Average Number Of Drugs Research Articles

Impact of antibiotic therapy management by clinical pharmacists on rational drug use in the perioperative period of retinal detachment surgery in china: a retrospective study from the perspective of prescription structure

Background This paper aims to assess the impact of antibiotic therapy management by clinical pharmacists on rational drug use (RDU) in the perioperative period of patients receiving retinal detachment surgery in China from the perspective of prescription structure. Methods: In this study, a retrospective study was used to compare the differences in the RDU between 233 patients (the experimental group) receiving medical treatment and 210 patients (the control group) without clinical pharmacist intervention. The data were collected with a set of indicators adjusted from the core medication use indicator proposed by the World Health Organization and the International Network of Rational Use of Drugs according to the background of China. Results: There were significant differences in average number of drugs per prescription (19.7 and 20.8, P = 0.001), percentage of drugs on the reimbursable list (98.32% and 72.4%, P = 0.003), and average treatment expenditure per prescription (555.3 yuan and 707 yuan) between the experimental group and the controlled group, while average number of antibiotics per prescription (4.2 and 4.3, P = 0.114), average number of injections per prescription (12.02 to 11.96, P = 0.804) were not changed significantly. Conclusions: More efforts are needed to improve the effectiveness of the antibiotic therapy management by clinical pharmacist on rational drug use, meanwhile the objective of cost-saving should be included in the service pattern of clinical pharmacy services.

Assessment of drug use in primary health centers in Lagos State, Nigeria.

rational drug use prevents wastage of resources, loss of confidence in healthcare system and drug-related morbidity and mortality. This study aims to assess drug use in Primary Health Centers (PHCs) in Lagos State, Nigeria using the World Health Organization in collaboration with the International Network of Rational Use of Drugs core drug use indicators. the study was conducted between February to October 2021 as a comparative observational survey of selected PHCs. It included a retrospective and prospective cross-sectional design for prescribing and patient care indicators assessing 2640 prescriptions and clients respectively. Data were analyzed and presented as frequency with percentage or mean with standard deviation, as applicable. The performances of the types of PHCs were compared using two-sample t-test. A 2-tailed p-value < 0.05 was considered statistically significant. average number of drugs per prescription, drugs prescribed by the generic name, percentage of encounters with prescribed antibiotics and injections were 3.6 ± 0.9%, 76.5 ± 18.5%, 63.3 ± 19.1% and 21.1 ± 24.1% respectively with no significance difference between the comprehensive and basic PHCs. For all the facilities, the average consultation and dispensing times were 10.5 ± 6.0 minutes, 244.9 ± 179.2 seconds respectively. In this study, the percentage of patients' knowledge of the correct dosage was 72.4 ± 38.3%. There is statistically significant difference in availability of key drugs in stock between the comprehensive and basic PHCs (p-value 0.0001). irrational drug use practices exist in comprehensive and basic PHCs. There is a need to implement interventions aimed at strengthening good prescribing and patient-care practices across the PHCs in Lagos State.

A STUDY OF DRUG UTILIZATION PATTERN IN MEDICAL CRITICAL CARE UNIT OF A TERTIARY CARE TEACHING HOSPITAL

BACKGROUND:Chronic disease and life threatening disorders among CCU patients have resulted in medicating them with drugs from different pharmacological classes, which is further complicated by the altered physiology and multi-organ system failure. OBJECTIVE : To evaluate the drug utilization pattern in patients admitted in Medical Critical Care Unit (MCCU). MATERIALS AND METHODS: This was an observational study carried out in Medical Critical Care Unit at a tertiary care teaching hospital. The data were entered in pre tested case record form and analysed for demographic details, clinical management and prescribing pattern. The DDD per 100 bed days was calculated. RESULTS: A total of 400 patients were evaluated consisting 70% male patients. Average duration of stay was 7.38 + 0.34 (mean + SE) days. Most common causes for admission to the ICU were intraparenchymal haemorrhage (18%), cerebrovascular stroke (15%) and chronic obstructive pulmonary disease (15%). An average number of drugs per patient was 15.14 + 0.19 (mean + SE). Commonly prescribed drug group was the antimicrobial agents (AMAs) in which metronidazole has highest DDD/100 bed days of 11.08. Other commonly prescribed groups were drugs affecting blood and gastrointestinal drugs. It was observed that out of 400 patients, 223 (56%) patients were discharged and 177 (44%) patients were expired. CONCLUSION: The polypharmacy was present and antimicrobials were highest prescribed drug in our MCCU. The prescribers should be making aware about risks of polypharmacy.

TRENDS IN PRESCRIPTION PATTERN IN MEDICAL INDIAN ICU AND IT’S IMPACT ON PATIENT OUTCOME

Objective: The objective of this study is to evaluate the trends in prescribing pattern in medical ICU concerning patient age, gender, past, and current illness along with comorbidities for the evasion of polypharmacy and to improve patient outcomes. Methods: A prospective analysis of the case records of patients admitted to the ICU of Yashoda hospital in India was carried out. Results: 120 patients were evaluated, consisting of 77% male patients. The mean±SD of age is 53.81±14.63. The majority of the study subjects belonged to the age group of 50-67 y (32%) Most common causes for admission to the ICU were Respiratory diseases and Stroke. Diabetes mellitus and Hypertension are the most common co-morbidities identified. The total number of drugs used were 1502 during this study period. The average number of drugs per prescription is 12. The range is between 2-30. The average number of antibiotics per prescription is 3. Commonly prescribed drug classes were the GI agents in 100% of patients, followed by antimicrobial agents (AMAs) in 95.8% of patients. About 42.5% of patients received 3 antibiotics per day. 55 potential drug-drug interactions were interpreted in 46 patients. 30(55%) were moderate interactions 25(45%) were major interactions, which were addressed. De-escalation of antibiotics was seen in 29% of patients while escalation in 13%. The death rate is only 5% in our ICU setting. Conclusion: This prescription pattern study can provide a framework for continuous prescription audit in the ICU

Audit and quality assessment of prescriptions in a tertiary care hospital of Junagadh

Background: Analysis of prescription of doctors is done to determine, evaluate, and improve the care of patients in a well-organized way and it estimates on-going practice against a defined standard. Aim and Objective: The aim of the study was to provide the broad outline of performance and delineate parameter as per the check list of prescription audit. Materials and Methods: An observational and non-interventional study was carried out from July 2021 to November 2021 at peripheral medical college, Gujarat. Randomly, we have selected 500 prescriptions. This prescriptions were evaluated as per World Health Organization prescribing indicators and then it were analyzed for errors in prescription writing. Results: In this study, total 500 prescriptions were analyzed and total 1839 drugs were prescribed. Average number of drugs per prescription was 3.67. The percentage of drugs prescribed by generic name was 94.6%. The percentage of encounters with an antibiotic prescribed was 29%. In our prescription audit study, 39.16% (1762 count) prescriptions were non complete and 60.84% (2738 count) prescription were having complete details. Conclusion: If the drug is prescribe by generic name and from essential drug list chances of dispensing error decrease and hand out of incorrect drug to patient is reduced. Minimizing drug per prescription attenuates chances of drug-drug interactions. Regular prescription audit should be conducted regularly which increase the awareness in prescriber and effective, safe, and economics therapeutic practice.

PRESCRIPTION AUDIT USING THE WORLD HEALTH ORGANIZATION PRESCRIBING INDICATORS FOR INDOOR PATIENTS TREATED UNDER CMAAY/PMJAY INSURANCE SCHEMES IN A TERTIARY CARE TEACHING HOSPITAL

Objective: This study focused on the prescriptions audit of indoor patients treated under Pradhan Mantri Jan Arogya Yojana (PMJAY) and Chief Minister Arogya Arunachal Yojana (CMAAY) insurance schemes as per the World Health Organization (WHO) prescribing indicators. Materials and Methods: Retrospective cross-sectional study was conducted and the prescriptions of around 960 patients were analyzed who were treated from June 2020 to December 2020 under CMAAY/PMJAY insurance schemes at Tomo Riba institute of Health and Medical Sciences in Arunachal Pradesh. Study was conducted in five departments and Information was collected through the review of case sheets. The post-operative day prescription was analyzed for the patients who have undergone surgery and the patients who were managed conservatively; admission day prescription was analyzed using the WHO core drug prescribing indicators. Following data were analyzed. (1) Average no of drugs prescribed per encounter; (2) percentage of encounter having antibiotic; (3) percentage of drugs prescribed by generic name; (4) percentage of encounters with an injection; and (5) percentage of drugs prescribed from the essential drug list. Results: A total of 960 indoor patients treated under five departments, out of which 359 (37.4%) treated under general surgery, 383 (39.9%) under Obstetrics and Gynecology department, 65 (6.8%) under ENT department, 68 (7.1%) under orthopedics department, and 85 (8.9%) under General medicine department. All departments taken together, the average number of drugs used per patient was 4.91. Antibiotics were prescribed in 92.18% of the total patients when all departments were included, single antibiotic was used in 72.18%, two antibiotics in 17.29%, and three in 2.7% of the total patients. Overall, the generic names were written in 67.3% of the total drugs and the most commonly used route was parenteral route, in about 98.19% of the total prescribed drugs. From the essential drugs list, 89.33% of the total drugs were prescribed. Fixed drug combination was used in 13.59% of the total drugs prescribed. Conclusion: In our study, the percentage of prescriptions with average no of drugs per prescription, antibiotic used, injections used were much higher when compared to the WHO core prescribing indicators. The reason might be because we have analyzed the prescription of indoor patients and most of them were post-operative patients, so it is justified. While prescribing, the physicians and surgeons followed WHO essential drug list but use of generic names was in few prescriptions. The generic name use to be more emphasized, encouraged, and promoted.

The Pattern of Medicine Use in Ethiopia Using the WHO Core Drug Use Indicators.

Introduction Rational medicine use is an appropriate prescribing, dispensing, and patient use of medicines for the diagnosis, prevention, and treatment of diseases. It is affected by several factors. Irrational use of medicine is a widespread problem at all levels of care. This review is aimed at assessing the medicine use pattern in health facilities of Ethiopia using the medicine use pattern developed by WHO/INRUD. Methods Relevant literature was searched from Google Scholar, PubMed, Hinari, Web of Science, and Scopus using inclusion and exclusion criteria. A systematic review was used to summarize the medicine use pattern in health facilities of Ethiopia, and that WHO core drug use indicators were employed. Result From 188 searched studies, 30 literatures were reviewed. The average number of drugs per encounter was 2.11. The percentage of encounters with antibiotics and injection was 57.16% and 22.39%, respectively. The percentage of drugs prescribed by generic name and from an essential drug list was 91.56% and 90.19%, respectively. On average, patients spent 5.14 minutes for consultation and 106.52 seconds for dispensing. From prescribed drugs, 67.79% were dispensed, while only 32.25% were labeled adequately. The availability of key essential medicines was 64.87%. The index of rational drug use value was 7.26. Moreover, the index of rational drug prescribing, index of rational patient-care drug use, and index of rational facility-specific drug use were 3.74, 2.51, and 1.01, respectively. Conclusion Ethiopian health facilities were faced with antibiotic overprescribing, short consultation, and dispensing times, poor labeling of medicines, poor availability of key drugs, and nonadherence to the essential drug list. Routine, multidisciplinary awareness creation, and regulation should be implemented to promote rational medicine use at a national level.

Assessment of medicine use based on WHO drug-use indicators in public health facilities of the South Indian Union Territory.

To assess medicine use based on World Health Organization (WHO) core drug-use indicators in selected public health facilities of the South Indian Union Territory. A prospective cross-sectional study was conducted for period of one year (from March 2019 to February 2020) in 10 selected public health facilities based on the WHO document How to investigate drug use in health facilities. Total 900 prescriptions were analysed to study prescribing, patient care and health facility indicators. The results were compared with the WHO standard measures. The overall average number of drugs per prescription was 3.2. Percentage of prescriptions with antibiotics and injections were found to be 36.6 and 11.4%, respectively. Percentage of drugs prescribed by generic name was 74.6%. Percentage of drugs prescribed from the National List of Essential Medicine was 93.3%. Average consultation and dispensing time were found to be 3.9minutes and 49.3seconds, respectively. The percentage of drugs dispensed in this study was 98.5 and 61.6% of medicines were properly labelled; 76.7% of patients had correct knowledge of each medicine dispensed to them. Mean availability of key essential medicine was 73.4%. Indicators such as percentage of drugs prescribed from the National List of Essential Medicine, availability of copy of essential medicine list and percentage of drugs dispensed were found to be as per WHO optimal value. Indicators such as average number of drugs per prescription, average consultation and dispensing time and percentage of medicines labelled were found below optimal value and need to be improved.

Observational and cross-sectional study of prescription pattern in the pediatric out-patient department at a tertiary care center of Bihar

Medical therapy is the most common form of health care provided to the patients. More the practice, more the error is substantiated by the fact that medication errors are probably the most common medical error. Detailed information on these errors is the first step to prevent these errors becoming a health hazard for the individual as well as the society.To generate data on the extent of rational/irrational prescribing pattern, to review the prescribing practices.An observational study with cross sectional design Prescriptions of the patients attending the pediatric OPD were reviewed to collect required data.1200 prescriptions were reviewed that had 3384 drugs listed. The mean age was 8.3± 4.62 years with male&amp;#62; female. Weight of the patient was recorded in 82.8% of the prescriptions. The average number of drugs per prescription was 2.82. The range of drugs per encounter varied from zero to 5. Ailments like minor scratches or other non-organic problems were those where no drugs were prescribed. Around 50% of the drugs prescribed were in generic names. Syrups were most commonly prescribed followed by tablets and capsules. Injection use was very less. Antibiotics were widely used for treatment with 73.8% of the prescriptions had at least one antibiotic.The findings of the current study highlight the continuing crisis of the irrational drug practice in this part of the country. This will help authorities to take necessary action and formulate guidelines on proper and rational drug prescription.

A PROSPECTIVE OBSERVATIONAL STUDY ON MEDICATION USE PATTERN IN PATIENTS WITH RISK FACTORS OF CHRONIC KIDNEY DISEASE

Objectives: The current study was undertaken to review and assess the medication usage pattern in patients with chronic kidney disease (CKD). Methods: A 12-month prospective observational study was carried out at Shadan Teaching and General Hospital, Peerancheru (Hyderabad), involving 384 CKD patients considering the inclusion and exclusion criteria. Medication evaluation for optimization was done using the World Health Organization (WHO) core prescribing indicators. Data collected were entered using Microsoft Excel. Descriptive statistics such as mean, percentage, and standard deviation (SD) were used to present sociodemographic characteristics of the study participants. Results: Out of the total of 384 patients, 249 (65%) were male and 135 (35%) were female with a mean age of 58.28 (SD: 13.12). A total of 384 prescriptions were scrutinized with a total of 3634 drugs, out of which drugs acting on the cardiovascular system were the most prescribed drugs (36.37%). The average number of drugs per prescription was found to be 9.08 considering the total number of prescriptions. The percentage of drugs prescribed by generic name was 15.57%. The percentage of encounters with antibiotics was 25%, whereas the percentage of encounters with injections was 86%. The percentage of drugs prescribed from the Essential Drug List or Formulary was found to be 26.36%. Conclusion: Assessment of medication usage patterns using the WHO core indicators in CKD patients helps to reinforce the current hospital guidelines for the optimal usage of medications. The introduction of a clinical pharmacist along with a multidisciplinary team provides intensive care to the patients and helps to improve the clinical outcome.

Evaluating antimicrobial prescribing in a Tertiary Healthcare Institution in Nigeria

BackgroundRegular evaluation of antimicrobials prescriptions is important for optimal use.ObjectiveThis study determined the prescription patterns, class and costs of antimicrobials in the adult out-patient pharmacy of a Teaching Hospital in Nigeria.MethodsA 1-year retrospective study from 1st January to 31st December 2018. The data, which included identification code, age, sex, antibiotics prescribed, number of antibiotics per prescription, number of medicines per prescription, dosage form, generic prescribing, drug on the essential drug list, and cost, were used in the analysis. The Chi-square test and Analysis of Variance were used to compare our data with the WHO–developed antimicrobial prescription Guidelines for Anatomical Therapeutic Chemical and Defined Daily Dose assignment of 2019.ResultsFrom 450 patient records, significantly more females (70%) were prescribed with antimicrobials (P = 0.0038). The prescription pattern showed that antimicrobials selection by class was significantly different (P < 0.0001) (top three being Amino-penicillin > Nitroimidazoles > Fluoroquinolone). In addition, age differed significantly (P < 0.0001) with 46–50 as the highest class. Dosage forms profile showed that the percentage of encounter with injections prescribed (1.8%) was less than WHO recommendation (13.4–24.1%). Most of the prescriptions (84.22%) were from the Essential Drug List. The average cost of prescriptions with two antimicrobials was the highest ($14.0807), then three ($10.7949), and one ($6.39858). The average number of drugs per prescription that had one (4.28), two (4.46), and three (5.55) antimicrobials, respectively, were more than double the average (2) recommended by WHO.ConclusionThe study showed that most of the patterns are within limit, however, highlights the need for frequent evaluation.

Prevalence of Chronic Polypharmacy in Community-Dwelling Elderly People in Poland: Analysis of National Real-World Database Helps to Identify High Risk Group.

Introduction: Multimorbidity often comes with age, making elderly people particularly prone to polypharmacy. Polypharmacy, in turn, is a risk factor for adverse drug reactions, drug-drug interactions, non-adherence to medication, negative health outcomes, and increased healthcare services utilization. The longer the exposure to polypharmacy is, the higher the risk of these consequences is. Therefore, a detailed assessment of the prevalence and drivers of chronic polypharmacy in the elderly is particularly important. Aim of study: To find out the prevalence of chronic polypharmacy in the elderly population of Poland, and to characterize the subgroup with the highest risk of this problem, using real-world data. Methodology: A retrospective analysis of data on dispensation and healthcare services utilization held by the national payer organization for the year 2018. Chronic polypharmacy was defined as possession, as a result of dispensation, of five or more prescribed drugs within 80% of each of the consecutive 6 months. Results: Chronic polypharmacy was found in 554.1 thousand patients, i.e. in 19.1% of the national 65+ cohort. On average, those patients were 76 years old, and 49.3% of them were female. The vast majority (68.6%) continued their polypharmacy for the period of the whole year. There was a marked variation in geographical distribution of chronic polypharmacy with the highest value of 1.7 thousand per 100,000 inhabitants in the Łódź Voivodeship. Patients exposed to chronic polypharmacy filled prescriptions from 4.5±2.36 healthcare professionals. The average number of drugs they used was 8.3±3.84 DDD per patient per day. The most often prescribed drugs were Metformin, Atorvastatin and Pantoprazole. The average annual hospitalisation rate in those patients was 1.03±2.4. Conclusion: This study was the first of this kind involving a nationwide assessment of chronic polypharmacy in Polish elderly people. We found that this problem affected one fifth of Polish older adults and it remains stable due to its direct relation to chronic conditions. Thus, our results confirm that this phenomenon is highly important for the national health policy and requires relevant interventions. The planned introduction of pharmaceutical care in Poland is expected to help in solving the problem.

Intrabases divergences in the mHealth era: a drug interaction investigation in an infectious-diseases hospital setting

Introduction: Information on potential drug interactions (PDI) are obtained from databases available on the web or through mobile healthcare applications (mHealth), and can prevent unfavorable clinical outcomes for patients. This study compared PDI information available in Micromedex® drug interaction checker, its web version and its mHealth app. Method: A cross-sectional study realized based on a retrospective review of drug prescriptions in a reference hospital in infectology in the Midwest Region of Brazil, 2018. We selected all prescriptions containing two or more drugs. Drugs were classified according to the first level of the Anatomical Therapeutic Chemical (ATC) classification, according to the route of administration and the number of drugs prescribed. PDIs were classified according to the severity system and four-level evidence classification system. Results: This study selected 72 patients, predominantly male, median age of 38 years, average length of stay of 15.8 days, and most diagnosed with HIV/AIDS. The most frequently prescribed anatomical groups according to ATC were digestive system and metabolism (22.1%) and general anti-infectives for systemic use (21.6%). The average number of drugs per prescription was 10.8 (SD±6.7). The Micromedex® mHealth app found 381 PDIs while its web version detected 502 PDIs, with an average of 5.3 and 7.0 and frequency of 61.1% and 72.2%, respectively. According to the severity classification in mHealth and web versions, the following stood out, respectively: 221 and 321 severe; 139 and 149 moderate. The majority (&gt;65%) of identified PDIs had their documentation classified as reasonable. Conclusion: Digital tools although they aid decision-making, are not unanimous and consistent in detecting such interactions.

Potential drug-drug interactions in University Hospital Medical Intensive Care Unit patients in Turkey.

Concomitant use of drugs not only enhances the therapeutic effect, but may also lead to undesirable interactions. Drug interactions are frequently seen in intensive care patients. In this study, we aimed to determine the frequency and clinical severity of drug interactions in Medical Intensive Care Unit (MICU) patients. The ordered drugs and blood analysis results of 314 patients aged ≥18 years who stayed in the MICU for at least 24 h between January and December 2020 were evaluated. Using the Lexi-Interact online database, clinically significant types of drug interactions, frequently interacting drug/drug groups, and potential adverse reactions were identified. The average number of drugs in 314 patients was 8.98±5.19. It was determined that polypharmacy was associated with comorbidity and the amount of drug used increased as the number of diagnoses increased. Potential drug-drug interactions were observed in 69.7% of the MICU patients, and it was determined that the amount of interactions increased as the amount of drug used increased. The most common X, D, and C type potential drug-drug interactions, were found between furosemide and salbutamol, enoxaparin and acetylsalicylic acid, ipratropium and potassium chloride, respectively. Use of frequently interacting drugs in the treatment of critically MICU patients may lead to potential drug-drug interactions and adverse reactions. Daily monitoring and updating of drug therapy can improve patient's quality of life by preventing or reducing potential drug-drug interactions.

Study on drug utilization pattern in conservative management of patients with pancreatitis in a tertiary care teaching hospital

Background: Drug utilization plays a key role in helping the healthcare system to understand, interpret and improve the prescribing, administration and use of medications. The objective of the study was to assess the drug utilization pattern of drugs prescribed in conservative management of pancreatitis patients in a tertiary care teaching hospital.Methods: This prospective observational study was conducted in department of surgery, Rajah Muthiah Medical College and Hospital, Annamalai University. The study period was six months from November 2019 to April 2020. A total of 115 patients were selected based on inclusion and exclusion criteria.Results: The study population containing of 90% (n=104) males and 10% (n=11) females were included in the study. Most of the patients between age group of 25-44 years (48%). The most common etiology was alcoholic 68% (n=78). 7% of population with comorbidities (5% hypertension, 2% diabetes mellitus). In analgesics, tramadol (28%) and in antibiotics cefotaxime 21% was most prescribed. Lactated ringer solution (36%) was prescribed most as intravenous hydration. 7% (n=8) and 3% (n=4) of patients receiving enteral nutrition and parenteral nutrition. The average number of drugs per prescription was 8.5. Out of 1205 drugs, 61% of drugs prescribed in generic form, 39% were prescribed in brand name. The study analyzed that 69% of drugs were prescribed from essential drugs list (EDL) 2019 and 84% drugs prescribed from national list of essential medicines (NLEM) 2015. Number of prescriptions with injection were 79.07%. The overall antibiotic encounter rate 15%. Prescribed daily dose/defined daily dose (PDD/DDD) ratio of folic acid was 5.Conclusions: Drug utilization study can help in evaluating the quality of care given to the pancreatitis patients and promote rational use of medicines.

Decreasing trends in suboptimal prescribing in older people: a French nationwide study

Abstract Background Potentially Inappropriate Medications (PIMs) and polypharmacy are widely used indicators of suboptimal prescribing in older people. These indicators have been associated with an increased risk of adverse drugs event, hospitalization and healthcare use. However there is no recent evaluation of the evolution of these indicators in France. The aim of this study was to describe the prevalence of PIM and polypharmacy and its evolution among older people between 2011 and 2019 in France. Methods A repeated cross sectional study was conducted every two calendar years between 2011 and 2019 using the French health insurance data system. People aged 75 years and over and not deceased in a given study year were included. Sixteen PIM criteria from the 2015 Beers or STOPP lists were assessed. Moderate polypharmacy (5 to 9 drugs) and hyper-polypharmacy (≥10 drugs) were defined based on the average number of drugs dispensed per quarter. Age and sex-standardized prevalence of PIMs and polypharmacy were assessed and stratified by age (75 to 84/85+) and sex. To estimate trends over time, the Annual Percent Change (APC) was calculated with linear regression models. Results The study population included 5,777,645 individuals in 2011 and 6,328,155 in 2019. The prevalence of PIMs decreased from 49.6% to 39.6% over the study period (APC=-1.2%). Benzodiazepines were the most frequent PIMs (APC=-1.3%), followed by drugs with anticholinergic effects (APC=-2.1%), oral non-steroidal anti-inflammatory drugs (APC=-2.0%), and antihypertensive drugs (APC=-1.1%). Overall, women and individuals aged 85 years and older were more likely to receive PIMs. The prevalence of hyper-polypharmacy decreased from 30.5% to 25.9% over the study period. Conclusions Prevalence of PIMs and hyper-polypharmacy declined in France between 2011 and 2019 and may reflect an improvement in prescribing practices. Still, suboptimal prescribing remains frequent in older people and often involves benzodiazepines. Key messages The prevalence of most potentially inappropriate medications decreased between 2011 and 2019 in France, consistently with trends previously reported in European countries, although still high. The observed diminution of hyper-polypharmacy over the study period also sends a positive and original signal.

The Effect of Educational Intervention on Rational Prescribing in Public Health Facilities in Selected Local Government Areas of Rivers State: An Interventional Study

Background: Despite progress made so far in identifying intervention models to improve drug use, irrational use of drugs has remained a serious global health problem. The study intends to determine the effectiveness of an educational intervention on rational prescribing among prescribers in selected local government areas of Rivers State.&#x0D; Methods: This was a quasi-experimental study that measured the effect of educational intervention on rational prescribing of drugs among prescribers in public health facilities in two selected Local Government Areas (LGA) of Rivers State: Ikwerre LGA (KELGA) which served as the control and Port Harcourt LGA (PHALGA) which served as the intervention by using cluster sampling with randomization. Paired data were analysed using McNemar’s Chi-square test and the paired t-test. The level of significance was set at P≤ 0.05. The EPI-INFO version 7.02 statistical software was used in the analysis.&#x0D; Results: Findings showed that the largest category of prescribers was nurse/midwives representing 48.61% and 44.4% in the intervention and control LGA respectively. There was an improvement in the knowledge and attitude of respondents in the facilities in the intervention LGA at one month and three months post-intervention (P&lt;0.05). The average number of drugs per encounter (ANDPE), the percentage encounters with an antibiotic (PEA), the percentage encounters with an injection (PEI) were lower for the interventions group compared to the control (P&lt;0.05). Percentage generic drug prescription (PGD) was higher in the intervention group compared to the control (P=0.001).&#x0D; Conclusion: Educational intervention was an effective and sustainable means of improving rational prescribing in the state. Update courses and continuing medical education on rational drug use should be held periodically for health care professionals by the State and National Primary Health Care Development Agency as well as other interested stakeholders.

Assessment of Prescription Pattern of Drugs Prescribed in the Outpatient Department of a Private Orthopedic Hospital – A Cross-sectional Study

Background: Drug utilization research (DUR) is vital in the health sector as it offers insight into the efficacy of drug use. The findings of DUR studies can help set goals for the rational use of drugs and health-care funds distribution. Objective: The objective of this DUR study was to evaluate the prescription pattern of drugs prescribed in the outpatient department (OPD) of a private orthopedic hospital. Settings and Design: The study was a cross-sectional, prospective, and observational study conducted at the OPD of a private orthopedic hospital. Materials and Methods: The study was carried out over a 6-month duration (from October 2020 to March 2021) at the OPD of a private orthopedic hospital and studied 609 prescriptions using the World Health Organization (WHO) recommended prescribing indicators. Statistical Analysis Used: Microsoft Excel and SPSS version 26.0 were used to capture and analyze the data of the study. Results: A total of 3082 drugs were prescribed in 609 prescriptions. The average number of drugs prescribed per encounter was 5.1 (SD = 1.9). Drugs prescribed using generic name of the drug were 2.6%, the encounters with an antibiotic and an injection prescribed were 39.4% and 7.1%, respectively. The drugs prescribed from the essential drugs list were 38.9%. In addition, vitamins and supplements (32.1%) were prescribed the most followed by analgesics (24.2%) and antacids (16.6%). Conclusions: The study highlighted the inadequate compliance with the WHO recommended prescribing indicators and suggested a need to train physicians and spread awareness about writing rational prescriptions, benefitting the patient.

Drug utilisation pattern of antihistamines in upper respiratory tract infections in paediatric patients

Background: Upper respiratory tract infections (URTIs) are the most common infections in the paediatric population leading to health care consultations. Antihistamines are commonly prescribed medicines in children. Objectives: This study attempted to assess the current prescription patterns of antihistamines used in the treatment of URTIs. Methods: A descriptive cross-sectional study was conducted in the outpatient paediatric department of Kathmandu Medical College from January 2020 to April 2021. Ethical approval was taken from Institutional Review Committee of Kathmandu Medical College. A convenient sampling technique was used. The data were collected from the outpatient department prescription card into a suitably designed proforma. Drug use indicator developed by the World Health Organisation for Rational Use of Drugs was utilised. Data were analysed using SPSS v.20. Results: Data from prescriptions of 345 patients aged less than 14 years were collected from the paediatric outpatient department of KMCTH. The most common condition was common cold (132, 38.26%). Most commonly prescribed antihistamines were Fexofenadine (156, 45.21%). Average number of drugs per prescription was 2.31. The total number of drugs prescribed by generic name was 128 (16%). Antibiotics made its place in prescriptions 279 (34.96%) times. No parenteral medication was used and 140 (17.5 %) of all drugs prescribed were from the National List of Essential Medicines. Conclusion: Antihistamines, mostly second generation, were commonly prescribed in URTIs in paediatric patients. Majority of WHO indicators were within normal limits while some needed marked improvement. Different programmes can be implemented for improvement in prescribing patterns and promotion of rational drug use.

Increase in recreational drug use between 2008 and 2018: results from a prospective cohort study among HIV-negative men who have sex with men.

AimsTo test whether recreational drug use (RDU) and sexualized drug use (SDU) changed in the Amsterdam area between 2008 and 2018 and quantify associations of SDU with condomless anal sex (CAS), recent human immunodeficiency virus (HIV) or sexually transmitted infections (STI) among human immunodeficiency virus (HIV)‐negative men who have sex with men (MSM).DesignOpen prospective cohort study.SettingPublic Health Service of Amsterdam, the Netherlands.ParticipantsA total of 976 HIV‐negative MSM, aged ≥ 18 years.MeasurementsSelf‐reported RDU and sexual behaviour in the past 6 months. Laboratory‐confirmed HIV and STI (chlamydia, gonorrhoea and syphilis). We studied: any RDU; any SDU (i.e. any RDU during sex); specific SDU (i.e. use of mephedrone, methamphetamine, gamma‐hydroxybutyric acid/gamma‐butyrolactone, ketamine, amphetamine, cocaine and/or ecstasy during sex); use of individual drugs; and use of individual drugs during sex. We evaluated changes over calendar years in the proportion of individuals with these end‐points [using logistic regression with generalized estimating equations (GEE)] and number of drugs (using negative binomial regression with GEE), adjusted for current age, country of birth and education level.FindingsMedian age of participants in 2008 was 33.2 years (interquartile range = 27.8–40.1); 83.1% were born in the Netherlands. The proportion of any RDU increased from 67.2% in 2008 to 69.5% in 2018 [adjusted odds ratio (aOR) = 1.25; 95% confidence interval (CI) = 1.03–1.51]. Any SDU increased from 53.8% in 2008 to 59.8% in 2013 (aOR = 1.23; 95% CI = 1.07–1.42) and remained stable afterwards. Specific SDU increased from 25.0% in 2008 to 36.1% in 2018 (aOR = 2.10; 95% CI = 1.71–2.58). The average number of drugs used increased for those reporting any RDU, any SDU and specific SDU (all P < 0.05. Among those engaging in sex, any SDU was associated with CAS (aOR = 1.36; 95% CI = 1.19–1.55), HIV (aOR = 5.86; 95% CI = 2.39–14.4) and STI (aOR = 2.31; 95% CI = 1.95–2.73). Specific SDU was associated with CAS (aOR = 1.58; 95% CI = 1.37–1.81), HIV (aOR = 6.30; 95% CI = 3.28–12.1) and STI (aOR = 2.15; 95% CI = 1.81–2.55).ConclusionsAmong human immunodeficiency virus (HIV)‐negative men who have sex with men in Amsterdam, recreational drug use, including sexualized drug use, increased between 2008 and 2018. Sexualized drug use was strongly associated with condomless anal sex, HIV and sexually transmitted infections.