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Objective: Medication therapy management clinics (MTM) in pharmacies are perceived and utilized differently by healthcare professionals Methods: Ninety-seven healthcare professionals participated in an anonymous, cross-sectional survey to determine their perceptions and utilization of MTM clinics. It consisted of ten questions that were delivered via an online application that was secure. Results: 60 healthcare professionals completed the survey. 60% of respondents had referred patients to MTM clinic, and 80% were familiar with the clinic. Medication adherence and disease state management were the most common reasons for referral. Lack of knowledge about the referral process prevented patients from being referred to MTM clinics. Fourty-five percent of providers rated MTM services as excellent, forty-three percent as good, twelve percent as fair, and zero percent as poor. MTM clinic pharmacists were identified as one of its strengths by healthcare providers for their comprehensive medication reconciliation, which included in-depth patient education and close follow-up. According to those familiar with the clinic, several recommendations can be made to improve the service provided by the MTM clinic; marketing efforts should be increased, collaborative practice agreements should be created between pharmacists and physicians, and brief progress notes should be written. Conclusion: MTM clinics are regarded as valuable resources in large, urban, academic institutions as they provide patients with detailed information about the medications and conditions they are prescribed. Due to MTM clinics' identified benefits, patients frequently refer themselves to these clinics for medication adherence and disease management

In a six-week study, 50 patients over the age of 65 who took five or more regular medications, had at least three co-morbid conditions, and/or were discharged from the hospital within three months of study participation participated. A pharmacist and general practitioner were contacted following patient interviews to confirm the medication history and complete the questionnaire. There were discrepancies related to 966 medications (83.9%) of the 576 medications used by 50 patients. 281 medications were completely omitted. Discrepancies usually involve dosage and frequency information that was incomplete or omitted. Approximately 29% of the medications treated cardiovascular disorders, whereas most were used to treat dermatological and ear, nose and throat disorders. A comprehensive and accurate medication history, which is compiled by emergency room pharmacists, can facilitate medication management throughout the continuum of care. The medication history of the patient should be clarified and confirmed, contact the patient's pharmacist and general practitioner

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation and systemic manifestations. Recent studies have explored the potential impact of RA on ovarian function in affected women. This review aims to summarize the existing literature on the relationship between decreased ovarian function and RA, including the possible mechanisms involved and the clinical implications for affected patients. RA treatments, such as diseasemodifying antirheumatic drugs (DMARDs) and glucocorticoids, may influence ovarian function. Methotrexate, a commonly used DMARD, has been associated with an increased risk of ovarian toxicity and impaired follicular development. Glucocorticoids may affect ovarian function through their suppressive effects on the hypothalamic-pituitary-gonadal (HPG) axis. Genetic factors and autoantibodies associated with RA are potential contributors to ovarian dysfunction. Genetic polymorphisms in genes involved in immune regulation and hormone metabolism have been linked to both RA susceptibility and ovarian dysfunction. Autoantibodies, such as anti-Müllerian hormone antibodies, have been detected in the serum of RA patients and could potentially interfere with ovarian function. Decreased ovarian function in RA patients may have implications for fertility, reproductive outcomes, and overall quality of life. Women with RA have been found to have an increased risk of adverse reproductive outcomes, including miscarriage and early menopause. In conclusion, there is evidence to suggest an association between RA and decreased ovarian function. Chronic inflammation, hormonal dysregulation, RA treatments, genetic factors, and autoantibodies are potential mechanisms that may contribute to this association. Further research is needed to elucidate underlying mechanisms and develop optimal management strategies for affected women.