Publications by authors named "Firouzeh Noghrehchi"
The short-term impact of copayment reductions for government subsidised medicines in Australia.
Expert Rev Pharmacoecon Outcomes Res
April 2025
Background: This study aims to examine the short-term, population-level effects of the 2023 Australian Pharmaceutical Benefits Scheme (PBS) copayment reduction on prescription volume, patients' out-of-pocket (OOP) expenditure, and government contributions.
Research Design And Methods: We conducted a quasi-experimental study using national data from January 2021 to April 2024. For system-level analysis, we examined all drugs used by general patients, focusing on 252 drugs that were 'above copayment' during 2022-2023.
Background: Australians' use of e-cigarettes has increased dramatically in the last few years, following trends worldwide. The Australian Federal government introduced legislation on October 1st, 2021, which reclassified nicotine e-cigarettes as prescription only medicine in an attempt to curb their rapid uptake, especially amongst adolescents.
Methods: This is a retrospective analysis of e-cigarette exposure cases reported to the Victorian Poisons Information Centre between January 1st, 2017, and September 30th, 2023.
Self-poisoning in young Australians: The impact of COVID-19 and recent trends following easing of restrictions.
Aust N Z J Psychiatry
January 2025
Article Synopsis
- Self-poisoning is the most common form of self-harm among young people in Australia, and rates have been increasing, especially during and after the COVID-19 pandemic.
- A study analyzed data from poison information centers from 2018 to 2023, finding a significant rise in self-poisoning cases, particularly among females aged 5-19, with an overall increase of 29.6% during this period.
- After pandemic restrictions lifted, there was an initial drop in self-poisoning cases, but they declined slowly overall, highlighting the need for ongoing monitoring and support for mental health among young people.
Article Synopsis
- The study highlights the growing issue of poisoning in New South Wales, Australia, indicating a need for better data on its impact on health outcomes and its epidemiology.
- It analyzed a decade's worth of health data (2011-2020) from various sources, revealing over 845,000 events related to poisoning, with the majority stemming from adverse drug reactions and intentional poisonings, particularly affecting younger individuals.
- The findings show that demographics and reasons for poisoning vary significantly, with notable contributions from substance and mood disorders, suggesting a complex interplay between mental health and poisoning cases in the region.
Article Synopsis
- A study on paracetamol dosing errors in Australia showed that unintentional overdoses can lead to serious liver damage, particularly due to small miscalculations in dosage; 14,380 such cases were recorded from 2017 to 2023, with a 2.5% annual increase.
- In 2021, detailed analysis of 1,899 exposures revealed that 26.8% of individuals required hospitalization; common factors included higher doses, prolonged use, and many using multiple paracetamol products.
- The findings highlight the need for better education on proper dosing and more noticeable labeling of ingredients to reduce the risk of overdose, as many cases involved patients using paracetamol
Has the rescheduling of modified-release paracetamol in Australia affected the frequency of overdoses?
Emerg Med Australas
August 2024
Objectives: In June 2020, modified-release paracetamol (paracetamol-MR) preparations were up-scheduled from schedule-2 (available in pharmacy) to schedule-3 (available by request to a pharmacist only). The present study aims to ascertain whether up-scheduling affected the frequency of paracetamol-MR overdoses.
Methods: This is a retrospective cohort study of two data sets from 1 June 2017 to 31 May 2022.
Article Synopsis
- The study looked at how many teenagers in Australia use more than one substance, like alcohol and drugs, and how their use changes as they grow up.
- Researchers followed almost 2,000 teens and their parents over several years, asking them about their substance use and other factors like family issues and friends' habits.
- They found that while very few teens started using multiple substances at a young age, this number increased significantly as they got older, and many factors like family and friends' behaviors were linked to these changes.
Medicine utilization studies in Australian individual-level dispensing data: A blinded, multi-center replicated analysis.
Pharmacoepidemiol Drug Saf
March 2024
Article Synopsis
- The study investigates how different methods of analyzing medicine dispensing data can lead to varying research outcomes, specifically in the context of patients starting metformin treatment.
- Four Australian sites used a HARper protocol to enhance reproducibility and assessed treatment events like discontinuation and switching, leading to good agreement on basic demographics but poor agreement on key treatment outcome measurements.
- The findings highlight that inconsistent analytical choices can compromise research replicability, underscoring the need for detailed protocols like HARPER to ensure clarity in study methods.
Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease.
Expert Opin Drug Metab Toxicol
July 2023
Introduction: Paracetamol is one of the most used medicines worldwide and is the most common important poisoning in high-income countries. In overdose, paracetamol causes dose-dependent hepatotoxicity. Acetylcysteine is an effective antidote, however despite its use hepatotoxicity and many deaths still occur.
View Article and Find Full Text PDFBackground: Codeine was restricted to prescription only in Australia in 2018. This intervention aimed to reduce harms from codeine dependance and use, including toxicity from co-formulated paracetamol. We aimed to quantify the impact of this intervention on paracetamol poisoning hospital admissions in a national hospital admissions database.
View Article and Find Full Text PDFHospitalised poisonings in Australian children: a 10-year retrospective study.
Clin Toxicol (Phila)
March 2023
Introduction: Paediatric poisoning is a major cause of childhood injury, and most poisonings are preventable. We aimed to describe hospitalisations resulting from poisoning and envenomation in Australian children, including demographics, cause of the exposure, hospital length of stay, rates of intensive care unit admission and in-hospital deaths. We also aimed to describe risk factors for increased length of stay and intensive care unit admission.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates how a patient's age and sex impact the risk of death from acute pesticide self-poisoning, revealing that age significantly affects fatality rates.
- Conducted in Sri Lanka over several years, the research included a large cohort of poisoned patients and used statistical methods to analyze outcomes while considering clinical symptoms.
- Results indicate that the risk of death increases more steeply with age in males compared to females, emphasizing the need for healthcare policies to consider these demographic factors during treatment.
Article Synopsis
- Multiple imputation and maximum likelihood estimation are two common methods for handling missing data, but improper multiple imputation can act similarly to a stochastic expectation-maximization approach.
- The article suggests that traditional model selection tools like Akaike's Information Criterion (AIC) and Bayesian Information Criterion (BIC) can help effectively choose the best imputation model, which is crucial to avoid bias in analysis.
- Simulations show that not only can incorrect imputation lead to biased parameter estimates, but also overfitting the imputation model can have negative effects, highlighting the need for careful model selection in imputation strategies.
Background: The literature suggests patient characteristics and higher opioid doses and long-term duration are associated with problematic opioid behaviours but no one study has examined the role of all these factors simultaneously in a long-term prospective cohort study.
Methods: Five-year, community-based, prospective cohort of people prescribed opioids for chronic non-cancer pain (CNCP). Logistic mixed effect models with multiple imputation were used to address missing data.