Rational Use Of Medications Research Articles

Bundles do combate à fraqueza adquirida na unidade de terapia intensiva

Intensive care unit acquired weakness (ICUAW) is frequent in survivors of critical illness. ICUAW is multifactorial clinical condition that is associated with loss of muscle mass and functionality. The loss of muscle mass in some diseases can be up to 1 kg per day because of intense catabolism, which can prolong the rehabilitation time of these patients by up to 5 years. The purpose of this article is to fight against ICUAW, mainly regarding modifiable factors such as: optimization of medical nutritional therapy, better metabolic and glycemic control, early mobilization, early ventilatory weaning, rational use of medication, evaluation of functionality and nutritional risk, periodic monitoring of nutritional status, metabolic and clinical condition, muscle mass assessment of all patients. To facilitate the recognition of these factors, a mnemonic was elaborated using the word FRAQUEZA.

Rational use of medicines

Rational use of drugs can be defined as prescribing the right drug, in sufficient dose for the adequate duration and suitable to the clinical requirements of the patients at least cost. Causes of irrational use comprise not have of knowledge, skills or self-determining information, unhampered accessibility of medicines, overburden of health personnel, unsuitable promotion of medicines and earnings motives from selling medicines. Inappropriate drug use can have dire consequences; it has been associated with hospitalization and even caused deaths of inpatients in health care facilities. A variety of situations and circumstances promote irrational use of medicines. Rational use of medication saves lives, confines undesired toxicity, adverse events and maximize on the benefits that can be imitative from best use of medications. According to surveys conducted in 2004 by HAI Africa and WHO in 11 Sub-Saharan Africa countries in 2004, the average accessibility of the essential medicines in public health facilities was below 70%.Communication between professionals and consumers is essential to the enhancement of rational use of medicines. It is essential to recommence collaboration of physicians and pharmacists concerning accurate and competent drugs prescribing. Governments, private health care institutions, entity health care providers and patients all have an accountability to endorse rational use of medicines. Professionals should provide information to the customers about the name of the medicine, the intention for which the medicine is being taken, dose, frequency of use, and duration of use.

Prevalence and patterns of birth defects among newborns in southwestern Ethiopia: a retrospective study.

Introductionprenatal development could be considered normal or abnormal. Abnormal development occurs because of interference of normal development from genetic disorders, environmental factors, and multifactorial inheritances during the critical period of embryogenesis. The present study was aimed at evaluating the prevalence and patterns of birth defects among newborns in southwestern Ethiopia.Methodsinstitutions-based cross-sectional study design was conducted in six purposively selected hospitals in southwestern Ethiopia based on their caseload. The study included data's from 2011 to 2015, during which 45,951 deliveries were recorded. All records of births in the selected hospitals were screened from medical records to identify the presence and types of birth defects.Resultsout of twenty-one different birth defects identified, nearly half of them belong to anencephaly and hydrocephalus. Five types of birth defects, namely: anencephaly (25.0%), hydrocephalus (24.6%), spina bifida (13.1%), meningomyelocele (7.1%), and umbilical hernia (4.8%) accounted for about three-fourths (75%) of all recorded birth defects. The prevalence rate of birth defects at birth was 55 per 10,000 births.Conclusionin the present study, the neural tube defects were identified to be the most prevalent. Nearly equal proportions of birth defects occurred among male and female newborns. The majority of the mothers who gave birth to newborns with birth defects were younger than 35 years. The high prevalence of birth defects revealed in this study call for the need to implement urgent prevention strategies including but not limited to the provision of sustained family planning, youth education and antenatal care services, and strict observation of rational medication use during pregnancy to curb the possible occurrences of the birth defect.

Osteopathy in primary health care: partial results of continuing education experience and some initial outcomes.

This paper presents partial results of a research-intervention, through training of PHC work teams. Initial consultation was made in a group by HC professionals, and the osteopath then performed the consultation. The socialization and training of practical knowledge and techniques of the osteopathic approach was done between consultations. Multiprofessional teams from three health centers from Florianópolis, southern Brazil, participated in the training, and the process was audio and videorecorded, along with a final interview. Data was analyzed using the Grounded Theory. Apprehending the osteopathic knowledge was a triggering tool for reflective processes about care. Faced with the efficiency and resolution of this approach in practice, participants showed a willingness to transform their acts of care of patients and also their self-care. The professionals argue that the common understanding about self-regulating mechanisms and the inclusion of the tissue mobility in their anamnesis, including the stimulation of endogenous mechanisms, contributed to less protocol-based care, more appropriate care for each case, better multidisciplinary team work, the rational use of additional tests, medication, and surgical procedures.

Rational Use of Medicines by Mothers Having Children Under Five Years Old and Factors Affecting Their Medication Use

Giriş: Bu çalışmada, beş yaş altı çocuğu olan annelerin akılcı ilaç kullanım (AİK) durumunun belirlemesi ve etkileyen faktörlerin saptanması amaçlanmıştır. Yöntem: Tanımlayıcı ve kesitsel tipte olan bu araştırma, Haziran 2015- Mart 2016 tarihleri arasında Pınarhisar’da yürütülmüştür. Araştırmanın örneğini, Aile Sağlığı Merkezlerine kayıtlı 0-59 aylık çocuğu olan 320 kadın oluşturmuştur. Veriler, araştırmacılar tarafından geliştirilen anket formu yardımıyla yüz yüze toplanmıştır. Bulgular: Katılımcıların AİK prevalansı %30,0 saptanmıştır. Kadınların reçetesiz ilaç ve reçetesiz antibiyotik kullanım prevalansı sırasıyla %90,0 ve %19,1 idi. Kadınların çocuklarına yönelik reçetesiz ilaç ve reçetesiz antibiyotik kullanım prevalansı sırasıyla %66,3 ve %6,3 bulunmuştur. Grubun %38,4’ünün evde ilaç bulundurduğu, %33,4’ünün tavsiye ile ilaç kullandığı saptanmıştır. Annelerin %18,8-%52,2’si antibiyotik kullanımına yönelik doğru bilgiye sahip olduğu görülmüştür. Çok değişkenli lojistik regresyon analizinde; geniş veya parçalanmış aile yapısına sahip olanlara göre çekirdek ailede yaşayanların, asgari ücretin altında (<1400 TL) geliri olanlara göre 1400-2800 TL geliri olanların, ilaç fiyatı arttıkça ilacın etkinliğinin artmadığını bilenlerin ve ilaçların akılcı kullanımı ile ilgili farkındalığı olanların, ilaçları akılcı kullanma olasılığı yüksek saptanmıştır. Sonuç: Beş yaş altı çocuğu olan yaklaşık üç anneden biri ilaçları akılcı kullanmaktadır. Annelerin kendilerine yönelik reçetesiz ilaç kullanımı ve reçetesiz antibiyotik kullanımı çocuklarına kıyasla yüksek düzeydedir. İlaçların akılcı kullanımında aile tipi, gelir düzeyi, AİK bilgi veya farkındalık düzeyi belirleyici olarak saptanmıştır. Beş yaş altı çocuğu olan annelerin sağlık kuruluşlarına başvurularında, görüşme süreçleri iyi değerlendirilmeli, eğitim çalışmaları planlanmalı ve katılımları sağlanmalıdır.

Perfil do consumo de medicamentos por graduandos em uma universidade do Planalto Norte Catarinense

Introdução: Segundo a Organização Mundial da Saúde, 2002, a morbidade e a mortalidade causadas por produtos farmacêuticos são problemas de saúde. Objetivo: Este trabalho identificou o hábito da utilização de medicamentos entre estudantes de uma Universidade do Planalto Norte Catarinense, delineando o consumo e seus motivos, para obter subsídios na elaboração da promoção do uso racional de medicamentos. Metodologia: O estudo buscou caracterizar de forma quantitativa os estudantes, foi uma pesquisa descritiva, enfatizando a descrição do consumo de medicamentos, segundo a perspectiva dessa prática enquanto um problema de saúde pública, visando caracterizar o perfil dos medicamentos consumidos e o perfil dos fatores associados. Resultados e discussões: Foram aplicados 234 questionários, sendo 61% do sexo feminino. A média de idade foi de 17-32 anos. Dos entrevistados, grande parte afirma que não possui nenhum problema de saúde atualmente. Porém, os dados revelam que 57,26% faz uso de algum medicamento, e que 36,32% o faz diariamente, sendo a classe de analgésicos é a mais consumida. 14,10% dos entrevistados sentem-se desanimados antes de consumir o medicamento. Conclusão: o perfil do consumo de medicamentos alerta para a prática da automedicação, desencadeando a necessidade de se realizar estratégias na promoção do uso racional de medicamentos. Palavras-Chave: Uso de medicamentos. Universitários. Automedicação. Emoções.

The anti-retrovirus therapy: Medicinal resources and their rational choice

The purpose of the study was to determine potential availability of anti-retrovirus therapy and to justify proposals for selecting and prescribing rational combining of anti-retrovirus medications for HIV treatment. The objects of the study were anti-retrovirus medications authorized in the Russian Federation, information on current national and international approaches and recommendations concerning management of HIV-infected patient and application of anti-retrovirus therapy, including criteria of selecting medications and their combinations. The mathematical approach was applied to calculate the number of potential combinations of anti-retrovirus medications that can be applied to objects in certain conditions. The systemic approach was implemented including content analysis, methods of comparative and one-off analysis, generalization and grouping of information from regulatory documents on anti-retrovirus therapy and official materials on anti-retrovirus medications to develop algorithm of rational selection of anti-retrovirus treatment. Based on the results of the study, large number of potential combinations of anti-retrovirus medications were established to select the proper combination for treatment of HIV infection. The approach included organizational steps, evaluation criteria and algorithm of selecting rational combination of anti-retrovirus medications. The practical implementation of developed proposals can contribute to development of system of rational use of medications at the level of medical organization and to improve medication support of patients with HIV infection.

The Pattern of Substance Abuse in the Psychiatry Department of a Tertiary Care of Srinagar Hospital, Jammu and Kashmir, India

Background: Substance-use related disorders (SUD) are a major public health concern worldwide, especially in developing nations. Currently, it is characterized by high rates of mortality and morbidity. Moreover, through increased utilization of healthcare services, it causes both direct and indirect significant medical expenditures. Objectives: The current study aimed to evaluate the pattern of Substance abuse in the department of psychiatry of a Tertiary Care Hospital, Srinagar, Jammu, and Kashmir, India. Methods: This is a descriptive, cross-sectional, and open study conducted in the psychiatry inpatient department of a tertiary care hospital, Srinagar, Jammu, and Kashmir, India, for 7 months (January to May 2020). Results: Over a period of seven months, a total of 135 participants were recruited (105 males and 30 females). Most of them were Muslim (96.29%), married (68.14%), and living as a nuclear family (75.55%). Tobacco (Nicotine) was the most commonly used substance by those admitted to the psychiatry ward (62.96%), followed by cannabis (11.11%) and opioids (11.11%). The most comorbidity associated with substance abuse was psychiatric disorders (36.84%), followed by neurological disorders (21.05%), and gastrointestinal disorders (7.89%). Among those with psychiatric disorders, 14 (10.37%) had mood (bipolar) disorders. A total of 1129 medicines were prescribed for 135 patients. The mean ± standard error of the mean (SEM) of the prescribed medicines was 8.48 ± 3.3. The average number of drugs per encounter was 8.48%. Conclusions: In this study, cigarette smoking (nicotine) was the most commonly abused substance. It can be justified by the fact that Kashmir is a conflict zone, and many people suffer from the post-traumatic stress disorder. Hence, a collaborated effort is necessary to improve the prescribing pattern and to enhance the rational use of medications for better treatment outcomes.

Pharmaceutical assistance: lawsuits to obtain medication in Sinop-MT

With the support of the Secretaria Municipal de Saúde (Municipal Health Secretariat) until 2018, the court orders regarding the obtainment of medication was assessed descriptively and quantitatively through cross-sectional data, which included all active processes registered in the judicial support sector of the Secretariat, 355 court orders including one or more prescription drugs were analyzed. The processes contained 598 drugs, 57% of the lawsuit authors were female and the medication was targeted to 4-years-old children to 91-years-old. Most legal representatives were public agents, 82% (N=292) of them, and 14% (N=50) were private agents. 52% (N=184) of the prescriptions came from public health establishments, and 27% (N=96) from private establishments. 20% (N=73) of the requests had no medical prescription annexed to the lawsuit. 46% (N=164) of the prescriptions were made by specialized physicians and 32% (N=114) by general practitioners. In 94% (N=333) of the lawsuits, the city or the state were the defenders. Regarding the competence to supply the medication, 75% (N=452) of the solicited medication was not included in any official lists, 8% (N=48) belonged to REMUME (the official municipal medication list), and 8% (N=48) belonged to RESME (the official state list). The results suggest it is possible to see face judicialization as an elite phenomenon, if the official lists of medication supplied by SUS are properly updated and if the number of specialized physicians by prescription is emphasized. However, the lack of information compromises the technical analysis and clarifications necessary to fulfill the claims and to ensure safety, efficiency and rational use of medication. Additionally, the court decision to determine the supply of the drug by means of an injunction is supported only by the prescription or medical report without first consulting a technical team.

Potentially inappropriate medications for the elderly: Incidence and impact on mortality in a cohort ten-year follow-up.

IntroductionPharmacological therapy plays an important role in disease control in the elderly; unfortunately, this comes with a high prevalence in the use of medications classified as potentially inappropriate.ObjectiveTo analyze the incidence, risk factors, and survival of elderly people using potentially inappropriate medications (PIM).MethodA ten-year follow-up assessment of elderly participants residing in a capital of Central Brazil was conducted. The initial assessment (baseline) included 418 elderly people. Data were collected through home interviews guided by a questionnaire covering socioeconomic, demographic, living conditions, and health variables. The medication information obtained comprised active ingredient, dosage, route, and regimen for the medications. The PIMs were classified according to 2019 Beers Criteria. The analyses were performed using STATA 15.0. For survival analysis, a Cox Regression was performed with the respective Kaplan Meier curve.ResultsThe incidence of PIM was 44.1 cases (95% CI: 35.2–54.7) per 1,000 people a year. The most used PIMs were nifedipine, glibenclamide, and sodium diclofenac. The risk factors were polypharmacy (aRR: 3.00; 95% CI: 1.31–6.88) and diabetes mellitus (aRR: 1.57; 95% CI: 1.03–2.39). We identified no statistically significant association between survival and the use of PIM.ConclusionThe study highlights the high consumption of PIM among the elderly causing polypharmacy risks. Health professionals working in drug treatment need to be alert to polypharmacy risks to ensure the rational use of medications to prevent adverse reactions and other health problems.

Developing Core Competencies for Pharmacy Graduates: The Lebanese Experience

Background: In the absence of a national qualification framework for health professionals, the Lebanese Order of Pharmacists (OPL) took the initiative of developing a pharmacy competency framework to standardize pharmacy education in all universities. The objective of this manuscript is to describe the steps that led to the Lebanese Pharmacy Core Competencies Framework. Methods: Based on a primer developed by a group of academic instructors, following international reference documents from different parts of the world, the Academic board appointed by the OPL, reviewed, streamlined, and validated the suggested primer using the Delphi technique over three rounds, to come up with the final framework. Results: The framework encompassed competencies distributed over 7 domains: fundamental knowledge, professional practice, personal skills, supply of medications, safe and rational use of medications, pharmaceutical public health competencies, and organization and management competencies. Its structure was similar to that of the International Pharmaceutical Federation (FIP), with cultural and legal adaptations and the addition of some behaviors related to OPL specific practice and research projects. Conclusion: This work describes the elaboration of the Lebanese Pharmacy Core Competencies Framework, a project considered to be an essential step forward for the profession and a first step toward providing information on human resource planning and professional development of the pharmacy workforce. Instead of adapting existing international educational standards from resource-rich contexts, which may not meet the actual needs of Lebanon, universities can draw our findings to develop relevant programs targeting the skills needed for health workers in Lebanon.

<p>Self-Medication and Associated Factors Among Pregnant Women Attending Antenatal Care at Kemisie General Hospital, North East Ethiopia</p>

IntroductionSelf-medication is an important part of daily self-care, without the supervision of health professionals. It is commonly practiced by pregnant women all over the world and may result in maternal and fetal risks. Hence, this study assessed self-medication practices and associated factors among pregnant women attending Kemisie General Hospital.MethodsA facility-based cross-sectional study was conducted using a structured questionnaire on pregnant women who were attending antenatal care at Kemisie General Hospital. A simple random sampling technique was employed to select the study participants. Descriptive and inferential statistics were computed using the Statistical Package for Social Sciences version 20.ResultsAmong 223 pregnant women, 60 (26.9%; 95% CI: 20.9%, 32.9%) and 111 (48.9%; 95% CI: 43%, 58%) practiced self-medication on conventional and herbal medicine, respectively. The predictors of self-medication of conventional medicine among pregnant women were prior experience to the drug (P-value: 0.00, AOR=126.04, 95% CI: 32.55–488.04) and no pervious history of abortion (P-value: 0.00, AOR=0.01,95% CI:0.002–0.04), while college educational level (P-value: 0.00, AOR=13.45,95%, CI: 3.58–50.5), history prior herbal medicine use (P-value: 0.00, AOR=9, 95% CI: 3.32–24.39), Ruta chalepensis (P-value:0.001,AOR=193.7,95% CI:8.64–4342.1) and Ocimum lamiifolium type of herb use (P-value: 0.004, AOR=12.72, 95% CI: 2.27–71.38), and 5–10km health facility distance (P-value:0.022, AOR=0.1, 95% CI: 0.01–0.73) were predictors for self-medication practice of herbal medicines among pregnant women.ConclusionNearly one-third and two-third of pregnant women practiced self-medication on conventional and herbal medicine, respectively. Prior experience to the drug and no previous history of abortion associated with self-medication of conventional medicine, while college educational level, history prior herbal medicine use, Ruta chalepensis and, Ocimum lamiifolium type of herb use, and 5–10km distance were predictors for self-medication practice of herbal medicines. Improving health service coverage and awareness creation on rational medication use is recommended to prevent fetal and maternal risks.

Community and hospital pharmacists in Europe: encroaching on medicine?

Pharmacy has been historically regarded as a discipline between health and chemistry devoted to drug development, production, and compounding. These tasks have been almost lost with the industrial manufacturing, and dispensing remains the main activity of pharmacists. Hospital pharmacists are usually employees in their workplace, while the professional framework of community pharmacists is very different, being pharmacies predominantly private shops in almost all European countries. In the last years pharmacists have strongly advocated that the focus of their services should switch from ‘product’ to ‘patient’. Clinical pharmacy and pharmaceutical care are the two most cited concepts to support this shift. Clinical pharmacy was originally defined as the area of pharmacy concerned with the science and practice of rational medication use, pharmaceutical care as the responsible provision of drug therapies to achieve definite outcomes. The practice of clinical pharmacy should embrace the philosophy of pharmaceutical care. The new wave of pharmacists’ patient-centered care in Europe still seems to be a reaction against the loss of their traditional professional role after the drug manufacturing revolution. To depict a realistic scenario for progress, it is worth differentiating between hospital and community. Hospital pharmacists should strengthen their pivotal role of medication gatekeepers to improve among clinicians the appropriateness of drug prescriptions and generate savings in expenditures. Any proposal for clinical services provided by community pharmacists is inevitably affected by the issue of their potential remuneration, especially in countries where the remuneration for reimbursable drugs is still a proportion of the retail price.

Use of World Health Organization Indicators to Assess Pharmaceutical Assistance in Primary Health Care: An Integrative Review

<!DOCTYPE html> <html> <head> </head> <body> <p style="text-align: justify;"><strong>Objective:</strong> Synthesize evidence related to the use of World Health Organization indicators to assess Pharmaceutical Assistance in Primary Health Care. <strong>Methods: </strong>The integrative review type research was carried out from 2008 to 2018. The Web of Science, Scopus, LILACS, MEDLINE via PubMed, Virtual Scielo Library, Virtual Health Library databases were used, using the keywords &ldquo; Pharmaceutical Assistance &ldquo;,&rdquo; Primary Health Care &ldquo;and&rdquo; World Health Organization Indicators &ldquo;in Portuguese, Spanish and English. <strong>Results: </strong>1,102 publications were identified. 21 publications were selected that met the inclusion criteria. The most used indicators were those of prescription, present in 20 publications (95.2%), followed by assistance indicators, in eight (38.1%), indicators on the service, in seven (33.3%).The research design was prospective in three (14%) publications, retrospective in eight (38%), retrospective / prospective in one (5%) and the design was not cited in nine (43%). All studies were above the recommended value (&lt;2) for the number of drugs prescribed per prescription and the percentage of drugs prescribed by the generic name, which must be 100% according to the recommended by the World Health Organization. <strong>Conclusion:</strong> It was observed that the group of indicators of rational use of medicines was the most used, overlapping the other indicators of the World Health Organization (access and quality), applied for monitoring and evaluation in the pharmaceutical sector. In general, the indicators used in the studies included in the review did not show satisfactory results in comparison with the values established by the World Health Organization. <p style="text-align: justify;"><strong>Key words:</strong> Evaluation, Drug Policies, Rational use of Medication, Health Status Indicators, Pharmaceutical Services, National Policy of Pharmaceutical Assistance. </body> </html>

Schizo-obsessive presentation in a young girl with DiGeorge syndrome

DiGeorge syndrome (DGS), linked with the deletion of a gene located in chromosome 22-band 22q11, commonly presents with a triad of conotruncal cardiac anomalies, hypoplastic thymus, and hypocalcaemia. DGS is associated with cognitive deficits, neurodevelopmental disorders, and high rates of schizophrenia and anxiety disorders; hence, psychiatrists have an important role in the diagnosis and timely treatment of the disorder. Comorbid Schizophrenia with Obsessive Compulsive Disorder presentation is one of the uncommon ways in which patients might present. The aim of this report is to raise awareness of picking up early sub-threshold features, the need for long term follow up, rational use of medications in atypical presentations, and multi-faceted approach to intervention.

General characteristics, economic burden, causative drugs and medical errors associated with medical damage litigation involving severe cutaneous adverse drug reactions in China.

To investigate the general characteristics, economic burden, causative drugs and medical errors associated with litigation involving severe cutaneous adverse drug reactions (SCADRs) in China, with the aims of improving rational medication use and reducing the extent of damage from SCADRs. This study analysed 150 lawsuit judgements involving SCADRs from 2005 to 2019, collected from China Judgments Online. In total, 50% of lawsuits stemmed from SCADRs occurring in general hospitals. The average time elapsed from the date of occurrence of the SCADRs to the end of litigation procedures was 1055days. Of the patients involved, 51% were female and more than two thirds (69%) were under 60years old. The most common outcome of SCADRs was death (39%), followed by disabilities (30%). The average responsibility of the medical provider was 48±29%. The average amount of compensation was $43424. Of the cases studied, 51% of SCADRs were Stevens-Johnson syndrome or toxic epidermal necrolysis, which together accounted for 75% of cases with known clinical subtype. The overall average economic burden of SCADRs was $99178, of which indirect costs made up the largest proportion (more than 60%). The most common causative drug groups were antimicrobial drugs (49%), Chinese patent medicine and Chinese herbal medicine (17%), and antipyretic analgesics (16%). Finally, 61% of medical errors were found to stem from violation of duty of care, 20% from violation of informed consent and 18% from violations related to the medical record writing and management system. Severe cutaneous adverse drug reactions not only severely affect patient survival and quality of life, but also impose a heavy economic burden in terms of health care and societal costs. Medical providers should be better educated on strategies to reduce risk to patients and establish mechanisms of risk sharing and management.

PRESCRIBING TREND AMONG HOSPITALIZED PEDIATRIC PATIENTS IN PRIVATE SECTOR HOSPITAL: A PROSPECTIVE OBSERVATIONAL STUDY IN NADIAD, INDIA

Objectives: Purpose of this study was to analyze the prescription pattern among the hospitalized pediatric patients in private sector hospital.&#x0D; Methods: The study was conducted from January 2018 to April, 2018 at Shaishav Hospital, Nadiad, Gujarat, India, and 178 patients were included into the study. Results were obtained by applying the World Health Organization (WHO) prescribing indicators as well as Indian Academy of Pediatrics List of Essential Medicines (IAP-LEM).&#x0D; Results: During the study period, infectious disease such as pneumonitis, bronchitis, enteric fever, gastroenteritis, and dehydration were the dominant disease among the patients. Average number of drugs per prescription was four but in many of prescription, poly-pharmacy has shown. Antibiotic agents were the most prescribed drug (38.6%) among different classes of drugs. Use of the parenteral route of drug administration was used beyond the range stated by the WHO (59% prescriptions vs. 13–24% WHO range). We found that doctor followed IAP-LEM (in 99.78% cases) for prescribing as well as for dosing also, which was very impressive.&#x0D; Conclusions: As this study indicates, there is a need of development of evidence-based treatment protocols for common disease condition for the rational use of medication, especially for an antibiotic medication.

Evaluation of Medication Use Pattern Among Patients Presenting to the Emergency Department of Hiwot Fana Specialized University Hospital, Using WHO Prescribing Indicators.

BackgroundEnsuring rational drug use requires ongoing evaluation of drug prescribing, dispensing, and use by patients. Health care providers working in an emergency department face unique challenges, including making urgent decisions, patient overload, and limited resources, which contribute to inappropriate drug use. Rational medication use should be an important aspect of emergency care to improve patient outcomes. Thus, this study was conducted to assess medication utilization patterns using World Health Organization (WHO) prescribing indicators in the emergency department.MethodsA cross-sectional study design was implemented among patients presenting at the emergency department of Hiwot Fana Specialized University Hospital (HFSUH) from January to March 2018. The data were collected from the medical charts of a total of 342 patients using a pre-prepared structured format according to WHO recommendations. The data were analyzed using SPSS version 21 software and presented in tables and figures.ResultsThe most commonly reported clinical diagnosis was found to be soft tissue laceration or abrasion, in 75 patients (21.9%), followed by dyspepsia, in 50 (14.6%), and severe pneumonia, in 44 (12.9%). A total of 810 drugs were prescribed for the 342 patients. The main category of drugs prescribed were analgesics, constituting 125 (29.2%), followed by antibiotics, 120 (28.0%). Regarding WHO prescribing indicators, the average number of drugs prescribed per encounter was 2.36, the number of encounters at which antibiotics were prescribed was 127 (37.13%), and injections were prescribed at 300 (87.7%) encounters. All of the drugs prescribed were from the National Essential Medicine List (NEML) of Ethiopia, and 780 (98.1%) of the drugs were prescribed by international nonproprietary name.ConclusionOverall, there were inflated use of antibiotics and injection drugs, whereas prescribing by international nonproprietary name and prescribing from NEML were according to the recommendations. Hence, the hospital should work to ensure the judicious use of antibiotics and injection drugs.

Assessment of the utilization pattern of chemotherapy agents in patients with head and neck cancer in an oncology hospital

The prevalence of head and neck cancers (HNC) is increasing in developing countries, and its pharmacotherapy has become complex. Evaluation of drug utilization patterns (DUPs) of chemotherapy agents is needed to ascertain the rational use of medications in HNC. The aim was to evaluate the DUPs of chemotherapy agents in patients with HNC in an oncology unit. This prospective observational study was designed to review chemotherapy orders for patients with HNC and assess DUPs over a period of 2 years. Cancer patients aged > 18 years who were receiving chemotherapy together with supportive care medications were enrolled. A total of 208 patients met inclusion criteria and were enrolled in the study. The majority of patients were aged 45–75 years (64.4%), were male (81.3%), and used tobacco (54.9%). The most common sites of HNC were pyriform fossa (18.3%), tongue (17.8%), buccal mucosa (13.9%), and tonsils (10.6%). The majority of patients had head and neck squamous cell carcinoma (HNSCC) [93.3%] and were in stage III (32.2%) or stage IV (48.5%). Neoadjuvant chemotherapy (51%) followed by adjuvant chemotherapy (41.4%) were frequently prescribed. Chemotherapy agents prescribed in > 25% of patients included cisplatin (68.8%), paclitaxel (43.8%), and carboplatin (29.8%); supportive care drugs prescribed in > 25% of patients included dexamethasone (51%), metoclopramide (44.2%), chloramphenicol (39.4%), and pantoprazole (27.9%). Platinum analogs and taxanes were highly prescribed chemotherapy agents as they are highly effective in HNSCC. To prevent chemotherapy-induced cytotoxicity, supportive care agents, such as anti-emetics, proton pump inhibitors, anti-infective agents, and colony-stimulating factors, were used along with miscellaneous supplements.

Retrospective assessment of acute poisoning incidents by pharmaceutical agents in Jordan: Data from Pharmacy One™ Poison Call Center, 2014 to 2018-Part II.

Poison control centers provide surveillance data that can be used to estimate the magnitude of poisoning cases and the level of public awareness and to evaluate control measures. The aim of this study is to describe the drug‐related poisoning queries received by the Pharmacy One™ Poisoning Call Center (P1PCC) in Jordan. This is a retrospective descriptive study of the acute drug‐related poisoning incidents in the Jordanian population recorded by the P1PCC during the 2014‐2018 period. The inquiries received were recorded on a predesigned form. The demographic data, including the age and the sex of the patient, the route of and reason for exposure and the drug therapeutic groups, in addition to medical outcomes, were extracted utilizing computerized Oracle and Excel spreadsheets. During the period of evaluation, 900 drug‐related poisoning incidents were reported to the P1PCC. The majority of calls (48.5%) were received via 911, followed by the public (48.56%) and healthcare professionals (27.1%). More than half of the poisoning incidents were recorded among males (52.5%). Adults were the most affected group (40.5%), followed by children (34.0%). Unintentional exposure was the most common cause of poisoning (58.6%), followed by suicide attempts (25.3%). Nonsteroidal anti‐inflammatory drugs and paracetamol caused the majority of the reported cases. Poisoning incidents were mainly classified as mild to moderate (56.1%), while only 16.6% were severe. The P1PCC has demonstrated an important and vital role in improving patient safety and providing education on rational drug use. Reflections on these data can be used to increase public awareness in promoting the rational use of medications among Jordanian citizens.