Pharmacoepidemiology, Volume 1, Issue 2 (September 2022) – 3 articles

This cross-sectional study sought to quantify medication use and change in use of prescription-only medications purchased in the past in Syria without medical prescription versus today in Norway in an adult population originating from Syria and living in western Norway. Data on adults born in Syria and living in Norway during December 2019–January 2020 were collected via a self-administrated questionnaire in Arabic. Participants were recruited at a community pharmacy and at a refugee center. We included 148 participants (mean age 36.4 years; 38.5% females and 60.8% males) of whom 62.6% had lived in Norway for 4–6 years. Most participants had low (45.9%) or medium (39.2%) health literacy. Painkillers and analgesics were the most widely used medications, in both Norway (69.6%) and Syria (78.4%). Use of antibiotics declined significantly in Norway (31.1%) relative to Syria (65.5%); 70.9% participants used prescription-only medications in both countries, while 6.1% and 13.5%, respectively, did so only in Norway or only in Syria. This study reports a relatively high rate of medication use, particularly painkillers and analgesics both in Syria and in Norway. Participants with low health literacy reported greater use of antibiotics than those with high level in Syria but not in Norway. Use of antibiotics decreased substantially in Norway relative to the past in Syria, reaching a comparable prevalence with that in the host community. Although uncommon, prescription-only medication use only in Norway was reported by some participants. Full article

Depolarization-blocking drugs (DB drugs) used for cardiac disease increase the risk of cardiac arrhythmia (ventricular tachycardia/ventricular fibrillation [VT/VF]) and out-of-hospital cardiac arrest (OHCA) in specific patient groups. However, it is unknown whether drugs for non-cardiac disease that block cardiac depolarization as the off-target effect increase the risk of OHCA on a population level. Therefore, we aimed to investigate OHCA risk of non-cardiac, DB drugs in the community. We conducted a population-based case-control study. We included OHCA cases from an emergency-medical-services-attended OHCA registry in the Netherlands (ARREST:2009–2018), and age/sex/OHCA-date matched non-OHCA controls. We calculated adjusted odds ratios (OR_adj) of use of non-cardiac DB drugs for OHCA using conditional logistic regression. Stratified analyses were performed according to first-registered rhythm (VT/VF or non-VT/VF), sex, and age (≤50, 50–70, or ≥70 years). We included 5473 OHCA cases of whom 427 (7.8%) used non-cardiac, DB drugs and 21,866 non-OHCA controls of whom 835 (3.8%) used non-cardiac, DB drugs and found that non-cardiac, DB-drug use was associated with increased OHCA-risk when compared to no use (OR_adj1.6[95%-CI:1.4–1.9]). Stratification by first-recorded rhythm revealed that this applied to OHCA with non-VT/VF (asystole) (OR_adj2.5[95%-CI:2.1–3.0]) but not with VT/VF (OR_adj1.0[95%-CI:0.8–1.2]; p-value interaction < 0.001). The risk was higher in women (OR_adj1.8[95%-CI:1.5–2.2] than in men (OR_adj1.5[95%-CI:1.2–1.8]; p-value interaction = 0.030) and at younger ages (OR_adj≥70yrs1.4[95%-CI:1.2–1.7]; OR_{adj50–70yrs}1.7[95%-CI:1.4–2.1]; OR_adj≤50yrs3.2[95%-CI:2.1–5.0]; p-value interaction < 0.001). Use of non-cardiac, DB drugs is associated with increased OHCA risk. This increased risk occurred in patients in whom non-VT/VF was the first-registered rhythm, and it occurred in both sexes but more prominently among women and more strongly in younger patients (≤50 years). Full article

The issue with the overlapping clinical symptoms from an electronic cigarette (e-cigarette) or vaping product use-associated lung injury (EVALI) and coronavirus disease 2019 (COVID-19) sometimes leads to incorrect diagnosis and, consequently, wrong treatment regimen. The purpose of this review is to study the burden of vaping-associated health consequences on the diagnosis and treatment of COVID-19 in young adults and adolescents with a misconception of e-cigarettes as a safer alternative to smoking. The online reference databases, including PubMed, Google Scholar, Web of Science, Medline, and Centers for Disease Control and Prevention (CDC), were used in the literature search, as we analyzed the complexity of timely diagnosis and treatment in the current COVID-19 era with the use of e-cigarettes. This study briefly describes the dysbiosis of the oral microbiome in e-cigarette users that could potentially aggravate the COVID-19 symptoms and lead to the complexity of timely diagnosis and treatment. Additionally, the patient case reports with a history of vaping and symptoms similar to COVID-19 disease are reviewed. Full article