Percentage Of Medicines Research Articles

A study on drug usage pattern of antibiotics in patients with skin disorders

Antibiotics are the crucial drugs of choice, and they are the greatest contributors to the treatment of bacterial skin diseases. The objective of the present study is to assess the drug usage patterns of antibiotics in the Department of Dermatology, Venereology, & Leprosy (DVL). A Cross-Sectional Study was conducted with ethical approval for a period of 6 calendar months. Patients were recruited according to the eligibility criteria. Relevant details were collected according to the objectives and analyzed using Microsoft Excel. During the study period, 200 patients were recruited, of which 64% were male. Most patients were in the age group of 21-40 (36%). The most commonly reported disease during our study was secondary pyoderma occurring over eczema (29.5%), followed by Psoriasis (9.5%). Penicillin (32%) and Cephalosporin (32%) were the most prescribed categories. Mainly, a duration of less than or equal to 1 week was recommended. A total of 680 drugs were prescribed, and the average number of drugs per encounter with an antibiotic was 4.50%. The percentage of encounters with injections was 12%, and the percentage of medicine from the Essential Medicine List (EML) was 43%. Most drugs were prescribed from the access groups according to the World Health Organization (WHO) AWARE (Access, Watch, Reserve) classification. According to the AWARE classification, drugs with lower resistance potential were commonly practiced here. This reflects good prescribing practice. The findings provide insight that, during our study period, the burden of bacterial skin diseases is lower in this locality when compared with other skin diseases.

WHO/INRUD Core drug use indicators and commonly prescribed medicines: a National Survey from Sri Lanka

BackgroundIdentification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Sri Lanka established a new National Medicines Regulatory Authority in 2015 and this survey evaluated the medication use indicators in Sri Lanka, according to the International Network on Rational Use of Drugs (INRUD), prior to its implementation.MethodsThis descriptive-cross-sectional study was conducted in 80 pharmacies, representing all 25 districts of the country. Three pharmacy categories were included; privately owned pharmacies, ‘Rajya Osusala’ pharmacies operated by the State Pharmaceuticals Corporation (SPC) of Sri Lanka and SPC Franchisee pharmacy outlets. Selection of pharmacies from respective districts were done proportionate to estimated population. Data were collected to identify WHO/INRUD core drug use indicators and the commonly prescribed medicines.ResultsTotal of 2328 prescriptions were included (‘Rajya Osusala 559; SPC Franchise 711; private pharmacies 1058). Altogether 7,255 medicines were prescribed, and the 3 most commonly prescribed medicines were atorvastatin, losartan and metformin. Average number of medicines per encounter was 3.1±1.9 (Median: 3; range 1-12) Highest average number of medicines per encounter was reported in prescriptions received at ‘Rajya Osusala’ pharmacies (3.6±2.2), significantly higher than in other categories of pharmacies (p<0.001). Percentage of medicines prescribed by generic name was only 35.5%, highest at the ‘Rajya Osusala’ pharmacies (40.6%), significantly higher than other categories of pharmacies. The overall percentage of medicines prescribed from essential medicine list (EML) was 68.8%, without any significant variation between different categories of pharmacies. The percentage of medicines actually dispensed and accurately labelled were 92.4 and 98.5% respectively.ConclusionsThe average number of medicines per encounter was higher than the WHO recommended value but the usage of antibiotic and injectable drugs were within recommended standards. Generic prescribing, was very much lower. The EML prescribing, labelling and percentage dispensed medicines fared much better although lower than the WHO recommended 100% compliance. This island wide study has provided national wide data before the implementation of key changes in regulation of medicines in Sri Lanka and a repeat survey will be useful to identify impact of the new legislations.

Access to medicines for children

Abstract Background Access to medicines for children remains a serious public health problem worldwide. The World Health Organization (WHO) has developed a Model List of Essential Medicines for Children (EMLc). However, many essential medicines are still not covered by National EMLc and not available in some countries. The objective of this work was to examine the current situation with access to essential medicines for children in Armenia and identify changes if compare with the situation in 2013. Methods The Armenian EMLc (AEMLc) of 2013 and 2018, the Lists of medicines authorized in Armenia (for 2013 and the current data), pricelists of main wholesalers and national clinical guidelines for children were analyzed. Results 81.2% of all the active ingredients from WHO EMLc were included in the AEML, 61.5% were authorized and only 56.1% were available on the pharmaceutical market. In 2013, 74.1% of all the active ingredients from WHO EMLc were included in the AEML, 62.0% were authorized and only 56.1% were available on the pharmaceutical market. The results of comparing the new data with those received in 2013 showed that the percentage of essential medicines for children recommended by WHO, which were covered by AEML, has increased; however the percentage of those which are authorized in the country stayed almost unchanged. The percentage of medicines from WHO EMLc (with taking into account pharmaceutical form and dose recommended by WHO), which were included in the current AEML was 57.7%; and authorized in the country - 68.5%. Conclusions Essential medicines for children recommended by WHO, are covered by a medicines supply system for children in Armenia, yet not in full. Political will is important. Development and approval of Armenian EMLc can be considered to be the first step in improving access to medicines for children. Draft of Armenian EMLc is developed and will be submitted to the Ministry of Health together with appropriate recommendations. Key messages Access to essential medicines for children remains a serious problem in Armenia. There is an urgent need in improving the situation, and introducing a National EMLc would be an important strategy aimed to increase supply of essential medicines for children.

Prescribing patterns of encounters in fourteen general practice clinics in rural Beijing: a cross-sectional study

BackgroundGeneral practice clinics are the main primary care institutions providing ambulatory care in the rural areas of Beijing, rational use of medicines is crucial for the rural primary care system. This study investigated the prescribing patterns of general practice clinics in rural Beijing to provide a baseline for monitoring and promoting the rational use of medicines.MethodsWe performed a cross-sectional study at 14 rural community health service centers in 6 non-central districts of Beijing sampled through a multistage approach, 85 general practitioners were selected from the 14 centers. Total 8500 prescriptions were derived by recording 100 consecutive patients of each the general practitioner. The World Health Organization drug use indicators and an additional indicator were adopted to assess the prescribing patterns.ResultsThe median number of medicines per encounter was 2.0 (1.0, 2.0); the percentage of generics and essential medicines prescribed were 97.0 and 58.2%, respectively; the percentage of encounters with antibiotics prescribed was 15.1%; the percentage of encounters with injections prescribed was 3.7%; the percentage of encounters with traditional Chinese patent medicines prescribed was 52.5%; the median duration of consultation time was 6.0 (4.0, 10.0) minutes. The most frequently prescribed medicine was aspirin (low dose, 4.6%). The prescribing indicators were influenced by different patient characteristics, patients with new cooperative rural medical scheme were less likely to be prescribed with ≥3 medicines (OR 0.865), essential medicines (OR 0.812) and traditional Chinese patent medicines (OR 0.631), but were more likely to be prescribed with injections (OR 1.551) in the encounter. Patients with ≥3 problems were more likely to be prescribed with ≥3 medicines (OR 6.753), antibiotics (OR 2.875) and traditional Chinese patent medicines (OR 2.926) in the encounter.ConclusionsMost indicators in this study showed similar or fair performance in comparison with World Health Organization and domestic reports, except the percentage of medicines prescribed from the essential medicine list. Regular monitoring on the prescription quality of general practice clinics in rural Beijing should be maintained.

Analysis of dynamics of the medcine list in the government program «available medicines» for treatment of bronchial asthma

The problem of accessibility for socially significant goods for the population, among which the most important place occupy medicines in Ukraine, is very acute today. In this regard, the need for specific state interference through regulatory processes becomes relevant. One of the priority directions for increasing the availability of medicines is the Government of Ukraine has recognized reimbursement.&#x0D; The mechanism of full or partial payment of the cost of medicines used to counteract most socially significant diseases. One of these diseases is bronchial asthma (BA), since it affects all age groups of the population, and with ineffective control of the disease, the quality of life of patients is significantly reduced.&#x0D; The aim of the work is to study the range of medicines for the treatment of BA, included in the Government program «Accessible medicines» for the period 2017–2019 years.&#x0D; From April 1, 2017 to July 1, 2019, the Ministry of Health of Ukraine issued five orders, which approved the Register of medicines, the cost of which is subject to reimbursement. In the study analyzed all editions of the Register and found that with each update, the number of trade names (TN) of the medicines increased: for the treatment of cardiovascular diseases – by 56%, diabetes – by 92%, and BA – by 133%. During the 2017–2019 years, the number of international non-proprietary names (INNs) for the treatment of BA also increased: 3 times Beclomethasone, Budesonide 3.5 times, and Salbutamol is almost 2 times. Also, found that 87% of TN are imported and only 13% – domestic. Total of medicines for the treatment of asthma, the value of which is refundable imports 6 countries, the main segment of which is formed by Spain (31%) and Sweden (23%). The analysis of the size and amount of rejection and the amount of the surcharge for packaging allows us to establish that the percentage of medicines without an additional payment is approximately up to 50%. At 75% of the medicines for the treatment of BA, the amount of packing surcharge with each edition of the Register of medicines subject to reimbursement was increased by 2 medicines (Beckhazon-eco 100 mcg/dose and 250 mcg/dose) and 1 medicine (Budesonide-inteli 200 mcg/dose) – decreased 1 medicine (Budesonide-inteli 200 mcg/dose) subject to partial compensation only once.&#x0D; The conducted studies allow us to conclude that there is a need to improve the assortment policy in order to provide the pharmaceutical market with the available and necessary domestic medicines, in accordance with the needs of the population and the standards for the treatment of BA.

The influence of physicians' specialty on prescribing patterns at a general medicine out-patients clinic.

Several factors have been identified that influence physicians' prescribing habits. The influence of physician's specialty has not been studied. This study is to determine if there are differences in the prescribing patterns amongst these various specialities that run a general medicine clinic at a tertiary hospital in Ghana. Data collected from the out-patients clinic attendance records were analysed using WHO Rational Use of Medicines indicators. Analysis of Variance Test was carried out to establish if there was any variance in the prescribing indicators amongst 4 units of Physicians. 678 patient encounters were utilised for this study. The average number of drugs prescribed per encounter was 4.4, drugs prescribed by generic name was 86.9%, patient encounters in which antibiotics prescribed were 6.5% (n= 44) and injections were prescribed in 3.2% (n=22) of patient encounters. 64.0% of all drugs prescribed were from the Ghanaian EML. The unit of the physician did not have a significant effect on the average number of medicines prescribed per patient encounter (F (3, 674) = 2.19, p = 0.088), and the percentage of medicines that were prescribed from the Essential Medicines List (F (3, 674) = 1.52, p = 0.207). The unit the physician belonged to however did have a significant effect at p < 0.05 on the prescription of generic medications (F (3, 674) = 4.79, p = 0.003). The physician units did not differ in their prescribing patterns at the general medicine clinic except for prescription of drugs by their generic names. None declared.

Drug utilization study in the paediatric department of a tertiary care teaching hospital

Background: Rational drug use is one of the main concerns of the health care system in India. Paediatric population being more vulnerable require additional focus to achieve this goal. Objectives of the study were to evaluate the prescription patterns according to WHO guidelines and the diseases, for which they are being prescribed, to identify the common diseases and common medications used.Methods: A cross sectional study was done in the paediatrics department for a period of 2 months. All the paediatric prescriptions were evaluated using WHO core indicators like average number of medicines per encounter, percentage of medicines from the essential drug lists and also complimentary indicators like utilization of different dosage forms and diagnostic patterns. Statistical Analysis: Data was analyzed and represented as frequency (n) and percentage (%).Results: 89 out of 302 prescriptions had 2 medicines per encounter, 100% of medicines were included from the Essential Drug List (EDL), 59.4% of the medicines were in generic format of prescription.Conclusions: This study gives a positive outlook at the utilization pattern of drugs with all the indicators specifically Essential Drugs List. Regular auditing, continuous medical education and evidence-based medicine can help in improving the health care.

Exploring the attitude of Faculty of Medicine students about herbal products usage: A cross-sectional study

Herbal products have gained popularity, and they are often perceived as safe. The roles of the pharmacists and physicians are essential in the proper usage of those products. This study aimed to investigate the students of Faculty of Medicine in Nis about the use of herbal preparations and the differences between medicine, pharmacy and dentistry students. The fifth-year university students were questioned through an anonymous survey. The obtained results were processed statistically and presented graphically. The majority of the students would prefer a combination of herb product and drug (76.9%). Usage of herbal products is based on students' knowledge, on the advice of pharmacists, family members, physicians, and the media. The majority of students purchase herbal products in the pharmacy and nobody obtained them via the Internet. Most of the students used them in preventive purposes (60%) and claimed that there were positive effects. Students (75%) read the instructions for use and side effects, especially pharmacy students (88.3%). Medicine students (60%) consider herbal products completely safe. Pharmacy students are considered to receive the necessary knowledge on herbal products (68.3%), while a smaller percentage of medicine and dentistry students consider the same. Students use herbal medicines but are not entirely familiar with their effects and safety. There is a need for raising awareness, the importance of side effects and interactions of herbs and drugs among medicine and dentistry students. This goal can be achieved by changing curriculum which would contain material from phytotherapy.

Feasibility and efficacy of the regional cooperative ST-segment elevation myocardial infarction rescue network among the prefectural-level city hospitals

Objective: To investigate the feasibility and efficacy of the establishment of regional cooperative acute ST-segment elevation myocardial infarction (STEMI) rescue network among the prefectural-level city hospitals in China. Methods: Based on real-time remote electrocardiogram transmission and "120" emergency systems, we established a regional collaborative STEMI treatment network with our hospital as the network unclears including 8 second-class affiliated hospitals of Jiangsu University in 2013. STEMI treatment time, therapeutic effects and economic indexes were compared before (from January 2010 to December 2012, 180 cases, pre-network) and after (From January 2013 to December 2015, 374 cases, post-network) the establishment of the regional collaborative STEMI treatment network. Results: Post establishment of the rescue network, mean first medical contact (FMC) to balloon (FMC-to-B) time, referral time and obtaining informed consent time were all significantly decreased from (191±41), (94±18), (25±9) minutes to (93±19), (53±18), (7±5) minutes, respectively, in comparison with the pre-network era(all P<0.05). There was a trend of prolonged FMC-to-B time in proportion to aging of STEMI patients(trend P<0.05). Three months post discharge, LVEF was higher (55.3%±10.7% vs. 48.8%±12.1%, P<0.05) and LVEDd was lower ((49.1±10.8)mm vs.(51.8±9.2)mm, P<0.05) in the post-network group compared to pre-network group.In-hospital mortality was also significantly reduced post the establishment of the rescue network (2.14%(8/374) vs. 3.89%(7/180), P<0.05). The results also showed that the total costs (42 017(25 069, 75 148)yuan vs.51 030(28 137, 105 861)yuan), days of hospitalization ((9.1±4.5) days vs. (15.3±4.8)days) and percentage of medicine and consumables were all significantly decreased in the post-network group compared to pre-network group(all P<0.05). Conclusion: Establishment of the regional cooperative rescue network is feasible among the prefectural-level city hospitals in China. Establishment of such network can improve the prognosis and decrease the FMC-to-B time, the rate of in-hospital mortality and financial burden of patients with STEMI, and serves as an effective strategy to improve the rescue ability for STEMI patients.

Baseline assessment of WHO's target for both availability and affordability of essential medicines to treat non-communicable diseases.

BackgroundWHO has set a voluntary target of 80% availability of affordable essential medicines, including generics, to treat major non-communicable diseases (NCDs), in the public and private sectors of countries by 2025. We undertook a secondary analysis of data from 30 surveys in low- and middle-income countries, conducted from 2008–2015 using the World Health Organization (WHO)/Health Action International (HAI) medicine availability and price survey methodology, to establish a baseline for this target.MethodsData for 49 medicines (lowest priced generics and originator brands) to treat cardiovascular diseases (CVD), diabetes, chronic obstructive pulmonary diseases (COPD) and central nervous system (CNS) conditions were analysed to determine their availability in healthcare facilities and pharmacies, their affordability for those on low incomes (based on median patient prices of each medicine), and the percentage of medicines that were both available and affordable. Affordability was expressed as the number of days’ wages of the lowest-paid unskilled government worker needed to purchase 30 days’ supply using standard treatment regimens. Paying more than 1 days’ wages was considered unaffordable.FindingsIn low-income countries, 15.2% and 18.9% of lowest-priced generics met WHO’s target in the public and private sectors, respectively, and 2.6% and 5.2% of originator brands. In lower-middle income countries, 23.8% and 23.2% of lowest priced generics, and 0.8% and 1.4% of originator brands, met the target in the public and private sectors, respectively. In upper-middle income countries, the situation was better for generics but still suboptimal as 36.0% and 39.4% met the target in public and private sectors, respectively. For originator brands in upper-middle income countries, none reached the target in the public sector and 13.7% in the private sector. Across the therapeutic groups for lowest priced generics, CVD medicines in low-income countries (11.9%), and CNS medicines in lower-middle (10.2%) and upper-middle income countries (33.3%), were least available and affordable in the public sector. In the private sector for lowest priced generics, CNS medicines were least available and affordable in all three country income groups (11.4%, 5.8% and 29.3% in low-, lower-middle and upper-middle income countries respectively).InterpretationThis data, which can act as a baseline for the WHO target, shows low availability and/or poor affordability is resulting in few essential NCD medicines meeting the target in low- and middle-income countries. In the era of Sustainable Development Goals, and as countries work to achieve Universal Health Coverage, increased commitments are needed by governments to improve the situation through the development of evidence-informed, nationally-contextualised interventions, with regular monitoring of NCD medicine availability, patient prices and affordability.

Approval status and evidence for WHO essential medicines for children in the United States, United Kingdom, and Japan: a cross-sectional study

BackgroundThe WHO Model List of Essential Medicines for Children (EMLc) covers medicines for globally high-burden diseases. Regulatory approval in high-income countries ensures evidence and dosage form but usually focuses on diseases common in those countries and not in low- and middle-income countries.MethodsThis cross-sectional study assessed supporting evidence for the 346 medicines in the 5th WHO EMLc and their approval data from the United States, United Kingdom, and Japan.ResultsOf the 346 EMLc medicines, 307 were approved in one or more of the three countries, 278 of which had supporting evidence of efficacy. The percentage of medicines approved in one or more of the three countries was lowest for antiparasitics (60%) whereas 100% for medicines for cancers and musculoskeletal and respiratory conditions were approved. Five of the 30 EMLc antineoplastics had no supporting paediatric evidence. Of the 39 EMLc medicines unapproved in all three countries, 26 were indicated for neglected infectious diseases (NIDs). Ten of the 26 had supporting paediatric evidence. Seventeen of the 39 unapproved medicines had no paediatric dosage form available, and all 17 were indicated for NIDs.ConclusionsMost EMLc medicines for diseases common in the three countries had supporting evidence, which was closely associated with approval, whereas a substantial number of medicines for NIDs were unapproved in the three countries, regardless of whether they had supporting evidence. Because of the limited contribution to the EMLc from high income countries, appropriate incentive mechanisms for pharmaceutical companies are required to make paediatric development for NIDs feasible and effective.

ASSESSMENT OF CLINICO-ECONOMIC EFFICACY OF MEDICAL TREATMENT OF STABLE ISCHEMIC HEART DISEASE PATIENTS WHO UNDERWENT MYOCARDIAL REVASCULARIZATION

Background: Impractical use of pharmaceuticals is a serious problem of the Russian healthcare system. Implementation of pharmacoeconomic analysis into the logistic technologies of medical organizations may promote the solution of this problem. Aim: To analyze real-practice data on medical therapy of patients with stable ischemic heart disease (IHD) during their hospital stay for transcutaneous coronary stent placement and coronary artery bypass grafting. Materials and methods: With the help of a structured form on medical treatment we extracted and analyzed data from 131 clinical records of patients with stable IHD who were hospitalized in 2014 to the Department of Internal Diseases and Department of Cardiovascular Surgery; 60 were patients after stent placement and 71, after coronary artery bypass grafting. We performed an ABC/VEN analysis of their treatment. Groups of pharmaceuticals for VEN analysis were formed according to the Recommendations of Russian National Atherosclerosis Society on Diagnosis and treatment of chronic IHD (Recommendations of Russian National Atherosclerosis Society, 2013) based on European Society of Cardiology guidelines on the management of stable coronary artery disease (ESC guidelines, 2013). We assessed if the treatment administered corresponded to the current Standard of care to patients with stable IHD – SMP No 2.01.216.0 (Russian Federal Standard, 2007). Results: A mismatch between medical treatment that was performed in the Departments of Internal Diseases and of Cardiovascular Surgery, and that recommended by the Russian Federal Standard (2007), was found. The regimens used include the majority of agents recommended by the Russian National Atherosclerosis Society (2013) and the ESC guidelines (2013). In the Department of Internal Diseases, the mean cost of medical treatment during the whole period of stay in the hospital was 79.6 rubles. The group A agents (those with cumulative cost percentage = 80%) were represented by 9 items from the total of 54. There was a low percentage of medicines that were not indicated for this disease (13 agents, or 9.5% of the total medical costs), and all of them were administered for the treatment of concomitant disorders. In general, medical treatment performed in the Department of Internal Diseases corresponded to the ESC guidelines (2013). The costs of medical treatment during the whole period of stay in the Department of Cardiovascular Surgery was 10 741.9 rubles. The group A included 9 agents from the total of 78 used. Sixty eight per cent of costs were related to pharmaceuticals not having compelling indications (solutions, detoxification agents, agents for prevention of gastrointestinal adverse effects), whereas the costs of vitally important drugs were only 12.3% of the total and those of necessary drugs (including antibacterials), 19.7%. Conclusion: It is obviously necessary to update the current Russian Federal Standard (2007), with inclusion of data corresponding to the worldwide trends and guidelines of the Russian National Atherosclerosis Society (2013), at least for two patient groups: those after coronary stent placement and after coronary artery bypass grafting. The elaboration of criteria for administration of medical treatment and strict compliance with them in the real practice would allow for controlling of medical treatment costs, to prevent polypragmasia and adverse drug reactions.

Essential medicines for children in Armenia.

Drug therapy plays a key role in pediatrics. Effective treatment in pediatric practice means that medicines should be both effective and safe for children. However, there is not enough data on effectiveness and safety of medicines for children due to small number of clinical trials [1]. Access to medicines for children remains a serious problem worldwide [2]. The World Health Organization (WHO) has significantly increased the efforts in the field of pediatric pharmaceuticals in order to improve the situation [4]. In 2007, the World Health Organization (WHO) Model List of Essential Medicines for Children (EMLc) was firstly developed. Although WHO promotes access to essential medicines for children in countries by encouraging inclusion of these medicines in national essential medicines lists (EMLs) and treatment guidelines, many essential medicines are not covered by (EMLs) in some countries. The results of a study performed in 14 countries has shown that of 20 surveyed medicines the proportion included in national EMLs ranged from 50% to 90% and some medicines of the EML were not included in local standard treatment guidelines [3]. To examine the current situation with access to essential medicines for children in the Republic of Armenia (RA). The Armenian Essential Medicines Lists (AEML) of 2007 and 2013, as well as the Lists of medicines registered in Armenia have been analyzed (2011 - 2013). The following indicators have been calculated: the percentage of medicines from the WHO EMLc, which were included on the current AEML, the percentage of medicines from the WHO EMLc which were registered in Armenia and the percentage of medicines from the WHO EMLc which were included in approved clinical guidelines. Also, recommendations on prescribing of medicines for pneumonia, included in Armenian clinical guidelines, were analyzed. The analysis of the use of pharmaceuticals from the WHO Model List of Essential Medicine for Children (WHO EMLc) by medicines supply system in the Armenia has revealed that in 2013 only 57.7% of all the medicines from WHO EMLc were included on the National List of Essential Medicines of RA (AEML) and only 68.5% were registered. The results of studies carried out in 2011, 2012, 2013 showed that the situation in regard to the coverage of medicines from the WHO EMLc (without taking into account drug formulations and strengths) by AEML and clinical guidelines used in RA has not changed considerably during that period of time, while the percentage of essential medicines for children recommended by WHO, which were registered in Armenia and available in the pharmaceutical market, slightly increased.Analysis of recommendations on prescribing medicines for pneumonia treatment, included in clinical guidelines used in Armenia, has revealed that these recommendations slightly differ in terms of recommended medicines and other treatment details. Accordingly, approval and use of a single set of criteria for selecting medicines to be included into pediatric clinical guidelines should be considered as an effective approach for optimizing supply of medicines for children. Access to essential medicines for children in Armenia is unsatisfactory. Essential medicines for children recommended by the WHO are only partially covered by the medicines supply system for children in Armenia. Development of the List of Essential Medicines for children in Armenia is an approach to solve this problem. Currently actions are being taken in this direction. It is also considered appropriate to develop national clinical guidelines on the most common childhood diseases in Armenia.

PENYIMPANAN OBAT DI GUDANG INSTALASI FARMASI RS PKU MUHAMMADIYAH YOGYAKARTA UNIT I

Background: Medicine arrangement in Hospital Pharmaceutical Installation included planning, procurement, distribution, and utilizing. Medicine storage indicator was : the suitability between goods and stock card, TOR (Turn Over Ratio), percentage of medicine which was expired and or damaged, storage room arrangement system, percentage of dead stock, and percentage of final stock value. Based on the result of work evaluation of Pharmaceutical Supply Inventory for tablet supply in Pharmaceutical Installation Storage Room at PKU Muhammadiyah Yogyakarta Hospital Unit I, it was found that unsuitability between goods quantity with stock card and computerization was as much as 15,38 %, TOR value was 29 times every year, final sock value was 6 %, medicine percentage was ED (expired date) 0,03 %. This data showed us that the suitability between goods and stock care, medicine ED percentage, TOR, and final stock value didnt meet the hospital target yet. Method: This research was a kind of qualitative description with a draft as observational research. The subjects at this research were The Head of Pharmaceutical Installation, The Head of Pharmaceutical Installation Storage Room, officers of Pharmaceutical Installation Storage Room, and The Head of Maintenance Unit. The means of the research used observatory method and a deep interview. Data analysis was made in a way of qualitative description, and triangulation technique was done to guarantee data validity. Results: Based on the result of research by using observation and deep interview, we knew that medicine storage system in Pharmaceutical Installation Storage Room didnt meet the standard because the medicine arrangement didnt refer to therapy class/ medicine merit. The building and the rooms were suitable with the standard, but the equipments didnt meet the standard because there was no alarm, gram and milligram measurement, box opener, and maintenance card. Human resource was already suitable with the standard because there were Pharmacist and the assistant available. Conclusion: The factor of medicine and equipment stock room system was not suitable with the standard, but the factor of building, rooms and human resource in Pharmaceutical Installation Storage Room at PKU Muhammadiyah Yogyakarta Hospital Unit I were already suitable with the standard. Keywords: Medicine storage, Building and Rooms, Equipment, Human Resource

Towards a framework for personalized healthcare: lessons learned from the field of rare diseases.

A large percentage of medicines do not work for the patient populations they are intended to treat. Increased knowledge regarding genomics and the underlying biological mechanism of diseases should help us be able to stratify patients into groups of likely responders and nonresponders, and to identify those patients for whom a treatment might do more harm than good. This article sets out different policy perspectives for the healthcare systems, and draws in on 25 years of particular experience from the rare disease and orphan drug field, to illuminate the pathway forward in relation to key implementation aspects of personalized healthcare. In principle, we submit that targeting medicines to preidentified groups for whom we can predict a beneficial outcome is a good thing for everyone - first of all for the patients, but also for all the other stakeholders, including payers, treating physicians and industry - because it has the potential to create sustainable and functioning healthcare systems directed to better health and prevention of disease. Personalized healthcare over time could also lead to shorter drug-development times because of lower rates of failure in late-stage drug development. Using orphan medicines to treat well-diagnosed patients suffering from a life-threatening or seriously debilitating rare disease, is an attempt to work according to these principles. As there is much that needs to be done to turn the promise into reality, we need to identify the barriers and challenges to transform the potential opportunities into real-life benefits, and what needs to be done in order to overcome them. Learning from the field of rare diseases and orphan drugs may provide, perhaps unexpectedly, some of the answers to public policy questions related to future (personalized) healthcare, but of course not all aspects, are common between the two fields.

Perfil de utilização de medicamentos em idosos da zona urbana de Santa Rosa, Rio Grande do Sul, Brasil

Medicines are one of the most important health care items for the elderly, who are particularly prone to use multiple drugs with a higher number of adverse reactions. The current study aimed to assess the profile of pharmaceutical consumption by the elderly. A cross-sectional epidemiological study used household interviews in a random sample of 294 elderly living in Santa Rosa, Rio Grande do Sul State, Brazil. The elderly represent 9% of the local population. The results showed a mean consumption of 2.79 medicines per individual. The prevalence rate for use of medicines in the previous week was 82%, and of the 827 medicines used by the elderly, 794 (96%) had been prescribed. The most widely used pharmacological classes were anti-hypertensives (21.3%) and diuretics (11.3%). Prevalence of pharmaceutical use was comparable to the results from other studies, thus confirming the importance of medicines in the health of the elderly. The percentage of medicines used without a medical prescription was low. The most frequently reported medicines and formulations were those usually prescribed and dispensed free of cost in the municipal basic health care system, which has been organized for more than 10 years, with coverage of nearly 100%.