No abstract

No abstract

Online streaming series ‘Thirteen Reasons Why’ (13RW), released in March 2017, was criticized for its sensationalist portrayal of the main character’s suicide, leading some people to voice fears of a global contagion of self-harm behaviors. The current investigation provides a systematic review of original studies analyzing the role of 13RW as an influencing factor for suicide. Articles were identified through a systematic search of Medline, Web of Science, Scopus, PsycInfo, and a manual search of reference lists from inception until the 16 January 2023. Twenty-seven published articles were identified from an initial search of 496 studies. The positive effects of watching 13RW included a reduction in suicide stigma and a greater likelihood to discuss mental health concerns and seek for help. However, several studies reported negative outcomes, including significant increases in the rate of deaths by suicide in adolescents, the number of admissions for suicidal reasons, and the prevalence and severity of suicidal ideation and self-harm behaviors in vulnerable viewers. Still, due to methodological limitations, no causal relationship could be established. Preventive measures are required to alert of the risk and should be particularly addressed to susceptible subjects. Psychoeducational programs should be focused on this kind of phenomena in vulnerable populations.

Background:Osteoporotic fractures have a high health and economic impact. The best strategy to minimize the incidence of fractures is, certainly, the prevention of these that includes pharmacological treatments. However, long-term discontinuation treatment and sub-optimal compliance of the treatment are common.Objectives:The aim of the study is to quantify the therapeutic compliance and permanence of the osteoporosis pharmacological treatments for patients who were discharged from hospitals in Catalonia with hip fracture during 2017.Methods:From the Hospital Discharge Database of the Catalan Health Service, all patients who had been discharged during 2017 were selected with the main diagnosis of femur fracture, according to the coding CIM-9. The consumption of drugs to assess compliance and permanence was obtained from the Catalan Health Service pharmacy Database. The study period was 18 months from the date of hospital discharge. Patients who died, moved to other areas or switched their treatment were excluded from the study. Good compliance was considered when sufficient drug was obtained to cover 80% of the time since treatment was prescribed until the end of the study period. In the case of denosumab, good post-fracture compliance was considered when the treatment time was remained at least 12 months. Permanence was considered positive if a drug had been obtained during the last three months of the study period. To compare the differences in compliance and permanence between the patients treated with different drugs, the chi-square statistic was used, considering statistically significant differences if p<0.05.Results:8,354 patients were discharged with the main diagnosis of hip fracture. Of these, 1,712 patients (20.49%) were treated after been discharged. After applying the exclusion criteria, the final sample was made up of 1,327 patients. 81,54% were women, and the median age was 84,79 years.The most commonly used treatments were bisphosphonates (69%), denosumab (23%) and teriparatide (7%)The results of good compliance and permanence of treatment were those described in the table.nCompliancePermanenceAlendronate86363,27%64,77%Alendronate+colecalciferol2774,07%81,48%Ibandronate366,67%100%Risedronate2339,13%60,87%Raloxifene1100%100%Bazedoxifene10%0%Teriparatide9976,77% (*)73,74%Denosumab31076,77% (*)74,52% (*)(*) p<0.05 for total bisphosphonates and for alendronateConclusion:The results obtained suggest that a small number of patients were treated after a hip fracture (20.49%) in addition the instituted treatments are followed in a suboptimal way. It is necessary to investigate which factors may lead to the detection of potential non-compliant patients. It seems appropriate to consider drugs that facilitate compliance and permanence of treatment.Our results suggest that denosumab and teriparatide improve compliance compared with oral bisphosphonates.The introduction of specific plans and cross-sectional health structures between levels of care should lead to improve detection, treatment and compliance in patients with osteoporosis.Disclosure of Interests:SILVIA PAREDES Consultant of: Amgen, Lilly, Ferrer, Roche, Novartis; BMS, Maria Guinovart: None declared, Aida Basco: None declared, Carles Llop: None declared