Journal of Preventive Medicine and Public Health

Original Articles

The Diabetogenic Effect of Statin Use May Interact With Polygenic Risk Scores for Type 2 Diabetes: Jong Hyun Park, Kyutaek Lim, Jooyeon Lee, Yong Jin Gil, Joohon Sung; Received November 6, 2024 Accepted November 22, 2024 Published online December 11, 2024; DOI: https://doi.org/10.3961/jpmph.24.671 [Accepted]

32 View
0 Download

Abstract PDF: Objectives
Statins are essential in the prevention of cardiovascular disease; however, their association with type 2 diabetes (T2DM) risk is concerning. We examined whether genetic susceptibility to T2DM modifies the association between regular statin use and T2DM risk.
Methods
This study included 447,176 individuals from the UK Biobank without baseline diabetes or major cardiovascular disease. Statin use was recorded at baseline, and T2DM incidence was determined using clinical records. Polygenic risk scores (PRS) for T2DM risk were provided by the UK Biobank. Using propensity scores adjusted for age, sex, body mass index, and comorbidities, 14,831 statin users were matched with 37,060 non-users. Cox proportional hazards models were used to estimate the interaction effect of statin use and PRS on T2DM incidence, adjusting for key confounders.
Results
In the propensity-matched cohort, 3,675 of 51,891 participants developed T2DM over a mean follow-up period of 13.7 years. Within the top 5% of the PRS distribution, per 1,000 person-years, the incidence of T2DM was 15.42 for statin users versus 12.18 for non-users. Among the lowest 5%, the incidence was 1.9 for statin users and 1.65 for non-users. Based on the Cox proportional hazards model, regular statin use was associated with a 1.239-fold increased T2DM risk (95% confidence interval [CI], 1.152 to 1.333). Furthermore, PGS exhibited a significant multiplicative interaction with regular statin use (odds ratio, 1.102; 95% CI, 1.024 to 1.186).
Conclusions
PRS may help identify individuals particularly susceptible to the diabetogenic effects of statins, providing a potential path for personalized cardiovascular disease management.; Summary

Predictors of Quality of Life among Older Residents in Rural and Urban Areas in Indonesia: An Approach Using the International Classification of Functioning, Disability, and Health: Dwi Rosella Komalasari, Chutima Jalayondeja, Wattana Jalayondeja, Yusuf Alam Romadhon; Received August 4, 2024 Accepted November 7, 2024 Published online November 29, 2024; DOI: https://doi.org/10.3961/jpmph.24.423 [Accepted]

157 View
5 Download

Abstract PDF: Objectives
The International Classification of Functioning, Disability, and Health (ICF) model provides a comprehensive framework for understanding health and quality of life (QoL) in older adults in both rural and urban settings, each presenting unique advantages and challenges. This study aimed to explore the relationship between factors based on the ICF model and QoL among older residents of these areas.
Methods
A cross-sectional study was conducted, involving 286 older adults aged 60 years or older from rural and urban areas of Surakarta, Central Java, Indonesia. The WHOQoL-BREF was utilized to assess QoL. The co-factors included personal factors, impairments, and activity limitations.
Results
Multiple linear regression analysis indicated that lower limb muscle strength was the most significant factor associated with QoL in older adults in rural areas (B=0.681, standard error [SE]=0.301, p=0.026), followed by static balance (B=0.085, SE=0.034, p=0.014). In urban areas, gender emerged as the most significant factor influencing QoL (B=-13.643, SE=2.499, p<0.001), followed by hemoglobin level (B=-1.847, SE=0.760, p=0.017), age (B=-0.935, SE=0.246, p<0.001), and cognitive function (B=0.493, SE=0.179, p=0.007).
Conclusions
Efforts to improve QoL for older adults in rural areas should focus on enhance physical performance through exercise. In urban areas, the maintenance of QoL is influenced by personal factors. It is crucial to address physical performance through exercise to enhance QoL in rural settings. Meanwhile, focusing on mental health, financial security, and social connections is recommended to improve QoL for older adults in urban areas.; Summary

The Impact of Student-led Community Health Screenings on Clients’ Health Knowledge and Outcomes: A Qualitative Study: Jia Rong Yap, Wendy Wenming Zhai, Cindy Seunghee Pak, Sharon Brownie; Received July 12, 2024 Accepted October 27, 2024 Published online November 28, 2024; DOI: https://doi.org/10.3961/jpmph.24.366 [Accepted]

95 View
6 Download

Abstract PDF: Objectives
This study investigated the impact of community health screenings (CHS) on the Asian community, focussing on the role of a student-led health and wellness centre in promoting and improving health outcomes. The CHS is a collaboration between Te Kotahi Oranga | Health and Wellness Centre and The Asian Network Incorporated, offering free health screenings to Asian migrants in the Waikato region, New Zealand.
Methods
Employing a qualitative approach, we interviewed clients who participated in the CHS to determine their perceptions regarding the effectiveness of the programme, its influence on their health knowledge and actions, and their overall satisfaction with the service. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used to report the study.
Results
Data analysis utilising reflexive thematic analysis yielded 5 themes: satisfaction and appreciation for the free health screening; strengthened commitment to better personal health; barriers and challenges in accessing public healthcare services; improved knowledge and awareness of health risks; and provision of more health screening tests and health seminars. The findings highlight the significance of culturally tailored health initiatives in addressing healthcare disparities, emphasising the need for innovative strategies to ensure continuity of care and support for underserved populations.
Conclusions
This research contributes to the understanding of how student-led health interventions can enhance public health efforts and improve health outcomes in Asian and migrant communities.; Summary

Health Effects of Heavy Metal Exposure Among E-waste Workers and Community-dwelling Adults in Thailand: A Cross-sectional Study: Chonyitree Sangwijit, Parichat Ong-artborirak, Warangkana Naksen, Kraiwuth Kallawicha, Pallop Siewchaisakul; Received July 31, 2024 Accepted October 18, 2024 Published online November 21, 2024; DOI: https://doi.org/10.3961/jpmph.24.415 [Accepted]

133 View
15 Download

Abstract PDF: Objectives
Global concern is increasing about the health effects of electronic waste (e-waste). This study examines the health impacts of heavy metal (HM) exposure among e-waste workers (EWWs) and community-dwelling adults (CDAs) in Northeastern Thailand and identifies factors associated with adverse health outcomes.
Methods
A cross-sectional study was conducted of 164 EWWs and 164 CDAs. A survey was employed to collect data on participant characteristics, symptoms, anxiety, depression, and sleep quality. Urine samples were analyzed for lead (Pb) and cadmium (Cd) levels using atomic absorption spectrometry. Multiple logistic regression analysis was used to identify factors impacting health.
Results
Across all participants, urinary Pb and Cd levels ranged from 5.30 to 29.50 µg/g creatinine and from 0.60 to 4.00 µg/g creatinine, respectively. The most frequently reported health issues pertained to musculoskeletal disorders (MSDs) at 38.70%, central nervous system (CNS) issues at 36.60%, and skin disorders at 31.10%. Multivariable analysis indicated that the presence of MSDs was significantly associated with exposure to Pb and Cd. Poor sleep quality (PSQ) was significantly linked to CNS problems, while body mass index was significantly related to skin disorders. Factors including primary education level or below, smoking, cleaning the house more than 3 times weekly, and PSQ were significantly linked to depression. Anxiety was significantly associated with PSQ.
Conclusions
Environmental exposure to Pb and Cd can have adverse health impacts in the form of MSDs. Depression and anxiety are common conditions among CDAs. Public health officials should monitor HM exposure and mental health within the community.; Summary

Systematic Review

Use of Data Linkage Methods to Investigate Healthcare Interactions in Individuals Who Self-harm and Die by Suicide: A Scoping Review: Ferdi W. Djajadisastra; Received August 14, 2024 Accepted November 11, 2024 Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.448 [Accepted]

164 View
8 Download

Abstract PDF: Objectives
In this review, the primary objective was to comprehensively summarize and evaluate the themes and findings of studies that used data linkage methods to examine the healthcare engagement of individuals with self-harming and suicidal tendencies. Additionally, the review sought to identify gaps in the existing literature and suggest directions for future research in this area.
Methods
This review utilized the PubMed, PsycINFO, and Scopus databases. Employing a scoping review methodology, 27 papers were analyzed.
Results
One particularly common data source is the routine information collected by government agencies. However, some studies augment this information with newly collected data. Compared to other research methods, data linkage has the advantage of incorporating participants from diverse backgrounds into the analysis. Most relevant studies employing data linkage methods have focused primarily on identifying sociodemographic correlates of self-harm, suicide deaths, and healthcare interactions. Additionally, cluster analysis has been used in certain studies to identify patterns of healthcare utilization within affected populations.
Conclusions
Data linkage offers a promising approach for researching self-harm and suicide. A notable challenge, however, is the focus of most studies on the associations between sociodemographic factors and the risks of self-harm and suicide. Integrating government datasets with data from recent studies, as well as fostering collaboration between researchers and government agencies to identify necessary data for routine administrative records, could help address these constraints. Despite its limitations, data linkage can reveal useful patterns in the interactions between individuals who self-harm or die by suicide and the healthcare system.; Summary

Original Articles

Medication-related Burden and Experience With Medications in Indonesian Older Adults With Chronic Diseases: A Mixed-method Study: Yeni Farida, Anna Wahyuni Widayanti, Tri Murti Andayani, Probosuseno Probosuseno; Received July 16, 2024 Accepted November 7, 2024 Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.374 [Accepted]

111 View
3 Download

Abstract PDF: Objectives
This study explored the specific medication-related burdens experienced by older adults with chronic disease and the contributing factors.
Methods
An exploratory mixed-method study was conducted at a teaching hospital in Surakarta City, Central Java, Indonesia. Combining the Indonesian version of the Living with Medicine Questionnaire (LMQ) and semi-structured interviews allowed for a comprehensive understanding of the medication-related burden. Differences in LMQ scores related to patient characteristics were analyzed using the t-test, F-test, or other alternatives. Quantitative and qualitative data triangulation was used to derive trustworthy and dependable results.
Results
The overall LMQ mean score was 90.4 (n=129), indicating a moderate burden. The average LMQ scores varied significantly based on the number of medications, treatment duration, and the presence of cardiovascular disease (CVD), diabetes mellitus (DM) and stroke. The qualitative study found 3 themes in the chronic medication use of older adults: experiences, challenges, and motivation. Despite their limited understanding of a medication’s name and indication, some patients managed their medications based on the physical look and packaging of the medication. The study also found that patient motivation and familial support could effectively counteract the fatigue and dissatisfaction associated with taking medication.
Conclusions
Older adults with chronic diseases faced medication-related burdens associated with the presence of CVD, DM, stroke, a treatment duration >5 years, and the use of >10 medications. Effective communication with healthcare professionals is required to understand patients\' needs and concerns, thereby helping manage the challenges of medication-related burdens.; Summary

Church Leaders’ Health Behaviors and Program Implementation in the Faith, Activity, and Nutrition Program: Kelsey Day, Sara Wilcox, Lindsay Decker, John Bernhart, Meghan Baruth, Andrew Kaczynski, Christine Pellegrini; Received July 20, 2024 Accepted October 18, 2024 Published online November 13, 2024; DOI: https://doi.org/10.3961/jpmph.24.384 [Accepted]

110 View
2 Download

Abstract PDF: Objectives
Church leaders are important to the success of faith-based health promotion interventions through the role modeling of health behaviors. However, clergy may be at a higher risk of chronic disease than their congregants and their health is understudied. This study examined church leaders’ health-related behaviors, differences in health behaviors by sociodemographic characteristics, and associations between health behaviors and church-level implementation of an ecological intervention.
Methods
Pastors (n=93) and church coordinators (n=92) reported body mass index (BMI), self-rated health, fruit and vegetable consumption (F&V), and physical activity (PA) at baseline and 12 months post-training in the intervention. Church coordinators reported program implementation for their church. Sociodemographic differences and associations between changes in health behaviors and program implementation were tested with regression models. Changes in health-related variables were examined using paired t-tests and McNemar’s test.
Results
Pastors (41% women, 42% Black/African American) had a mean BMI of 30 kg/m2; 45% met F&V guidelines and 24% met PA guidelines. Black/African American pastors were less likely to meet F&V guidelines and had lower self-rated health than their counterparts. Pastor PA improved over time, but pastor health behaviors were not associated with program implementation. Church coordinators’ (95% women, 39% Black/African American) mean BMI was 28 kg/m2; 27% met F&V guidelines and 63% met PA guidelines. Black/African American church coordinators had higher BMIs and lower self-rated health than their counterparts. Church coordinator F&V intake improved over time; self-rated health was positively associated with PA program implementation.
Conclusions
This study underscores the need for preventive interventions for church leaders.; Summary

The Development of an Assessment Instrument for Behavior Toward Hypoglycemia Risk Among Type 2 Diabetes Mellitus Outpatients in Jakarta, Indonesia: Putu Rika Veryanti, Rani Sauriasari, Ratu Ayu Dewi Sartika, Berna Elya, Muhammad Ikhsan Mokoagow; Received June 22, 2024 Accepted September 27, 2024 Published online November 13, 2024; DOI: https://doi.org/10.3961/jpmph.24.313 [Accepted]

131 View
5 Download

Abstract PDF: Objectives
The purpose of this study was to develop a valid and reliable instrument for assessing patients’ behavior toward the risk of hypoglycemia through self-assessment. Insufficient education and supervision of type 2 diabetes mellitus (DM) outpatients by healthcare providers is a significant concern, affecting their behavior during the treatment process. Additionally, inappropriate behavior typically increases the risk of hypoglycemia. To mitigate this risk, several studies have recommended evaluating patients’ behavior, necessitating the development of a new instrument.
Methods
The study procedures were conducted in 3 stages: instrument development (face and content validity, stage I), construct validity and reliability test (stage II), and criterion validity (stage III). Stage I involved 5 healthcare practitioners, including internal medicine doctors, nurses, dietitians, and pharmacists in hospitals and community health centers. Stage II included 20 respondents using a 1-shot test method. Stage III involved 237 type 2 DM outpatients at Central General Hospital (RSUP) in Jakarta, employing a cross-sectional design and consecutive sampling.
Results
The results indicated that the developed instrument was valid and reliable, comprising 9 domains (29 questions). These domains included behavior toward blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. Furthermore, poor behavior was found to increase the risk of hypoglycemia by 2.36 times.
Conclusions
Based on these results, the developed instrument could be effectively used to evaluate behavior toward hypoglycemia among type 2 DM outpatients, confirming its validity and reliability.; Summary

Knowledge, Attitudes, and Practices Regarding Influenza Vaccination Among Healthcare Workers in Saudi Arabia: A Cross-sectional Study: Laila M. Almutairi, Mona A. Almusawi, Abeer M. Albalawi, Musallam Y. Abu Hassan, Adel F. Alotaibi, Tariq M. Almutairi, Randah M. Alalweet, Abdullah M. Asiri; J Prev Med Public Health. 2024;57(6):586-594. Published online November 8, 2024; DOI: https://doi.org/10.3961/jpmph.24.283

422 View
56 Download

Abstract Summary PDF Supplementary Material: Objectives
Influenza vaccination is important for healthcare workers in order to prevent both the illness itself and transmission to patients. Previous studies in Saudi Arabia have revealed low influenza vaccine coverage among healthcare workers due to misconceptions. This study aimed to assess knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers during 2021, addressing the current data gap.
Methods
A cross-sectional study was conducted, including 1273 healthcare workers from the Ministry of Health in Saudi Arabia. A self-administered questionnaire was distributed to participants via email.
Results
Most participants had an appropriate extent of knowledge, with 37.1% having a high level and 26.6% having a moderate level. Positive attitudes toward the influenza vaccine were observed in 41.2% of participants, and 80.2% demonstrated good vaccine practices. However, the vaccine coverage was 50.8% in the past 12 months. Factors associated with vaccine uptake included previous vaccination, workplace availability, awareness of guidelines, engagement in training programs, type of workplace settings, and having positive attitudes toward the vaccine. The most common reason for not getting vaccinated was the perception of being at low risk, making vaccination unnecessary.
Conclusions
Participants exhibited positive knowledge, attitudes, and practices regarding influenza vaccination. However, the observed vaccine uptake rate fell below the recommended coverage rate, indicating the presence of a knowledge-behavior gap. Targeted interventions are recommended to improve vaccination uptake among healthcare workers in Saudi Arabia.; Summary

Key Message
This study assesses knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers in Saudi Arabia, and reveals that most participants had an appropriate extent of knowledge, positive attitudes toward the influenza vaccine, and good vaccine practices. However, the vaccine uptake rate was below the desired coverage target, indicating a knowledge-behavior gap. Our findings suggest implementing interventions that enhance accessibility, provide workplace support, conduct awareness campaigns, and tackle barriers impeding vaccination, to improve uptake rates among healthcare workers in Saudi Arabia.

Necessity of Analyzing the Korea Community Health Survey Using 7 Local Government Types: Seowoo Park, Haibin Bai, Jae-ryun Lee, Soomin Kim, Hyemin Jung, Jin Yong Lee; Received July 22, 2024 Accepted October 18, 2024 Published online November 5, 2024; DOI: https://doi.org/10.3961/jpmph.24.388 [Accepted]

92 View
2 Download

Abstract PDF: Objectives
This study examined the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size as a more effective tool to address local health problems and deduce practical implications.
Methods
Retrospective survey data from 2023 KCHS were obtained. Frequency analyses were performed for self-rated good health status, current smoking status, and unmet medical needs as proxies for health status, as well as healthcare utilization and health behavior, utilizing individual weights to represent national community residents.
Results
We established a new classification of local governments into 7 types to facilitate regional comparisons. These local government types are presumably composed of populations showing statistically significant differences in demographic characteristics. There were evident differences in health status, health behavior, and healthcare utilization in comparisons of groups categorized by local government types.
Conclusions
This study suggests that regional disparities can be analyzed using a new typology of local governments. This practically effective approach could be used in decision-making for community-centered health projects in terms of community health planning. Future research should conduct analyses of KCHS data that use these 7 local government types to comprehensively reflect regional characteristics.; Summary

Air Passengers’ Risk of SARS-CoV-2 Infection with a 14-day Quarantine and Accuracy Assessment of a Symptom-based Screening System at an Airport: Toonlaya Direkwutthikun, Chanapong Rojanaworarit, Isabella Andrade, Bhanasut Hunsajarupan, Nuttawoot Photisan, Pattarasuda Sookchom, Thawabhorn Jannok, Rome Buathong; Received September 9, 2024 Accepted October 2, 2024 Published online November 3, 2024; DOI: https://doi.org/10.3961/jpmph.24.517 [Accepted]

98 View
6 Download

Abstract PDF: Objectives
This study aimed to validate the risk of SARS-CoV-2 infection, identify infection risk factors among air passengers subject to a 14-day mandatory quarantine, and evaluate the accuracy of mass symptom-based screening criteria at an airport.
Methods
This retrospective cohort study analyzed data from 116,004 air passengers who entered Thailand through Suvarnabhumi Airport in Bangkok from April to September 2020. The incidence of SARS-CoV-2 infection, risk characteristics, and accuracy indices of symptom-based screening were calculated.
Results
The overall incidence of SARS-CoV-2 was 0.5%, or 540 infections per 100,000 air passengers. Identified risk factors included sex, nationality, continent of departure, on-arrival screening results, and month of travel. Positive screening results indicated a higher risk and positive likelihood ratio for SARS-CoV-2 infection. However, the on-arrival screening criteria demonstrated low sensitivity and area under the receiver operating characteristic curve.
Conclusions
The current study confirms previous findings that the risk of SARS-CoV-2 infection during air travel is low. However, this might result from strict pre-departure screening and the SARS-CoV-2 test requirement for arriving passengers. The symptom-based screening criteria used upon arrival showed a low probability of identifying positive cases, suggesting that incorporating additional criteria could help detect asymptomatic infections. The integrated screening and quarantine model proved effective in preventing the spread of the virus into local communities.; Summary

Perspective

Addressing Public Health Risks: Strategies to Combat Infectious Diseases After the August 2024 Floods in Bangladesh: Fatema Hashem Rupa, Mosharop Hossian; J Prev Med Public Health. 2024;57(6):600-603. Published online November 3, 2024; DOI: https://doi.org/10.3961/jpmph.24.495

553 View
33 Download

Abstract Summary PDF: The August 2024 floods in Bangladesh have precipitated a major public health crisis, significantly elevating the risk of waterborne and vector-borne diseases and exacerbating existing health vulnerabilities. This disaster has impacted over 5 million people, causing widespread environmental disruption, population displacement, and strained healthcare resources. The flooding of latrines, sewage systems, and agricultural land has led to the contamination of drinking water sources, increasing the risk of cholera, enterotoxigenic Escherichia coli diarrhoea, shigellosis, and hepatitis. Additionally, stagnant floodwaters have created breeding grounds for mosquitoes, thereby increasing the threat of malaria and dengue fever. The disruption of healthcare services has further compounded the crisis, delaying emergency responses and impeding access to care. The psychological impact on affected communities is profound, with mental health issues such as anxiety, depression, and post-traumatic stress disorder emerging as significant concerns. This perspective provides an analysis of these public health threats, supported by data on the impact of floods and a discussion of the underlying risk factors. This underscores the need for immediate and long-term public health interventions, including restoring clean water access, enhancing disease surveillance, repairing healthcare infrastructure, and addressing mental health needs. The response to this disaster must be rapid and comprehensive, with lessons learned to inform preparedness efforts to better manage similar events in the future.; Summary

Key Message
The August 2024 floods in Bangladesh have caused a severe public health crisis, elevating risks of waterborne and vector-borne diseases like cholera, shigellosis, malaria, and dengue. Over 5 million people have been affected, with contaminated water sources, disrupted healthcare services, and mental health issues worsening the impact. This article highlights the urgent need for clean water restoration, disease surveillance, healthcare system repairs, and mental health support, emphasizing the importance of immediate and long-term interventions to manage the crisis and strengthen disaster preparedness for the future.

Original Articles

The Impact of COVID-19 on Admissions and In-hospital Mortality of Patients with Stroke in Korea: An Interrupted Time Series Analysis: Youngs Chang, Soo-Hee Hwang, Haibin Bai, Seowoo Park, Eunbyul Cho, Dohoung Kim, Hyejin Lee, Jin Yong Lee; Received August 8, 2024 Accepted October 2, 2024 Published online October 28, 2024; DOI: https://doi.org/10.3961/jpmph.24.432 [Accepted]

113 View
7 Download

Abstract PDF: Objectives
This study aimed to investigate the impact of COVID-19 on admission rates and in-hospital mortality among patients with ischemic and hemorrhagic stroke.
Methods
We constructed a dataset detailing the monthly hospitalizations and mortality rates of inpatients with stroke from January 2017 to December 2021. Employing an interrupted time series analysis, we explored the impact of COVID-19 on hospitalizations and 30-day in-hospital mortality among stroke patients.
Results
The number of ischemic stroke admissions decreased by 18.5%, from 5,335 to 4,348, immediately following the COVID-19 outbreak (p<0.001). The in-hospital mortality rate for ischemic stroke increased slightly from 3.3% to 3.4% immediately after the outbreak, although it showed a decreasing trend over time. The number of hemorrhagic stroke admissions fell by 7.5%, from 2,014 to 1,864, immediately following the COVID-19 outbreak. The 30-day in-hospital mortality rate for hemorrhagic stroke initially decreased from 12.9% to 12.7%, but subsequently showed an increasing trend.
Conclusions
We confirmed that COVID-19 impacted both the admission and death rates of stroke patients. The admission rate for both ischemic and hemorrhagic strokes decreased, while in-hospital mortality increased. Specifically, in-hospital mortality from ischemic stroke rose initially after the outbreak before stabilizing. Additionally, our findings indicate variable effects based on sex, age, and socioeconomic status, suggesting that certain groups may be more susceptible. This underscores the need to identify and support vulnerable populations to mitigate adverse health outcomes.; Summary

Development and Validation of an Instrument to Assess the Safe Use of Antidiabetic Medication to Prevent Hypoglycemia Requiring Hospitalization Among Ambulatory Patients with Type 2 Diabetes Mellitus: Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati; Received August 4, 2024 Accepted October 2, 2024 Published online October 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.424 [Accepted]

100 View
4 Download

Abstract PDF: Objectives
Ambulatory patients with type 2 diabetes mellitus (T2DM) require special attention when being discharged from the hospital with anti-diabetes medication. This necessity stems primarily from the risk of adverse drug reactions, particularly hypoglycemia. However, this risk is significantly influenced by the patients\' knowledge and behavior regarding their medication use. This study aimed to develop instrument to assess the risk of medication-related hypoglycemia in ambulatory T2DM patients by clinical pharmacists.
Methods
The study was conducted using an observational design that included multiple stages. These stages involved item development through focus group discussions (FGDs), content validation by clinical pharmacists, and criterion and construct validation by ambulatory T2DM patients using a cross-sectional approach.
Results
A total of 10 question items were developed for assessment by clinical pharmacists following FGDs and content validation. Criterion and construct validation identified 8 valid question items through multivariate analysis (p<0.05). The scoring system developed demonstrated a linear relationship between the score and the number of items at risk in the instrument (p<0.05, R²: 0.988). Additionally, the instrument was named \"Medication-related Hypoglycemia Risk Score Assessment Tools (HYPOGLYRISK).\"
Conclusions
The findings of this study suggest that HYPOGLYRISK may serve as a useful tool for clinical pharmacists to evaluate the risk of medication-related hypoglycemia in ambulatory T2DM patients. Additionally, this instrument could assist clinical pharmacists in identifying priority patients and tailoring educational services to meet their specific goals and needs.; Summary

Development of Machine Learning Models to Categorize Life Satisfaction in Older Adults Living Alone: Suyeong Bae, Mi Jung Lee, Ickpyo Hong; Received June 26, 2024 Accepted September 20, 2024 Published online October 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.324 [Accepted]

90 View
2 Download

Abstract PDF: Objectives
This study aimed to identify factors associated with life satisfaction by developing machine learning (ML) models to predict life satisfaction in older adults living alone.
Methods
Data were extracted from 3,112 older adults participating in the 2020 Korea Senior Survey. We employed 5 ML models to classify the life satisfaction of older adults living alone: logistic Lasso regression, decision tree-based classification and regression tree (CART), C5.0, random forest, and extreme gradient boost (XGBoost). The variables used as predictors included demographics, health status, functional abilities, environmental factors, and activity participation. The performance of these ML models was evaluated based on accuracy, precision, recall, F1-score, and area under the curve (AUC). Additionally, we assessed the significance of variable importance as indicated by the final classification models.
Results
Out of the 1,411 older adults living alone, 45.34% expressed satisfaction with their lives. The XGBoost model surpassed the performance of other models, achieving an F1-score of .72 and an AUC of .75. According to the XGBoost model, the five most important variables influencing life satisfaction were overall community satisfaction, self-rated health, opportunities to interact with neighbors, proximity to a child, and satisfaction with residence.
Conclusions
Overall satisfaction with the community environment emerged as the most significant predictor of life satisfaction among older adults living alone. These findings indicate that enhancing the supportiveness of the community environment could improve life satisfaction for this demographic.; Summary

First
Prev
Page of 159
Next
Last

Article category