Review Article | DOI: https://doi.org/10.31579/2692-9562/159
Grodno State Medical University
*Corresponding Author: Bon E.I, Grodno State Medical University.
Citation: Bon E. I., Maksimovich N.Ye., Naidyuk K. D, (2026), Features of Pharmacotherapy in Elderly and Senile Individuals: Risks, Pharmacokinetics and Safety, Journal of Clinical Otorhinolaryngology, 8(1); DOI:10.31579/2692-9562/159
Copyright: © 2026, Bon E.I. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Received: 18 May 2026 | Accepted: 28 May 2026 | Published: 10 June 2026
Keywords: geriatrics; pharmacokinetics of aging; geriatric pharmacotherapy; drug interactions
When treating elderly and senile people, it is necessary to take into account that medicinal therapy should be only one of the links in the complex of therapeutic measures. Self-medication is unacceptable for elderly and senile people. It often contributes to the further development of diseases, which often turn into severe, incurable forms. The risk of adverse reactions in people over 60 years of age is 1.5 to 2 times higher than in people aged 30 to 40, and the risk of hospitalization for elderly people due to complications from drug therapy is 1.5 to 2 times higher. The highest number of deaths related to drug therapy occurs in people aged 80 to 90.
When administering drug therapy to elderly and senile individuals, there is an increased risk of toxic manifestations of drug accumulation, undesirable biological effects of drugs on the body, interactions between different drugs, and persistent hypersensitivity to a drug, which is often caused by previous years of drug use.
As the human body ages, both the pharmacokinetics and pharmacodynamics of drugs change, and they are impaired at various levels: absorption in the gastrointestinal tract, hepatic metabolism, biological transport, excretion, and receptor sensitivity and response. Many drugs have an increased effect in older people due to decreased clearance of the drug, which leads to an increase in its concentration in the serum [1].
Absorption. The oral route of drug administration is the most commonly used in geriatric practice.
Physiological age-related changes in the gastrointestinal tract, which are highly individual in older adults, can cause significant variations in the absorption of orally administered drugs. Both the rate and efficiency of the absorption process may be affected.
Studies of the gastrointestinal tract in practically healthy elderly and senile individuals show that the hypokinesia of the stomach and intestines progresses with age. The overall tone of various parts of the stomach naturally decreases during the aging process. This often leads to a decrease in the evacuation capacity of the stomach and a slower elimination of medications into the intestines. Delayed gastric emptying affects drugs that are unstable in acidic environments, as it postpones their arrival at the preferred absorption site [1, 2]. Enteric-coated medications, such as aspirin, may release early in the stomach due to altered absorption linked to increased gastric pH in geriatric patients, raising the risk of gastrointestinal (GI) ADEs [1, 3]. Since the small intestine is the site of maximum absorption due to its larger mucosal surface compared to the stomach and colon, a slower evacuation of medications from the stomach reduces the rate of their absorption.
Drugs with a short half-life are particularly sensitive to delayed gastric emptying. A decrease in the rate of drug evacuation, combined with normal or accelerated elimination, may prevent the achievement of therapeutic concentrations in the plasma and tissues. Delayed gastric emptying may have an undesirable effect on acid-resistant drugs (e.g., penicillin).
The decrease in the rate of drug absorption in older individuals may be due to the atrophic processes associated with aging in the gastric wall, changes in the gastric vessels, and a decrease in the mesenteric blood flow.
As people age, the secretory function of the stomach decreases. In older adults, hypochlorhydria and achlorhydria occur in almost 50% of cases. Along with a decrease in acid production, the production and activity of enzymes also change significantly. The pH of the gastric contents does not seem to have a significant impact on the absorption of drugs, as it occurs primarily in the intestines, but the solubility of certain drugs (such as tetracyclines) is highly dependent on an acidic PH. The degree of solubility of a drug in the stomach largely determines the rate and volume of its absorption in the small intestine.
Changes in the rate of drug absorption in elderly and especially senile individuals are also observed when drugs are administered subcutaneously or intramuscularly. This is due to a decrease in blood flow velocity and changes in the permeability of capillary walls. As a result, the effects of these drugs are often observed later and at a lower intensity compared to younger individuals.
Distribution of drugs in the body. The aging process can affect the distribution of drugs in the body in various ways. At this stage of pharmacokinetics, the rate of accumulation of drugs by tissues is greatly influenced by the decrease in cardiac output, the age-related characteristics of blood supply to various organs and systems, the rate of plasma flow, and the permeability of cell membranes. These changes, which gradually progress with aging and are not uniform in different tissues and organs, can lead to diverse distributions and interactions of drugs in the body. The dynamics of drug metabolism and elimination are largely dependent on the degree of impaired blood supply to the liver and kidneys.
The shifts in the protein composition of the blood observed during aging, due to a decrease in the content of albumins, lead to a decrease in the ability of the substance to bind to the blood protein. At the same time, the concentration of unbound substance, which is free to diffuse into the body's tissues, remains high. Thus, the decrease in the amount of the albumin fraction in the plasma proteins of older individuals makes them more susceptible to the effects of drug therapy and the development of drug intoxication, especially when multiple drugs are used.
With aging, body composition changes significantly — in the period from 25 to 60 years, body muscle mass decreases by 20%, the amount of fat increases by 10-20%, the amount of water decreases by 10-15%; after 75 years, the water content in the body decreases by 18-20%. This altered composition affects the distribution volume of hydrophilic and lipophilic drugs, causing higher concentrations of hydrophilic drugs and prolonging the elimination half-life of lipophilic drugs. Lipophilic drugs like chlordiazepoxide, morphine, and amiodarone tend to have a larger distribution volume in geriatric patients, creating a larger reservoir within the body [1]. Because drug clearance is proportional to distribution volume, lipophilic drugs exhibit longer clearance times, resulting in extended durations of action and increased risk of residual effects, as observed with drugs like acitretin and first-generation H1-antihistamines (diphenhydramine) used for chronic hives [1, 4]. Conversely, hydrophilic drugs such as digoxin, lithium, ethanol, and theophylline have a reduced distribution volume, leading to higher plasma concentrations and necessitating smaller doses to achieve therapeutic levels [1, 5, 6]. In contrast, lipid-soluble nonpolar drugs have increased volumes of distribution with age, leading to prolonged half-lives. This has been observed in drugs like diazepam, thiopentone, lignocaine, and chlormethiazole [1, 5-7].
As a rule, the mass of parenchymal organs decreases. In this regard, it is impossible to calculate the dose of the drug based on the total body weight.
It is known that drugs quickly penetrate into parenchymal organs, such as the heart, brain, liver, kidneys, and other well-perfused tissues, but they penetrate more slowly into muscles and even more slowly into adipose tissue. The latter is slower than the parenchymal organs in eliminating drugs and acts as a reservoir for their continued effects.
Metabolism of drugs. During the aging process, the structure and function of the liver, which is the main site of biological transformation of drugs, undergo a number of significant changes due to age-related atrophy and changes in the number and size of many cellular elements in the parenchyma. The liver's mass decreases by 10-15%. Regional blood circulation is significantly altered, and many of the liver's functions, including protein synthesis and antitoxicity, which play an important role in the normal metabolism of drugs, are reduced. Pathological liver damage in the elderly further reduces its synthetic and detoxifying functions. Due to the decrease in hepatic drug metabolism with aging, the liver often fails to reduce the high concentration of unbound drug to a normal therapeutic level, which can lead to drug intoxication. Reduced hepatic blood flow and decreased liver mass are the key factors contributing to diminished first-pass metabolism in geriatrics [1, 8-15].
Excretion of metabolites. The last phase of pharmacokinetics is the excretion of drug metabolites, which is primarily carried out by the kidneys. In older adults, the excretory function of the kidneys gradually decreases. The weakening of renal circulation is caused by the dilation of glomerular vessels. In healthy individuals, the effective renal blood flow decreases by more than half, averaging only 42% compared to younger individuals. By advanced age, the nitrogen excretion function of the kidneys decreases by more than three times. Age-related decrease in renal hemodynamics and the number of nephrons affects the effectiveness of drug excretion. Given the impairment of liver metabolism and renal excretory function, the initial dosage of drugs should be reduced to one-third to two-thirds of the adult dose.
A number of drugs are excreted from the body mainly by the kidneys in their unchanged form or as active metabolites; when they are prescribed, the functional capacity of the kidneys should be evaluated beforehand. Treatment of the elderly should be started with the lowest of the recommended doses, and then adjusted according to the clinical effect and the level of the drug in the blood. These drugs include: penicillin’s (large doses), digoxin, aminoglycosides, allopurinol, Novocain, cephalosporins (ceporin, cefamizin, etc.), methyldopa (dopegit), etambutol.
Chlorpropamide, sulfanilamide’s, tetracyclines, furadonin should not be prescribed to elderly and old people with significant renal impairment, as they are not effective in this case and have pronounced side effects.
The reaction of cells and tissues. The failure, and sometimes the negative effect, of drug therapy used in geriatric practice may be a consequence of changes in cell reactivity, their exhaustion, caused by the aging of the body and the superimposition of a pathological process that contributes to involution.
With aging, against the background of increased sensitivity, the reactivity of cells and tissues decreases, which is an expression of a reduction in the range of adaptive possibilities.
These data largely explain the origin of the inappropriate reactions in older people that can be observed when medications are administered. The negative effects, paradoxical reactions, and qualitative changes in tissue response are largely due to the lack of parallelism in changes in sensitivity, reactivity, and endurance, especially in cases where increased sensitivity is accompanied by reduced reactivity. This is why increasing the dosage of medications in older patients does not always provide a therapeutic effect and can relatively easily lead to adverse reactions. This is especially true for cardiac glycosides, nitroglycerin, sympathomimetics, and some other drugs.
Drug interactions. The problem of drug interactions is becoming increasingly relevant in modern medicine as new drugs are introduced, and the number of drugs has been rapidly increasing in recent years.
Elderly and senile age is not a reason to avoid using combination drug therapy, but the doctor must be aware of the increased risk associated with this therapy, as the line between the active and dangerous zones of drug action becomes narrower with age. The frequency of adverse reactions increases as the number of drugs used simultaneously increases, and it also increases with the age of the patient.
Absorption of drugs and motor activity of the digestive tract. Interactions between drugs at the level of absorption in the gastrointestinal tract can be very diverse. First of all, this is a change in absorption due to impaired motor activity of the stomach and intestines, and inhibition of absorption of one drug as a result of the inhibitory effect of another drug. The slower movement and absorption in the gastrointestinal tract of older individuals and the longer interaction between drugs in a specific part of the gastrointestinal tract can lead to metabolic transformations and subsequent inactivation of one drug before it is absorbed. In cases of achlorhydria, the absorption of weak acids (such as salicylic acid) and barbiturates is reduced. Hypochlorhydria, a condition more common in older adults, may reduce the absorption of weakly alkaline drugs such as ketoconazole [16, 17]. The habitual use of laxatives by elderly and senile individuals can lead to increased potassium excretion, which should be taken into account when treating patients with digitalis, especially when combined with diuretics. Drugs like levodopa show a notable increase in absorption rates in geriatric patients, likely due to reduced dopa-decarboxylase in the gastric mucosa [18].
Medications and food. The absorption of medications and their interactions in the gastrointestinal tract can also be affected by their interaction with food components.
An example of an undesirable interaction between food and medication is the simultaneous administration of tetracycline with milk, which contains high levels of calcium, which can form insoluble complexes with this antibiotic. Acidic fruit and vegetable juices can also reduce the effectiveness of acid-resistant antibiotics (such as ampicillin, erythromycin, etc.) when taken with them. Sweetening medications with syrups slows down the absorption of amidopyrine, calcium chloride, isoniazid, tetracycline, and others. Food slows down the absorption of many antibiotics and sulfanilamide’s. A meal before administration of acetylsalicylic acid causes a sharp decrease in its level in the blood compared to administration on an empty stomach.
Medications and alcohol. In geriatric practice, special attention should be paid to the interaction between alcoholic beverages and medications. Alcohol can potentiate the effects of barbiturates, which should not be prescribed to the elderly and senile, as well as amines, tricyclic antidepressants, and benzodiazepine derivatives (elenium, seduxen, tazepam, etc.). The toxicity of barbiturates can increase by more than 50%. Alcohol can also significantly enhance the side effects of acetylsalicylic acid. Therefore, in the elderly and senile age, the combination of aspirin with vodka should be avoided, which is quite often used as a "home remedy" for colds. For patients with diabetes, alcohol is dangerous when taking butamid, as it reduces its effect and makes it essentially ineffective.
Massive dosages. One of the main principles of geriatric pharmacology is the need to avoid large doses of medications. In the elderly and senile age, it is especially difficult to tolerate large doses of medications, which are often as inappropriate as large physical and emotional loads, food excesses, etc. These require the mobilization of significant reserves of the body's adaptive mechanisms, which are usually significantly reduced in older adults. The potentiation of the effects of medications by alcohol is one of these loads that can lead to very undesirable, sometimes tragic, results.
Two or more medications at the same time. If two medications are present in the blood at the same time, the medication with a higher ability to bind to proteins will displace a portion of the other medication and make it biologically active. Therefore, the administration of two medications without a pharmacological or clinical justification may result in an overdose or toxic effects, even if both medications are administered at normal doses. This risk is significantly increased when multiple medications are administered. In this case, the specific relationship between drugs and their interaction with protein receptors often leads to unexpected, often undesirable, and sometimes dangerous reactions.
An example of such reactions is the interaction between digitalis or strophanthin and calcium supplements, which are often prescribed for older adults with senile osteoporosis. Calcium can displace both digitalis and strophanthin from their protein-binding sites, leading to overdoses of these medications. Barbiturates can also accelerate the metabolism of digitalis and reduce its effectiveness.
Medications and cellular (tissue) receptors.
Interactions between medications can also occur in the pharmacodynamic phase, when their metabolites affect the peripheral receptors of various organ tissues. The nature of this interaction determines the final effect of the substance, which depends on its ability to bind to receptors, their reactivity, and sensitivity. Thus, the therapeutic effect is determined not only by the concentration of the free, non-protein-bound part of the drug, but also by the specific response of tissues, organs, systems, and the entire human body, which vary significantly with age.
Drug interactions can change the biological activity of one or more drugs due to competitive effects at the receptor level. Due to the age-related characteristics of the aging body's response to drugs, these changes and their clinical manifestations can be quite unexpected and undesirable in older adults during the treatment of a pathological process.
In many cases, these changes may be evident, such as hemorrhagic events, lack of response to antihypertensive drugs, excessive sedation, and others. However, they are often overlooked. For elderly people, latent, mild-symptom, and prolonged course of diseases is typical. The same is true for drug interaction reactions. Usually, they occur, being masked by the general picture of the disease, and, remaining unrecognized, affect the general condition of patients.
2.5. Principles Of Pharmacotherapy
The main principle of geriatric pharmacotherapy is the more cautious use of drugs in the treatment of elderly and old people than young people. This position receives new justifications in pharmacological studies, everyday clinical observations. The position put forward in geriatrics about the need to assess all other possibilities of influencing the sick body of an old person before prescribing drug therapy, not to use drugs if other therapy is possible, deserves great attention.
Everyday experience shows that it is not the presence of pronounced organic changes, but rather unfavorable social factors, that often cause an elderly or old person to feel ill. In such cases, the use of medication is often unnecessary and sometimes even harmful. In geriatric practice, it is crucial to pay attention not only to the patient's physical condition but also to their mental status and the external factors that can affect their well-being, sleep, mood, and desire to live.
In some cases, medications can actually contribute to the development of a disease. Long-term drug treatment requires periodic review of the pharmacotherapy regimen to reduce the list of medications.
When conducting drug therapy for the elderly and senile, the factor of full confidence in the therapeutic properties of drugs, as well as knowledge of their effect on the body during long-term use, is especially important. The side effects of drugs on individuals who have reached retirement age, and especially on the elderly, are often unpredictable. As a general principle, geriatrics should avoid medications with anticholinergic effects whenever possible [1, 19, 20].
The objectives of clinical pharmacology include assessing the indications for pharmacotherapy, not only for new and still poorly studied drugs, but also for well-established drugs, especially when they are used in combination and over many months and years.
The unjustified prescription of medications in geriatric practice is caused not only by a lack of knowledge about the pharmacological effects on the elderly patient's body, but also by a lack of knowledge about physiological age-related norms. Not only is hypodiagnosis (the failure to recognize existing diseases or pathological processes) harmful, but so is hyperdiagnosis (the misinterpretation of age-related norms, functional tests, and clinical analyses as symptoms of a disease) and the resulting irrational use of medication.
Special attention should be paid to the regular intake of prescribed medications. People of older age, especially the elderly, often forget to take their medications or take them again after a short period of time. Therefore, in a hospital setting, the nurse should personally administer the medication prescribed by the doctor. At home, the daily dose of the medication should be stored so that the patient can see how many times they have taken it based on the remaining powders or tablets. In geriatric practice, it is convenient to use colored tablets or capsules. When prescribing the simultaneous intake of several drugs at home, it is advisable to place them in the lids of medicine bottles in the morning, with cut-out circles of paper of different colors or other markings on the bottom. If possible, liquid medications should be avoided. Due to poor eyesight and hand tremors, it is often difficult for patients to accurately dose medications, especially the number of drops. Additionally, the lack of precise control over the packaging can lead to leaks and changes in the concentration of the medication due to evaporation, microbial contamination, and degradation.
The basic principles and features of drug therapy in geriatric practice:
1) the risk of adverse effects on the organs of drugs, due to age-related features, which are often aggravated by changes associated with pathological processes, is significantly higher in elderly and old people than in younger people;
2) in old age, adaptation to loads of any kind, including natural toxic metabolites and drugs, is significantly reduced. In this regard, the resistance to intoxication in the old body is less and even a small intoxication is dangerous;
3) polypragmasia (multiple drug therapy) is unacceptable. It is necessary to limit the number of medications as much as possible, using their targeted effect on the main disease. The method of taking medications should be as simple as possible. When prescribing medications, the mental health of the elderly person and their social conditions, as well as the possibility of care, should be taken into account. Great attention should be paid to observing the intervals between medication doses;
4) the most important rule is individualization of doses; reduced doses of medications are recommended, especially at the beginning of treatment. By gradually increasing the doses, it is possible to establish tolerance to the medication. This is particularly important for cardiac glycosides, sedatives, antihypertensive medications, and antipsychotics. The initial doses of these medications should be reduced by half compared to the doses used for middle-aged individuals. Once the therapeutic effect is achieved, the dose should be reduced and a maintenance dose should be determined, which is usually lower than in adults.
5) treatment with antibiotics and antibacterial chemotherapy drugs should be carried out at normal or slightly reduced dosages, according to the general rules. It should be noted that the risk of intoxication and side effects of these substances on the elderly and senile body is higher, especially if they are not adequately supplied with vitamins, especially B vitamins;
6) it is important to consider not only the nutritional value of the patient's diet, but also their water and salt intake, as well as the amount of urine produced. This is particularly important due to the frequent underconsumption of fluids by the elderly, which can lead to drug intoxication.
7) long-term use of many medications, such as sedatives, painkillers, and sleeping pills, can lead to addiction and cause patients to increase their doses, which can result in drug-related intoxication. It is recommended to use these medications for a short period of time, frequently replace them with similar medications, and take breaks between doses when possible.
8) To prevent toxic effects and enhance the effectiveness of medications, it is advisable to use a combination of pharmacological agents in small doses that have similar therapeutic effects and complement each other, but target different aspects of the body's self-regulation.
9) Inborn or acquired specific sensitivity to certain drugs can be observed in all age groups. Drug allergies are a common complication in older age groups;
10) The so-called geriatric drugs, general stimulants aimed at maintaining metabolic processes and functions, and above all, appropriate complex vitamin therapy, have a certain significance in the prevention and treatment of premature aging and can be combined with a number of other drugs in the treatment of diseases. Vitamin therapy should be considered as a factor that reduces the risk of drug intoxication and other side effects.
Pharmacotherapy in the elderly requires particular caution due to age-related changes in pharmacokinetics, which increases the risk of toxic effects and drug interactions. Initial doses should be reduced, and polypharmacy should be avoided, as adaptive mechanisms are weakened in old age. Treatment should be initiated with minimal doses under clinical supervision, avoiding self-medication and taking into account the patient's individual response.
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Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
