Current medical research and opinion
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Observational Study
COPD management according to old and new GOLD guidelines: an observational study with Italian general practitioners.
Guideline recommendations for COPD management are only partially applied within primary care clinical practice. ⋯ Guideline recommendations are applied only partially within clinical practice. A higher prescriptive appropriateness is shown by GPs using nGOLD classification. This might be due to the fact that nGOLD, with respect to oGOLD, takes into account anamnestic usual features considered by GPs in their clinical practice.
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Randomized Controlled Trial
Genital mycotic infections with canagliflozin, a sodium glucose co-transporter 2 inhibitor, in patients with type 2 diabetes mellitus: a pooled analysis of clinical studies.
To characterize genital mycotic infections with canagliflozin, a sodium glucose co-transporter 2 inhibitor, in patients with type 2 diabetes mellitus (T2DM) using pooled data from Phase 3 studies. ⋯ Genital mycotic infection incidences were higher with canagliflozin than control in patients with T2DM; events were generally mild to moderate in intensity and responded to standard treatments.
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Adhering to prescribed medication is often a problem for patients with diabetes yet there is no consensus on how best to measure adherence in this patient population. This systematic literature review critically reviewed and summarized the methods used to measure medication adherence in patients with diabetes (on oral hypoglycemic agents [OHAs] and/or insulin) in original research published between 2007-2013. ⋯ No gold standard exists for measuring medication adherence in patients with diabetes. The plethora of adherence methods precludes the comparison of adherence rates across studies. Greater consistency is therefore needed in adherence measurement, including question content, recall period, and response options for self-report measures. Novel methods for understanding adherence to variable-dosed insulin require further research. Researchers should select a methodology that best fits their research question, study design, patient population and resources.
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Smoking is one of the major risk factors causing morbidity and mortality in chronic obstructive pulmonary disease (COPD) and lung cancer patients. Use of smoking cessation pharmacotherapy is an effective way to help quit smoking. The purpose of the study was to determine the prevalence of smoking and the proportion of patients using smoking cessation agents, and to identify the socio-demographic factors that affect the use of these agents among COPD and lung cancer patients. ⋯ Results showed that a large number of patients continued to smoke even after the diagnosis of COPD and lung cancer; whereas only a few among them used smoking cessation agents. Ethnicity disparities and insurance status were associated with the use of smoking cessation agents. Differential use among population sub-groups suggests a requirement for need based smoking cessation programs and appropriate prescription drug coverage. Further research needs to be done to evaluate reasons for disparities in smoking cessation agents' use. The study had limitations common to research designs based on observational and self-reported datasets.
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Randomized Controlled Trial Multicenter Study
Saxagliptin versus glipizide as add-on therapy to metformin: assessment of hypoglycemia.
To compare characteristics of hypoglycemic episodes in patients with type 2 diabetes receiving saxagliptin or glipizide add-on therapy to metformin. ⋯ Saxagliptin + metformin was associated with fewer patients reporting hypoglycemia and fewer and less severe hypoglycemic events in those experiencing hypoglycemia compared with glipizide + metformin. ClinicalTrials.gov registration number: NCT00575588.