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Background: Social relationships refer to the existing associations between family members, friends, neighbours, co-workers, and other associates. Due to the COVID-19 pandemic, social distancing has been imposed by the curfew program in Jordan. Aim: To evaluate the effects of social distancing on the social relationships of the Jordanian population. Methods: A cross-sectional study using an online survey was conducted in Jordan between the 6th and the 30th of May, 2020. Our questionnaire was constructed to explore the population's perception of the quarantine period, how it is affecting their relationship with others, and the characteristics of their social relationships and communication with various population categories, including family members and work colleagues. Multiple linear regression was used to identify predictors of better social relationships and communication. Results: A total of 4,301 participants were involved in this study. The average score of the influence of the COVID-19 pandemic on social relationships among the whole study population was 5.68 (SD: 2.33) out of 10 (equal to 56.8%), which indicates the marginal strength of the social relationships. Around 31.6% of the participants reported that their social relationships were affected to a high degree by the COVID-19 pandemic. Participants who were aged 36–45 were positively affected in terms of their social relationships during the COVID-19 pandemic. Conclusion: The COVID-19 pandemic is negatively affecting social relationships, which could ultimately lead to negative health implications. Decision-makers are advised to provide educational campaigns that improve the sociological health of the general population. [ABSTRACT FROM AUTHOR]

Aims: Oral anticoagulant (OAC) is recommended for preventing stroke in atrial fibrillation (AF). However, the OAC utilisation in AF patients with dementia or cognitive impairment (CI) is limited. This study aimed to examine the prevalence of OAC prescriptions in AF patients with dementia/CI and to identify factors associated with OAC treatment within 180 days after dementia/CI diagnosis. Methods: Using The Health Improvement Network database, the annual trends of OAC between 2000 and 2015 were calculated. Multivariable logistic regression was performed to identify factors associated with OAC treatment. Results: The prevalence rate of OAC prescriptions increased from 6.1% in 2000 to 45.9% in 2015. Among OAC users, the proportion of direct oral anticoagulants (DOACs) use increased significantly from 0.1% in 2011 to 33.8% in 2015 (P‐trend < 0.001), while the proportion of vitamin K antagonist use decreased by 28.6% from 100% in 2000 to 71.4% in 2015 (P‐trend < 0.001). In the multivariable analysis, younger age, very old age, female sex, higher Charlson Comorbidity Index, having a HAS‐BLED score ≥3, a history of intracranial bleeding, falls and polypharmacy were significantly associated with lower odds of receiving OAC. Conclusions: In UK primary care, OAC use increased from 2000 to 2015 in AF patients with dementia/CI, with a substantial increase in use of DOACs. Characteristics related to frailty are associated with lower odds of OAC prescription. Given the increasing use of DOACs in patients with dementia/CI, further studies are needed to investigate the safety and effectiveness of DOACs in this important patient group. [ABSTRACT FROM AUTHOR]

Aims: Comprehensive diabetes management may include treatment intensification or the administration of antidiabetic combination therapy. However, this may be associated with an increased risk of adverse events and death. The aim of this study was to understand physicians' perspectives regarding treatment de‐intensification, HbA1c goals individualisation, and factors affecting their treatment choice for patients with type 2 diabetes mellitus (T2DM). Methods: A cross‐sectional study was conducted in primary and secondary care units in Saudi Arabia using online questionnaire. Two previously validated questionnaires were used to understand physicians' awareness of, agreement with, and their practices of individualising HbA1c goals and antidiabetic treatment optimisation, and to assess factors affecting physicians' treatment choice when prescribing antidiabetic treatment for patients with type 2 diabetes mellitus. Study population were physicians who are treating patients with diabetes mellitus during the period between October 2017 and May 2018. Results: A total of 205 physicians have participated in the study. Approximately 50% of physicians had family medicine speciality (n = 98, 47.8%). The majority of physicians (n = 183, 89.3%) were familiar with the concept of HbA1c goals individualisation. However, only 66.3% of them (n = 136) reported that they apply it either always or most of the time. 58.5% (n = 120) of physicians reported that they would not initiate conversations about de‐intensifying antidiabetic therapy even if their patients had a stable HbA1c values for one year. Physicians showed higher consideration to objective patient clinical data and their assessment of patient's health status, with minor consideration to patient‐related factors. Conclusions: Healthcare professionals should focus more on implementing contemporary practices and applying any necessary treatment de‐intensification or dose adjustment. Subjective patient factors should be taken into account further, as these factors are associated with better disease management. [ABSTRACT FROM AUTHOR]

Introduction: Oral oncolytic treatments (OOTs) have improved the prognosis of patients with multiple myeloma (MM). However, the effectiveness of these therapies is undermined by poor adherence. We aimed to characterize the real-world adherence to, and persistence with, OOTs for MM., Materials and Methods: MEDLINE, EMBASE, and the International Pharmaceutical abstracts databases were searched for relevant observational studies published in English up to November 21, 2021. This was supplemented by manual searches of abstracts from the annual meetings of the American Society of Hematology, the American Society for Clinical Oncology, and the European Hematology Association as well as screening the references of included articles. Random-effects meta-analysis was performed., Results: Following screening of 11,557 articles, 19 studies involving 27,129 patients in 8 countries (France, the US, Germany, Italy, the UK, Brazil, South Korea, and Belgium) prescribed OOTs (lenalidomide, thalidomide, pomalidomide, panobinostat, ixazomib, and melphalan) for MM were included. The overall pooled proportion of adherent patients was 67.9% (95% confidence interval [CI]: 57.1%-77.8%). The pooled proportion of adherent patients was higher in self-reported questionnaire-based studies compared to those using prescription/dispensing data (81.6% vs. 61.0%; P-value for difference = .08). Across 5 studies involving 15,363 patients, a pooled proportion of 35.8% (95% CI: 22.0-50.9) discontinued treatment. Factors reported to be associated with nonadherence included increasing age, higher comorbidity, polypharmacy, and a lack of social support., Conclusion: In patients with MM, adherence to and persistence with OOTs remains suboptimal. To achieve desired clinical outcomes, interventions to improve adherence and minimize discontinuation may be warranted., (Copyright © 2022. Published by Elsevier Inc.)

Background: Medication use assessment has a critical role in promoting the effective and rational use of pharmaceutical medications. There are no studies that have explored the utilization of all medications in England and Wales in the past 15 years without restrictions in the age group being studied or class of medications., Aim: To explore the medication utilization pattern of dispensed medications in England and Wales in the past 15 years., Method: A secular trend analysis study using publically available dispensing data on the population level in England and Wales for the duration between 2004 and 2019. Medication dispensing data was extracted from the Prescription Cost Analysis database., Results: Medication prescriptions rate increased by 42.6% [from 1,345,095.75 (95% CI 1,345,004.25 - 1,345,187.26) in 2004 to 1,918,138.48 (95% CI 1,918,038.38 - 1,918,238.57) in 2019 per 100,000 persons, trend test, p < 0.001]. During the study period, the most common medication prescriptions were for the cardiovascular system, central nervous system, and endocrine system, which accounted for 30.2%, 18.8%, and 9.4%, respectively. The rate of medication prescriptions for skin, immunological products and vaccines, infections, and musculoskeletal and joint diseases decreased by 18.4%, 15.8%, 9.8%, and 5.7%, respectively., Conclusion: The last two decades have witnessed a remarkable rise in the quantity of medications dispensed in community settings. Utilization of chronic disease medications has increased in the past 15 years, specifically, dispensed medications for the cardiovascular system, central nervous system, and endocrine system. It is necessary to conduct additional cohort studies to investigate the clinical outcomes and prescribing safety of these medications., (© 2022. The Author(s).)

Background: Nomophobia is a psychological condition caused by a fear of disconnecting from others through mobile phones., Aim: This study aims to determine the prevalence of and predictors of nomophobia and anxiety symptoms among the general population in Saudi Arabia and Jordan., Methods: This study was an observational cross-sectional study using a web-based online survey distributed in two middle eastern countries (Saudi Arabia and Jordan) between Jun 24 and Jul 20, 2021. A convenience sample was used to recruit the study participants. Categorical variables were identified as frequencies and percentages. In addition, a binary logistic regression analysis was used to determine the factors associated with nomophobia symptoms. The Statistical Package for Social Science (SPSS) software, version 27 (IBM Corp, Armonk, NY, USA), analyzed the data., Results: A total of 5,191 responded to the online survey. Around (26.5%) reported that they suffer from an anxiety problem or use a treatment for anxiety. The median daily time spent using a mobile phone (IQR) (minutes) was around 210 min per day. About half of the study sample (51.2%) are diagnosed with dependence syndrome. The binary logistic regression analysis revealed that those within the age group of 30-49 years and 50 years and above) are less likely to have mobile phone dependence compared to those less than 30 years old. Females were 16% at lower risk of developing mobile phone dependence compared to males Married participants were less likely to have mobile phone dependence compared to single participants (OR: 0.62 (95% CI 0.56-0.70)), while divorced participants were at a 46% higher risk of developing mobile phone dependence., Conclusion: Nomophobia prevalence among Saudi Arabia and Jordon's population is 51.2%. Several factors may predict mobile phone dependence including age, gender, marital status, and previous history of anxiety., (© 2022. The Author(s).)

Background: Infectious diseases continue to account for considerable illness and death worldwide, and emerging infectious diseases (EIDs) are a significant burden on global economies and public health. This study aimed to investigate the trends in infectious and parasitic disease (IPD) hospital admissions (HA) in England and Wales between 1999 and 2019., Methods: This is an ecological study using publicly available data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admission data were collected for the period between April 1999 to March 2019. IPDHA were identified using the tenth version of the International Statistical Classification of Diseases system, diagnostic codes (A00-B99). The trend in hospital admissions was assessed using a Poisson model., Results: The overall annual number for IPD hospital admissions for various causes increased by 412.9%, from 151,336 in 1999 to 776,215 in 2019, representing an increase in hospital admission rate of 349.9% from 290.25 (95% CI 288.79-291.71) in 1999 to 1305.88 (95% CI 1303.00-1308.77) in 2019 per 100,000 persons: trend test, p < 0.01. The most common causes of infectious and parasitic disease hospital admissions were intestinal infectious diseases, other bacterial diseases, and other viral diseases, which accounted for 33.6, 27.5, and 23.8%, respectively. Patients aged 15 years and below accounted for 34.2% of the entire number of IPD hospital admissions, followed by the age group 15-59 years with 27.9%, the age group 75 years and above with 22.7%, and then the age group 60-74 years with 15.2%., Conclusion: There was an increase in the hospital admission rate due to infectious diseases in the UK from 1999 to 2019. The most common causes of infectious and parasitic disease hospital admissions were intestinal infectious diseases, other bacterial diseases, and other viral diseases., (© 2022. The Author(s).)

Background: Pharmaceutical companies spend more than one-third of their sales revenue on marketing and promotion directed toward healthcare professionals. There has been a focus on the relationship between healthcare professionals and the pharmaceutical industry in recent years. This study aims to explore the attitude toward and acceptability of medical promotional tools and their influence on physicians' prescribing practices in Jordan and Iraq., Methods: A cross-sectional survey study was conducted to explore the influence of visits by medical representatives (MRs) and medical promotions on physicians' prescribing practices between June and October 2020 in Jordan and Iraq. Previously validated questionnaires were used., Results: A total of 801 physicians completed the questionnaires. Face-to-face visits, followed by the dispensing of medical samples, were the two most common promotional methods used by MRs. 48% of participating physicians reported that they would accept the promotional marketing tools offered to them. MRs focused on the key selling points of their product during medical promotions, and 39.6% of the physicians reported that MRs had a negative attitude toward their competitors' products. 69.9% of the physicians reported that they would change their practice after participating in conferences or meetings., Conclusion: Medical promotional tools have a clear influence on physicians' prescribing practices in Jordan and Iraq. Therefore, medical promotion should be controlled and guided by clear and country-specific ethical guidelines. This will ensure safe medical promotion to physicians and optimise the healthcare practices provided to patients., (© 2022. The Author(s).)

Background: Identifying trends of hospital admissions for respiratory diseases is crucial for public health and research to guide future clinical improvements for better outcomes. This study aims to define the trends of respiratory disease-related hospital admissions (RRHA) in England and Wales between 1999 and 2019., Methods: An ecological study was conducted using hospital admission data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admissions data for respiratory diseases were extracted for the period between April 1999 and March 2019. The trend in hospital admissions was assessed using a Poisson model., Results: Hospital admission rate increased by 104.7% [from 1535.05 (95% CI 1531.71-1538.38) in 1999 to 3142.83 (95% CI 3138.39-3147.26) in 2019 per 100,000 persons, trend test, p < 0.01]. The most common causes were influenza and pneumonia, chronic lower respiratory diseases, other acute lower respiratory infections, which accounted for 26.6%, 26.4%, and 14.9%, respectively. The age group 75 years and above accounted for 34.1% of the total number of hospital admissions. Males contributed to 50.5% of the total number of hospital admissions. Hospital admission rate in females increased by 119.8% [from 1442.18 (95% CI 1437.66-1446.70) in 1999 to 3169.38 (95% CI 3163.11-3175.64) in 2019 per 100,000 persons, trend test, p < 0.001]. Hospital admission rate increased by 92.9% in males [from 1633.25 (95% CI 1628.32-1638.17) in 1999 to 3149.78 (95% CI 3143.46-3156.09) in 2019 per 100,000 persons, trend test, p < 0.001]., Conclusion: During the study period, hospital admissions rate due to respiratory diseases increased sharply. The rates of hospital admissions were higher among males for the vast majority of respiratory diseases. Further observational studies are warranted to identify risk factors for these hospital admissions and to offer relevant interventions to mitigate the risk., (© 2021. The Author(s).)

Background and Aims: Lipid-modifying agents (LMAs) are increasingly used to reduce lipid levels and prevent cardiovascular events but the magnitude of their consumption in different world regions is unknown. We aimed to describe recent global trends in LMA consumption and to explore the relationship between country-level LMA consumption and cholesterol concentrations., Methods: This cross-sectional and ecological study used monthly pharmaceutical sales data from January 2008 to December 2018 for 83 countries from the IQVIA Multinational Integrated Data Analysis System and total and non-high-density lipoprotein (non-HDL) cholesterol concentrations from the NCD Risk Factor Collaboration. Compound annual growth rate (CAGR) was used to assess changes in LMA consumption over time., Results: From 2008 to 2018, use of LMAs increased from 7468 to 11,197 standard units per 1000 inhabitants per year (CAGR 4.13%). An estimated 173 million people used LMAs in 2018. Statins were the most used class of LMA and their market share increased in 75% of countries between 2008 and 2018. From 2013 to 2018, consumption of low-density lipoprotein lowering therapies increased (statins 3.99%; ezetimibe 4.01%; proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors 104.47%). Limited evidence supports a clear relationship between country-level changes in LMA consumption and mean total and non-HDL cholesterol concentrations in 2008 versus 2018., Conclusions: Since 2008, global access to LMAs, especially statins, has improved. In line with international lipid guideline recommendations, recent trends indicate growth in the use of statins, ezetimibe, and PCSK9 inhibitors. Country-level patterns of LMA use and total and non-HDL cholesterol varied considerably., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Previous meta-analysis investigating the incidence and prevalence of hypoglycaemia in both types of diabetes is limited. The purpose of this review is to conduct a systematic review and meta-analysis of the existing literature which investigates the incidence and prevalence of hypoglycaemia in individuals with diabetes., Methods: PubMed, Embase and Cochrane library databases were searched up to October 2018. Observational studies including individuals with diabetes of all ages and reporting incidence and/or prevalence of hypoglycaemia were included. Two reviewers independently screened articles, extracted data and assessed the quality of included studies. Meta-analysis was performed using a random effects model with 95% confidence interval (CI) to estimate the pooled incidence and prevalence of hypoglycaemia in individuals with diabetes., Results: Our search strategy generated 35,007 articles, of which 72 studies matched the inclusion criteria and were included in the meta-analysis. The prevalence of hypoglycaemia ranged from 0.074% to 73.0%, comprising a total of 2,462,810 individuals with diabetes. The incidence rate of hypoglycaemia ranged from 0.072 to 42,890 episodes per 1,000 person-years: stratified by type of diabetes, it ranged from 14.5 to 42,890 episodes per 1,000 person-years and from 0.072 to 16,360 episodes per 1,000-person years in type 1 and type 2 diabetes, respectively., Conclusion: Hypoglycaemia is very common among individuals with diabetes. Further studies are needed to investigate hypoglycaemia-associated risk factors., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)