Current Issue : October - December Volume : 2017 Issue Number : 4 Articles : 7 Articles
Pharmacovigilance is the science of collecting, monitoring, researching, assessing and evaluating information from healthcare providers and patients on the adverse effects of medications, biological products, herbalism and traditional medicines. Glucocorticosteroids are the commonly used drugs in dermatological diseases like leprosy, Pemphigus vulgaris diseases and allergic contact dermatitis. The main aim of this study to improve patient care and safety in relation to the use of corticosteroids in dermatological diseases. A total of 40 patients were recruited, in that 23 (57.50 %) were males and 17 (42.50 %) were females, glucocorticoids like predisolone (42.50 %), betamethasone (17.50 %) and dexamethasone causing highest number of ADRs. Diabetes mellitus (16.00%), hypokalemia (8.00%), hypotension (4.00%), peptic ulcer (4.00%), hypocalcaemia (4.00%), moon face (4.00%), facial puffiness (4.00%), erythematic patches (4.00%). Majority of ADR’s observed in cardiovascular system (56.00 %) endocrine system (16.00 %), electrolyte disturbances (12.00 %), skin (12.00 %) and GI system (4.00 %). Clinical pharmacists are the upcoming breed of pharmacists in our country. Clinical pharmacists can contribute improved patients outcomes by monitoring, identifying, assessing and prevention of ADRs and can also promote rational use of drugs....
[Background] Medical staff have many occasions to be exposed to anticancer\ndrugs (ACDs) in the process of performing cancer chemotherapy. Although\nguidelines for the safe handling of ACDs have been published, actual measures\nagainst exposure to ACDs differ between hospitals, and no surveillance\ndata regarding the conditions of each hospital in relation to performing che-motherapy in Japan are available. [Methods] To understand current measures\nagainst exposure to ACDs and problems related to cancer chemotherapy at\noutpatient departments, we conducted a questionnaire survey on doctors,\npharmacists, and nurses in 10 leading hospitals for cancer chemotherapy in\nJapan. [Results] Responses were received from all 10 institutions. The hospital\npharmacists prepared all ACDs for outpatients in each institution. All hospitals\ntook basic measures against ACD exposure, such as using personal protective\nequipment and penetration-resistant waste containers. Conditions against\nexposure to ACDs generally improved between 2012 and 2015, especially in\nterms of conveyance of ACDs and use of a closed-system drug transfer device.\nHowever, no measures linking ACDs with administration routes or injection\nsites were commonly taken in any of the hospitals in 2015. [Conclusions]\nConditions against ACD exposure improved between 2012 and 2015, possibly\nbecause new guidelines were issued. To improve measures for ACD exposure\nin Japan, preparing more appropriate manuals and offering more opportunities\nto medical staff for continuing education are considered important....
Background There are concerns about maintaining\nappropriate clinical staffing levels in Emergency\nDepartments. Pharmacists may be one possible solution.\nObjective To determine if Emergency Department attendees\ncould be clinically managed by pharmacists with or\nwithout advanced clinical practice training. Setting\nProspective 49 site cross-sectional observational study of\npatients attending Emergency Departments in England.\nMethod Pharmacist data collectors identified patient\nattendance at their Emergency Department, recorded\nanonymized details of 400 cases and categorized each into\none of four possible options: cases which could be managed\nby a community pharmacist; could be managed by a\nhospital pharmacist independent prescriber; could be\nmanaged by a hospital pharmacist independent prescriber\nwith additional clinical training; or medical team only\n(unsuitable for pharmacists to manage). Impact indices\nsensitive to both workload and proportion of pharmacist\nmanageable cases were calculated for each clinical group.\nMain outcome measure Proportion of cases which could be\nmanaged by a pharmacist. Results 18,613 cases were\nobserved from 49 sites. 726 (3.9%) of cases were judged\nsuitable for clinical management by community pharmacists,\n719 (3.9%) by pharmacist prescribers, 5202 (27.9%)\nby pharmacist prescribers with further training, and 11,966\n(64.3%) for medical team only. Impact Indices of the most\nfrequent clinical groupings were general medicine (13.18)\nand orthopaedics (9.69). Conclusion The proportion of\nEmergency Department cases that could potentially be\nmanaged by a pharmacist was 36%. Greatest potential for\npharmacist management was in general medicine and\northopaedics (usually minor trauma). Findings support the\ncase for extending the clinical role of pharmacists....
Even though pharmaceutical care is not a new concept in pharmacy, its introduction and\ndevelopment has proved to be challenging. In Iceland, general practitioners are not familiar with\npharmaceutical care and additionally no such service is offered in pharmacies or primary care settings.\nIntroducing pharmaceutical care in primary care in Iceland is making great efforts to follow other\ncountries, which are bringing the pharmacist more into patient care. General practitioners are key\nstakeholders in this endeavor. The aim of this study was to introduce pharmacist-led pharmaceutical\ncare into primary care clinics in Iceland in collaboration with general practitioners by presenting\ndifferent setting structures. Action research provided the framework for this research. Data was\ncollected from pharmaceutical care interventions, whereby the pharmaceutical care practitioner\nensures that each of a patient�s medications is assessed to determine if it is appropriate, effective, safe,\nand that the patient can take medicine as expected. Sources of data included pharmaceutical care notes\non patients, researcher�s notes, meetings, and interviews with general practitioners over the period\nof the study. The study ran from September 2013 to October 2015. Three separate semi-structured\nin-depth interviews were conducted with five general practitioners from one primary health care\nclinic in Iceland at different time points throughout the study. Pharmaceutical care was provided to\nelderly patients (n = 125) before and between general practitioners� interviews. The study setting was\na primary care clinic in the Reykjavik area and the patients� homes. Results showed that the GPs�\nknowledge about pharmacist competencies as healthcare providers and their potential in patient\ncare increased. GPs would now like to have access to a pharmacist on a daily basis. Direct contact\nbetween the pharmacist and GPs is better when working in the same physical space. Pharmacist�s\naccess to medical records is necessary for optimal service. Pharmacist-led clinical service was deemed\nmost needed in dose dispensing polypharmacy patients. This research indicated that it was essential\nto introduce Icelandic GPs to the potential contribution of pharmacists in patient care and that action\nresearch was a useful methodology to promote and develop a relationship between those two health\ncare providers in primary care in Iceland....
This study sought to understand the medication adherence and quality of life (QOL) of\nrecipients of a pharmacist-based medication management program among independently living older\nadults. Using a cross-sectional, quasi-experimental study design, we compared older adults enrolled\nin the program to older adults not enrolled in the program. Data were collected via face-to-face\ninterviews in independent-living facilities and in participants� homes. Independently living older\nadults who were enrolled in the medication management program (n = 38) were compared to older\nadults not enrolled in the program (control group (n = 41)). All participants were asked to complete\nquestionnaires on health-related quality of life (QOL, using the SF-36) and medication adherence\n(using the four-item Morisky scale). The medication management program recipients reported\nsignificantly more prescribed medications (p < 0.0001) and were more likely to report living alone\n(p = 0.01) than the control group. The medication management program recipients had a significantly\nlower SF-36 physical functioning score (p = 0.03) compared to the control group, although other SF-36\ndomains and self-reported medication adherence were similar between the groups. Despite taking\nmore medications and more commonly living alone, independent living older adults enrolled in\na pharmacist-based medication management program had similar QOL and self-reported medication\nadherence when compared to older adults not enrolled in the program. This study provides initial\nevidence for the characteristics of older adults receiving a pharmacist-based medication management\nprogram, which may contribute to prolonged independent living and positive health outcomes....
Undergraduate medical education has been criticised for failing to adequately prepare\ndoctors for the task of prescribing. Pharmacists have been shown to improve medication use in\nhospitals. This study aims to elicit the views of intern doctors on the challenges of prescribing, and to\nsuggest changes in education to enhance prescribing practice and potential role of the pharmacist.\nSemi-structured, qualitative interviews were conducted with intern doctors in their first year post\nqualification in an Irish hospital. Data collection was conducted until no new themes emerged\nand thematic analysis was performed. Thirteen interviews took place. Interns described training\nin practical prescribing as limited and felt the curriculum failed to convey the reality of actual\nprescribing. Pharmacists were perceived to be a useful, but underutilised, information source in the\nprescribing process. They requested an earlier introduction, and repeated exposure, to prescribing,\nand suggested the involvement of peers and pharmacists in this teaching. Intern doctors reported\ndifficulties in applying knowledge gained in medical school to clinical practice. New strategies\nare needed to enhance the clinical relevance of the medical curriculum by rethinking the learning\noutcomes regarding prescribing practice and the involvement of pharmacists in prescribing education....
Migraine is the most prevalent disease and it is affecting the most of the population worldwide. It was showing effect on person’s quality of life. In most of the migraineurs the migraine was triggered by some triggering factors by avoiding those triggers we can improve patient quality of life. Relieving factors are also playing a role in relieving the migraine episode. Main aim of our study is to find out any dietary triggers in Indian population because most of the triggers in Indian population are similar to other population but the dietary factors showing some difference. Some of the studies in India reported that there are no dietary triggering factors in Indians. A prospective study was conducted on neurology outpatients from December 2016 to may 2017. Both triggering and relieving factors in migraineurs were collected by interviewing the patient and by verifying their medical records. A total of 250 patients with migraine are interviewed in that majority of migraineurs are females (76%), the prevalence was more in between age group of 30-39 years of age and majority of the patients are migraine without aura, 67% of the migraineurs are triggered by different triggering factors, 32% are without triggers. Major triggering factors are sound (63%) followed by stress (29%), tension (16%) and lack of sleep, sunlight (11%). Cool drinks as a triggering factor in2% of patients, coffee in 1% of patients. 53% of the patients are with one triggering factor, 33% are having 2 triggering factors. In majority of the patients migraine attack is relieved by taking drugs (73%). The triggering factors in Indian population are similar compared with other population but in Indian studies they concluded that there are no dietary triggers in Indian population but in our study population we detected that coffee and cool drinks are dietary triggers. By our study we concluded that in Indians diet also playing a role as migraine trigger....
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