Bethany Atkins

and 7 more

Objective Explore parents’ experiences of care before and after stillbirth to identify potential areas for improvement. Design Internet-based survey of parents distributed via International Stillbirth Alliance networks. Setting Global. Population or Sample 2488 parents with a stillborn baby in the previous 5 years Methods Framework analysis of free-text responses, using an a priori framework developed from global respectful maternity care rights and guidelines. Main Outcome Measures Self-reported experience of care Results Four major themes arose: compassionate communication and shared decision making; respect for individuality, autonomy and legal rights; competent staff, facilities, and care systems; and holistic support. Many parents reported individualised, compassionate, and high-quality care, with synergistic community support. Negative experiences involved paternalistic or disrespectful care. Commonly parents felt that not enough information about stillbirth prevention had been provided. Conclusions Bereaved parents want supportive healthcare providers who listen to them, provide information and treat them with kindness and respect. Parents do not want, or expect, all care to come from healthcare providers. Intersection of healthcare with community, charities and spiritual support is important. The option of legal registration and naming of the stillborn baby is important to many parents. Funding The Centre of Research Excellence in Stillbirth (Stillbirth CRE) at the Mater Research Institute, The University of Queensland, Australia funded the survey. The National Health and Medical Research Council (NHMRC) provides core funding to the Stillbirth CRE. Keywords Stillbirth, stillborn, perinatal loss, intra-uterine death, perinatal bereavement, online survey, qualitative, respectful care

Giada Crescioli

and 10 more

Background and aim: The search for early and emergency effective treatments for COVID-19 infection may have led to loss of sight of treatments safety. In addition, characteristics of drug-drug interactions (DDIs)-related adverse drug reactions (ADRs) in COVID-19 patients have not yet been studied in depth. The aim of the present case-series study is to describe clinical and pharmacological characteristics of SARS-CoV-2 inpatients, focusing on ADRs, particularly those related to DDIs. Methods: We evaluated all reports of COVID-19 medications-related ADRs collected within the COVID-19 Units of Careggi University Hospital, Florence (Italy), between January 1st and 31st May 2020. Information regarding COVID-19 medications, patients’ demographic and clinical characteristics, concomitant drugs, ADRs description and outcome, were collected. Each case was evaluated for the causality assessment and to identify the presence of DDIs. Results: During the study period, 23 Caucasian patients (56.5% males, mean age 76.1 years) experienced one or more ADRs. The majority of them were exposed to polypharmacy and 17.4% presented concomitant conditions. ADRs were referred to cardiovascular, psychiatric and gastrointestinal disorders. The most frequently reported preferred term was QT prolongation (mean QT interval 496.1 msec). ADRs improved or resolved completely in 60.8% of cases. For all patients, a case-by-case evaluation revealed the presence of one or more DDIs, especially those related to pharmacokinetic interactions. Conclusions: Despite the small number of patients, our evidence underline the clinical burden of DDIs in SARS-CoV-2 inpatients and the risk of unexpected and uncommon psychiatric ADRs.