ObjectivesThe aim of this study is to explore the barriers and enablers of deprescribing from the perspectives of home care nurses, as well as to conduct a scalability assessment of an educational plan to address the learning needs of home care nurses about deprescribing.MethodsThis study employed an exploratory qualitative descriptive research design, using scalability assessment from two focus groups with a total of 11 home care nurses in Ontario, Canada. Thematic analysis was used to derive themes about home care nurse’s perspectives about barriers and enablers of deprescribing, as well as learning needs in relation to deprescribing approaches.ResultsHome care nurse’s identified challenges for managing polypharmacy in older adults in home care settings, including a lack of open communication and inconsistent medication reconciliation practices. Additionally, inadequate partnership and ineffective collaboration between interprofessional healthcare providers were identified as major barriers to safe deprescribing. Furthermore, home care nurses highlighted the importance of raising awareness about deprescribing in the community, and they emphasised the need for a consistent and standardised approach in educating healthcare providers, informal caregivers and older adults about the best practices of safe deprescribing.ConclusionTargeted deprescribing approaches are important in home care for optimising medication management and reducing polypharmacy in older adults. Nurses in home care play a vital role in medication management and, therefore, educational programmes must be developed to support their awareness and understanding of deprescribing. Study findings highlighted the need for the future improvement of existing programmes about safer medication management through the development of a supportive and collaborative relationship among the home care team, frail older adults and their informal caregivers.

No abstract

This study examined the prevalence of high blood pressure, heart disease, and medical diagnoses in relation to blood disorders, among 6,329 adolescent students (age 15 to 18 years) who reside in the United Arab Emirates (UAE). Findings indicated that the overall prevalence of high blood pressure and heart disease was 1.8% and 1.3%, respectively. Overall, the prevalence for thalassemia, sickle-cell anemia, and iron-deficiency anemia was 0.9%, 1.6%, and 5%, respectively. Bivariate analysis revealed statistically significant differences in the prevalence of high blood pressure among the local and expatriate adolescent population in the Emirate of Sharjah. Similarly, statistically significant differences in the prevalence of iron-deficiency anemia were observed among the local and expatriate population in Abu Dhabi city, the western region of Abu Dhabi, and Al-Ain. Multivariate analysis revealed the following significant predictors of high blood pressure: residing in proximity to industry, nonconventional substance abuse, and age when smoking or exposure to smoking began. Ethnicity was a significant predictor of heart disease, thalassemia, sickle-cell anemia, and iron-deficiency anemia. In addition, predictors of thalassemia included gender (female) and participating in physical activity. Participants diagnosed with sickle-cell anemia and iron-deficiency anemia were more likely to experience different physical activities.

This study examines predictors of locating participants that were last contacted 20 years ago using public web-search directories, in order to facilitate longitudinal environmental health research. Participants (n = 3,202) resided in four distinct geographical neighborhoods in Hamilton, Ontario during childhood; they were between 15 and 17 years old when they were last contacted in 1986. Data used for tracing included available addresses, telephone numbers, given names, and parental names. Reverse and forward search strategies were used to retrieve updated contact details. 43% of the sample was traced using online directories. Following ethical approval, participants were contacted using traced data and 29% of the original cohort was located. Predictors of locating participants were: availability of paternal names, being traced to original addresses or telephone numbers, gender (male), relatively higher socioeconomic status in childhood, and not being exposed to smoking in childhood. Where participants resided in childhood was not a significant predictor of locating participants. Although 13% of the sample was traced using forward search by name, only 4% were located. For participants traced to available addresses or telephone numbers, the difference between the proportions of traced and located participants was <3%. Prospective studies on children may benefit from including the listed names that pertain to each child's telephone number and full parental names at recruitment, thereby increasing the likelihood of locating participants using Internet resources. Integrating the use of Internet-based public directories for cohort reconstruction can reduce financial costs related to follow-up for longitudinal research.