Self-Medication Practices and Associated Factors in the Prevention and/or Treatment of COVID-19 Virus: A Population-Based Survey in Nigeria.

The anxiety caused by the emergence of the novel coronavirus disease (COVID-19) globally has made many Nigerians resort to self-medication for purported protection against the disease, amid fear of contracting it from health workers and hospital environments. Therefore, this study aimed to estimate the knowledge level, causes, prevalence, and determinants of self-medication practices for the prevention and/or treatment of COVID-19 in Nigeria. A web-based cross-sectional survey was conducted between June and July 2020 among the Nigerian population, using a self-reported questionnaire.

Electronic medical record systems: A pathway to sustainable public health insurance schemes in sub-Saharan Africa.

Pubic health insurance schemes are usually set up by governments to provide cover for their insured populations against healthcare costs. These schemes are usually administered by a government agency and vary both in how they are funded and provide their services. A number of developing countries have introduced such schemes to minimise the impact of financial barriers to healthcare access by their populations.

Description of an incidence-based model for Assessing comorbidity patterns in disease natural history.

Background: Patients with a chronic disease often suffer from other diseases called comorbidities, which can be important factors in the assessment of risks associated with the disease and its management. However, comorbidities can pose important methodological issues because factors such as time, age, duration and the disease can influence their impact on the risk of interest.

Methods: To identify comorbidities of a chronic disease, it is common practice to construct 2 separate cohorts of patients-a set with the disease and another as a random sample of patients free of the disease-and compare the event rates for each candidate's comorbidity over a specific period between the 2, while accounting for factors which may confound the results.

A pathway to improved prospective observational post-authorization safety studies.

Randomized controlled trials (RCTs) are the gold standard for assessing the efficacy of drugs but not necessarily so for drug safety where inadequate power to detect either multiple or rare adverse events is a major handicap. Furthermore, the conditions under which drugs are approved for market use are often different from the settings in actual use. Indeed, with their control mechanisms, trials are by design largely inadequate for the identification of potential safety signals, especially of the rare type, hence the value of postmarketing surveillance and risk management plan-based activities.

Recent trends in lung cancer and its association with COPD: an analysis using the UK GP Research Database.

Background: The association between lung cancer and COPD has not been investigated in the primary care setting.

Method: We determined the recent trends of lung cancer in COPD patients in the UK during the period 1991-2004, by investigating the population aged 45 and over in the General Practice Research Database.

Results: The annual-incidence rates of lung cancer per 10,000 person-years were at least four-fold higher in patients with prior COPD (increasing from 45 to 64 in men; 29 to 48 in women) compared with the general population (from 10 to 15 in men; 5 to 10 in women).

How real is intention-to-treat (ITT) analysis in non-interventional post authorization safety studies? We can do better.

Although cohort studies which are based on intention-to-treat (ITT) approach offer a simple design with data which are simpler to analyse and results easier to interpret, such studies also intrinsically assume that any time-varying treatment effect that exits can be adequately estimated by a fixed-effect component. However, such an assumption may not reflect real-life drug use. Reflection of real-life clinical practice is a major strength of epidemiologic safety studies.

Chronic obstructive pulmonary disease and hospitalizations for pneumonia in a US cohort.

Objective: To better understand risk factors for pneumonia hospitalizations in people with impaired lung function.

Methods: We analyzed longitudinal data from participants in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS). We limited our analysis to 20,375 participants aged 45 and older at baseline.

Inhaled corticosteroids and risk of lung cancer among COPD patients who quit smoking.

Rationale And Objectives: COPD is associated with an increased risk of lung cancer. We examined whether inhaled corticosteroids (ICS) used concomitantly with long-acting beta(2)-agonists (LABA) were associated with reduction in lung cancer risk in COPD patients.

Methods: We conducted a retrospective cohort study of patients with a first-time diagnosis of COPD (index date) between 1989 and 2003 who were initially free of lung cancer, had quit smoking, were aged >or=50 years at time of diagnosis, and were regular users of ICS, ICS/LABA concomitantly, or short-acting bronchodilators (SABD).

Inhaled corticosteroids are more effective in COPD patients when used with LABA than with SABA.

Adding long-acting beta agonists (LABA) to inhaled corticosteroids (ICS) has been associated with beneficial effects in COPD patients in randomized controlled trials and observational studies. However, it is not known whether adding short-acting beta agonists (SABA) to ICS instead of LABA will be similarly effective in COPD. We compared the effectiveness of combination therapies involving ICS with LABA versus ICS with SABA in reducing risk of re-hospitalization or death among COPD patients within a year of discharge from a first COPD hospitalization.

Inhaled corticosteroids in chronic obstructive pulmonary disease: results from two observational designs free of immortal time bias.

Rationale: Recent cohort studies in chronic obstructive pulmonary disease (COPD) have questioned the validity of previously reported associations between inhaled corticosteroids (ICS) and reductions in mortality and rehospitalization in observational studies. Using time-dependent versions of statistical survival models, these studies have suggested immortal time bias as responsible for the proposed beneficial association.

Objectives: We explored the extent of this bias in a study of patients with COPD monitored for a year from COPD discharge with two designs free of any immortal time bias in the General Practice Research Database in the United Kingdom.

Gender differences in the management and experience of Chronic Obstructive Pulmonary Disease.

Whether women receive the same medical care for COPD as men and if they are at risk of different outcomes as a result, is not known. The Confronting COPD International Survey was performed in the USA, Canada, France, Italy, Germany, The Netherlands, Spain and the UK in 2000 with 3265 COPD participants. Forty-one per cent were women; mean age in women and men was 61.

Inhaled corticosteroids with/without long-acting beta-agonists reduce the risk of rehospitalization and death in COPD patients.

Introduction: In patients with COPD who have recently been hospitalized for their disease, we examined whether treatment with inhaled corticosteroids without or with long-acting beta-adrenoceptor agonists (beta-agonists) reduced rehospitalization and mortality.

Study Design: Retrospective cohort analysis in the UK General Practice Research Database.

Methods: We compared rehospitalization for a COPD-related medical condition or death within 1 year after first hospitalization, in 3636 COPD patients receiving prescriptions for inhaled corticosteroids or long-acting beta-agonists compared with 627 reference patients with COPD who were prescribed short-acting bronchodilators only.