Current Issue : July - September Volume : 2012 Issue Number : 3 Articles : 8 Articles
Background: Data on adverse drug reactions (ADRs) related to antiretroviral (ARV) use in public health practice are\r\nfew indicating the need for ART safety surveillance in clinical care.\r\nObjectives: To evaluate the incidence, type and risk factors associated with adverse drug reactions (ADRs) among\r\npatients on antiretroviral drugs (ARV).\r\nMethods: Patients initiated on ARVs between May 2006 and May 2009 were evaluated in a retrospective cohort\r\nanalysis in three health facilities in Nigeria. Regimens prescribed include nucleoside backbone of zidovudine (AZT)/\r\nlamivudine (3TC), stavudine (d4T)/3TC, or tenofovir (TDF)/3TC in combination with either nevirapine (NVP) or\r\nefavirenz (EFV). Generalized Estimating Equation (GEE) model was used to identify risk factors associated with\r\noccurrence of ADR.\r\nResults: 2650 patients were followed-up for 2456 person-years and reported 114 ADRs (incidence rate = 4.6/100\r\nperson-years).There were more females 1706(64%) and 73(64%) of the ADRs were reported by women. Overall, 61\r\n(54%) of ADRs were reported by patients on AZT with 54(47%) of these occurring in patients on AZT/NVP. The\r\ncommonest ADRs reported were pain 25(30%) and skinrash 10(18%). Most ADRs were grade 1(39%) with only 1%\r\nbeing life threatening (grade 4). Adjusted GEE analysis showed that ADR was less likely to occur in patients on\r\nlonger duration of ART compared to the first six months on treatment; 6-12 months AOR 0.38(95% CI:0.16-0.91)\r\nand 12-24 months AOR 0.34(95% CI:0.16-0.73) respectively. Compared to patients on TDF, ADR was less likely to\r\noccur in patients on d4T and AZT AOR 0.18(95% CI 0.05-0.64) and AOR 0.24(95% CI:0.7-0.9) respectively. Age,\r\ngender and CD4 count were not significantly associated with ADRs.\r\nConclusion: ADRs are more likely to occur within the first six months on treatment. Close monitoring within this\r\nperiod is required to prevent occurrence of severe ADR and improve ART adherence. Further research on the\r\ntolerability of tenofovir in this environment is recommended....
To evaluate the prescribing pattern of anti-malarial drug and to assess the adherence of anti-malarial drugs prescribing according to National List of Essential Medicines of India 2011. A retrospective, Single-centric study with cases of anti-malarial drugs prescribed in duration of 1 year from Jan-2011 to Dec-2011 at Lions General hospital, Mehsana, Gujarat, India. Data were analyzed with different evaluations. A total of 474 cases were collected including 282 (59.49%) male and 192 (40.51%) female. Of the total medicine formulations (553) prescribed in hospital, 550 (99.46%) were matching well with those listed in National List of Essential Medicines of India 2011 (NELM), whereas remaining medicine formulations could be constructed as non-essential. Most of Primaquine prescribed in the correct dosage (100%) and within the correct duration (90%). This study shows the prescribing pattern of anti-malarial drug adherence to essential list is high. Also anti-malarial drugs prescribed in appropriate manner with correct dosage form and in correct duration. Only Artesunate were highly irrationally prescribed. Mostly drugs were prescribed by their brand name. It may make irrational prescription pattern or increase the cost of prescription....
Background: Each day, millions of health consumers seek drug-related information on the Web. Despite some\r\nefforts in linking related resources, drug information is largely scattered in a wide variety of websites of different\r\nquality and credibility.\r\nMethods: As a step toward providing users with integrated access to multiple trustworthy drug resources, we aim\r\nto develop a method capable of identifying drug�s dosage form information in addition to drug name recognition.\r\nWe developed rules and patterns for identifying dosage forms from different sections of full-text drug monographs,\r\nand subsequently normalized them to standardized RxNorm dosage forms.\r\nResults: Our method represents a significant improvement compared with a baseline lookup approach, achieving\r\noverall macro-averaged Precision of 80%, Recall of 98%, and F-Measure of 85%.\r\nConclusions: We successfully developed an automatic approach for drug dosage form identification, which is\r\ncritical for building links between different drug-related resources....
To understand patients attitudes toward the use and knowledge of Herb-drug interactions, survey instrument included questions about the patient’s demographic information, familiarity with various specific herbs, attitudes toward and beliefs about herbs, and the patient’s comfort level when discussing herb use with their physician.68% respondents felt that herbs were drugs and that some herbs could harm a baby if taken during pregnancy (30%). 58% believed that some herbs could interact with prescription medications and that herbs were safe to use during pregnancy, compared with prescription or over-the-counter drugs (44%). 71% respondents indicated that a family member recommended they take herbs. 41.13% respondents indicated they had given their children or grandchildren herbs. Our conclusion is herbal products are familiar to most patients and used by many of them. So Primary care physicians and pharmacists need to be aware that most patients are likely to use herbs without aware of its interactions....
A proper understanding of the knowledge, attitude, belief and practice (KABP) of diabetic patients is considered vital in accomplishing the goal of management. The aim of the study was: To assess the KABP of diabetic patients towards their disease, treatment, life style and diet. To evaluate the impact of clinical pharmacist provided education on diabetic patient’s KABP. This study describes the KABP among 78 patients attending the Jalaram hospital at Surat. A face-to-face interview using a structured questionnaire was carried out for data collection. A 31-items questionnaire was designed to assess the KABP and administered at the start of the study. A clinical pharmacist educated the patient regarding their disease, life style, diet and medications. The KABP questionnaire was re-administered after 30 to 40 days to assess the impact of patient education. The results revealed that 20 (25.7%) of the respondents were able to answer 50% or more questions correctly. After education, 64 (82%) of them had 50% or more score indicating an improvement by 56.4%. At baseline, majority of the study patients 58 (74.4%) and 65 (83.3%) were not aware of what diabetes is and its types, respectively. After pharmacist provided education there was a significant (p<0.001) increase in the awareness. In our study, patients with higher education exhibited more improvement in KABP than patients of lower education group after counseling session. At baseline assessment we observed that knowledge of patients towards diet was good which is followed by medication, life style and disease respectively. After pharmacist provided counseling this knowledge improved and maximum improvement was found in area towards disease. The result of the study point out that patient education improved the knowledge of patients regarding their disease, treatment, life style and diet and hence would be a useful tool in achieving good management and quality of life (QOL) in diabetic patients....
Background: The choices for self-medication in Hong Kong are much diversified, including western and Chinese\r\nmedicines and food supplements. This study was to examine Hong Kong public knowledge, attitudes and\r\nbehaviours regarding self-medication, self-care and the role of pharmacists in self-care.\r\nMethods: A cross-sectional phone survey was conducted, inviting people aged 18 or older to complete a 37-item\r\nquestionnaire that was developed based on the Thematic Household surveys in Hong Kong, findings of the health\r\nprorfessional focus group discussions on pharmacist-led patient self management and literature. Telephone\r\nnumbers were randomly selected from residential phone directories. Trained interviewers invited eligible persons to\r\nparticipate using the ââ?¬Å?last birthday methodââ?¬Â. Associations of demographic characteristics with knowledge, attitudes\r\nand beliefs on self-medication, self-care and role of pharmacists, and spending on over-the-counter (OTC) products\r\nwere analysed statistically.\r\nResults: A total of 1, 560 phone calls were successfully made and 1, 104 respondents completed the survey which\r\nindicated a response rate of 70.8%. 63.1% had adequate knowledge on using OTC products. Those who had no\r\nformal education/had attended primary education (OR = 3.19, 95%CI 1.78-5.72; p < 0.001), had attended secondary\r\neducation (OR = 1.50, 95%CI 1.03-2.19; p = 0.035), and aged =60 years (OR = 1.82, 95% CI 1.02-3.26; p = 0.042)\r\nwere more likely to have inadequate knowledge on self-medication. People with chronic disease also tended to\r\nspend more than HKD100 on western (OR = 3.58, 95%CI 1.58-8.09; p = 0.002) and Chinese OTC products (OR =\r\n2.94, 95%CI 1.08-7.95; p = 0.034). 94.6% believed that patients with chronic illnesses should self-manage their\r\ndiseases. 68% agreed that they would consult a pharmacist before using OTC product but only 45% agreed that\r\npharmacists could play a leading role in self-care. Most common reasons against pharmacist consultation on selfmedication\r\nand self-care were uncertainty over the role of pharmacists and low acceptance level of pharmacists.\r\nConclusions: The majority of respondents supported patients with chronic illness to self-manage their diseases but\r\nless than half agreed to use a pharmacist-led approach in self-care. The government should consider developing\r\ndoctors-pharmacists partnership programs in the community, enhancing the role of pharmacists in primary care and\r\nproviding education to patients to improve their awareness on the role of pharmacists in self-medication and self-care....
Background: Addressing the problem of preventable drug related morbidity (PDRM) in primary care is a challenge\r\nfor health care systems internationally. The increasing implementation of clinical information systems in the UK and\r\ninternationally provide new opportunities to systematically identify patients at risk of PDRM for targeted medication\r\nreview. The objectives of this study were (1) to develop a set of explicit medication assessment criteria to identify\r\npatients with sub-optimally effective or high-risk medication use from electronic medical records and (2) to identify\r\nmedication use topics that are perceived by UK primary care clinicians to be priorities for quality and safety\r\nimprovement initiatives.\r\nMethods: For objective (1), a 2-round consensus process based on the RAND/UCLA Appropriateness Method\r\n(RAM) was conducted, in which candidate criteria were identified from the literature and scored by a panel of 10\r\nexperts for ââ?¬Ë?appropriatenessââ?¬â?¢ and ââ?¬Ë?necessityââ?¬â?¢. A set of final criteria was generated from candidates accepted at each\r\nlevel. For objective (2), thematically related final criteria were clustered into ââ?¬Ë?topicsââ?¬â?¢, from which a panel of 26 UK\r\nprimary care clinicians identified priorities for quality improvement in a 2-round Delphi exercise.\r\nResults: (1) The RAM process yielded a final set of 176 medication assessment criteria organised under the\r\ndomains ââ?¬Ë?qualityââ?¬â?¢ and ââ?¬Ë?safetyââ?¬â?¢, each classified as targeting ââ?¬Ë?appropriate/necessary to doââ?¬â?¢ (quality) or ââ?¬Ë?inappropriate/\r\nnecessary to avoidââ?¬â?¢ (safety) medication use. Fifty-two final ââ?¬Ë?qualityââ?¬â?¢ assessment criteria target patients with unmet\r\nindications, sub-optimal selection or intensity of beneficial drug treatments. A total of 124 ââ?¬Ë?safetyââ?¬â?¢ assessment\r\ncriteria target patients with unmet needs for risk-mitigating agents, high-risk drug selection, excessive dose or\r\nduration, inconsistent monitoring or dosing instructions. (2) The UK Delphi panel identified 11 (23%) of 47 scored\r\ntopics as ââ?¬Ë?high priorityââ?¬â?¢ for quality improvement initiatives in primary care.\r\nConclusions: The developed criteria set complements existing medication assessment instruments in that it is not\r\nlimited to the elderly, can be implemented in electronic data sets and focuses on drug groups and conditions\r\nimplicated in common and/or severe PDRM in primary care. Identified priorities for quality and safety improvement\r\ncan guide the selection of targets for initiatives to address the PDRM problem in primary care....
South East Asia is a growing pharmaceutical market. The regulatory environment has similar characteristics but drug registration requirements and processes differ among the countries. An Association of South East Asian Nations (ASEAN) initiative to harmonize the requirements for drug registration is in progress and there will be a single ASEAN market by 2015. ASEAN pharmaceutical market mostly depends on imports to meet the demand of health facilities and through development of ACTD they have provided a single window for drug approval in all 10 countries. Even though ACTDformat is mandatory from 2009 the member countries have their own requirements for registration process like administrativedocuments, labeling. The purpose of this paper is to give a comparative overview on the Drug market regulation in ASEAN countries and consequently facilitate proper understanding of main critical issues, differences and similarities of the related Drug regulations. In fact each legal system has different requirements but there is also a similar outline which consists of common rules and topics involving registration procedure, labeling, licensing, and product safety requirements. Therefore this review will try to focus on some main issues of the Drug regulations throughout a very practical approach....
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