Symptom Rating Scale and Hamilton Depression Rating Scale during the study course. All participants had a PANSS negative symptoms subscale score of ⩾16 at baseline. Sixty-eight patients completed the trial. RESULTS Vortioxetine improved the negative symptoms score as the primary outcome and total PANSS score as a secondary outcome significantly better than placebo from baseline to end point at week 8, accompanied by significant time × treatment interactions and effect sizes (negative symptoms: mean difference (95% confidence interval (CI)) = -1.82 (-2.73 to -0.92); total scores: mean difference (95% CI) = -2.09 (-3.16 to -1.01). No significant difference was detected for changes in positive symptoms score or PANSS general psychopathology score as the other secondary outcomes from baseline to end point between the two treatment arms. The incidence of adverse events was comparable between groups. CONCLUSIONS This is the first study to provide evidence for the therapeutic effect of vortioxetine on negative symptoms as an adjunctive to treatment with antipsychotics in patients with schizophrenia.
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Affiliation(s)
- Ehsan Moazen-Zadeh
- Psychiatric Research Centre, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada
| | - Samaneh Bayanati
- Psychiatric Research Centre, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimia Ziafat
- Psychiatric Research Centre, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada
| | - Farzin Rezaei
- Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Centre, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
BACKGROUND Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined evidence about the use of acupuncture and acupressure for pain management in labour. This is an update of a review last published in 2011. OBJECTIVES To examine the effects of acupuncture and acupressure for pain management in labour. SEARCH METHODS For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, (25 February 2019), the Cochrane Central Register of Controlled Trials (the Cochrane Library 2019, Issue 1), MEDLINE (1966 to February 2019), CINAHL (1980 to February 2019), ClinicalTrials.gov (February 2019), the WHO International Clinical Trials Registry Platfory (ICTRP) (February 2019) and reference lists of included studies. SELECTION CRITERIA Published and unpublished randomised controlled trials (RCTs) comparing acupuncture or acupressure with placebo, no treatment or other non-pharmacological forms of pain management in labour. We included all women whether nulliparous or multiparous, and in spontaneous or induced labour. We included studies reported in abstract form if there was sufficient information to permit assessment of risk of bias. Trials using a cluster-RCT design were eligible for inclusion, but quasi-RCTs or cross-over studies were not. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included 28 trials with data reporting on 3960 women. Thirteen trials reported on acupuncture and 15 trials reported on acupressure. No study was at a low risk of bias on all domains. Pain intensity was generally measured on a visual analogue scale (VAS) of 0 to 10 or 0 to 100 with low scores indicating less pain. Acupuncture versus sham acupuncture Acupuncture may make little or no difference to the intensity of pain felt by women when compared with sham acupuncture (mean difference (MD) -4.42, 95% confidence interval (CI) -12.94 to 4.09, 2 trials, 325 women, low-certainty evidence). Acupuncture may increase satisfaction with pain relief compared to sham acupuncture (risk ratio (RR) 2.38, 95% CI 1.78 to 3.19, 1 trial, 150 women, moderate-certainty evidence), and probably reduces the use of pharmacological analgesia (RR 0.75, 95% CI 0.63 to 0.89, 2 trials, 261 women, moderate-certainty evidence). Acupuncture may have no effect on assisted vaginal birth (very low-certainty evidence), and probably little to no effect on caesarean section (low-certainty evidence). Acupuncture compared to usual care We are uncertain if acupuncture reduces pain intensity compared to usual care because the evidence was found to be very low certainty (standardised mean difference (SMD) -1.31, 95% CI -2.14 to -0.49, 4 trials, 495 women, I2 = 93%). Acupuncture may have little to no effect on satisfaction with pain relief (low-certainty evidence). We are uncertain if acupuncture reduces the use of pharmacological analgesia because the evidence was found to be very low certainty (average RR 0.72, 95% CI 0.60 to 0.85, 6 trials, 1059 women, I2 = 70%). Acupuncture probably has little to no effect on assisted vaginal birth (low-certainty evidence) or caesarean section (low-certainty evidence). Acupuncture compared to no treatment One trial compared acupuncture to no treatment. We are uncertain if acupuncture reduces pain intensity (MD -1.16, 95% CI -1.51 to -0.81, 163 women, very low-certainty evidence), assisted vaginal birth or caesarean section because the evidence was found to be very low certainty. Acupuncture compared to sterile water injection We are uncertain if acupuncture has any effect on use of pharmacological analgesia, assisted vaginal birth or caesarean section because the evidence was found to be very low certainty. Acupressure compared to a sham control We are uncertain if acupressure reduces pain intensity in labour (MD -1.93, 95% CI -3.31 to -0.55, 6 trials, 472 women) or assisted vaginal birth because the evidence was found to be very low certainty. Acupressure may have little to no effect on use of pharmacological analgesia (low-certainty evidence). Acupressure probably reduces the caesarean section rate (RR 0.44, 95% CI 0.27 to 0.71, 4 trials, 313 women, moderate-certainty evidence). Acupressure compared to usual care We are uncertain if acupressure reduces pain intensity in labour (SMD -1.07, 95% CI -1.45 to -0.69, 8 trials, 620 women) or increases satisfaction with pain relief (MD 1.05, 95% CI 0.75 to 1.35, 1 trial, 105 women) because the evidence was found to be very low certainty. Acupressure may have little to no effect on caesarean section (low-certainty evidence). Acupressure compared to a combined control Acupressure probably slightly reduces the intensity of pain during labour compared with the combined control (measured on a scale of 0 to 10 with low scores indicating less pain) (SMD -0.42, 95% CI -0.65 to -0.18, 2 trials, 322 women, moderate-certainty evidence). We are uncertain if acupressure has any effect on the use of pharmacological analgesia (RR 0.94, 95% CI 0.71 to 1.25, 1 trial, 212 women), satisfaction with childbirth, assisted vaginal birth or caesarean section because the certainty of the evidence was all very low. No studies were found that reported on sense of control in labour and only one reported on satisfaction with the childbirth experience. AUTHORS' CONCLUSIONS Acupuncture in comparison to sham acupuncture may increase satisfaction with pain management and reduce use of pharmacological analgesia. Acupressure in comparison to a combined control and usual care may reduce pain intensity. However, for other comparisons of acupuncture and acupressure, we are uncertain about the effects on pain intensity and satisfaction with pain relief due to very low-certainty evidence. Acupuncture may have little to no effect on the rates of caesarean or assisted vaginal birth. Acupressure probably reduces the need for caesarean section in comparison to a sham control. There is a need for further high-quality research that include sham controls and comparisons to usual care and report on the outcomes of sense of control in labour, satisfaction with the childbirth experience or satisfaction with pain relief.
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Affiliation(s)
- Caroline A Smith
- Western Sydney UniversityNICM Health Research InstituteLocked Bag 1797PenrithNew South WalesAustralia2751
| | - Carmel T Collins
- South Australian Health and Medical Research InstituteWomen and Kids72 King William RoadAdelaideSouth AustraliaAustralia5006
| | - Kate M Levett
- Western Sydney UniversityNICM Health Research InstituteLocked Bag 1797PenrithNew South WalesAustralia2751
- University of Notre DameSchool of MedicineSydneyAustralia
| | - Mike Armour
- Western Sydney UniversityNICM Health Research InstituteLocked Bag 1797PenrithNew South WalesAustralia2751
| | - Hannah G Dahlen
- Western Sydney UniversitySchool of Nursing and MidwiferyLocked Bag 1797PenrithNSWAustralia2751
| | - Aidan L Tan
- National University HospitalDepartment of Preventive MedicineSingaporeSingapore
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD)Cochrane Iran Associate CentreTehranIran
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Hajizadeh-Zaker R, Ghajar A, Mesgarpour B, Afarideh M, Mohammadi MR, Akhondzadeh S. l-Carnosine As an Adjunctive Therapy to Risperidone in Children with Autistic Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial. J Child Adolesc Psychopharmacol 2018; 28:74-81. [PMID: 29027815 DOI: 10.1089/cap.2017.0026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES This study aimed at investigating the efficacy and tolerability of l-carnosine as an add-on to risperidone in the management of children with autism. METHODS This was a 10-week, randomized, double-blind, placebo-controlled study. Seventy drug-free children aged 4-12 years old with a diagnosis of autism spectrum disorder (ASD), according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. (DSM-5) who had an Aberrant Behavior Checklist-Community (ABC-C) scale irritability subscale score of ≥12, entered the study. The patients were randomly assigned to l-carnosine (800 mg/day in 2 divided doses) or placebo in addition to risperidone titrated up to 2 mg/day (based on body weight) for 10 weeks. The children were assessed by using ABC-C at baseline and weeks 5 and 10 post-baseline. The primary outcome measure was the mean change in the ABC-C irritability subscale score, and other subscale scores were defined as secondary outcomes. RESULTS Using the general linear model repeated measures, no significant effect was observed for time × treatment interaction on the irritability subscale scores. However, significant effect was detected on the hyperactivity/noncompliance subscale [F (1.62, 64.96) = 3.53, p-value = 0.044]. No significant improvements were obtained on the lethargy/social withdrawal, stereotypic behavior, and inappropriate speech subscale scores. Significantly greater score reduction in the hyperactivity/noncompliance subscale occurred in the l-carnosine group compared with the placebo group at the end of the trial. Extrapyramidal Symptom Rating Scale Scores and its changes did not differ between the two groups. The frequency of other side effects was not significantly different between the two groups. CONCLUSIONS Although no significant difference was detected on the irritability subscale scores, l-carnosine add-on can improve hyperactivity/noncompliance subscales of the ABC-C rating scale in patients with ASD.
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Affiliation(s)
- Reihaneh Hajizadeh-Zaker
- 1 Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Alireza Ghajar
- 1 Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Bita Mesgarpour
- 2 National Institute for Medical Research Development (NIMAD) , Tehran, Iran
| | - Mohsen Afarideh
- 1 Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Mohammad-Reza Mohammadi
- 1 Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Shahin Akhondzadeh
- 1 Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
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Abstract
BACKGROUND Anaemia is a common problem experienced by critically-ill people. Treatment with erythropoiesis-stimulating agents (ESAs) has been used as a pharmacologic strategy when the blunted response of endogenous erythropoietin has been reported in critically-ill people. The use of ESAs becomes more important where adverse clinical outcomes of transfusing blood products is a limitation. However, this indication for ESAs is not licensed by regulatory authorities and is called off-label use. Recent studies concern the harm of ESAs in a critical care setting. OBJECTIVES To focus on harms in assessing the effects of erythropoiesis-stimulating agents (ESAs), alone or in combination, compared with placebo, no treatment or a different active treatment regimen when administered off-label to critically-ill people. SEARCH METHODS We conducted a systematic search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO via OvidSP, CINAHL, all evidence-based medicine (EBM) reviews including IPA and SCI-Expanded, Conference Proceedings Citation Index- Science, BIOSIS Previews and TOXLINE up to February 2017. We also searched trials registries, checked reference lists of relevant studies and tracked their citations by using SciVerse Scopus. SELECTION CRITERIA We considered randomized controlled trials (RCTs) and controlled observational studies, which compared scheduled systemic administration of ESAs versus other effective interventions, placebo or no treatment in critically-ill people. DATA COLLECTION AND ANALYSIS Two review authors independently screened and evaluated the eligibility of retrieved records, extracted data and assessed the risks of bias and quality of the included studies. We resolved differences in opinion by consensus or by involving a third review author. We assessed the evidence using GRADE and created a 'Summary of findings' table. We used fixed-effect or random-effects models, depending on the heterogeneity between studies. We fitted three-level hierarchical Bayesian models to calculate overall treatment effect estimates. MAIN RESULTS Of the 27,865 records identified, 39 clinical trials and 14 observational studies, including a total of 945,240 participants, were eligible for inclusion. Five studies are awaiting classification. Overall, we found 114 adverse events in 33 studies (30 RCTs and three observational studies), and mortality was reported in 41 studies (32 RCTs and nine observational studies). Most studies were at low to moderate risk of bias for harms outcomes. However, overall harm assessment and reporting were of moderate to low quality in the RCTs, and of low quality in the observational studies. We downgraded the GRADE quality of evidence for venous thromboembolism and mortality to very low and low, respectively, because of risk of bias, high inconsistency, imprecision and limitations of study design.It is unclear whether there is an increase in the risk of any adverse events (Bayesian risk ratio (RR) 1.05, 95% confidence interval (CI) 0.93 to 1.21; 3099 participants; 9 studies; low-quality evidence) or venous thromboembolism (Bayesian RR 1.04, 95% CI 0.70 to 1.41; 18,917 participants; 18 studies; very low-quality evidence).There was a decreased risk of mortality with off-label use of ESAs in critically-ill people (Bayesian RR 0.76, 95% CI 0.61 to 0.92; 930,470 participants; 34 studies; low-quality evidence). AUTHORS' CONCLUSIONS Low quality of evidence suggests that off-label use of ESAs may reduce mortality in a critical care setting. There was a lack of high-quality evidence about the harm of ESAs in critically-ill people. The information for biosimilar ESAs is less conclusive. Most studies neither evaluated ESAs' harm as a primary outcome nor predefined adverse events. Any further studies of ESA should address the quality of evaluating, recording and reporting of adverse events.
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Affiliation(s)
| | | | - Dominik Roth
- Medical University of ViennaDepartment of Emergency MedicineAllgemeines Krankenhaus, Währinger Gürtel
18‐20,ViennaAustria1090
| | - Susanne Schmitz
- Luxembourg Institute of HealthDepartment of Population Health1A‐B, rue Thomas EdisonStrassenLuxembourg1445
| | - Cathal D Walsh
- Department of Mathematics and StatisticsHealth Research Institute (HRI) and MACSIUniversity of LimerickIreland
| | - Harald Herkner
- Medical University of ViennaDepartment of Emergency MedicineAllgemeines Krankenhaus, Währinger Gürtel
18‐20,ViennaAustria1090
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26
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Desai RJ, Thaler KJ, Mahlknecht P, Gartlehner G, McDonagh MS, Mesgarpour B, Mazinanian A, Glechner A, Gopalakrishnan C, Hansen RA. Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review. Arthritis Care Res (Hoboken) 2017; 68:1078-88. [PMID: 26663412 DOI: 10.1002/acr.22815] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To systematically compare the risk of adverse events (AEs) for 13 targeted immunomodulators (TIMs) indicated for ankylosing spondylitis (AS), inflammatory bowel diseases, juvenile idiopathic arthritis, plaque psoriasis, psoriatic arthritis (PsA), or rheumatoid arthritis (RA). METHODS We searched electronic databases through July 2015 to retrieve randomized controlled trials (RCTs) and observational studies comparing AEs between 2 or more TIMs head-to-head. We reported on the following outcomes: number of AEs, discontinuation due to AEs, serious AEs, mortality, serious infections, tuberculosis, herpes zoster, and malignancies. We qualitatively synthesized the literature and conducted random-effects meta-analyses if 3 or more studies provided data for an outcome. RESULTS Ten head-to-head RCTs and 51 observational studies were included in this systematic review. A majority of the studies (70%) were conducted in RA patients. Risk of treatment discontinuation due to AEs was higher with infliximab than with adalimumab or etanercept in RA, PsA, and AS. A higher risk for serious infections was noted with infliximab than with abatacept, adalimumab, or etanercept in RA. Risk for treatment discontinuation due to AEs, serious infections, and tuberculosis was lower with etanercept than with adalimumab in RA. Limited evidence suggested no comparative differences in risk for mortality, malignancies, and herpes zoster for adalimumab, etanercept, and infliximab in RA. CONCLUSION Important differences were noted in the safety profile of TIMs in RA, generally favoring abatacept, adalimumab, and etanercept over infliximab. Head-to-head comparative evidence for other TIMs and non-RA populations was insufficient to draw conclusions for most of the safety outcomes.
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Affiliation(s)
- Rishi J Desai
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Gerald Gartlehner
- Danube University, Krems, Austria, and RTI International, Research Triangle Park, North Carolina
| | - Marian S McDonagh
- Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, Portland, Oregon
| | - Bita Mesgarpour
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Rezaei F, Mesgarpour B, Jeddian A, Zeionoddini A, Mohammadinejad P, Salardini E, Shahriari M, Zeinoddini A, Akhondzadeh S. Cilostazol adjunctive therapy in treatment of negative symptoms in chronic schizophrenia: Randomized, double-blind, placebo-controlled study. Hum Psychopharmacol 2017; 32. [PMID: 28421639 DOI: 10.1002/hup.2583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 03/03/2017] [Accepted: 03/05/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of cilostazol, a selective inhibitor of phosphodiesterase III, as an adjunctive to risperidone in alleviating the negative symptoms of schizophrenia. METHODS Eighty-four in-patients with diagnosis of chronic schizophrenia participated in a randomized, placebo-controlled trial and underwent 8 weeks of treatment with either cilostazol (50 mg twice a day) or placebo as an adjuvant to risperidone. Participants were assessed using the positive and negative syndrome scale (PANSS) at baseline and at weeks 2, 4, 6, and 8. The primary outcome measure of the trial was to evaluate the efficacy of cilostazol compared to placebo in improving the PANSS negative subscale score. RESULT General linear model repeated measures demonstrated significant effect for time × treatment interaction on negative subscale scores (p < .001) and PANSS total (p = .006) but did not demonstrate significant effect on the PANSS positive (p = .37) and general (p = .06) subscales. Frequency of adverse events was not significantly different between the 2 treatment groups. No serious adverse event was observed. CONCLUSION An 8-week course of treatment with cilostazol as an adjunct to risperidone showed a favorable safety and efficacy profile in patients with schizophrenia.
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Affiliation(s)
- Farzin Rezaei
- Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development, Tehran, Iran
| | - Alireza Jeddian
- Digestive Disease Research Institute, Tehran University of medical science, Tehran, Iran
| | - Atefeh Zeionoddini
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Mohammadinejad
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaheh Salardini
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Shahriari
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arefeh Zeinoddini
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Arabzadeh S, Shahhossenie M, Mesgarpour B, Rezaei F, Shalbafan MR, Ghiasi Z, Akhondzadeh S. L-carnosine as an adjuvant to fluvoxamine in treatment of obsessive compulsive disorder: A randomized double-blind study. Hum Psychopharmacol 2017; 32. [PMID: 28485008 DOI: 10.1002/hup.2584] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 02/20/2017] [Accepted: 03/03/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Dysregulation of glutamate is implicated in the pathogenesis of obsessive-compulsive disorder (OCD). Consistently, glutamate-modulating agents, such as riluzole and memantine have been used in OCD treatment. Previous research has identified some neuroprotective role for L-carnosine potentially via its modulatory effect on glutamate. Here, we assessed the efficacy of L-carnosine as adjuvant to fluvoxamine in OCD treatment. METHODS Forty-four patients diagnosed with moderate to severe OCD were recruited in a randomized double-blind trial. Patients received either L-carnosine or placebo as adjuvant to fluvoxamine for 10 weeks. The Yale- Brown Obsessive Compulsive Scale (Y-BOCS) was used for assessing the severity of symptoms at baseline and at weeks 4, 8, and 10. RESULTS General linear model repeated measure showed significant effects for Time × Treatment interaction on total Y-BOCS [F (2.10, 88.42) = 8.66, p < 0.001], obsession [F (1.88, 79.34) = 4.96, p = 0.01] and compulsion [F (1.88, 79.11) = 4.57, p = 0.01]. At week 10, the change from baseline in Y-BOCS scores was 8.86 ± 2.89 (mean ± SD) in the L-carnosine group compared to 5.86 ± 2.88 in the placebo group. CONCLUSION L-carnosine results in significant reduction of obsessive-compulsive symptoms when used as an adjuvant to fluvoxamine.
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Affiliation(s)
- Somaye Arabzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Shahhossenie
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Farzin Rezaei
- Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Reza Shalbafan
- Mental Health Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghiasi
- Department of Psychiatry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
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29
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Esalatmanesh S, Biuseh M, Noorbala AA, Mostafavi SA, Rezaei F, Mesgarpour B, Mohammadinejad P, Akhondzadeh S. Comparison of Saffron and Fluvoxamine in the Treatment of Mild to Moderate Obsessive-Compulsive Disorder: A Double Blind Randomized Clinical Trial. Iran J Psychiatry 2017; 12:154-162. [PMID: 29062366 PMCID: PMC5640576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: There are different pathophysiological mechanisms for obsessive- compulsive disorder (OCD) as suggested by the serotonergic, dopaminergic, and glutamatergic hypotheses. The present study aimed at comparing the efficacy and safety of saffron (stigma of Crocus sativus) and fluvoxamine in the treatment of mild to moderate obsessive- compulsive disorder. Method: In this study, 50 males and females, aged 18 to 60 years, with mild to moderate OCD, participated. The patients were randomly assigned to receive either saffron (30 mg/day, 15 mg twice a day) or fluvoxamine (100 mg/day) for 10 weeks. Using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Adverse Event Checklist, we assessed the patients at baseline, and at the second, fourth, sixth, eighth, and tenth week. Finally, the data were analyzed using general linear repeated measures. Results: In this study, 46 patients completed the trial. General linear repeated measures demonstrated no significant effect for time-treatment interaction on the Y-BOCS total scores [F (2.42, 106.87) = 0.70, P = 0.52], obsession Y-BOCS subscale scores [F (2.47, 108.87) = 0.77, p = 0.49], and compulsion Y-BOCS subscale scores [F (2.18, 96.06) = 0.25, P = 0.79]. Frequency of adverse events was not significantly different between the 2 groups. Conclusion: Our findings suggest that saffron is as effective as fluvoxamine in the treatment of patients with mild to moderate OCD.
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Affiliation(s)
- Sophia Esalatmanesh
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Biuseh
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ali Noorbala
- Psychosomatic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Rezaei
- Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Payam Mohammadinejad
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding Author: Address: Roozbeh Hospital, South Kargar Avenue, 1333715914, Tehran, Iran. Tel: +98 21 55412222, Fax: +98 21 55419113,
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Mesgarpour B, Mesgarpour M, Herkner H. SensPrecOptimizer: a software tool that combined search queries to design efficient search strategies. J Clin Epidemiol 2016; 71:122-3. [DOI: 10.1016/j.jclinepi.2015.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/12/2015] [Accepted: 11/09/2015] [Indexed: 11/29/2022]
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Mesgarpour B, Gouya G, Herkner H, Reichardt B, Wolzt M. A population-based analysis of the risk of drug interaction between clarithromycin and statins for hospitalisation or death. Lipids Health Dis 2015; 14:131. [PMID: 26497728 PMCID: PMC4619489 DOI: 10.1186/s12944-015-0134-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 10/13/2015] [Indexed: 11/16/2022] Open
Abstract
Background Clarithromycin, known as a potent inhibitor of the cytochrome P450 isoenzyme CYP3A, may increase the plasma concentration of statins metabolized by this pathway; therefore, increase the risk of interaction with statins in reference to pharmacokinetic studies. This study aimed to characterize whether the concomitant use of a statin with clarithromycin is associated with serious outcomes among adult persons. Methods Health claims data of adult persons in the Regional Sickness Fund of Burgenland, Austria, who filled a prescription for clarithromycin between July 1, 2009 and June 30, 2012 were reviewed retrospectively. We assumed that the risk of hospitalisation increases acutely with the indication for taking an antibiotic, whereas statin use can be considered a chronic exposure with a low constant effect on hospitalisation. When defining the population as persons taking clarithromycin and the use of statins as the exposure we could achieve a comparable effect in both groups from the acute condition on hospitalisation. Therefore, we defined exposed patients as those who had overlapping treatment with a statin and unexposed controls as those who had filled a prescription for clarithromycin without concomitant statin therapy. Outcome was defined as a composite of hospital admission or death within 30 days after starting clarithromycin. We used generalised linear regression to model an association between outcome and exposure to statins. Results Among 28,484 prescriptions of clarithromycin, 2317 persons were co-exposed to statins. Co-administration of CYP3A4 metabolized statins and clarithromycin was associated with a 2.11 fold increased risk of death or hospitalisation (95 % confidence interval [CI]: 1.79–2.48). This effect was explained by age, evidence of cardiovascular disease, diabetes mellitus and utilization of other antibiotics (multivariable adjusted risk ratio: 1.02, 95 % CI: 0.85–1.22). The sensitivity analyses did not change the significance of effect. Conclusions The risk for hospitalisation or death in persons receiving clarithromycin increases with age and cardiovascular disease but is not causally associated with statin-clarithromycine co-administration. Electronic supplementary material The online version of this article (doi:10.1186/s12944-015-0134-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bita Mesgarpour
- Department of Clinical Pharmacology, Allgemeines Krankenhaus Wien, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Digestive Diseases Research Institute (DDRI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ghazaleh Gouya
- Department of Clinical Pharmacology, Allgemeines Krankenhaus Wien, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Michael Wolzt
- Department of Clinical Pharmacology, Allgemeines Krankenhaus Wien, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Mesgarpour B, Heidinger BH, Roth D, Schmitz S, Walsh CD, Herkner H. Safety of off-label erythropoiesis-stimulating agents for critically ill patients. Cochrane Database Syst Rev 2014. [DOI: 10.1002/14651858.cd010969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mesgarpour B, Griebler U, Glechner A, Kien C, Strobelberger M, Van Noord M, Michalek-Sauberer A. Extended-release opioids in the management of cancer pain: A systematic review of efficacy and safety. Eur J Pain 2013; 18:605-16. [DOI: 10.1002/j.1532-2149.2013.00401.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 01/31/2023]
Affiliation(s)
- B. Mesgarpour
- Department of Clinical Pharmacology; Medical University of Vienna; Austria
- Department of Emergency Medicine; Medical University of Vienna; Austria
| | - U. Griebler
- Department for Evidence-based Medicine and Clinical Epidemiology; Danube University Krems; Austria
| | - A. Glechner
- Department for Evidence-based Medicine and Clinical Epidemiology; Danube University Krems; Austria
| | - C. Kien
- Department for Evidence-based Medicine and Clinical Epidemiology; Danube University Krems; Austria
| | - M. Strobelberger
- Department for Evidence-based Medicine and Clinical Epidemiology; Danube University Krems; Austria
| | - M.G. Van Noord
- Department for Evidence-based Medicine and Clinical Epidemiology; Danube University Krems; Austria
| | - A. Michalek-Sauberer
- Department of Special Anaesthesia and Pain Therapy; Medical University of Vienna; Austria
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Abstract
BACKGROUND Medications are frequently prescribed outside their regulatory approval (off-label) by physicians particularly where appropriate therapies are not available. However, the risk/benefit ratio of drugs in off-label use needs to be critically appraised because it may differ from approved on-label usage. Therefore, an extensive exploration of current evidence on clinical data is well-advised. The objective of this study was to develop a search strategy that facilitates detection of the off-label drug use documents in EMBASE via OvidSP. METHODS We constructed two sets of gold standards from relevant records to off-label drug use by a sensitive search of MEDLINE and EMBASE. Search queries, including search words and strings, were conceived based on definition of off-label use of medications as well as text analysis of 500 randomly selected relevant documents. The selected terms were searched in EMBASE (from 1988 to 2011) and their retrieval performance was compared with the gold standards. We developed a sensitivity-maximizing, and a sensitivity- and precision-maximizing search strategy. RESULTS From 4067 records relevant to off-label drug use in our full gold standard set, 3846 records were retrievable from EMBASE. "off label*.af." was the most sensitive single term (overall sensitivity 77.5%, sensitivity within EMBASE 81.9%, precision 88.1%). The highest sensitive search strategy was achieved by combining 36 search queries with overall sensitivity of 94.0% and precision of 69.5%. An optimal sensitive and precise search strategy was yielded precision 87.4% at the expense of decreasing overall sensitivity to 89.4%. CONCLUSION We developed highly sensitive search strategies to enhance the retrieval of studies on off-label drug use in OvidSP EMBASE.
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Affiliation(s)
- Bita Mesgarpour
- Department of Clinical Pharmacology, Medical University Vienna, General Hospital, Währinger Gürtel 18-20, Vienna, 1090, Austria
- Department of Emergency Medicine, Medical University Vienna, General Hospital, Währinger Gürtel 18-20, Vienna, 1090, Austria
| | - Markus Müller
- Department of Clinical Pharmacology, Medical University Vienna, General Hospital, Währinger Gürtel 18-20, Vienna, 1090, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University Vienna, General Hospital, Währinger Gürtel 18-20, Vienna, 1090, Austria
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Mesgarpour B, Müller M, Herkner H. Search strategies-identified reports on "off-label" drug use in MEDLINE. J Clin Epidemiol 2012; 65:827-34. [PMID: 22726764 DOI: 10.1016/j.jclinepi.2012.01.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 01/19/2012] [Accepted: 01/29/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE We developed search strategies that facilitate the identification of studies on "off-label" drug use in the bibliographic database OvidSP MEDLINE. STUDY DESIGN AND SETTING We compiled a gold standard reference set of reports classified as relevant or not relevant to off-label drug use. We conceived search queries, including search words and word strings. We searched MEDLINE via OvidSP from 1948 to 2011. In comparison with the gold standard, we determined sensitivity and precision of search queries and their combinations. We attempted to achieve the highest possible sensitive search strategy and an optimal balance of sensitivity and precision. RESULTS Our gold standard set contained 4,067 relevant documents overall of 6,785 records, among those 2,177 could be retrieved from MEDLINE. The most sensitive single term was "off label∗.af." (overall sensitivity 40.9%, sensitivity within MEDLINE 76.4%, and precision 84.4%). A combination of 31 search queries had the maximum overall sensitivity of 53.3% (sensitivity within MEDLINE 99.5%) at a precision of 60.3%. A search strategy with the maximum precision (84.0%) yielded a sensitivity of 49.0% (sensitivity within MEDLINE 91.5%). CONCLUSION We empirically developed two versions of optimized sensitive search strategies, which can achieve reasonable performance for retrieving off-label drug use documents in OvidSP MEDLINE.
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Affiliation(s)
- Bita Mesgarpour
- Department of Clinical Pharmacology, Medical University Vienna, General Hospital, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Merat S, Khatibzadeh S, Mesgarpour B, Malekzadeh R. A survey of the current status of web-based databases indexing Iranian journals. Arch Iran Med 2009; 12:271-278. [PMID: 19400605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The scientific output of Iran is increasing rapidly during the recent years. Unfortunately, most papers are published in journals which are not indexed by popular indexing systems and many of them are in Persian without English translation. This makes the results of Iranian scientific research unavailable to other researchers, including Iranians. The aim of this study was to evaluate the quality of current web-based databases indexing scientific articles published in Iran. METHODS We identified web-based databases which indexed scientific journals published in Iran using popular search engines. The sites were then subjected to a series of tests to evaluate their coverage, search capabilities, stability, accuracy of information, consistency, accessibility, ease of use, and other features. Results were compared with each other to identify strengths and shortcomings of each site. RESULTS Five web sites were indentified. None had a complete coverage on scientific Iranian journals. The search capabilities were less than optimal in most sites. English translations of research titles, author names, keywords, and abstracts of Persian-language articles did not follow standards. Some sites did not cover abstracts. Numerous typing errors make searches ineffective and citation indexing unreliable. CONCLUSION None of the currently available indexing sites are capable of presenting Iranian research to the international scientific community. The government should intervene by enforcing policies designed to facilitate indexing through a systematic approach. The policies should address Iranian journals, authors, and indexing sites. Iranian journals should be required to provide their indexing data, including references, electronically; authors should provide correct indexing information to journals; and indexing sites should improve their software to meet standards set by the government.
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Affiliation(s)
- Shahin Merat
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
This study explored the prevalence of social phobia (SP) in the general population of Iran, the sociodemographic characteristics of subjects with SP, and its comorbidity with the other lifetime psychiatric disorders. Our study was part of the nationwide study on the prevalence of psychiatric disorders in Iran. Overall, 25,180 Iranian subjects, age 18 years and over, from urban and rural areas of Iran were selected by a clustered random sampling method and interviewed face-to-face by 250 trained clinical psychologists using DSM-IV diagnostic criteria. Out of 12,398,235 households, 7,795 households in the form of 1,559 clusters of five households were selected. The statistical framework was based on the household lists available from the Department of Health in the provinces. The response rate was 90%. The lifetime prevalence of SP was 0.82%. The rate was 0.4% in males and 1.3% in females. The rate was higher in younger age groups and widows/widowers. It was not related to educational level and residential area. Specific phobia (66.7%), obsessive-compulsive disorder (17.4%), major depressive disorder (15%), and panic disorder (12.1%) were the most common lifetime psychiatric disorders among subjects with SP. The rate of SP in Iran is more similar to that in other Asian countries, and it is lower than that in Western countries. The rate of other psychiatric disorders among subjects with SP is more than that in the general population, and the most common psychiatric disorders were the other anxiety disorders and major depressive disorder.
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Affiliation(s)
- Mohammad-Reza Mohammadi
- Department of Psychiatry, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, Tehran, Iran.
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Mohammadi MR, Davidian H, Noorbala AA, Malekafzali H, Naghavi HR, Pouretemad HR, Yazdi SAB, Rahgozar M, Alaghebandrad J, Amini H, Razzaghi EM, Mesgarpour B, Soori H, Mohammadi M, Ghanizadeh A. An epidemiological survey of psychiatric disorders in Iran. Clin Pract Epidemiol Ment Health 2005; 1:16. [PMID: 16185355 PMCID: PMC1253522 DOI: 10.1186/1745-0179-1-16] [Citation(s) in RCA: 136] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2005] [Accepted: 09/26/2005] [Indexed: 11/10/2022]
Abstract
BACKGROUND The nation-wide epidemiological survey of psychiatric disorders in term of lifetime prevalence is not adequately known in Iran. The prevalence of lifetime psychiatric disorders was estimated among the population of aged 18 and over on gender, age group, educational level, occupational status, marital status, and residential area. METHODS The subjects were 25,180 individuals selected through a clustered random sampling method. The psychiatric disorders were diagnosed on the bases of Diagnostic and Statistical Manual of Mental Disorders-IV criteria. It is the first study in which the structured psychiatric interview administered to a representative sample of the Iranian population age 18 and over by the 250 trained clinical psychologist interviewers. The data was entered through EPI-Info software twice in an attempt to prevent any errors and SPSS-11 statistical software was also used for analyses. The odds ratios and their confidence intervals estimated by using logistic regression. RESULTS AND DISCUSSION The prevalence of psychiatric disorders was 10.81%. It was more common among females than males (14.34% vs. 7.34%, P < 0.001). The prevalence of anxiety and mood disorders were 8.35% and 4.29% respectively. The prevalence of psychotic disorders was 0.89%; neuro-cognitive disorders, 2.78% and dissociative disorders, 0.77%. Among mood disorders, major depressive disorder (2.98%) and among anxiety disorders, phobic disorder (2.05%) had the higher prevalence. The prevalence of psychiatric disorders among divorced and separated 22.31%; residents of urban areas 11.77%; illiterates 13.80%; householders 15.48%; unemployed 12.33% that were more than other groups. CONCLUSION The mental health pattern in Iran is similar to the western countries, but it seems that the prevalence of psychiatric disorders in Iran may be lower than these countries. It is estimated that at least about 7 millions of Iranian population suffer from one or more of the psychiatric disorders. It shows the importance of the role of the psychiatric disorders in providing preventive and management programs in Iran.
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Affiliation(s)
- Mohammad-Reza Mohammadi
- Department of Psychiatry, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar AV., 13185/1741, Tehran, Iran
- Director of National Research Center for Medical Sciences of Iran, No. 26, 1st Al., Kooh-e-Noor St., Motahhari Ave., Tehran, Iran
| | - Haratoon Davidian
- Department of Psychiatry, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar AV., 13185/1741, Tehran, Iran
| | - Ahmad Ali Noorbala
- Department of Psychiatry, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar AV., 13185/1741, Tehran, Iran
| | - Hossein Malekafzali
- Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Naghavi
- Department of Psychiatry, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar AV., 13185/1741, Tehran, Iran
| | | | | | - Mehdi Rahgozar
- Department of statistics and Computer, Social Welfare and Rehabilitation University, Tehran, Iran
| | - Javad Alaghebandrad
- Department of Psychiatry, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar AV., 13185/1741, Tehran, Iran
| | - Homayoon Amini
- Department of Psychiatry, Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar AV., 13185/1741, Tehran, Iran
| | | | - Bita Mesgarpour
- Director of National Research Center for Medical Sciences of Iran, No. 26, 1st Al., Kooh-e-Noor St., Motahhari Ave., Tehran, Iran
| | - Hamid Soori
- Department of Community Medicine, Medical School, Ahvaz University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Mohammadi
- Director of National Research Center for Medical Sciences of Iran, No. 26, 1st Al., Kooh-e-Noor St., Motahhari Ave., Tehran, Iran
| | - Ahmad Ghanizadeh
- Department of Psychiatry, Hafez Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Mohammadi MR, Ghanizadeh A, Alaghband-Rad J, Tehranidoost M, Mesgarpour B, Soori H. Selegiline in comparison with methylphenidate in attention deficit hyperactivity disorder children and adolescents in a double-blind, randomized clinical trial. J Child Adolesc Psychopharmacol 2005; 14:418-25. [PMID: 15650498 DOI: 10.1089/cap.2004.14.418] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to examine the selegiline treatment compared to methylphenidate (MPH) in children and adolescents with attention deficit hyperactivity disorder (ADHD). METHOD Forty subjects, aged 6-15 years, boys and girls, who were diagnosed as having ADHD, using the criteria of the Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (DSM-IV), were randomly assigned to receive either selegiline or MPH for 60 days. Treatment outcomes were assessed using the Attention Deficit Hyperactivity Scale (ADHS) administered at baseline and on days 14, 28, 42, and 60 following the commencement of treatment. Side effects were also rated. RESULTS There were no significant differences between sex, age, weight, and ethnicity of participants in the 2 groups. Both groups showed a significant improvement over the 60 days of treatment resulting from the teachers' and parents' ADHS scores across the treatment. CONCLUSION Following the trial, MPH did not effect greater mean improvement as a result of the parents' or teachers' ADHS scores than selegiline. Thus, selegiline appears to be effective and well tolerated for ADHD in children and adolescents.
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Affiliation(s)
- Mohammad Reza Mohammadi
- Department of Psychiatry, Tehran University of Medical Sciences, Psychiatry and Clinical Psychology Research Center, Roozbeh Hospital, Tehran, Iran
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Mohammadi MR, Ghanizadeh A, Rahgozar M, Noorbala AA, Davidian H, Afzali HM, Naghavi HR, Yazdi SAB, Saberi SM, Mesgarpour B, Akhondzadeh S, Alaghebandrad J, Tehranidoost M. Prevalence of obsessive-compulsive disorder in Iran. BMC Psychiatry 2004; 4:2. [PMID: 15018627 PMCID: PMC362878 DOI: 10.1186/1471-244x-4-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2003] [Accepted: 02/14/2004] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Estimates of the annual prevalence for Obsessive Compulsive Disorder (OCD) were consistent across the international sites range, 1.9%-2.5%. The nine population surveys, which used Diagnostic Interview Schedule, estimated a six-month prevalence of OCD ranging from 0.7% to 2.1%. This study performed in order to determine the prevalence of OCD in a population-based study among Iranian adults aged 18 and older and to study the association of them with factors such as sex, marital status, education, type of occupation and residential area. METHODS A cross-sectional nationwide epidemiological study of the Iranian population aged 18 and older was designed to estimate the prevalence of psychiatric disorders and their association with the above mentioned factors. 25180 individuals were selected and interviewed through a randomized systematic and cluster sampling method from all Iranian households. Schedule for Affective Disorders and Schizophrenia (SADS) and Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria were used in diagnosis of OCD. 250 clinical psychologists interviewed the selected subjects face to face at their homes. RESULTS The prevalence of OCD in Iran is 1.8% (0.7% and 2.8% in males and females; respectively). 50.3% of the survey sample were men, 49.9% women, 29.1% single, 67.45% married, 0.4% separated or divorced, 2.5% widow/widower and 4% undetermined. All of the above-mentioned factors were examined in the univariate and multivariate logistic regression models. Although the data did not fit the models well, but in univariate models, sex, the category "single" of marital status, age, the categories "business" and "housewife" and residential areas showed significant effect adjusting for the factors, but the models didn't fit the data properly. CONCLUSION The study suggests that the prevalence of OCD is not rare in the community of Iran and is within the range of other countries. Similar to prior studies in other communities, OCD is more common in females than males.
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Affiliation(s)
- Mohammad Reza Mohammadi
- Psychiatry and Clinical Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar St., 13185/1741, Tehran, Iran
- National Research Center of Medical Sciences, No. 26, 1Al., Kooh-e-Noor St., Motahhari Ave., Tehran, Iran
| | - Ahmad Ghanizadeh
- Psychiatry and Clinical Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar St., 13185/1741, Tehran, Iran
| | - Mehdi Rahgozar
- Tarbiat Modarres University, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Ahmad Ali Noorbala
- Psychiatry and Clinical Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar St., 13185/1741, Tehran, Iran
| | - Haratoun Davidian
- Psychiatry and Clinical Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar St., 13185/1741, Tehran, Iran
| | - Hossein Malek Afzali
- Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Naghavi
- Psychiatry and Clinical Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar St., 13185/1741, Tehran, Iran
| | - Seyed Abbas Bagheri Yazdi
- Youth and School Health Department, Mental Health Unit, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Bita Mesgarpour
- National Research Center of Medical Sciences, No. 26, 1Al., Kooh-e-Noor St., Motahhari Ave., Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatry and Clinical Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar St., 13185/1741, Tehran, Iran
| | - Javad Alaghebandrad
- Psychiatry and Clinical Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar St., 13185/1741, Tehran, Iran
| | - Mehdi Tehranidoost
- Psychiatry and Clinical Psychology Research Center, Tehran University of Medical Sciences, Roozbeh Hospital, South Kargar St., 13185/1741, Tehran, Iran
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