Pharmaceutical Systems Research Articles

Docking assisted DNA-binding, biological screening, and nuclease activity of copper complexes derived from sulfonamides

Copper(II) complexes of sulfonamides have found importance in biological and pharmaceutical systems. This study focuses on copper(II) complexes that were synthesized by precipitation method. The spectroscopic characterization was done by different techniques like FT-IR, UV–Vis, and ESI-MS. Compound 6 [Cu(L2)]2·2DMSO [HL = 4-((naphthalene-1-sulfonamido)methyl)cyclohexanecarboxylic acid] was recrystallized from DMSO, and its structure was determined by single-crystal X-ray diffraction to confirm the results of the synthesis of series of compounds. The geometry around each Cu(II) is tetrahedral bipyramidal with monodentate DMSO at the apical and bidentate carboxylates in the equatorial positions and a Cu–Cu bond. The synthetic compounds were screened for their biological applications involving antibacterial (Escherichia coli [E.C], Staphylococcus aureus [S.A], Sheigella sonnei [S.S], Bacillus subtilis [B.S], Nesseria gonorrhoeae [N.G], and Chromohalobacter israelensis [C.I]), antifungal (Aspergillus niger [A.N] and Neurospora crassa [N.C]), enzyme inhibition (acetylcholinesterase [AChE] and butyrylcholinesterase [BChE]), and antioxidant study. Furthermore, molecular docking study of all compounds was performed against enzymes and DNA using AutoDock Tools version 1.5.6. After confirmation of DNA-interaction through docking studies, nuclease activity was performed using agarose gel electrophoresis method and all compounds have been found to cleave DNA. These results concluded that copper complexes of sulfonamide may be good induction in the future for medical purposes.

Polymer-free hydrogel made of lipid nanocapsules, as a local drug delivery platform

Nanoparticle-loaded hydrogels are attractive pharmaceutical drug delivery systems that combine the advantages of both hydrogel (local administration and/or sustained drug release) and nanoparticle (stealthiness, targeting and decreased toxicity). The design of nanoparticle-loaded hydrogels is largely conventional, consisting of the dispersion of nanoparticles in a natural or synthetic polymer matrix to form a gel network. Novel nanoparticle-loaded hydrogels architecture could provide advantages in terms of innovation and application. We focused on the development of lipid nanocapsule (LNC)-based hydrogels without the use of a polymer matrix as a platform for drug delivery. Cytidine was modified by grafting palmitoyl chains (CytC16) and the new entity was added during the LNC phase-inversion formulation process allowing spontaneous gelation. Positioned at the oil/water interface, CytC16 acts as a crosslinking agent between LNCs. Association of the LNCs in a three-dimensional network led to the formation of polymer-free hydrogels. The viscoelastic properties of the LNC-based hydrogels depended on the LNC concentration and CytC16 loading but were not affected by the LNC size distribution. The LNC and drug-release profiles were controlled by the mechanical properties of the LNC-based hydrogels (slower release profiles correlated with higher viscoelasticity). Finally, the subcutaneous administration of LNC-based hydrogels led to classic inflammatory reactions of the foreign body-reaction type due to the endogenous character of CytC16, shown by cellular viability assays. New-generation nanoparticle-loaded hydrogels (LNC-based polymer-free hydrogels) show promise as implants for pharmaceutical applications. Once LNC release is completed, no gel matrix remains at the injection site, minimizing the additional toxicity due to the persistence of polymeric implants. Sustained drug-release profiles can be controlled by the mechanical properties of the hydrogels and could be tailor-made, depending on the therapeutic strategy chosen.

Urea as a Cocrystal Former-Study of 3 Urea Based Pharmaceutical Cocrystals.

Cocrystallization is commonly used for its ability to improve the physical properties of APIs, such as solubility, bioavailability, compressibility, etc. The pharmaceutical industry is particularly interested in those cocrystals comprising a GRAS former in connection with the target API. In this work, we focus on the potential of urea as a cocrystal former, identifying three novel pharmaceutical cocrystal systems with catechin, 3-hydroxyl-2-naphthoic and ellagic acid. Interestingly, the stability of catechin under high humidity or high temperature environment is improved upon cocrystallization with urea. Moreover, the solubility of ellagic acid is improved about 17 times. This work displays the latent possibility of urea in improving the physical property of drug molecules using a cocrystallization approach.

A Study Into the Use of Milliflex Quantum as Rapid Microbial Detection Method for Microorganisms in Pharmaceutical...

Control of pharmaceutical water systems represents an essential part of Good Manufacturing Practice and embedded within this is the quality control testing of water systems for viable microorganisms, and subjecting the data obtained to trend analysis. This has traditionally been achieved by membrane filtration and the use of a culture medium. While such test methodologies can recover a level of the bioburden present, the incubation times are lengthy. To address the problem of time-to-result, rapid microbiological methods offer an alternative approach. One such example is the Milliflex Quantum, which is the focus of this article.

QUALITY BY DESIGN APPROACH: REGULATORY NEED, CURRENT, AND FUTURE PERSPECTIVE

Quality by design (QbD) is utilized in the event of pharmaceutical processes to create certain predefined product quality. QbD ideas unit of measurement explained in International Conference on Harmonization (ICH) pointers Q8 (R1) (Pharmaceutical development), Q9 (Quality risk management [QRM]), and Q10 (Pharmaceutical quality system). ICH Q8 (R1) guideline defines QbD as “a systematic approach to develop that begins with predefined objectives and emphasizes product and methodology, understanding, and methodology management, supported sound science and QRM.” QbD approach studied the implications of various input variables (e.g. methodology parameters, and materials) of the merchandise development methodology, on the final word product (active pharmaceutical ingredient or drug product). The late QbD approach integrates the principles of QRM, and methodology analytical technology (PAT). QbD combined with methodology analytical technology (PAT) tools modify methodology management and increase assurance that the merchandise quality attributes unit of measurement achieved consistently. An integrated and risk-based approach for review of the merchandise development methodology is also a future need of the QbD plan. Although implementing the QbD approach is not a restrictive demand, restrictive agencies to supply flexibility in their pointers for producing that unit of measurement developed by the QbD approach. Rising trends embody the growing interest in quantifying and managing the impact of raw materials’ attributes variability of methodology and product, what is more, as a result of the event of retrospective QbD approaches in complement to simple QbD. Thus, the QbD approach is also a tool for developing worth effective and quality pharmaceutical products.

Characterisation and fundamental insight into the formation of new solid state, multicomponent systems of propranolol

The physiochemical properties of acidic or basic active pharmaceutical ingredients (APIs) can be optimised by forming salts with different counterions. The aim of this work was to synthesise a novel salt of propranolol (PRO) using sebacic acid (SEBA) as the counterion and to gain mechanistic understanding of not only the salt formation, but also its eutectic phase formation with SEBA. Thermal analysis showed a solid-state reaction occurring between PRO and SEBA leading to the formation of dipropranolol sebacate (DPS) melting at app. 170 °C and the eutectic composed of DPS and SEBA melting at app. 103 °C, comprising 0.33 mol fraction of PRO as determined by the Tammann plot. X-ray diffraction and Fourier-transform infrared spectroscopy (FTIR) confirmed the identity of the new multicomponent phases of PRO. DPS can be conveniently obtained by heat-induced crystallisation, grinding and conventional solvent crystallisation. Detailed analysis by FTIR revealed H-bond interactions between DPS and SEBA at the inter-phase in the eutectic. Bravais, Friedel, Donnay and Harker crystal morphology coupled with full interaction maps analysis allowed to understand further the nature of interactions which led to formation of the eutectic phase. This work contributes to furthering research on multicomponent pharmaceutical systems to harness their full potential.

A Stalled Revolution? Misoprostol and the Pharmaceuticalization of Reproductive Health in Francophone Africa.

Misoprostol entered the global market under the name Cytotec in the mid-1980s for the treatment of gastric ulcers. Decades of research have since demonstrated the safety and effectiveness of off-label use of misoprostol as a uterotonic in pregnant women to prevent and treat post-partum hemorrhage, treat incomplete abortion, or terminate first-trimester pregnancy. Global health experts emphasize misoprostol’s potential to revolutionize access to reproductive health care in developing countries. Misoprostol does not require refrigeration, can be self-administered or with the aid of a non-physician, and is relatively inexpensive. It holds particular promise for improving reproductive health in sub-Saharan Africa, where most global maternal mortality related to post-partum hemorrhage and unsafe abortion occurs. Although misoprostol has been widely recognized as an essential obstetric medication, its application remains highly contested precisely because it disrupts medical and legal authority over pregnancy, delivery, and abortion. I draw on fieldwork in Francophone Africa to explore how global health organizations have negotiated misoprostol’s abortifacient qualities in their reproductive health work. I focus on this region not only because it has some of the world’s highest rates of maternal mortality, but also fertility, thereby situating misoprostol in a longer history of family planning programs in a region designated as a zone of overpopulation since the 1980s. Findings suggest that stakeholders adopt strategies that directly address safe abortion on the one hand, and integrate misoprostol into existing clinical protocols and pharmaceutical supply systems for legal obstetric indications on the other. Although misoprostol has generated important partnerships among regional stakeholders invested in reducing fertility and maternal mortality, the stigma of abortion stalls its integration into routine obstetric care and availability to the public. I demonstrate the promises and pitfalls of pharmaceuticalizing reproductive health: despite the availability of misoprostol in some health facilities and pharmacies, low-income and rural women continue to lack access not only to the drug, but to quality reproductive health care more generally.

The Off-Patent Biological Market in Belgium: Is the Health System Creating a Hurdle to Fair Market Competition?

We investigated the off-patent biological market in Belgium from a policy maker’s perspective, in light of the Belgian pharmaceutical health system. The main barriers relate to a short-term budgetary focus, to the overwhelming innovator’s reach and to a concertation model with assessment and appraisal being mixed which results in poorly effective policy measures.

Post-synthesis nanostructuration of BSA-Capsaicin nanoparticles generated by sucrose excipient

In the pharmaceutical industry nano-hydrocolloid systems frequently coalesce or present nanoparticle aggregation after a long storage periods. Besides, the lyophilization process used to dry nanoparticles (NPs) produces loss of their original properties after dispersion. In this work we evaluated the effect on morphology and physicochemical properties of different protective excipients during drying of bovine serum albumin (BSA) NPs loaded with different concentrations of capsaicin. Capsaicin concentrations of 0, 812, 1625, 2437, and 3250 µg mL−1 were used; subsequently, NPs were dried with deionized water (DW), NaCl (DN), sucrose (DS), and not dried (ND). We found that ND, DW, and DN treatments showed a negative effect on the NPs properties; while, DS reduced the aggregation and produced the formation of isolated nanoparticles at higher concentrations of capsaicin (3250 µg mL−1), improving their circular shape, morphometrical parameters, and ζ-potential. The stability of the BSA-capsaicin NPs was associated to complex capsaicin/amino acid/water, in which GLY/GLN, ALA/HIS, ARG, THR, TYR, and Iso/CYS amino acids are involved in the restructuration of capsaicin molecules into the surface of nanoparticles during the drying process. The secondary nanostructuration in the post-synthesis stage can improve the molecular stability of the particles and the capacity of entrapping hydrophobic drugs, like capsaicin.

Milk protein-based nanodelivery systems for the cancer treatment

The numerous advantages that nanotechnology can bring to the design of pharmaceutical delivery systems are perhaps nowhere better illustrated than in the area of cancer treatment. These nanostructures not only can improve the anti-proliferative properties of the drugs but also ameliorate the side effects by providing site-specific drug delivery. Furthermore, food-based proteins, due to their biocompatibility and biodegradability, provide a ready-made ingredient as a carrier for various chemotherapeutic agents. The most popular proteins in this field are milk proteins including β-lactoglobulin (β-LG), lactoferrin (LF), and the caseins (CN), all of which have desirable properties to make them ideal for this purpose. Grafting these two approaches, different milk protein-based nanodrugs have been synthesized that show promising potential in providing more targeted delivery of drugs thereby reducing the cytotoxic effects of chemotherapy. In some cases, being encapsulated in these proteins (in nanoscale), the chemotherapeutic agents can be consumed orally while enhancing site-specific delivery. This article reviews various nanodrug delivery systems containing milk proteins, which are designed for cancer treatment. Moreover, their physical and their anti-proliferative characteristics are briefly described.

Chitosan based co-processed excipient for improved tableting

Chitosan is a multipurpose polymer with immense utility in pharmaceutical drug delivery systems. Low density, poor flowability and inadequate compression characteristics have limited its use as a tablet excipient. To address these limitations, a new tri-component excipient system composed of chitosan, mannitol and crospovidone was developed using spray drying technique. Mannitol was utilized for its ability to act as a bulking agent and to harness its unique characteristics such as a low hygroscopicity, strong inertness towards other excipients, whereas crospovidone was used as the disintegrant. Central composite response surface model was employed to obtain optimum combination of these components. Resulting coprocessed excipient showed remarkable improvement in density and flowability as confirmed by SeDeM diagram expert system. Heckel and Kawakita analysis predicted superior compression features of developed excipient for tableting. Furthermore, the applicability of developed excipient was studied by formulating paracetamol tablet as a model formulation by direct compression. Co-process excipient consisting of 50% chitosan, 43% mannitol and 6.5% crospovidone provided tablets with desired hardness of 100 N having disintegration time less than 25 s. Therefore, developed multifunctional coprocessed excipient exhibited promising results with potential for scale up and wide applicability in drug delivery.

ЭКСТЕМПОРАЛЬНОЕ ИЗГОТОВЛЕНИЕ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ: ПРОБЛЕМЫ И РЕШЕНИЯ

Despite the decrease in the number of pharmacies having prescription and manufacturing departments the need for extemporally manufactured dosage forms remains high. Pharmaceutical organization dealing with medicines manufacture is currently facing a number of problems: lack of modern pharmaceutical substances at pharmacies, manufacture of medicines containing narcotic substances, psychotropic substances and their precursors, high costs, low profitability of in-pharmacy manufacture and etc. The urgency to preserve and revive ex tempore formulations at pharmacies is highlighted. The groups of patients for whom individual manufacture of medicines is most relevant are identified: children, especially newborn and children under 1 year old, elderly patients, as well as patients with orphan diseases and patients requiring palliative care. The advantages of the extemporal formulation are noted, in particular, the selection of an individual composition and dosage taking into account body characteristics, age, concomitant diseases of the patient, tolerance of medicinal substances and their excipients, etc. Some ways to solve problems arising are suggested. Promising directions for the development of extemporal manufacture are noted: the use of modern excipients, technologies, packaging facilities, the development of internal regulatory documentation for the pharmaceutical quality system and etc.

Safeguards for Accelerated Market Authorization of Vaccines in Europe

People around the globe are concerned about safety issues encircling the accelerated introduction of corona vaccines. In this article, we discuss the regulatory safeguards for fast-track market authorization of vaccines in Europe. In addition, we explain how the transmission of European Union law into national Member State legislation works. We then clarify what happens before a drug can be introduced into the European market. We conclude that governments should build bridges of mutual understanding between communities and increase trust in the safety of authorized vaccines across all population groups, using the right messengers.Drug development normally takes several years. The fact that it has been a few months now seems ridiculously short. How is the quality and integrity of the vaccine ensured? That people - on both sides of the Atlantic - are concerned about this is entirely understandable. How does one prevent citizens from being harmed by vaccines and medicines that do not work for everyone, because the admission procedures have been simplified too much? The purpose of this article is to shed a little light upon the accelerated market authorization procedures on the European continent, with a focus on the situation in the Netherlands.How a vaccine is introduced into the market.In June 2020, the Dutch government, in close cooperation with Germany, France and Italy, formed a Joint Negotiation Team which, under the watchful eye of the European Commission, has been negotiating with vaccine developers. Its objective: to conclude agreements with drug manufacturers at an early stage about the availability of vaccines for European countries. In case these manufacturers are to succeed in developing a successful vaccine for which the so-called Market Authorization (MA) is granted by EMA or CBG, this could lead to the availability of about 50 million vaccines (for the Netherlands alone).Who is allowed to produce these vaccines?Who is allowed to produce these vaccines? The Dutch Medicines Act is very clear about this. Only "market authorization holders" are allowed to manufacture medicines, including vaccines. These are parties that have gone through an extensive application procedure, who demonstrably have a solid pharmaceutical quality management system in place and have obtained a pharmaceutical manufacturing license (the MIA, short for Manufacturing and Importation Authorisation). This license is granted after assessment by the Health and Youth Care Inspectorate of the Ministry of Health, Welfare & Sport (IGJ) – by Farmatec. Farmatec is part of the CIBG, an implementing body of the Ministry of Health, Welfare and Sport (VWS). The M-license is mandatory for parties who prepare, or import medicines.

Multivariate Spectroscopic Method Lifecycle Management as Part of the Quality Management System.

Multivariate model based spectroscopic methods require model maintenance through their lifecycle. A survey conducted by the International Consortium for Innovation and Quality in Pharmaceutical Development (IQ) in 2019 showed that regulatory reporting categories for the model related changes can be a hurdle for the routine use of these types of methods. This article introduces industry best practices on multivariate method and model lifecycle management within the Pharmaceutical Quality System. Case studies are provided to demonstrate how the Established Conditions and Post-Approval Change Management Protocol concepts may be leveraged to allow regulatory flexibility for change management and to encourage the use of these techniques for the development and commercialization of pharmaceutical products.

Magnitude and determinants of drug-related problems among patients admitted to medical wards of southwestern Ethiopian hospitals: A multicenter prospective observational study.

Drug-related problem (DRP) is an event involving drugs that can impact the patient's desired goal of therapy. In hospitalized patients, DRPs happen during the whole process of drug use such as during prescription, dispensing, administration, and follow-up of their treatment. Unrecognized and unresolved DRPs lead to significant drug-related morbidity and mortality. Several studies conducted in different hospitals and countries showed a high incidence of DRPs among hospitalized patients. Despite the available gaps, there were scanties of studies conducted on DRPs among patients admitted to medical wards in Ethiopia. Therefore, this study assessed the magnitude of drug-related problems and associated factors among patients admitted to the medical wards of selected Southwestern Ethiopian hospitals. A multicenter prospective observational study was conducted at medical wards of Mettu Karl Hospital, Bedele General Hospital and Darimu General Hospital. Adult patients greater than 18 years who were admitted to the non-intensive care unit (ICU) of medical wards and with more than 48 h of length of stay were included. Identified DRPs were recorded and classified using the pharmaceutical care network Europe foundation classification system and adverse drug reaction was assessed using the Naranjo algorithm of adverse drug reaction probability scale. Hill-Bone Compliance to High Blood Pressure Therapy Scale was used to measure medication adherence. Multivariable logistic regression was used to analyze the associations between the dependent variable and independent variables. Of the 313 study participants, 178 (56.9%) were males. The prevalence of actual or potential DRPs among study participants taking at least a single drug was 212 (67.7%). About 125 (36.63%) patients had one or more co-morbid disease and the average duration of hospital stay of 7.14 ± 4.731 days. A total of 331 DRPs were identified with an average 1.06 DRP per patient. The three-leading categories of DRPs were unnecessary prescription of drugs 92 (27.79%), non-adherence (17.22%) and dose too high (16.92%). The most common drugs associated with DRPs were ceftriaxone (28.37%), cimetidine (14.88%), and diclofenac (14.42%). The area of residence (AOR = 2.550, 95CI%: 1.238-5.253, p = 0.011), hospital stay more than 7 days (AOR = 9.785, 95CI%: 4.668-20.511, p≤0.001), poly pharmacy (AOR = 3.229, 95CI%: 1.433-7.278, p = 0.005) were predictors of drug-related problem in multivariable logistic regression analysis. The magnitude of drug therapy problems among patients admitted to the medical wards of study settings was found to be high. Therefore, the clinical pharmacy services should be established in hospitals to tackle the DTPs in this area. Additionally, healthcare providers of hospitals also should create awareness for patients seeking care from health facilities of the importance of rational drug usage.

The risk-oriented approach to the development and implementation of the pharmaceutical quality system in the production of in-bulk finished products

Aim. To determine the areas of the risk-based approach to the development and implementation of the pharmaceutical quality system with the emphasis on the production of in-bulk finished products, identify the main factors affecting the stability of the functional characteristics of drugs in order to provide their compliance with the international quality standards, Good Manufacturing Practice and quality risk management. Results. 29 pharmaceutical companies with the license in Ukraine for dispensing and packing of medicines from in-bulk products have been identified. The control strategy for the production of medicines for in-bulk products has been developed as a set of measures covering the incoming control of in-bulk products, the primary, secondary packing and their labeling, patient information leaflets, finished drug at release and shelf life, control of operating conditions of premises and equipment, parameters of dispensing and packing stages. The analysis of the specificity of the production of finished drugs from in-bulk products has been performed, and the areas of the risk-oriented approach have been determined to the development and implementation of the pharmaceutical quality system in this type of production based on the risk assessment of significant factors affecting the pharmaceutical production and the use of the appropriate risk management methods for quality in the production of medicines from in-bulk products. Conclusions. It has been determined that the risk-oriented approach to the development and implementation of the pharmaceutical quality system in the production of medicines from in-bulk products is a strategic direction. It allows increasing the effectiveness of the quality management system at a qualitatively new level, achieving goals in order to prevent adverse effects on quality and safety, and it means the best possible customer satisfaction. In our research, the quality guarantees that the pharmaceutical quality system should provide in the production of medicines from in-bulk products have been identified, and the control strategy has been developed. Key words: in-bulk products; medicines; drug quality; risk-based approach; pharmaceutical quality system; Good Manufacturing Practice; quality risk assessment

A Review on Bio-Polymers Derived from Animal Sources with Special Reference to their Potential Applications

Biopolymers are naturally found material and most of the materials are made in nature during the life cycles of plants, animals, fungi and bacteria. For any pharmaceutical formulation the two main ingredients are active pharmaceutical ingredient and excipients. As excipients in any kind of dosage form, the biopolymers play a vital function. Biopolymers are pharmacologically inert ingredients formulated along with the active ingredient to increase the volume; they help in the formulating dosage form and also simultaneously can improve the physicochemical parameters of the dosage form and so are widely used in the development of new drug delivery system. The biopolymers which are obtained from animal sources are usually non-toxic, biocompatible, stable and economic; and can control the release pattern of the drug. Natural polymers have more preponderant effects on fast dissolving tablets than synthetic polymers. Now-a-days, because of many problems regarding drug release and adverse effects of synthetic polymers, manufacturers are going towards using natural polymers. In this review article we mainly discussed about types of polymer, different alignment of natural polymer, advantages of natural polymers over synthetic polymers, drawbacks of natural polymers, mechanism of drug release of polymer, different methods of preparation of biopolymers, role of polymer in pharmaceutical industry and drug delivery systems.
 Keywords: Natural polymers, Chitin, Collagen, Sources, Preparation.

The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: a systematic review and meta-analysis

BackgroundClinical Decision Support Systems (CDSSs) for Prescribing are one of the innovations designed to improve physician practice performance and patient outcomes by reducing prescription errors. This study was therefore conducted to examine the effects of various CDSSs on physician practice performance and patient outcomes.MethodsThis systematic review was carried out by searching PubMed, Embase, Web of Science, Scopus, and Cochrane Library from 2005 to 2019. The studies were independently reviewed by two researchers. Any discrepancies in the eligibility of the studies between the two researchers were then resolved by consulting the third researcher. In the next step, we performed a meta-analysis based on medication subgroups, CDSS-type subgroups, and outcome categories. Also, we provided the narrative style of the findings. In the meantime, we used a random-effects model to estimate the effects of CDSS on patient outcomes and physician practice performance with a 95% confidence interval. Q statistics and I2 were then used to calculate heterogeneity.ResultsOn the basis of the inclusion criteria, 45 studies were qualified for analysis in this study. CDSS for prescription drugs/COPE has been used for various diseases such as cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, and mental diseases. In the meantime, other cases such as concurrent prescribing of multiple medications for patients and their effects on the above-mentioned results have been analyzed. The study shows that in some cases the use of CDSS has beneficial effects on patient outcomes and physician practice performance (std diff in means = 0.084, 95% CI 0.067 to 0.102). It was also statistically significant for outcome categories such as those demonstrating better results for physician practice performance and patient outcomes or both. However, there was no significant difference between some other cases and traditional approaches. We assume that this may be due to the disease type, the quantity, and the type of CDSS criteria that affected the comparison. Overall, the results of this study show positive effects on performance for all forms of CDSSs.ConclusionsOur results indicate that the positive effects of the CDSS can be due to factors such as user-friendliness, compliance with clinical guidelines, patient and physician cooperation, integration of electronic health records, CDSS, and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts, and the real-time alerts in the prescription.

Analysis the Centralized Drug Procurement Results at Ho Chi Minh city Department of Health

In recent years, the procurement of drugs in public health facilities is mostly done in the form of bidding. In particular, the concentrated bidding form at the Department of Health brings advantages to the process of drug supply as well as safe, appropriate and effective management of drug use. In the period 2014-2019, at the Ho Chi Minh City Department of Health (DoH), the number of drugs in the concentrated bidding list increases year by year, from 92 (2014) to 101 (2019). The number of winning drugs on the list promulgated by the Ministry of Health has increased year by year. DoH focuses mainly on purchasing drugs under generic packages when the quantity of drugs is in the range of 67-70% higher than the quantity of drugs in the original brand name package (30-33%). In terms of value, compared to the total planned value, the generic package decreased by 65% (2017-2019), while the original brand name package only decreased by 35%. Bid prices and winning prices of each commodity decrease over the years. The difference between bid prices and winning bid prices ranged from 20% to 40%. DoH's locally concentrated list of tenders has not yet fully met the needs of local health facilities, so there is still planning to add new drugs out of the list. Therefore, it is advisable to conduct a further survey on drug use needs in each health facility through data from open bidding at hospitals in Ho Chi Minh City. From there, consider which drugs should be added to DoH's centralized procurement list.
 Keywords: Centralized bidding, generic bidding package, original brand name bidding package, drug price, HCMC Department of Health.
 References
 [1] World Health Organization, How pharmaceutical systems are organized in Asia and the Pacific, OECD Publishing, 2018.[2] Government of Vietnam, The World Bank, Fiscal Policies towards Sustainability, Efficiency, and Equity, World Bank Washington DC, 2017.[3] Ministry of health, Circular 09/2016/TT-BYT promulgation of list of drugs for procurement through bidding, list of drugs for concentrated procurement, list of drugs for procurement through price negotiation, 2016 (Vietnamese).[4] Ministry of health, Circular 21/2013/TT-BYT prescribing organization and operation of the drug and treatment council in hospitals, 2013. (Vietnamese).[5] Xuan-Phuoc Nguyen-Thi et al, Analysis of drug bidding results in the form of centralized drug bidding at the Nghe An Province Health Department, Pharmaceutical journal 59 (7), 2019, 03-07 (Vietnamese).[6] Ministry of health, Circular 11/2016/TT-BYT bidding for supply of drugs for public health facilities, 2016 (Vietnamese).[7] Ministry of health, Joint Circular 01/2012/TTLT-BYT-BTC guiding bidding of drugs procurement in the medical facilities, 2012 (Vietnamese).
 
 
 
 

Developing an Integrated Electronic Medication Reconciliation Platform and Evaluating its Effects on Preventing Potential Duplicated Medications and Reducing 30-Day Medication-Related Hospital Revisits for Inpatients.

The aims were to develop an integrated electronic medication reconciliation (ieMR) platform, evaluate its effects on preventing potential duplicated medications, analyze the distribution of the potential duplicated medications by the Anatomical Therapeutic and Chemical (ATC) code for all inpatients, and determine the rate of 30-day medication-related hospital revisits for a geriatric unit. The study was conducted in a tertiary medical center in Taiwan and involved a retrospective quasi pre-intervention (July 1-November 30, 2015) and post-intervention (October 1-December 31, 2016) study design. A multidisciplinary team developed the ieMR platform covering the process from admission to discharge. The ieMR platform included six modules of an enhanced computer physician order entry system (eCPOE), Pharmaceutical-care, Holistic Care, Bedside Display, Personalized Best Possible Medication Discharge Plan, and Pharmaceutical Care Registration System. The ieMR platform prevented the number of potential duplicated medications from pre (25,196 medications, 2.3%) to post (23,413 medications, 3.8%) phases (OR 1.71, 95% CI, 1.68-1.74; p < .001). The most common potential duplicated medications classified by the ATC codes were cardiovascular system (28.4%), alimentary tract and metabolism (26.4%), and nervous system (14.9%), and by chemical substances were sennoside (12.5%), amlodipine (7.5%), and alprazolam (7.4%). The rate of medication-related 30-day hospital revisits for the geriatric unit was significantly decreased in post-intervention compared with that in pre-intervention (OR = 0.12; 95% CI, 0.03-0.53; p < .01). This study indicated that the ieMR platform significantly prevented the number of potential duplicated medications for inpatients and reduced the rate of 30-day medication-related hospital revisits for the patients on the geriatric unit.