Hospital Dispensary Research Articles

Assesing health needs of women with breast cancer in a Regula Hospital Dispensary in Crete, Greece

Abstract Background Understanding the health needs of women with breast cancer is essential for tailor-made care. Socio-economic factors impact care access and outcomes. Previous research has indicated variations in healthcare experiences based on factors such as education level, employment status, and income. However, specific insights into the health needs of women with breast cancer in Crete, Greece, remain limited. Purpose The current study aimed at assessing the health needs of women with breast cancer. Methods A total of 161 women were surveyed between June 2023 and December 2023 in a regular Hospital Dispensary at a General Hospital in Heraklion, Greece. Results The majority were married (46%) and had an average of 2 children. 16% were graduates of secondary education and 42 % graduates of higher education, 33% retired and 19% full-time employees. Most participants (45%) reported a family income between 10,001 to 20,000 €, 29% under 10000 € and 26 % between 20001 to 30000 €. The majority had received additional medical treatment (75%), with surgery being the most common (30.6%). Other treatment included radiation therapy (28%), chemotherapy (23%), and hormone therapy (18%). Prevalence of comorbidities was high, with hypertension (97%), coronary heart disease (92%), cholesterol issues (43.5%), arrhythmias (82%), thyroid disease (81%), diabetes mellitus (79.5%), and bleeding disorders (43.5%) being reported. Smoking was also prevalent among participants (79.5%). Conclusions This study highlights the complex health needs of women with breast cancer in Crete region, Greece and emphasizes the prevalence of comorbidities and the importance of tailored support services and comprehensive care approaches for this population. Key messages • Considering socio-economic factors is critical in healthcare planning and intervention strategies. • Emphasizing the importance of tailored support services and comprehensive care approaches for this population.

Analyzing the Impact of Drug Name Similarity on Dispensing Errors: An Examination Using a Drug Name Similarity Index.

Dispensing errors pose a significant health risk, with drug name similarity being a potential contributory factor. To determine the impact of drug name similarity on dispensing errors within clinical settings, we analyzed 563 dispensing errors at an acute hospital in Japan from April 2015 to June 2018. Drug name similarity between two drugs was classified into Name-Similar and Name-Dissimilar groups using the m2-vwhtfrag index, the value of the drug name similarity. Drug efficacy similarity was categorized into Efficacy-Same, Efficacy-Close, and Efficacy-Far. The drug name similarity and drug efficacy similarity of all possible pair combinations were obtained and similarly classified. The proportion of the number of pairs with dispensing errors per the total number of drug pairs in the hospital's drug formulary in each category was calculated. The highest proportion of the number of pairs with dispensing errors was 36% for the Efficacy-Same and Name-Similar group, and the lowest proportion was 0.022% for the Efficacy-Far and Name-Dissimilar group. The proportion of the number of pairs with dispensing errors was significantly higher in the Name-Similar category than in the Name-Dissimilar category for all drug efficacy categories. Our results indicate that drug name similarity increases the risk of dispensing errors, and that m2-vwhtfrag is a useful indicator to assess dispensing errors in clinical practice. Such drug name and efficacy similarity evaluations can help identify factors causing dispensing errors, and predict the risk of dispensing errors for newly adopted drugs, considering the relationship with the whole drug formulary in the hospital dispensary.

Dr. Newton Shaffer (1846-1928): Renowned Orthopedic Surgeon and Founder of the American Orthopaedic Association.

An unsung hero of American orthopedic surgery is the largely forgotten Dr. Newton Melman Shaffer (1846-1928). Upon graduating from medical school at New York University, Shaffer began his career training at the Hospital for the Ruptured and Crippled in 1867. Shaffer then went on to practice at St. Luke's Hospital and New York Orthopaedic Dispensary and Hospital where he became chief. Here, Shaffer made major contributions to the field in treating clubfoot and tuberculosis. He then declared orthopedics as a separate entity from general surgery at the 10th International Medical Congress. He helped start the American Orthopaedic Association to push for the recognition of American orthopedics to the international community. In 1900, Shaffer opened the first state-run hospital for underprivileged children requiring rehabilitation. During his career, Shaffer advocated for conservative orthopedic treatments, aided in the invention of medical devices, contributed largely to academic orthopedics, and successfully advocated for the inception of the field of orthopedic surgery.

Climbing the Ladder, Chasing the Dream: The History of Homer G. Phillips Hospital By Candace O’Connor

Reviewed by: Climbing the Ladder, Chasing the Dream: The History of Homer G. Phillips Hospital By Candace O’Connor Linda T. Wynn Climbing the Ladder, Chasing the Dream: The History of Homer G. Phillips Hospital. By Candace O’Connor. (Columbia: University of Missouri Press, 2021. Pp. xvi, 314. $40.00, ISBN 978-0-8262-2247-3.) Candace O’Connor’s Climbing the Ladder, Chasing the Dream: The History of Homer G. Phillips Hospital is one of several books written about African American hospitals that came into existence because of de facto or de jure practices that decreed the separation of African Americans and whites in spaces that delivered health care and social services. When St. Louis’s Homer G. Phillips Hospital opened in 1937, it joined the ranks of other hospitals for African Americans founded in the late nineteenth and early twentieth centuries such as Chicago’s Provident Hospital and Training School, established in 1891; Philadelphia’s Frederick Douglass Memorial Hospital and Training School, established in 1895; Baltimore’s Provident Hospital and Free Dispensary, established in 1894; and Nashville’s Millie E. Hale Hospital, established in 1916. The number of these institutions peaked in the 1920s and 1930s, during a period when ambitious stratagems were developed for creating segregated medical training and practice facilities. These hospitals delivered a higher standard of medical care to African American patients and provided education and training for African American physicians and nurses. Like many African American medical institutions, Homer G. Phillips held a special place within its community’s collective memory. O’Connor’s book was prompted by an association of retired nurses who trained at Homer G. Phillips Hospital over the course of its four-decade existence. Through interviews [End Page 380] excavating the memories of those who studied and worked at “Homer G.,” O’Connor brings the narrative of a successful hospital and its attendant auxiliaries to life (p. xiii). However, Climbing the Ladder, Chasing the Dream is more than a history of Homer G. It also provides significant perspectives on numerous themes including the Great Migration, the causes of systemic racism, the aftereffects of racial desegregation, and the overall spectrum of race relations in America from the late 1930s to the late 1970s. O’Connor has drawn on her extensive previous research into St. Louis’s medical institutions to explore the history of Homer G. Phillips Hospital. To bring its story to the printed page, she combed through “more than 40 years of stories from Black and white newspapers,” researched “stacks of scholarly books and articles,” and held “dozens of interviews” with former staff members and others associated directly or indirectly with the institution (p. xiii). To cover Homer G.’s impact on the community and beyond, O’Connor has divided the tome into chapters that chronicle the hospital’s forty-two-year history, tracing its events and vicissitudes through decades of operation. Yet Climbing the Ladder, Chasing the Dream is also thematic and broaches wide-ranging topics such as the “Ville,” the thriving African American community that was home to “more than a third of the city’s Black leadership” (p. 5). Like many African American communities, the population of the Ville included “school-teachers and janitors; doctors and meat packers; lawyers and railroad men; hospital staff and domestics” (p. 5). Other major themes include hospital units and nursing life. Consisting of thirteen chapters, Climbing the Ladder, Chasing the Dream begins with “The Mysterious Life and Death of Homer G. Phillips, 1878–1931” and ends with an account of the hospital’s closure on August 17, 1979. The chapter on the hospital’s namesake is one of the book’s more intriguing contributions. Homer G. Phillips was an influential Black attorney with a law degree from Howard University. During the 1920s, he passionately supported the establishment of a hospital for St. Louis’s African American community. But Phillips was murdered in 1931, six years before his dream came to fruition. O’Connor’s historical chronicle develops into a true-crime account as the author investigates Phillips’s mystifying murder in a tome already brimming with captivating local history and personal stories. For more than forty years, one of the country...

Iron Deficiency and Iron Deficiency Anemia Among Children 3 to 59 Months of Age in Kinondoni Municipal, Dar es Salaam: A Facility-Based Cross-Sectional Study

Background: Iron deficiency with subsequent iron deficiency anemia is the most common micronutrient disorder in children below 5 years of age worldwide. The developing countries bear more weight on the problem as the result of multifactorial factors including but not limited to recurrent infections such as malaria, helminths infestation, and inadequate food security. However, its magnitude in children living in Kinondoni Municipal in Dar es salaam is not well understood. Therefore, the aim of this study was to determine the prevalence of anemia and how it is contributed by the presence ofiron deficiency among children between 3-59months of age in the above-mentioned setting. Methods: A facility-based cross-section study was conducted among children 3-59months attending Reproductive and Child Health Services at Kairuki, Sinza Hospital, and Kambangwa dispensary. Children who met the criteria, their basic social demographic information, complete blood count and differentials as well as blood ferritin levels were collected to assess the level of anemia, erythrocytic indices, and iron deficiency. Data were analyzed using the Statistical Package of Social Sciences (SPSS version 22). The magnitude of anemia and iron deficiencies were presented in percentages, and the relationship between hemoglobin and blood ferritin was assessed using Spearman’s correlation test for two continuous variables. The p-value of less or equal to 0.05 was considered statistically significant. Results: A total of 350 children were recruited for the study, 255 Children (72.9%) were anemic. Children below 24 months of age were more anemic compared to the older age group (X2 = 50, p <0.001). Furthermore, anemia was significantly associated with low ferritin levels (X2 = 65, p <0.001). Iron deficiency was found in 156 (44.6%) participants while iron deficiency anemia (low MCV, low ferritin, and low hemoglobin) was found in 138 (39.4%) participants. However, among 255 participants with anemia, 147(65.3%) had iron deficiency. There was a significant positive correlation between hemoglobin and blood ferritin levels (Spearman’s correlation coefficient = 0.6; p<0.01. Conclusion: Prevalence of anemia was high among children and was highly associated with younger age and iron deficiency. To overcome this problem, appropriate interventions such as massive promotion of breastfeeding, appropriate complementary feeding, and ensuring food security are warranted.

Antibiotic use in Moshi Urban: A cross-sectional Study of Knowledge and Practices among Caretakers of Children in Kilimanjaro Tanzania

IntroductionAntibiotics are commonly accessed and used for the management of illness in children without a prescription. We investigated the caretaker’s knowledge and practices on antibiotics and antibiotics use to their children.MethodThis was the hospital-based cross-sectional study conducted from April to July 2017 in three facilities located in Moshi Municipality. A convenience sampling was employed to select for caretakers with their sick children at KCMC, Mawenzi hospital, and Longuo dispensary. Face-to-face interviews were conducted with 224 caretakers who had visited health facilities with their children seeking health care.ResultsThe majority (87.9%, 197/224) of all interviewed caretakers had good knowledge of the use of antibiotics. Irrespective of knowing that it is not safe to self-medicate a child with any antibiotics (95.1%, 213/224), most (61.6%, 138/224) caretakers practiced self-medication with the medicines. Having two children (aOR = 7.75, 95% CI: 1.89-31.67) and having three children (aOR=7.23, 95%CI: 1.08-48.51) were significantly associated with good knowledge of antibiotics.ConclusionThis study has revealed that caretakers in Moshi had a good knowledge of antibiotic use. However, despite such good knowledge, malpractices were observed. We call upon the use of media campaigns to advocate for the importance of the rational use of antibiotics and its effect on human health and the risk of antimicrobial resistance development.Rwanda J Med Health Sci 2021;4(3):347-356

Patient Satisfaction of Service and Availability of Medical and Drugs among Inpatient Hospital West Sulawesi

This study discusses how patient satisfaction with services and availability of medical facilities and medicines in the inpatient unit of the West Sulawesi Provincial Hospital, in terms of indicators of completeness of medical equipment and laboratory services so that they do not need to be sent to other hospitals, indicators of the availability of medicines in hospital pharmacy, indicator of length of service time at hospital dispensary and indicator of service for hospital dispensary officers. The method used in this research is descriptive method with quantitative approach. The population in this study were 2874 patients treated at the West Sulawesi Provincial Hospital. The sample in this study using accidental sampling technique, so that samples of this study amounted to 97 people. Data collection techniques used in this study questionnaires, interviews, review of documents and documentation. Data analysis using frequency distribution tables and percentage analysis. The results showed that the percentage of patient satisfaction with the service and availability of medical facilities and medicines in the inpatient unit of the West Sulawesi Provincial Hospital in terms of indicators of completeness of medical equipment and laboratory services, so there was no need to be sent to other hospitals by 66.2%, indicator the availability of medicines in hospital dispensaries was 67.4%, the indicator of length of service time at hospital dispensaries was 76.1% and the indicator of service for hospital dispensaries was 75.7%. Dan hasil perhitungan persentase seluruh item indikator diperoleh nilai rata-rata skor sebesar 71,3%. Secara keseluruhan pelayanan dan ketersediaan sarana medis dan obat-obatan di unit rawat inap RSUD Provinsi Sulawesi Barat sudah dapat memenuhi harapan pasien. And the results of calculation of the percentage indicator of all items obtained average value score of 71.3%. Overall the service and the availability of medical facilities and medicines in the hospital inpatient units of West Sulawesi province has been able to meet the expectations of patients.

“Postnatal Care Utilization is Meant Only for Our Children”: Perceptions and Experience of Women in Nachingwea District Council, Tanzania

Background Postnatal care (PNC) is essential for ensuring the optimal health of women and their newborns. In Africa, most mothers and newborn do not visit healthcare facilities following childbirth despite the fact that majority of maternal and neonatal deaths occur during this period. Regardless the the existence of several programs for improving maternal and child health, the utilization of PNC yet remains low. The objective of this study was to assess the experiences and perceptions of women on postnatal care services utilization. Methodology A qualitative study design was used. The study was conducted in Nachingwea district. Women who delivered children within one year before the study and reside in Nachingwea district were recruited from Nachingwea district hospital and Naipanga dispensary. The selection was based on their age, education and parity. IDIs and FGDs were used. Qualitative content analysis was used for analysis. Results Sixty-six (66) women who brought their babies to PNC services for immunization and growth monitoring participated in the study. Sixteen (16) IDIs and seven FGDs were conducted. Upon analysis of data, three main categories that explain the experiences and perceptions of women on postnatal care services utilization were generated. These categories are women’s experiences on postnatal care services utilization; perceived benefits of postnatal care services utilization, and, perceived barriers towards PNC services utilization. Women had negative experience and perceptions regarding PNC services utilization and they did not understand the advantages of PNC services to them, except for their children. Conclusion Women’s negative perceptions on PNC services utilization were revealed. Women did not understand the benefits of PNC services to them, except for their children. Barriers such as health systems, socio economic and cultural factors also affected PNC utilization. The government should improve PNC services through health education, promotion interventions aiming at PNC utilization. Improvements should address the availability and accessibility of services and importance of PNC services for both mother and her newborn in reducing maternal and newborn morbidity and mortality during postnatal period. Key words: Experiences, Perceptions, Postnatal Care, Nachingwea District, newborn.

An audit of prescription forms of patients from obstetrics and gynecology clinics in tertiary care hospitals: An exploratory study

Objective: The main aim is to analyze the prescription forms to evaluate the completeness of these forms, and we also aim to bring to light the factors which need to be emphasized on while writing a prescription. Materials and Methods: This is a prospective cross-sectional study. Prescriptions of 200 patients visiting the gynecology and antenatal outpatient department (OPD) were evaluated using a specially designed questionnaire containing specific questions pertaining about OPD prescriptions, and a score of 0, 1, or 2 was allotted to each question. Results: In an audit of 200 OPD prescription papers, complete name, age, date of consultation, sex, and OPD registration number of the client were present in 100% prescriptions as it was preprinted. Legible handwriting was seen in 93%. Essential medicines advised were available in the hospital dispensary in 77%. Dosage schedule/doses were clearly written in 85%. Prescription duly signed and the name is written (legibly)/stamped in 87%. The highest score for a prescription was found to be 17/17 and the lowest score for a prescription form was 8/13. Conclusion: Many areas are lagging in prescription writing, especially writing presumptive diagnosis and salient features of clinical examination. Physicians need to improve their prescription writing skills for the benefit of patients.

Objective assessment of handwriting in outpatient prescriptions of a tertiary care hospital

Background: Poor physician handwriting may lead to wrong comprehension and dispensing errors. This study was planned to objectively assess the quality of handwriting of doctors and their readability by physician, pharmacist and patient and to explore the impact of experience and familiarity of pharmacist on prescription readability.Methods: A 100 prescriptions were selected and were given to a pharmacist, a doctor and an educated lay person. They rated the readability of prescriptions on a scale of 1-10 and an average readability score was calculated. Prescriptions with average score 4 or less were subjected to analysis by a pharmacist working at the hospital dispensary (P1) and another pharmacist not working at hospital pharmacy (P2).Results: Average score of pharmacist, physician and lay person was 6.14, 5.2 and 3.14 respectively. A total of 28 prescriptions, containing 93 medicines, had an average readability score of 4 or less. P1 was not able to comprehend one medicine while P2 could not comprehend 19 medicines out of these 93. The performance of both pharmacists was compared by diagnostic tests (EPI 6.04D). The sensitivity of P2 was 80% (95% CI 70.6-87.7), specificity and positive predictive value were 100, and negative predictive value was 5.3 (0.3-28.1).Conclusions: Familiarity of the pharmacist with the prescribing physicians’ handwriting is an important factor in comprehension of poorly legible prescriptions. This could limit the patients to pharmacists around the prescribers. Implementation of appropriate steps need to be assured to minimize the prescription errors.

Medicine authentication technology: a quantitative study of incorrect quarantine, average response times and offline issues in a hospital setting

ObjectivesTo introduce serialised medicines into an operational hospital dispensary and assess the technical effectiveness of digital medicine authentication (MA) technology under European Union Falsified Medicines Directive (EU FMD) conditions.DesignThirty medicine...

Healthcare Quality of Bangladesh and Outbound Medical Travel to Thailand

The healthcare system in Bangladesh suffers from many shortcomings. This drives not only the affluent and the middle-class, but also the poor Bangladeshi to travel cross-border to India, Thailand, Singapore and Malaysia for medical treatment. In Bangladesh, there are an over-crowded public healthcare system, the paucity of funds, a lack of medical expertise and technology, and few quality private hospitals to service the local high-income population. For this paper, Bangladeshi patients (n=113) who had undergone medical treatment in Thailand during February 2017 to June 2017, completed the survey. Statistical findings suggest that the medical costs are high in Thailand and hiring personal attendants for older patients is expensive. Apart from the language barrier with no interpreting services, the patients are also required to purchase sample medicine from the hospital dispensary at a higher price. On the positive side, the physicians in Thailand were overseas qualified, caring, trustworthy, honest and straightforward while dealing with patients, and had the expertise to provide diagnostic results for several diseases. Results also show that compared to Bangladesh, Thailand has less waiting-time for surgery with state-of-the-art medical facilities, and excellent healthcare service, resulting in an increasing outbound medical travel from Bangladesh. Healthcare policy implications are that the public and private hospitals in Bangladesh need to provide the quality of accredited and timely healthcare to the locals, so that the poor and middle-class Bangladeshi do not have to travel cross-border for healthcare. Unless Bangladesh improves its healthcare system, the outbound medical travel to Thailand and other neighboring countries will continue, and can it dream to develop a medical tourism market to attract foreign patients. Doctors, nurses and lab technicians along with health management personnel must be ethical and corruption free. Improved excellence in healthcare delivery, international accreditation, and elimination of dishonest performs in Bangladeshi healthcare will steadily decrease outbound medical travel by the poor and middle class Bangladeshi, save medical travel costs, medical travel-risk and anxiety of being away from home and relatives, resulting in more and more Bangladeshi patients preferring to trust and use their healthcare system. Future research directions will explore the quality, access and affordability of inclusive healthcare in both public and private hospitals of Bangladesh.

Optimising workflow processes in an advanced medication dispensary.

The workload measurement of an inpatient hospital dispensary is critical to improve efficiency in the face of limited budgets. This single-centre pilot study used work sampling to observe and identify areas to improve efficiency of dispensing prescribed medications at one tertiary level acute care teaching hospital. Workload sampling was conducted at a 1096-bed hospital in Calgary, Alberta, Canada. The dispensary services the entire hospital, 24h per day, seven days per week. Pharmacists are solely involved in clinical screening. The hospital uses a tech-check-tech practice. The observer was a registered pharmacist who collected data in the dispensary over two-hour blocks during November 14-24, 2017. A pre-made data collection sheet was used to record observations. Pharmacists duplicated tasks performed by dispensary technicians, such as ensuring STAT orders were delivered or identifying floor stock medications. Assistants inconsistently organised orders for filling. The assistant delivering STAT medications was difficult to find. Not all STAT medications were delivered first on a scheduled delivery route. Overall, areas for improvement in the dispensary process may include reinforcing the pharmacist clinical duties, establishing clinical competency baseline, supporting the full scope of practice of registered technicians, and consistent training of assistants, and clarifying communication processes.

Comparing the accuracy of medication order verification between pharmacists and a tech check tech model: A prospective randomised observational study.

Medication errors have the potential to cause significant harm and the final verification of dispensed medications is essential to patient safety. There is international evidence to demonstrate that trained pharmacy technicians can safely and accurately undertake the verification of medication orders in ward-based unit dose containers. There is a need for evaluation of pharmacy technician verification of medication orders in broader contexts including the hospital inpatient dispensary. To compare the accuracy of Accuracy Checking Pharmacy Assistants (ACPTs) to pharmacists when verifying inpatient medication orders within the hospital pharmacy setting. This 'real world' single-blinded study was conducted in the inpatient dispensary of a major tertiary hospital in Melbourne, Australia. Inpatient medication orders were randomly allocated to an ACPT or pharmacist for final verification, before being reviewed for accuracy by an independent research pharmacist blinded to study allocation. Errors identified by the reviewing pharmacist were documented and severity was assessed by an independent Medication Safety pharmacist. Between February and August 2014, three ACPTs verified 4718 items with 75 errors missed (1.59%), and twelve pharmacists verified 4194 items with 158 errors missed (3.77%). There was a statistically significant difference between both total and minor error rates, with pharmacists missing significantly more errors (total errors: p<0.0001; minor errors: 1.42 vs 3.53%; p<0.0001). There was no statistically significant difference in the rate of major errors missed by the two groups (0.17 vs 0.24%; p=0.48). This study is the first of its kind in the hospital dispensary setting, demonstrating that the overall accuracy of ACPTs was greater than pharmacists for verifying dispensed medication orders. ACPTs missed fewer minor and overall errors than pharmacists, indicating that trained pharmacy technicians can verify medication orders safely and accurately. This study provides support for the tech-check-tech model in the hospital setting.

St John's Hospital (Morton House), Launceston, Australia: A history of the hospital and Dr William Russ Pugh's first operations under ether.

On 7 June 1847, William Russ Pugh, MD, performed two operations at the St John's Hospital and Self-Supporting Dispensary, Launceston, Tasmania, while his patients were rendered insensible by the inhalation of sulphuric ether. These operations are the earliest documented surgical operations under ether in Australia. St John's Hospital officially opened on 1 September 1845. The hospital may have closed in late 1853 because of financial difficulties. The two-storey Georgian-style building which served as the hospital was completed c1831-1832. It has served as a residence, school, boarding school, hospital, medical consulting rooms and commercial offices. The building is now known as Morton House. We could not identify the date when the name Morton House was adopted, or explain the origin of the name. The earliest identified use of this name is in May 1873 in a newspaper advertisement for boarders. No person with the surname Morton is known to have been associated with the building as an owner or as a tenant. The name Morton House may honour William T.G. Morton, MD, the Boston dentist who performed the first public demonstration of surgical etherisation on 16 October 1846.

REGISTRY MANAGEMENT PROGRAM FOR ISCHEMIC HEART DISEASE IN ALTAISKY KRAY

Aim. To evaluate the results of the program for management of ischemic heart disease registry in Altaisky kray in 2011-2015 y. Material and methods . The system was developed and implemented in 2011 as a pilot project, with software named “Monitoring + [Registry of CIHD]”. The project was planned as retro-, prospective observational cohort study. The registry was primarily tested on the bases of Regional Clinical Hospital and Altai Regional Cardiological Dispensary. From the beginning of 2014, other 28 institutions were involved into the registry. The work is being done continuously, with patients admission and investigation if fulfill the registry criteria. For statistics the descriptory methods were applied. Results and discussion . From 2011 to 2015, the data of 12886 patients was entered to the registry, with the diagnosis “ischemic heart disease”. Mean age — 65,1±9,9 y.o. Region capital citizens were 35,5% of the registry, and inhabitants of the Region — 64,5%. Two thirds were males. By the anamnesis data, there was significantly more persons after myocardial infarction — 7094 (p<0,01). Hightechnology care under “Cardiovascular surgery” unit was provided to 6115 (47,4%) patients. Medication treatment was done according to guidelines and standards for ischemic heart disease patients management. With the implementation of registry, availability of cardiovascular care for rural inhabitants improved: three times increased the volumes of outpatient stage high-technology care, and cardiosurgery increased 1,8 times. The decrease of cardiovascular mortality during last 5 years reached 18,6%. Conclusion . A universal approach has been formulated for a unified base of patients suffering from ischemic heart disease, that makes it to follow-up the epidemiological situation in districts of Region by disease, to find out the risk factors and correct them. With the Registry of CIHD, it is possible to analyze the performance of cardiological care, to influence on its qualitative and quantitative parameters. The necessity is shown, for the development of this monitoring system in all treatmentprevention institutions of the Region for equality in specialized care accessibility, including high-technology care.

Effectiveness of medicines authentication technology to detect counterfeit, recalled and expired medicines: a two-stage quantitative secondary care study

ObjectivesTo identify the authentication and detection rate of serialised medicines using medicines authentication technology.Design and intervention4192 serialised medicines were entered into a hospital dispensary over two separate 8-week stages in...

Therapeutic use of oral sodium phosphate (phosribbon(®) combination granules) in hereditary hypophosphatemic rickets.

Oral sodium phosphate formulations indicated for hypophosphatemia are commercially available worldwide. In Japan, however, many medical institutes have used hospital dispensary or foreign over-the-counter formulations because no such medication with an indication covered by the health insurance system is domestically available. To address this problem, we initiated the development of Phosribbon(®). The present study evaluated the efficacy and safety of Phosribbon(®) in 16 patients with hereditary hypophosphatemic rickets. The optimal dosage and an administration pattern were also investigated. Administration of the agent resulted in an increase in the level of serum phosphorus in all patients, which implied that the employed dosage was appropriate. The dosage and administration pattern were adjusted based on comprehensive considerations, including changes in clinical laboratory values such as serum phosphorus, alkaline phosphatase and intact PTH, the dosage of a concomitantly administered activated vitamin D formulation and characteristics of individual patients. Adverse drug reactions were observed in 2 patients, neither of which were serious or necessitated therapy dose reduction or discontinuation. We conclude that Phosribbon(®) is a safe and effective treatment for patients with hypophosphatemic rickets and that dose adjustment in this therapy can be guided by the results of regular clinical examination and renal ultrasonography. (ClinicalTrials.gov Identifier: NCT01237288).

Therapeutic Use of Oral Sodium Phosphate (Phosribbon&lt;sup&gt;®&lt;/sup&gt; Combination Granules) in Hereditary Hypophosphatemic Rickets

Oral sodium phosphate formulations indicated for hypophosphatemia are commercially available worldwide. In Japan, however, many medical institutes have used hospital dispensary or foreign over-the-counter formulations because no such medication with an indication covered by the health insurance system is domestically available. To address this problem, we initiated the development of Phosribbon®. The present study evaluated the efficacy and safety of Phosribbon® in 16 patients with hereditary hypophosphatemic rickets. The optimal dosage and an administration pattern were also investigated. Administration of the agent resulted in an increase in the level of serum phosphorus in all patients, which implied that the employed dosage was appropriate. The dosage and administration pattern were adjusted based on comprehensive considerations, including changes in clinical laboratory values such as serum phosphorus, alkaline phosphatase and intact PTH, the dosage of a concomitantly administered activated vitamin D formulation and characteristics of individual patients. Adverse drug reactions were observed in 2 patients, neither of which were serious or necessitated therapy dose reduction or discontinuation. We conclude that Phosribbon® is a safe and effective treatment for patients with hypophosphatemic rickets and that dose adjustment in this therapy can be guided by the results of regular clinical examination and renal ultrasonography. (ClinicalTrials.gov Identifier: NCT01237288)

Not Registered

The article caused irritation. From the first line, or even in the title, the term “Mitgabe”—i.e. issuing, or dispensing—is used. This implies a hospital or surgery's dispensing a substitute drug to be taken by the patient under his/her own responsibility. This is not provided for within the Narcotic Drugs Prescription Ordinance (Betaubungsmittel-Verschreibungsverordnung, BtMVV) (§ 5) and therefore not permitted within the framework of the German law governing the prescription of medicines. The guideline of the German Medical Association dated 19 February 2010, No 9, 3rd sentence, is (suggest, for clarity's sake: “also”) unequivocal: “Eine Mitgabe von Substitutionsmitteln aus dem Praxisbestand ist hingegen strafbar [providing substitution medication from the practice's own dispensary is a punishable offense].” Furthermore the authors report that patients from 20 psychiatric hospitals participated in their study. Providing take home medication from the hospital's dispensary is legally not permitted, and professional and ethical regulatory guidelines naturally also apply to the inpatient setting. Regarding the methods, the authors wrote: “5032 patients were registered at the Berlin Medical Association as being on maintenance treatment.” According to § 5a section 2 of the German Narcotics Law, any doctor prescribing substitution medication is under obligation to report immediately the start and end date of every case of substitution treatment in coded form to the substitution registry held at the Federal Institute for Drugs and Medical Devices (Bundesinstitut fur Arzneimittel und Medizinprodukte, BfArM) in Bonn. Ignoring this rule is a regulatory offense under §17 of the narcotics law. On the basis of this obligation, the BfArM is able to determine the number of registered cases of substitution treatment at federal and state levels. Hence none of the 5032 described patients are registered with a medical association. The deficiencies described unfortunately limit the value of the overall conclusion. Further remarks are unfortunately not possible in view of the space restrictions imposed by Deutsches Arzteblatt’s instructions for authors.