Purpose: Hypertension (HTN) poses a significant health risk for Indonesia’s large population. Underlying factors contributing to this disease are not fully understood at a national level. Therefore, this study aimed to evaluate factors associated with HTN in Indonesia. Patients and Methods: This study used data from the Indonesian Family Life Survey-5, a 2014 national cross-sectional population-based survey of individuals aged 15 years and older. The mean arterial pressure (MAP) value was determined from three blood pressure measurements taken by trained nurses using Omron digital sphygmomanometers. The respondent was classified as hypertensive when the MAP value was at least 100. The study summarised the socio-demographic factors (age, gender, marital status, ethnicity and occupation status) and lifestyle habits (smoking, sleep quality, physical activity) with descriptive statistics. The potential associations between these factors and HTN were assessed using logistic regression analysis. The results were reported in terms of odds ratios (OR) with a 95% confidence interval (CI). Results: The study included 32,670 respondents; 31.2% of them had HTN. Factors that were more likely associated with HTN were being < 65 years old, being married (OR 1.257, 95% CI 1.170– 1.352) and being smoker (OR 1.297, 95% CI 1.198– 1.404), while being male (OR 0.677, 95% CI: 0.625– 0.733) and doing no physical activity (OR 0.870, 95% CI: 0.813– 0.930) were less likely to be associated with HTN. Conclusion: This study indicates that there are associations between certain socio-demographic factors and lifestyle habits with HTN in Indonesia. This information may help policymakers and healthcare providers to develop effective strategies in order to control HTN in Indonesia, thereby improving the overall health and well-being of the population.

Background: Digital health interventions (DHIs) have shown promising results in enhancing the management of heart failure (HF). Although health care interventions are increasingly being delivered digitally, with growing evidence on the potential cost-effectiveness of adopting them, there has been little effort to collate and synthesize the findings. Objective: This study’s objective was to systematically review the economic evaluations that assess the adoption of DHIs in the management and treatment of HF. Methods: A systematic review was conducted using 3 electronic databases: PubMed, EBSCOhost, and Scopus. Articles reporting full economic evaluations of DHIs for patients with HF published up to July 2023 were eligible for inclusion. Study characteristics, design (both trial based and model based), input parameters, and main results were extracted from full-text articles. Data synthesis was conducted based on the technologies used for delivering DHIs in the management of patients with HF, and the findings were analyzed narratively. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed for this systematic review. The reporting quality of the included studies was evaluated using the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) guidelines. Results: Overall, 27 economic evaluations were included in the review. The economic evaluations were based on models (13/27, 48%), trials (13/27, 48%), or a combination approach (1/27, 4%). The devices evaluated included noninvasive remote monitoring devices (eg, home telemonitoring using digital tablets or specific medical devices that enable transmission of physiological data), telephone support, mobile apps and wearables, remote monitoring follow-up in patients with implantable medical devices, and videoconferencing systems. Most of the studies (24/27, 89%) used cost-utility analysis. The majority of the studies (25/27, 93%) were conducted in high-income countries, particularly European countries (16/27, 59%) such as the United Kingdom and the Netherlands. Mobile apps and wearables, remote monitoring follow-up in patients with implantable medical devices, and videoconferencing systems yielded cost-effective results or even emerged as dominant strategies. However, conflicting results were observed, particularly in noninvasive remote monitoring devices and telephone support. In 15% (4/27) of the studies, these DHIs were found to be less costly and more effective than the comparators (ie, dominant), while 33% (9/27) reported them to be more costly but more effective with incremental cost-effectiveness ratios below the respective willingness-to-pay thresholds (ie, cost-effective). Furthermore, in 11% (3/27) of the studies, noninvasive remote monitoring devices and telephone support were either above the willingness-to-pay thresholds or more costly than, yet as effective as, the comparators (ie, not cost-effective). In terms of reporting quality, the studies were classified as good (20/27, 74%), moderate (6/27, 22%), or excellent (1/27, 4%). Conclusions: Despite the conflicting results, the main findings indicated that, overall, DHIs were more cost-effective than non-DHI alternatives. Trial Registration: PROSPERO CRD42023388241; https://tinyurl.com/2p9axpmc

Medication adherence among heart failure (HF) patients in the Middle East remains a critical, under-explored issue. This systematic review examines medication adherence rates and their influencing factors in this region. A search of PubMed, Scopus, and Google Scholar identified 12 studies published between 2013 and 2023, revealing an average non-adherence rate of 60%. Influential factors include socioeconomic status, education, psychiatric conditions, and medication-related issues. Significant gaps in research methodologies and reporting were noted. The review highlights the impact of socio-economic determinants on adherence and calls for more robust research and targeted interventions to address these barriers. Improving patient education and healthcare provider communication are crucial to enhancing adherence rates. These findings underscore the importance of addressing regional challenges through tailored approaches and suggest further studies are needed to develop effective strategies for improving adherence among HF patients in the Middle East.

Cough and cold symptoms (CCS) are common pediatric conditions often treated with over-the-counter (OTC) medications. However, the available knowledge regarding the safety and toxicity of these medications in children is inadequate. Therefore, understanding their clinical toxicology is crucial for safeguarding children’s well-being. This narrative review highlights the importance of clinical toxicology in evaluating the safety and toxicity profile of OTC medications for treating CCS in pediatric patients. The pharmacology, clinical features, and adverse effects of various drug classes commonly found in cough and cold medications are briefly discussed. Pharmacokinetic and pharmacodynamic parameters are also examined to understand the interactions between these drugs and the body. OTC cough and cold medications often contain active ingredients such as antihistamines, decongestants, antitussives, expectorants, and analgesics-antipyretics. The combination of multiple ingredients in these products significantly increases the risk of adverse effects and unintentional overdoses. Several case studies have reported significant toxicity and even fatalities associated with the use of these medications in children. This review underscores the critical importance of clinical toxicology in evaluating the safety and toxicity profile of OTC medications employed for treating CCS in pediatric patients. The findings highlight the significance of informed clinical practice and public health policies to ensure the well-being of children using OTC cough and cold medications.

This report summarizes the proceedings of a policy and planning meeting convened in Indonesia, by the Ministry of Health and the World Health Organization, on potential new tuberculosis (TB) vaccines intended for adults and adolescents. Given that Indonesia bears the second highest TB burden globally, and that it is participating in the phase III efficacy study for one of the leading vaccine candidates that could be approved for use by 2028, the meeting aimed to discuss strategies and evidence needs that could accelerate vaccine introduction. The meeting, held in November 2024, was attended by Indonesian policymakers, researchers, health advocates and community representatives, alongside observers from immunization and TB programmes working at the global level, as well as donors. This report offers several key recommendations to ensure new TB vaccines for adults and adolescents are available, accessible and acceptable in Indonesia, as soon as possible after regulatory approval. The vaccine implementation strategy is expected to be through a stratified, geographical approach, initiating in provinces with the highest disease and socio-economic burden. As such, improved data on disease, infection prevalence and acceptability within different age cohorts and populations are needed to inform national and sub-national (e.g., province or district level) health and economic impact modelling. Early studies on knowledge, attitudes and practices of new TB vaccines for adults and adolescents will help to engage community leaders and advocates and ensure effective, culturally acceptable communication to improve acceptability. Of greatest urgency, a national strategic plan for new TB vaccine introduction, including a roadmap of critical activities, responsible entities and a stakeholder engagement plan are needed.