Journal articles on the topic 'Drugs Prescribing Data processing'
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Colling, Craig, Christoph Mueller, Gayan Perera, Nicola Funnell, Justin Sauer, Daniel Harwood, Robert Stewart, and Delia Bishara. "‘Real time’ monitoring of antipsychotic prescribing in patients with dementia: a study using the Clinical Record Interactive Search (CRIS) platform to enhance safer prescribing." BMJ Open Quality 9, no. 1 (March 2020): e000778. http://dx.doi.org/10.1136/bmjoq-2019-000778.
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BackgroundThe use of antipsychotic drugs in dementia has been reported to be associated with increased risk of cerebrovascular events and mortality. There is an international drive to reduce the use of these agents in patients with dementia and to improve the safety of prescribing and monitoring in this area.ObjectivesThe aim of this project was to use enhanced automated regular feedback of information from electronic health records to improve the quality of antipsychotic prescribing and monitoring in people with dementia.MethodsThe South London and Maudsley NHS Foundation Trust (SLaM) incorporated antipsychotic monitoring forms into its electronic health records. The SLaM Clinical Record Interactive Search (CRIS) platform provides researcher access to de-identified health records, and natural language processing is used in CRIS to derive structured data from unstructured free text, including recorded diagnoses and medication. Algorithms were thus developed to ascertain patients with dementia receiving antipsychotic treatment and to determine whether monitoring forms had been completed. We used two improvement plan-do-study-act cycles to improve the accuracy of the algorithm for automated evaluation and provided monthly feedback on team performance.ResultsA steady increase in antipsychotic monitoring form completion was observed across the study period. The percentage of our sample with a completed antipsychotic monitoring form more than doubled from October 2017 (22%) to January 2019 (58%).Conclusion‘Real time’ monitoring and regular feedback to teams offer a time-effective approach, complementary to standard audit methods, to enhance the safer prescribing of high risk drugs.
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Walker, Lauren E., Aseel S. Abuzour, Danushka Bollegala, Andrew Clegg, Mark Gabbay, Alan Griffiths, Cecil Kullu, et al. "The DynAIRx Project Protocol: Artificial Intelligence for dynamic prescribing optimisation and care integration in multimorbidity." Journal of Multimorbidity and Comorbidity 12 (January 2022): 263355652211454. http://dx.doi.org/10.1177/26335565221145493.
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Background Structured Medication Reviews (SMRs) are intended to help deliver the NHS Long Term Plan for medicines optimisation in people living with multiple long-term conditions and polypharmacy. It is challenging to gather the information needed for these reviews due to poor integration of health records across providers and there is little guidance on how to identify those patients most urgently requiring review. Objective To extract information from scattered clinical records on how health and medications change over time, apply interpretable artificial intelligence (AI) approaches to predict risks of poor outcomes and overlay this information on care records to inform SMRs. We will pilot this approach in primary care prescribing audit and feedback systems, and co-design future medicines optimisation decision support systems. Design DynAIRx will target potentially problematic polypharmacy in three key multimorbidity groups, namely, people with (a) mental and physical health problems, (b) four or more long-term conditions taking ten or more drugs and (c) older age and frailty. Structured clinical data will be drawn from integrated care records (general practice, hospital, and social care) covering an ∼11m population supplemented with Natural Language Processing (NLP) of unstructured clinical text. AI systems will be trained to identify patterns of conditions, medications, tests, and clinical contacts preceding adverse events in order to identify individuals who might benefit most from an SMR. Discussion By implementing and evaluating an AI-augmented visualisation of care records in an existing prescribing audit and feedback system we will create a learning system for medicines optimisation, co-designed throughout with end-users and patients.
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Bizuneh, Gizachew Kassahun, Betelhem Anteneh Adamu, Getenet Tadege Bizuayehu, and Solomon Debebe Adane. "A Prospective Observational Study of Drug Therapy Problems in Pediatric Ward of a Referral Hospital, Northeastern Ethiopia." International Journal of Pediatrics 2020 (March 21, 2020): 1–6. http://dx.doi.org/10.1155/2020/4323189.
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Background. A drug therapy problem is any undesirable event experienced by a patient during drug therapy that interferes with achieving the desired goals of therapy. It has been pointed out that hospitalized pediatric patients are particularly prone to drug-related problems. Identifying drug therapy problems enables risk quantification and determination of the potential impact of prevention strategies. The purpose of this study was to assess the drug therapy problems in a pediatric ward of Dessie Referral Hospital, northeast of Ethiopia, and to identify associated factors for drug therapy problems. Methods. A prospective observational study design was carried out to assess drug therapy problems in a pediatric ward of Dessie Referral Hospital from February 1, 2018, to May 30, 2018. Ethical approval was obtained, and informed consent was signed by each study participant’s parent before the commencement of the study. All patients admitted to the ward during the study period were included in the study. Data was collected by trained pharmacy staffs through medical record reviews of patients using a prepared standard checklist and semistructured questionnaire. The collected data were cleared and checked every day for completeness and consistency before processing. Data were entered, and descriptive statistical analysis was done using SPSS Version 20 Software. A P value of less than 0.05 was considered significant. Results. The participants’ mean age was 2.32 years with the standard deviation (SD) of 0.76 years. Among 81 patients, 71 (87.7%) of them had at least one drug therapy problem per patient which indicates that the prevalence of the drug therapy problem was substantially high. Needs additional drug was the most predominantly encountered drug therapy problem accounted (30 (25.2%)). On the other hand, ineffective drug was the least (3 (2.5%)) drug therapy problem. Antibiotics (47 (39.5%)) followed by fluid and electrolyte (25 (21%)) were classes of drugs mostly involved in the drug therapy problem. The main risk factors reported to the occurrence of the drug therapy problems were prescribing and dose calculation errors. Conclusion. The present study revealed that majority of the patients had at least one DTP per patient; this indicates that prevalence of DTP was very high in the study area. Needs additional drug therapy followed by noncompliance was the major cause of the occurrence of DTP. Antibiotics were the main class of drugs involved in the drug therapy problem, and among the risk factors assessed, prescribing and dose calculation errors showed statistical significance.
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Herigon, Joshua C., Amir Kimia, and Marvin Harper. "1358. Using natural language processing to optimize case ascertainment of acute otitis media in a large, state-wide pediatric practice network." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S690—S691. http://dx.doi.org/10.1093/ofid/ofaa439.1540.
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Abstract Background Antibiotics are the most commonly prescribed drugs for children and frequently inappropriately prescribed. Outpatient antimicrobial stewardship interventions aim to reduce inappropriate antibiotic use. Previous work has relied on diagnosis coding for case identification which may be inaccurate. In this study, we sought to develop automated methods for analyzing note text to identify cases of acute otitis media (AOM) based on clinical documentation. Methods We conducted a cross-sectional retrospective chart review and sampled encounters from 7/1/2018 – 6/30/2019 for patients < 5 years old presenting for a problem-focused visit. Complete note text and limited structured data were extracted for 12 randomly selected weekdays (one from each month during the study period). An additional weekday was randomly selected for validation. The primary outcome was correctly identifying encounters where AOM was present. Human review was considered the “gold standard” and was compared to ICD codes, a natural language processing (NLP) model, and a recursive partitioning (RP) model. Results A total of 2,724 encounters were included in the training cohort and 793 in the validation cohort. ICD codes and NLP had good performance overall with sensitivity 91.2% and 93.1% respectively in the training cohort. However, NLP had a significant drop-off in performance in the validation cohort (sensitivity: 83.4%). The RP model had the highest sensitivity (97.2% training cohort; 94.1% validation cohort) out of the 3 methods. Figure 1. Details of encounters included in the training and validation cohorts. Table 1. Performance of ICD coding, a natural language processing (NLP) model, and a recursive partitioning (RP) model for identifying cases of acute otitis media (AOM) Conclusion Natural language processing of outpatient pediatric visit documentation can be used successfully to create models accurately identifying cases of AOM based on clinical documentation. Combining NLP and structured data can improve automated case detection, leading to more accurate assessment of antibiotic prescribing practices. These techniques may be valuable in optimizing outpatient antimicrobial stewardship efforts. Disclosures All Authors: No reported disclosures
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Gumułka, Paweł, Joanna Żandarek, Monika Dąbrowska, and Małgorzata Starek. "UPLC Technique in Pharmacy—An Important Tool of the Modern Analyst." Processes 10, no. 12 (November 24, 2022): 2498. http://dx.doi.org/10.3390/pr10122498.
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In recent years, ultra-efficient liquid chromatography (UPLC) has gained particular popularity due to the possibility of faster separation of small molecules. This technique, used to separate the ingredients present in multi-component mixtures, has found application in many fields, such as chemistry, pharmacy, food, and biochemistry. It is an important tool in both research and production. UPLC created new possibilities for analytical separation without reducing the quality of the obtained results. This technique is therefore a milestone in liquid chromatography. Thanks to the increased resolution, new analytical procedures, in many cases, based on existing methods, are being developed, eliminating the need for re-analysis. Researchers are trying to modify and transfer the analytical conditions from the commonly used HPLC method to UPLC. This topic may be of strategic importance in the analysis of medicinal substances. The information contained in this manuscript indicates the importance of the UPLC technique in drug analysis. The information gathered highlights the importance of selecting the appropriate drug control tools. We focused on drugs commonly used in medicine that belong to various pharmacological groups. Rational prescribing based on clinical pharmacology is essential if the right drug is to be administered to the right patient at the right time. The presented data is to assist the analyst in the field of broadly understood quality control, which is very important, especially for human health and treatment. This manuscript shows that the UPLC technique is now an increasingly used tool for assessing the quality of drugs and determining the identity and content of active substances. It also allows the monitoring of active substances and finished products during their processing and storage.
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Kinderbaeva, N. K., K. Bazira, N. M. Karabekova, R. M. Mamatova, Zh Asel, A. K. Nartaeva, and S. M. Mamatov. "Analysis of antithrombotic therapy in elderly patients with nonvalvular atrial fibrillation in the Kyrgyz Republic and ways to increase treatment adherencе." Kazan medical journal 102, no. 4 (August 8, 2021): 439–45. http://dx.doi.org/10.17816/kmj2021-439.
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Aim. To analyze anticoagulant therapy in elderly patients with non-valvular atrial fibrillation and ways to increase adherence in the work of a specialized team.
Methods. The study followed 250 patients with non-valvular atrial fibrillation aged 65 to 74 years (mean age 70.74.39 years). The patients were divided into three groups: the first group included 105 people, who were prescribed warfarin in a retrospective study; the second group 57 people treated with rivaroxaban, and the third group 88 people treated with warfarin. The second and third groups were prospective study groups which were supervised by a specialized team of physicians. The groups were matched on sex and age, comorbidities. Statistical data analysis and mathematical processing were performed by using the methods of descriptive and variational statistics. Most parameters reported as absolute values and percentages, while quantitative data the 25th and 75th percentiles.
Results. All patients included in the study had a high risk of developing thromboembolic complications by their CHA2DS2-VASc score (2) and a low risk of developing hemorrhagic complications on the HAS-BLED scale (average score 1.490.04). They were prescribed anticoagulant therapy. By the end of the year follow-up from the start of anticoagulant therapy, only 9.5% of patients were treatment adherent, in the second group 43.8%, in the third group 70.5% of patients. The reason for refusing to take warfarin in the vast majority of cases was the inability to control the international normalized ratio, medical contraindications, and the high cost of the drug in prescribing rivaroxaban. The results showed that the majority of patients with atrial fibrillation (90.5%) receive inadequate antithrombotic therapy in routine outpatient clinical practice. At the same time, in a very small number of patients (9.5%) receiving warfarin, this type of therapy can be considered adequate (60% or more of the stay time in the therapeutic range of international normalized ratio of 2.0 to 3.0).
Conclusion. Anticoagulant therapy prescription under the supervision of a specialized team contributes to a significant improvement in treatment adherence (from 43.8 to 70.5%); promising in the future is the use of drugs from the group of new oral anticoagulants that do not require routine monitoring of coagulogram.
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Лысенко, О. В. "Comparative Efficacy of Various Forms of Estrogen-Containing Drugs for Endometrial Preparation During Frozen Embryo Transfer in Protocols with Hormone Replacement Therapy." Репродуктивное здоровье. Восточная Европа, no. 3 (August 18, 2022): 356–63. http://dx.doi.org/10.34883/pi.2022.12.3.007.
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Цель. Сравнить эффективность, удобность в использовании, финансовые затраты при применении эстрогенсодержащих лекарственных средств в протоколах переноса размороженных эмбрионов.Материалы и методы. Под нашим наблюдением находилось 114 женщин репродуктивного возраста в протоколах переноса размороженных эмбрионов с заместительной гормонотерапией. Первую группу составили 29 женщин, которым назначено эстрогенсодержащее лекарственное средство в таблетках, вторую – 25 пациенток, которые использовали гель трансдермальный в тубах, третью – 31 женщина, использовавшая гель для наружного применения в саше, в четвертую группу вошли 30 пациенток, которым был назначен спрей во флаконах с насосом.Всем женщинам было произведено трансвагинальное ультразвуковое исследование в 2D-режиме при старте протокола и через 10 дней от начала применения эстрогенов.Статистическая обработка данных осуществлялась с применением программного пакета Statistica 6.0. Во всех случаях критическое значение уровня значимости принималось р<0,05 (5%).Результаты. Стартовый ультразвуковой мониторинг проводился со 2-го по 5-й день менструального цикла для исключения патологии органов малого таза и беременности. Следующий ультразвуковой мониторинг проводили на 10-й день стандартной гормонотерапии эстрогенами. Терапию считали достаточной, если толщина эндометрия достигла не менее 8 мм, но не более 14 мм. Установлено, что эффективность эстрогенсодержащих лекарственных средств с точки зрения толщины эндометрия сопоставима. Но наиболее приемлемо с точки зрения цены применение спрея во флаконах с насосом. При наименьшей стоимости одного флакона спрея при назначении эквивалентной дозы его хватает на 2 недели в сравнении с 7-8-9 днями при использовании таблеток, геля трансдермального в тубах, геля в саше.Заключение. При одинаковой эффективности с другими лекарственными средствами предпочтительно применение спрея с насосом, учитывая удобство в использовании и наименьшую цену лекарственного средства при наибольшей длительности применения. Purpose. To compare the efficiency, ease of use, and financial costs of using estrogen- containing drugs in frozen embryo transfer protocols.Materials and methods. We examined a total of 114 cases – women of reproductive age in the frozen embryo transfer protocols with hormone replacement therapy. The first group consisted of 29 women who used the estrogen-containing drug in tablets, the second – 25 patients who used the transdermal gel in tubes, the third – 31 women who used the gel for external use in sachets, the fourth group included 30 patients who used a spray in pump bottles.All women underwent 2D-transvaginal ultrasound at the start of the protocol and 10 days after the start of estrogen use.Statistical data processing was carried out using the Statistica 6.0 software package. In all cases, the critical significance level was taken as p<0.05 (5%).Results. To exclude the pathology of the pelvic organs and pregnancy starting ultrasound monitoring was carried out from the 2nd to the 5th day of the menstrual cycle. The next ultrasound monitoring was performed on the 10th day of standard estrogen hormone therapy. Therapy was considered sufficient if the thickness of the endometrium reached at least 8 mm, but not more than 14 mm. We have established that the effectiveness of estrogen-containing drugs in terms of endometrial thickness is comparable. But the most acceptable in terms of price is the use of a spray in bottles with a pump. At the lowest cost of one bottle of spray when prescribing an equivalent dose, it lasts for 2 weeks compared to 7-8-9 days when using tablets, transdermal gel in tubes, gel in a sachet.Conclusion. With the same efficiency as other drugs, it is preferable to use a spray with a pump, given the ease of use and the lowest price of the drug for the longest duration of use.
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Qaiser, Aimen, Zahra Hassan Kiani, Farina Abid, Tania Pervaiz, and Zafar Iqbal. "Evaluation of Prescribing Pattern in Mirpur Azad Kashmir using who Prescribing Indicators." Global Pharmaceutical Sciences Review V, no. I (December 30, 2020): 17–24. http://dx.doi.org/10.31703/gpsr.2020(v-i).03.
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Promotion of rational use of drugs in developing countries is necessary for improving the quality of life. Therefore, evaluation of drug use pattern using World Health Organization (WHO) indicators is necessary for assessment of rational use of drugs. 200 prescriptions were randomly collected from different pharmacies in Mirpur and evaluated to measure prescribing indicators. Data was analyzed using SPSS (version 25). Average count of drugs prescribed per prescription was 3.8 (S.D+ 2.01). Percentage of antibiotics prescribed, and injections prescribed per prescription was 42% (n=84) and 16% (n=32) respectively. The percentage of drugs prescribed from Essential Drugs List was 90.5%. It was concluded that prescribing pattern was far away from the standard WHO requirements. Greater number of drugs and overuse of antibiotics focused on close monitoring and regulation of prescribing pattern. Steps should be taken to encourage the rational use of drugs to improve the quality of life.
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Brodie, Martin J., and Ian Harrison. "Practical prescribing." Drug and Therapeutics Bulletin 25, no. 20 (October 5, 1987): 80. http://dx.doi.org/10.1136/dtb.25.20.80.
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This book is a practical manual for the prescriber rather than a text book. The first chapter usefully explains pharmacological terms which are used later in the book. This is followed by three sections concerned with choosing drugs. The first section gives a list of ‘best buys’ for common complaints, the second looks at treatment policies and the third gives basic pharmacological information to help in making choices. Side-effects and drug interactions are presented in the next two chapters in a readily accessible form. The final chapter, called ‘Cautions,’ has some useful information not readily found elsewhere including data on teratogenesis and shelf-life of formulations. It also suggests which drugs we should stop using, and discusses factors to consider before using a new drug.
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Bruck, P., C. A. Antao, and J. A. Henry. "Generic Prescribing of Antidepressants." Journal of the Royal Society of Medicine 85, no. 11 (November 1992): 682–85. http://dx.doi.org/10.1177/014107689208501109.
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Analysis of National Health Service prescription data for the antidepressants from 1980 to 1989 shows a consistent secular trend towards the increased use of generic names on prescriptions for this group of drugs. This apparently reflects national trends for all drugs, and was similar for most antidepressants. However, generic prescribing had by 1989 increased significantly more rapidly with fluvoxamine, which was introduced in 1987. The two drugs introduced in 1989, fluoxetine and amoxapine, also had a high generic prescribing rate in their year of introduction. Incrased generic prescribing may become a feature with further new drugs. However, the use of the generic name on the prescription has relatively little influence on what is dispensed to the patient. Pharmacists may dispense a brand name when given a generic prescription. Moreover, pressures on doctors to write generic names on prescriptions may have limited relevance for some drugs; generic alternatives were available for only four out of 22 antidepressants.
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Fomina, Daria S., Olga A. Mukhina, Marina S. Lebedkina, Mirada K. Gadzhieva, Elena N. Bobrikova, Dmitry O. Sinyavkin, Vasiliy V. Parshin, Anton A. Chernov, and Andrey S. Belevskiy. "Analysis of predictors of response to anti-IgE therapy in patients with severe atopic bronchial asthma in real clinical practice." Terapevticheskii arkhiv 94, no. 3 (March 15, 2022): 413–19. http://dx.doi.org/10.26442/00403660.2022.03.201437.
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Introduction. Guidelines on Biological Therapy for Bronchial Asthma of the European Academy of Allergy and Clinical Immunology (EAACI) identified a number of controversial issues for additional outcome analysis using randomized clinical trials and data from routine clinical practice. In particular, there is unmet need to clarify algorithms for prescribing biologicals using predictors of response and its timing, taking into account risk factors and multimorbidity. Omalizumab is a recombinant humanized monoclonal anti-IgE antibody of IgG1 class used for the treatment of severe refractory atopic bronchial asthma (BA) and a variety of IgE-mediated diseases. Among biological agents, this "pioneer molecule" has the greatest experience in the "allergology and immunology" profile. Detailed description of the "nonresponders" portraits will allow to perform the therapy response assessment on time and facilitate rational planning of individual therapy, which is a prerequisite for biologicals era. Using only routine methods, it is possible to perform initial and dynamic screening to phenotype a heterogeneous cohort of patients with severe asthma and chose the optimal strategy.
Aim. To identify predictors of nonresponse to omalizumab anti-IgE therapy in patients with severe atopic BA and to establish optimal timing of efficacy assessment using retrospective analysis of data from the Biologic Therapy Registry of Allergology and Immunology in routine clinical practice.
Materials and methods. A retrospective single-center registry study was conducted at the Allergy and Immunology Reference Center from June 2017 to August 2021. 135 patients with severe BA, with confirmed perennial sensitization, who received omalizumab according to the recommendations of the current version of GINA, were selected from the clinical and dynamic observational system (registry). Dosing regimen and administration frequency of omalizumab were determined in accordance with the instructions for the drug. Assessment of therapy efficacy was performed at the time point 4, 6 and 12 months. Patients were subgrouped into "responders" and "non-responders" according to the following criteria: ACT score less than 19 and/or difference between initial ACT score in dynamics less than 3 points; forced expiratory volume in the first second less than 80%; combination of these two criteria. Nonparametric methods of descriptive statistics were used in data processing: median, interquartile range. Differences were considered significant at p0.05. MannWhitney U-test, KruskalWallis one-way analysis of variance, and Fisher's 2 test were used to compare quantitative characteristics.
Results. Heterogeneous subgroups of patients differing in reaching the criteria of "non-responders" to treatment were identified; the informativity of modifiable and unmodifiable factors differed at time-points of dynamic observation. In the differential analysis, two profiles of "nonresponders" were defined in combination with the most significant predictors of "nonrsponse" to omalizumab. According to the data obtained, one of the clinical phenotypes, namely the combination of severe asthma with the Samters triad, corresponded to the characteristics of the patient "nonresponders": age of onset is about 30 years, females, severe exacerbations of BA while taking non-steroidal anti-inflammatory drugs, accompanied with high levels of eosinophilia.
Conclusion. The data obtained illustrates the hypothesis of pathogenetic heterogeneity of severe BA with the phenomenon of overlapping phenotypes and can serve as an additional orienteer for creating the individual plan of anti-IgE therapy in real clinical practice.
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S, Abhilash, Rashmi R. Rao, and Sivaguha Yadunath P. "ASSESSMENT OF PRESCRIBING PATTERN AMONG ORTHOPEDIC IN-PATIENTS USING WHO PRESCRIBING INDICATORS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 12 (December 7, 2018): 505. http://dx.doi.org/10.22159/ajpcr.2018.v11i12.28855.
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Objective: Evaluating the prescribing indicators regularly help to monitor the prescriptions to reduce indiscriminate use of drugs. The present study was conducted to explore the prescribing pattern in orthopedic in-patients using the WHO prescribing indicators in a tertiary care teaching hospital, Mangalore.Methods: Data was collected from case records of orthopedic in-patients regarding patient demographics, diagnosis, and details of drugs in a structured pro forma and analyzed for the WHO prescribing indicators using descriptive statistics. Values are expressed as mean ± standard deviation, percentages as applicable.Results: A total of 379 patient prescriptions were included in the study which consisted of 2195 drugs. Of the 379 patients, 221 (58.3%) were male and 158 (41.7%) were female. The mean age group of the patients was 44 years. Acute trauma such as fractures, tendon damage, and disc prolapse (57.8%) were the most common indications for admission. Analgesics were the most commonly prescribed group of drugs comprising 27.28% of the prescriptions followed by multivitamins (20.68%) and proton-pump inhibitors (17.12%). The most commonly prescribed analgesic was nonsteroidal anti-inflammatory drugs (86.81%). Most of the drugs (65.80%) were administered through the oral route and 40.31% of drugs were fixed-dose combinations. The mean number of drugs per prescription was 5.79± 2.59. Antibiotics were prescribed in 60.4% of the prescriptions. 76.3% of prescriptions were with injectables. Use of drugs by generic name was 7.7% and only 44% of drugs were from the national list of essential medicines 2015.Conclusion: The study provides an insight into the prescribing pattern in orthopedic in-patients. It highlights the importance of emphasizing rational drug prescribing and toward improving awareness of the physicians and medical students to the WHO recommended standards on prescribing indicators.
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Yimenu, Dawit Kumilachew, Abdurazak Emam, Endilik Elemineh, and Wagaye Atalay. "Assessment of Antibiotic Prescribing Patterns at Outpatient Pharmacy Using World Health Organization Prescribing Indicators." Journal of Primary Care & Community Health 10 (January 2019): 215013271988694. http://dx.doi.org/10.1177/2150132719886942.
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Background: Overuse of antibiotics is a common problem in health care, which leads to unnecessary expenditure on drugs, raised risk of adverse reactions, and the development of antimicrobial resistance. Inappropriate prescribing habits lead to ineffective and unsafe treatment, worsening of disease and increment of health care costs. The aim of this study was to assess antibiotic prescribing patterns using World Health Organization prescribing indicators at the outpatient Pharmacy Department of University of Gondar referral hospital, Gondar, Northwest Ethiopia. Methods: A retrospective cross-sectional study was conducted. One-year prescription data was collected from prescription and prescription registration books retained at the pharmacy store. World Health Organization/International Network of Rational Use of Drugs prescribing indicators were utilized to measure rational use of drugs with due focus on antibiotics prescribing patterns. The collected data was analyzed using SPSS version 20. Results and Discussion: A total of 968 drugs were prescribed from 600 patient encounters. The average number of drugs per encounter was 1.6. The percentage of encounters in which an antibiotics and injections were prescribed was 69.7% and 6.3% respectively. Amoxicillin (28.5%) followed by ciprofloxacin (12%) and metronidazole(11.1%) were the most commonly prescribed antibiotics. The percentage of drugs prescribed from essential drugs list and by generic name was 95.3% and 96%, respectively. Rate of antibiotics prescribing showed deviation from the standard recommended by World Health Organization whereas polypharmacy, injectable prescribing pattern, uses of brand names, and prescription of drugs from the National Essential Drugs List were not found to be a significant problem though there were slight deviations from the standard. Conclussion: Interventions aimed at improving the antibiotic prescribing patterns need to be implemented so as to prevent the inappropriate use of antibiotics and avoid further complications.
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Hadi Al Tukmagi, Haydar Fakhri. "Prescribing Pattern and Rational use of Drugs in Al-Basrah Governorate Retail Pharmacies, Iraq." Al Mustansiriyah Journal of Pharmaceutical Sciences 13, no. 1 (June 1, 2013): 147–54. http://dx.doi.org/10.32947/ajps.v13i1.192.
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This study was designed to investing the drug prescribing pattern, the important factor to determine the rational or irrational use of drugs among patients dispensing their prescriptions from the private pharmacies in Al-Basrah governorate, Iraq for a period of 1 month.The data collected from prescriptions were calculated and analyzed according to the WHO prescribing guidelines.The data showed that the mean of drugs included in single prescription was 4%, and 13% of prescribed drugs were written as generic names; moreover, the percentage of antibiotics,corticosteroids and anxiolytics were 45.7%, 12% and 19.3% respectively. Those results indicate the irrationality of prescribing drugs when compared with the world health organization standard values of prescribing indicators; in addition to the bad prescribing pattern regardless of the degree of specialization of the physician, were 61% of those prescriptions have been written by specialized physicians.In conclusion, actual intervention and follow up, training on rational use of drugs and intervention strategies for prescribers is required to improve the rational use of drugs.
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van Dijk, Karen N., Lisa G. Pont, Corinne S. de Vries, Maria Franken, Jacobus RBJ Brouwers, and Lolkje TW de Jong-van den Berg. "Prescribing Indicators for Evaluating Drug Use in Nursing Homes." Annals of Pharmacotherapy 37, no. 7-8 (July 2003): 1136–41. http://dx.doi.org/10.1345/aph.1c073.
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OBJECTIVE: To evaluate drug use in 2 Dutch nursing homes (254 residents) by developing and evaluating prescribing indicators based on pharmacy prescription data. METHODS: We evaluated the prescribing of benzodiazepines, nonsteroidal antiinflammatory drugs (NSAIDs), ulcer-healing drugs, and diuretics. Prescribing indicators were used to identify prescribing that was potentially not in line with recommendations in national and regional prescribing guidelines. We used both descriptive indicators, such as the number and percentage of users, and indicators reflecting potentially suboptimal prescribing, such as use of drugs outside the regional drug formulary, use of >1 drug from the same drug class, and prescription of drug dosages above recommended values. When potentially suboptimal prescribing was found, we verified the findings by means of an interview with 1 of the prescribers. RESULTS: The prescribing indicators we assessed were generally in agreement with national and regional guidelines. However, prescribing of NSAIDs without concomitant prescribing of gastroprotective drugs was found in a relatively high number of patients. After prescriber interview and patient chart review, it was found that some prescribing indicators, such as dosages above recommended values, were not always indicative for suboptimal prescribing. CONCLUSIONS: This pilot study showed that prescribing indicators based solely on pharmacy prescription data can be a useful tool to evaluate drug prescribing. With some of these prescribing indicators, we identified cases of potentially suboptimal prescribing. However, with other indicators such as those based on drug dosages, we could not identify suboptimal prescribing, and clinical information from the prescriber was necessary to get insight into the appropriateness of prescribing.
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Movig, Kris LL, Antoine CG Egberts, Albert W. Lenderink, and Hubert GM Leufkens. "Selective Prescribing of Spasmolytics." Annals of Pharmacotherapy 34, no. 6 (June 2000): 716–20. http://dx.doi.org/10.1345/aph.19267.
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BACKGROUND: Daily clinical practice often differs largely from the clinical trial setting, so extrapolation of outcomes from trial data, such as safety, effectiveness, and economic outcomes, can be deceptive. Prescribers may intend to treat a selected group of patients with new drugs; this practice could result in significant bias in assessing outcomes of these agents during their use in daily clinical practice. OBJECTIVE: To evaluate what type of patient received tolterodine compared with the spasmolytic drugs previously marketed (oxybutynin, flavoxate, emepronium). DESIGN: An observational, follow-up study. SETTING: Eighteen collaborating community pharmacies. PATIENTS: Aged ≥18 years, noninstitutionalized; initial therapy with tolterodine, oxybutynin, flavoxate, or emepronium. RESULTS: Tolterodine was often used as a second-line and even as a third-line treatment, and was prescribed to a “polluted” population in terms of concomitant psychotropic medication. Tolterodine users were 7.5 times more likely to have received another spasmolytic drug (RR 7.5, 95% CI 4.8 to 11.9). In addition, these patients more frequently used antiparkinsonian drugs (RR 4.1, 95% CI 1.6 to 10.4) as well as antipsychotic drugs (RR 2.9, 95% CI 1.4 to 6.2). There was a small difference in concomitant use of antidepressants and benzodiazepines between patients receiving tolterodine versus those taking other spasmolytic drugs. CONCLUSIONS: Tolterodine is prescribed for a population differing from that receiving previously marketed spasmolytic drugs. Selective prescribing should be recognized when evaluating new drugs in daily clinical practice. Policy makers, such as pharmacy and therapeutics committees, should consider this aspect in their formulary decisions since selective prescribing can lead to unjustified conclusions about a drug's therapeutic effects (e.g., efficacy, safety, cost-effectiveness).
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Soyombo, Stephanie, Harpal Aujla, Rhian Stanbrook, David Capewell, Mary Shantikumar, Daniel Todkill, and Saran Shantikumar. "Socioeconomic deprivation and benzodiazepine/Z-drug prescribing: a cross-sectional study of practice-level data in England." British Journal of General Practice 69, suppl 1 (June 2019): bjgp19X703229. http://dx.doi.org/10.3399/bjgp19x703229.
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BackgroundBenzodiazepines and Z-drugs (such as zopiclone) are widely prescribed in primary care in England. Prescribed for various indications, such as anxiolysis and insomnia, it has been previously reported that an association may exist with deprivation.AimTo determine whether there was an association between benzodiazepine/Z-drug prescribing (overall, and by individual drug) and practice-level socioeconomic deprivation in England.MethodMonthly primary care prescribing data for 2017, as well as practice age and sex profile, were downloaded from NHS Digital. Prescribing was aggregated by year. Drug doses were converted to their milligram-equivalent of diazepam to allow comparison. Practice-level Index of Multiple Deprivation (IMD 2015) scores were obtained from Public Health England. Multiple linear regression was used to examine the association between IMD and prescribing (for all benzodiazepines/Z-drugs, and individually), after adjusting for practice sex (% male) and older age (% >65 years) distribution. Practice-level prescribing was defined as milligrams of diazepam-equivalent per 1000 registered patients in 2017.ResultsOn univariate analysis, overall benzodiazepine prescribing was positively associated with practice-level IMD score, with more prescribing in more deprived practices (P<0.001). After adjusting for practice age and sex profile, IMD score remained an independent predictor of prescribing levels (P<0.001). These associations were consistent for all benzodiazepines/Z-drugs when analysed separately.ConclusionHigher practice-level socioeconomic deprivation, as described by IMD score, was associated with increased benzodiazepine/Z-drug prescribing. This may, in part, be a reflection of an underlying association of the indications for prescribing and socioeconomic deprivation. Further work is required to more accurately define the underlying reasons for these associations.
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Weatherburn, Christopher J. "Benzodiazepines and non-benzodiazepine hypnotics – impact of a cluster adopted protocol on primary care prescribing." Scottish Medical Journal 64, no. 3 (May 12, 2019): 97–102. http://dx.doi.org/10.1177/0036933019849369.
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Background and Aims Reduction of benzodiazepines and non-benzodiazepine hypnotics (BZDs and Z-drugs) prescribing is a priority. Dundee, Scotland, has a total of 25 general practices, split into four clusters. The cluster with the highest recorded prescribing of BZDs and Z-drugs adopted a prescribing protocol that aimed to reduce such prescribing. This paper evaluates the impact of this protocol. Methods Quarterly prescribing data were obtained from Information Service Division, NHS Scotland from Q1 2015/16 to Q4 2017/18. Data were split into four clusters and standardised to Defined Daily Dose (DDDs) per 1000 registered patients. Interrupted time series (ITS) analysis was performed to assess prescribing one year after this protocol was introduced. Results There was a crude reduction in prescribing of BZDs and Z-drugs across all GP practice clusters, but this related to an ongoing downward trend in prescribing. Allowing for this, in the cluster that adopted the protocol, ITS revealed there was no significant reduction attributable to the intervention in prescribing of DDD equivalent doses (−0.4%, 95% CI: −7.2 to 7.6). Conclusions Introduction of a cluster-wide prescribing protocol did not provide significant reduction of prescribing. Although crude figures might suggest an improvement, ITS analysis revealed this not to be the case.
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F. Al-Tukmagi, Haydar, and Abdul Rasool M.Wayyes. "Prescribing Pattern and Rational use of Drugs in Maysan Governorate, Iraq." Iraqi Journal of Pharmaceutical Sciences ( P-ISSN 1683 - 3597 E-ISSN 2521 - 3512) 21, no. 1 (March 28, 2017): 112–16. http://dx.doi.org/10.31351/vol21iss1pp112-116.
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This study was designed to investing the drug prescribing pattern which is the important point in the rational or irrational use of drugs among patients dispensing their prescriptions from the private pharmacies in Maysan governorate, Iraq for a period of 1 month. The data collected from prescriptions were calculated and analyzed according to the WHO prescribing guidelines. The data showed that the mean of drugs included in single prescription was 3.4, and 12% of prescribed drugs were written as generic names; moreover, the percentage of antibiotics, corticosteroids and anxiolytics were 33.3%, 11.4% and 23.8% respectively. Those results indicate the irrational use of drugs when compared with the world health organization standard values of prescribing indicators, in addition to the bad prescribing pattern regardless of the degree of specialization of the physician, where 52% of those prescriptions (analyzed in the present study) written by specialized physicians. In conclusion, actual intervention and follow up, training on rational use of drugs and intervention strategies for prescribers is required to improve the rational use of drugs.
Key words: prescription pattern, polypharmacy, rational drug use
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Kalitin, K. Y., G. V. Pridvorov, A. A. Spasov, and O. Y. Mukha. "Effect of Clozapine and 5-NT2A-Antagonist RU-31 on electroencephalography and Motor Activity of Rats in a Model of Schizophrenia with Neonatal Destruction of the Ventral Hippocampus." Kuban Scientific Medical Bulletin 29, no. 5 (July 14, 2022): 108–22. http://dx.doi.org/10.25207/1608-6228-2022-29-5-108-122.
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Background. Schizophrenia is a socially signifi cant disease that takes a variety of forms. The form of the course determines prescribing antipsychotic drugs with a different range of clinical effects. The study of the pharmacological activity of neuroleptics involves an experimental model using animals which makes it possible to reproduce some aspects of schizophrenia.Objectives. The study is aimed at evaluating the antipsychotic activity of 5-HT2A— RU-31 antagonist and atypical neuroleptic clozapine in behavioral tests and electroencephalography (EEG).Methods. The research methodology involved a dysontogenetic model of schizophrenia, implemented via aspiration destruction of the ventral hippocampus of rats on day 7 of postnatal development. The study was carried out on white outbred male rats selected from the offspring of females, represented by a simple random sample, provided by Rappolovo animal breeding facility of the National Research Center “Kurchatov Institute”. Injection of the studied substances was initiated on day 35 of postnatal development. Motor activity was assessed on day 54 of postnatal development in the Open Field unit and included assessing vertical motor activity, measured as the number of acts of verticalization in 5 minutes, and horizontal motor activity of rats, recorded as the number of crossed squares in 5 minutes. EEG signals were recorded on day 55 of postnatal development; thereafter the spectral density was calculated in the delta- (д) (0.4–4 Hz), theta- (и) (4.8–8 Hz), alpha- (б) (8–12 Hz) and beta- (в) (12–30 Hz) frequency ranges and the effect of the “operation” and “substance” factors on spectral density was evaluated in comparison with control groups. Statistical data processing was performed using GraphPad Prism 9 (Insight Partners, USA).Results. The antipsychotic activity of 1-(2-diethylaminoethyl)-2-(4-methoxyphenyl)-imidazo[1,2-a] benzimidazole — RU-31 compound with 5-HT2A-antagonistic mechanism of action was evaluated. RU-31 compound (10 mg/kg, intraperitoneally (i.p.)) statistically signifi cantly reduced vertical and horizontal spontaneous locomotor activity in rats with psychotic disorder by 18.8% and 20.9%, while the atypical neuroleptic clozapine (2 mg/kg, i.p.) signifi cantly reduced these values by 41.15% and 27.67%, respectively. The 5-HT2A-receptor antagonist RU-31 increased EEG signal power in the delta range by 123.33% and decreased it in the alpha range by 41.86% in surgically operated animals (p < 0.05). Clozapine increased the EEG signal power in all studied frequency ranges: in delta — by 107.99%, theta — by 97.16%, alpha — by 41.86% and in beta — by 49.16% in animals with neonatal destruction of the ventral hippocampus (p < 0.05).Conclusion. The studied substances contributed to the correction of behavioural disturbances associated with hypermobility as well as electrophysiological changes induced by a surgical operation, while similar activity was not observed (or was observed to a lesser extent) in healthy animals.
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Simarmata, Hendrico H. P., Sudiro -, and Asriwati -. "Analisis Penggunaan Obat Rasional Dalam Peresepan Pada Kasus ISPA Non Pneumonia Di Rumah Sakit Umum Dr. Pirngadi Kota Medan." Jurnal Kesmas Prima Indonesia 3, no. 2 (February 4, 2022): 20–28. http://dx.doi.org/10.34012/jkpi.v3i2.1998.
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RSUD DR Pirngadi Medan has a large number of cases of non-pneumonia ARI in Medan city and found some irrational drug prescriptions by doctors. This study aims to analyze drugs by doctors in prescribing rational drug use in cases of ARI Non Pneumonia. This research is quantitative. The study took place from July-August 2020. The research population consisted of all general practitioners, pulmonary specialists, pediatricians and internal medicine specialists totaling 79 people. The survey data were analyzed using the Chi-Square test and linear regression. Based on the results of the study, it was found that there was a relationship between prescribing drugs by doctors based on correct diagnosis (p = 0.000), there was a relationship between prescribing drugs by doctors based on appropriate indications (p = 0.000), there was a relationship between prescribing drugs by doctors based on the exact type of drug (p = 0.000) , there is a relationship between prescribing drugs by doctors based on the right dose (p = 0.000), there is a relationship between prescribing drugs by doctors based on the correct assessment of the patient's condition (p = 0.000), there is a relationship between prescribing drugs by doctors based on accurate information (p = 0.000), there is a relationship prescribing drugs by doctors based on appropriate follow-up with rational drug use (p=0.000). The conclusion in this study is that all variables in this study are related to rational drug use in cases of ARI Non Pneumonia and the most dominant variable is the correct information variable. Research suggestions are to make improvements to patient records so that patient profiles are easier to see and therapeutic decisions are easier and more accurate
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Green, Katlyn, Nora Cooke O'Dowd, Hilary Watt, Azeem Majeed, and Richard J. Pinder. "Prescribing trends of gabapentin, pregabalin, and oxycodone: a secondary analysis of primary care prescribing patterns in England." BJGP Open 3, no. 3 (September 17, 2019): bjgpopen19X101662. http://dx.doi.org/10.3399/bjgpopen19x101662.
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BackgroundThe risk of iatrogenic harm from the use and misuse of prescription drugs such as gabapentin, pregabalin, and oxycodone is substantial. In recent years, deaths associated with these drugs in England have increased.AimTo characterise general practice prescribing trends for gabapentin, pregabalin, and oxycodone — termed dependence forming medicines (DFM) — in England and describe potential drivers of unwarranted variation (that is, very high prescribing).Design & settingThis study is a retrospective secondary analysis of open source, publicly available government data from various sources pertaining to primary care demographics and prescriptions.MethodThis study used 5 consecutive years (April 2013–March 2018) of aggregate data to investigate longitudinal trends of prescribing and variation in prescribing trends at practice and clinical commissioning group (CCG) level.ResultsAnnual prescriptions of gabapentin, pregabalin, and oxycodone increased each year over the period. Variation in prescribing trends was associated with GP practice deprivation quintile, where the most deprived GP practices prescribed 313% (P<0.001) and 238% (P<0.001) greater volumes of gabapentin and pregabalin per person respectively, than practices in the least deprived quintile. The highest prescribing CCGs of each of these drugs were predominantly in northern and eastern regions of England.ConclusionSubstantial increases in gabapentin, pregabalin, and oxycodone prescriptions are concerning and will increase iatrogenic harm from drug-related morbidity and mortality. More research is needed to understand the large variation in prescribing between general practices, and to develop and implement interventions to reduce unwarranted variation and increase the appropriateness of prescribing of these drugs.
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Duborija-Kovacevic, Natasa, and Zdenko Tomic. "Did a reform strategy in drug management improve doctors’ prescribing habits in Montenegro: The example for the cardiovascular drugs." Vojnosanitetski pregled 63, no. 5 (2006): 451–56. http://dx.doi.org/10.2298/vsp0605451d.
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Background/Aim. A comprehensive reform strategy in drug management has been applying for a few years in Montenegro in order to promote a rational use of drugs. The reform strategy covered: an information system named ?The Control of Distribution and Use of Drugs?, a new List of Essential Drugs (that are reimbursed by the Republic Fund for Health), legislative and regulatory measures in order to establish a better control of drug prescribing and more efficient processing of the prescriptions. The aim of this study was to evaluate the effects of the reform strategy on the doctors' prescribing habits and the subsequent use of cardiovascular drugs within the outpatient setting of Montenegro. Methods. A retrospective-prospective pharmacoepidemiologic study included a sample of 100% of cardiovascular drugs that were taken with prescription from state pharmacies during 2000 and 2004. The results were presented by the number of defined daily doses (DDD) per 1000 inhabitants per day. All the drugs were classified according to the uniform anatomical-therapeutic-chemical (ATC) classification of the drugs. The Wilcoxon test for matched pairs was used in order to calculate the significance of difference in cardiovascular drugs utilization before and after the introduction of new measures. Results. Although prescribing and the resulting outpatient use of cardiovascular drugs (ATC group C) that were reimbursed by the Republic Fund for Health was increased approximately by 13% in 2004 in comparison with 2000 (67.98 vs. 60.17 DDD/1000 inh./day), we did not find a statistically significant difference (p > 0.05). Prescribing of ACE inhibitors (C09A) increased approximately by 45% during the investigated period (15.30 vs. 22.17 DDD/1000 inh./day). The selection of drugs was also altered: cilazapril, ramipril and quinapril were left out, captopril and enalapril were more prescribed, and a newly-included fosinopril was prescribed mostly (31.5%). Calcium-channel blockers (C08) were prescribed 33.7% more (7.12 vs. 9.52 DDD/1000 inh./day), mostly because of seven times higher prescribing of amlodipine in 2004. Pentaerythritol tetranitrate was left out, but isosorbide dinitrate and isosorbide mononitrate were prescribed more frequently. High-priced atorvastatin was replaced with the older simvastatin, that was prescribed three times more. Conclusion. The reform strategy in drug management mostly improved the doctors' prescribing habits and the subsequent use of cardiovascular drugs within the outpatient setting. For the most part, the noticed changes were in accordance with the actual recommendations, but some cases need additional measures. Regulatory policy, however, could not compensate for the continual education of doctors that prescribe drugs.
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Hollingworth, Samantha A., and Gerard J. Byrne. "Prescribing trends in cognition enhancing drugs in Australia." International Psychogeriatrics 23, no. 2 (July 30, 2010): 238–45. http://dx.doi.org/10.1017/s1041610210001146.
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ABSTRACTBackground: This study sought to examine the trends in the prescribing of subsidized and unsubsidized cognition enhancing drugs (CEDs) in Australia over five years from 2002 to 2007. Subsidized cholinesterase inhibitor medication could be prescribed to people with mild to moderate Alzheimer's disease (AD) once a specialist physician had confirmed this diagnosis. Memantine was available for use in moderately severe AD but not subsidized.Methods: We analyzed the Medicare Australia and Drug Utilisation Sub-Committee databases for CED prescription data, 2002–2007, by gender, age and prescriber class. Aggregated prescription data for each medication were converted to defined daily doses (DDD) per 1000 persons per day using national census data.Results: There were 1,583,667 CED prescriptions dispensed during the study period. CED use increased 58% from 0.91 to 1.56 DDD/1000 persons/day between 2002 and 2007. Peak use was in those aged 85–89 years. Age-adjusted utilization was slightly higher in females than males. Donepezil was the most widely used CED (66%), followed by galantamine (27%) then memantine (4%). General practitioners prescribed the majority of CEDs. Geriatricians exhibited a greater preference for galantamine than other prescribers. CED dispensing peaked towards the end of each calendar year, reflecting stockpiling by patients under the influence of a federal safety net subsidy.Conclusions: Despite subsidized access to CEDs in Australia, only a minority of people with AD was prescribed these drugs during the period of the study. It is likely that the combination of complex prescribing rules and negative perceptions about efficacy or cost-effectiveness might have contributed to these findings.
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Gujar, Amol G. "EVALUATION OF RATIONAL DRUG USE BASED ON WORLD HEALTH ORGANIZATION CORE DRUG USE INDICATORS AT A PRIVATE HOSPITAL OF WESTERN INDIA: A CROSS SECTIONAL STUDY." Journal of Medical pharmaceutical and allied sciences 10, no. 6 (November 15, 2021): 4045–49. http://dx.doi.org/10.22270/jmpas.v10i6.2405.
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Recent data from the National sample survey highlighted that many Indians prefer private hospitals over public hospitals for their healthcare needs. Hence, drug utilization research at private hospitals may help promote rational drug use, avoid risk to patient safety, and minimize pharmaceuticals wastage. The study aimed to evaluate the drugs prescription pattern using the World Health Organization (WHO)-recommended prescribing indicators at a private hospital in Pune, India. The study was an observational, prospective, and cross-sectional study conducted at the out-patient department of a private hospital in Pune, Maharashtra, India. Total 1023 prescriptions from October 2020 to May 2021 were studied using WHO drug prescribing indicators. Microsoft Excel and SPSS v26.0 was used to capture and analyse the data of the study. A total of 3954 drugs were prescribed in 1023 prescriptions. The average number of drugs prescribed per encounter was 3.9 (standard deviation: 1.3). Drugs prescribed by using the drug's generic name were 6.6%, the encounters with an antibiotic and an injection prescribed were 47.0% and 1.8%, respectively. The drugs prescribed from the Essential Drugs List (EDL) were 62.0%. Additionally, nonsteroidal anti-inflammatory drugs were prescribed the most (17.7%), followed by antacids (17.3%) and vitamins and supplements drugs (17.0%). The study highlighted deviations in prescribing practices compared to WHO standards. The study suggests a need to train the physicians and implement the WHO prescribing indicator on a trial basis in private hospitals to develop policies to achieve a long-lasting benefit.
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Падалкин, Василий, Vasiliy Padalkin, Георгий Новиков, Georgiy Novikov, Олег Ковальцов, and Oleg Koval'cov. "Legal changes in the order of prescribing and processing of prescriptions for medical use drugs." Vestnik Roszdravnadzora 2019, no. 5 (October 23, 2019): 60–67. http://dx.doi.org/10.35576/article_5db0384345ae91.33881264.
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Legal regulation of medical practice is an integral part of the Russian health care system. The improvement of regulatory legal documents in this area shows the growth in the need not only to be modern and “up to date” with the social and political environment, but to stay in balance between the rights and the obligations in legal relations in the “patient-healthcare professional-state” system. In this article we observed the novelties in legislation made to regulate the order of drugs prescription and the procedure of prescription new prescription lists. We tried to reflect the main and problematic aspects of the electronic form of prescriptions. In our article the main source of these legal changes to be used was the new Order of the Ministry of Health of Russia dated January 14, 2019 N 4n, registered with the Ministry of Justice of Russia on March 26, 2019 N 54173.
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Patel, Khyati M., Shilpa D. Jadav, Shailesh P. Parmar, and Hiren Trivedi. "Drug prescribing pattern in surgical wards of a tertiary care hospital in Western part of India." International Journal of Basic & Clinical Pharmacology 7, no. 8 (July 23, 2018): 1587. http://dx.doi.org/10.18203/2319-2003.ijbcp20183028.
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Background: In surgical wards, drugs are required to manage pain, nausea, vomiting, infections, etc. A growing number of pharmaceutical products are available in present era. Irrational prescribing of drugs is prevalent worldwide. Drug utilization study can be used to assess prescribing patterns. Authors undertook this study to determine current practice of prescribing in surgical wards of the hospital.Methods: Authors conducted observational, noninterventional, descriptive study among patients admitted in surgical wards for one year. Authors have analysed collected data of 604 patients using descriptive statistics to determine utilization pattern of drugs and drug use indicators.Results: Appendicitis (14.9%) followed by hernia (10.6%) were leading diseases for admission. Mean duration of stay was 7.44. Average number of drugs in a prescription was 8.94. Antibiotics (32.07 %), analgesics (17.11 %) and antacids (16.09 %) were leading drug groups prescribed. Amikacin (5.81 %) followed by metronidazole (5.30 %) and ciprofloxacin (5.19 %) were commonly prescribed antimicrobial drugs. Tramadol (5.31 %) and pantoprazole (7.17 %) were leading drugs prescribed from analgesics and antacids respectively. All prescriptions had at least one injectable drug. At least one antibiotic was present in 92.05 % prescriptions. Majority of drugs (87.27 %) were prescribed by generic names. Proportion of drugs prescribed from essential medicine list was 84.22 %.Conclusions: Polypharmacy and injectable drug prescribing were common in practice. There is a scope for improving such prescribing practices among practitioners. Use of multiple antibiotics should be avoided whenever possible and usage should be evidence based.
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ALSHAKHSHIR, SAMI MUSTAFA, SYED AZHAR SYED SULAIMAN, MAHMOUD SADI ALHADDAD, and MOHD PAZUDIN. "THE RATIONALITY OF DRUG PRESCRIPTIONS AT THE GYNAECOLOGY DEPARTMENT IN A TERTIARY CARE TEACHING HOSPITAL IN KELANTAN." Malaysian Journal of Pharmaceutical Sciences 19, no. 1 (May 24, 2021): 29–44. http://dx.doi.org/10.21315/mjps2021.19.1.3.
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The aim of this study is to assess the rational prescribing pattern of drugs for pregnant women using World Health Organization (WHO)/International Network for Rational Use of Drugs (INRUD) core drug prescribing indicators. A one-year retrospective research design from (October 2016–September 2017) was used to review pregnant women prescriptions from their medical records at Hospital Universiti Sains Malaysia (HUSM). A structured data collection form using WHO/INRUD document on prescribing indicators was used. Data was sorted and categorised according to the US Food and Drug Administration (USFDA) pregnancy classification systems and Anatomical Therapeutic Classification (ATC). Then, data was compared with the references values of WHO/INRUD. Descriptive analysis were performed using SPSS version 20. A total of 741 medical files met the study inclusion criteria. The average number of prescribed drugs per prescription and the percentage of prescribed drugs from hospital formulary list and health ministry list were within the acceptable range listed by WHO. Whereas, the percentage of pregnant women with antibiotics and injection drugs were lower than normal values 17.67% and 8.23%, respectively. Percentage of prescribed drugs from categories C and D were 13.8% and 2.8%, respectively. Whereas 24.8% of prescribed drugs were from unclassified risk category. On the other hand, multivitamins preparations were the highest category of prescriptions 17.7%. Injections and number of antibiotics per encounter were lower than the recommended range listed by WHO. However, a great caution and careful prescribing behaviour of physicians were noticed at gynaecology/obstetric departments and most of the prescribed medications were rational and safe during pregnancy.
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Thomson, S., and P. Crome. "Appropriate prescribing in older people." Reviews in Clinical Gerontology 12, no. 3 (August 2002): 213–20. http://dx.doi.org/10.1017/s0959259802012340.
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It is clearly established that older people suffer a high rate of disease related to medication. Probably the major reason for this is that older patients are prescribed more drugs than younger people and the rate of prescribing appears to be increasing all the time. In the UK, data are currently collected on all prescriptions dispensed and this shows that older patients (aged over 65 years) receive 35-40% of all drugs prescribed. Between 1977 and 1988, prescription items increased by 17% overall, but by 52% in people over 65 years. compared to only 1% in adults under 65. Prescription rates are rising for a number of reasons, including new advances in therapeutics, a rapidly enlarging older population, moves to treat older patients more effectively (i.e. a less agist policy), rising patient expectations and defensive medical practice.
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Dmytriw, Adam A., Georgios A. Maragkos, Jeffrey Zuccato, Jeffrey M. Singh, M. Elizabeth Wilcox, and Sacha Schweikert. "Use of Antiepileptic Drugs in Aneurysmal Subarachnoid Hemorrhage." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, no. 04 (May 22, 2019): 423–29. http://dx.doi.org/10.1017/cjn.2019.54.
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ABSTRACT:Introduction: Controversy exists in antiepileptic drug (AED) prophylaxis prescribing in patients with aneurysmal subarachnoid hemorrhage (SAH). We undertook the Use of Antiepileptic Drugs in Aneurysmal Subarachnoid Hemorrhage (ALIBI) study to identify factors associated with prescribing practices. Methods: A retrospective chart review of all consecutive patients requiring Level 1 care with aneurysmal SAH admitted between 2012 and 2014 to the intensive care unit at Toronto Western Hospital, Ontario, Canada, was conducted. Data were collected on clinical and imaging characteristics. Primary and secondary outcomes were AED prophylaxis and clinical seizure activity during hospitalization. Data were compared using chi-square or Mann–Whitney U-tests. Those variables found to be significant, or trending toward significance, on univariate analysis were fitted to multivariate regression. Results: Sixty-eight patients were included. Mean age was 62 ± 12.2, and 42.6% of patients were male. Of these, 21 patients (30.9%) received AED prophylactically, while 18 (26.5%) had reported seizures at some point during hospitalization. Female gender and presence of midline shift (MLS) were significantly associated or approached significance with AED prophylaxis in univariate analysis (p = 0.036 and p = 0.062, respectively). In multivariate analysis, only MLS was an independent predictor (odds ratio 5.09, p = 0.04). Conclusion: The presence of MLS was an independent predictor of seizure activity in patients with aneurysmal SAH. AED prophylaxis prescribing patterns seemed arbitrary and was not informed by identifiable clinical factors or true risk factors for seizure. A current lack of evidence guiding AED prescribing practice highlights the need for larger studies in this patient population.
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Fatin, Mia N. A., ED Y. M. Pasha, Khairunnisa Fadhilah, and Vera L. Fitriani. "EVALUASI POLA PERESEPAN PADA PASIEN LANJUT USIA MENGGUNAKAN WHO PRESCRIBING INDICATORS." Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan 7, no. 1 (March 29, 2022): 84–91. http://dx.doi.org/10.36387/jiis.v7i1.827.
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Older patients are very susceptible to drug use problems. Drug use problems are related to physiological conditions that affect the pharmacokinetics and pharmacodynamics of the drug. This study aimed to evaluate drug prescribing pattern in older patients at Pasundan Health Center Bandung. Data were retrospectively collected from prescriptions from March to June 2021. The pattern of prescribing drugs was evaluate using the WHO prescribing indicator with five indicators: the number of drugs per prescription, antibiotic use, generic drugs, the percentage of injection preparations, essential drug use. A total of 638 prescriptions met the inclusion criteria. The average number of drugs per prescription is 2.8. The prescription drugs from a total of 1.777 drugs in the form of generic drugs amounted to 83.29%, and essential drugs amounted to 74.28%. The antibiotics and injection use percentage were 11.82% and 0%, respectively. The most frequently prescribed antibiotics were amoxicillin, clindamycin, ciprofloxacin, betamethasone, and miconazole. The most frequently prescribed drugs were amlodipine, paracetamol, diclofenac sodium, chlorpheniramine maleate, and multivitamins. The use of essential and generic drugs was below WHO standard, while the average number of drugs per prescription was above WHO standard.
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Pandey, S., C. K. Yadav, P. Ghimire, and A. C. Shrestha. "Prescription Pattern Monitoring and Off-label Use of Medicines in the Pediatric Department at Tertiary Care Teaching Hospital." Kathmandu University Medical Journal 18, no. 4 (December 31, 2020): 367–71. http://dx.doi.org/10.3126/kumj.v18i4.49247.
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Background Off-label use means the use, concerning dosage, indication, route of administration, or age, of pharmaceutical products which are beyond the terms of the product license. For regulatory bodies and physicians, the global challenge is to achieve optimum pediatric drug therapy.
Objective This prospective observational work was carried out in the paediatric department to evaluate the prescribing pattern of medicines and to identify the use of off-label drugs.
Method A cross-sectional study was carried in 200 paediatric patients of ages between 0 and 12 years at the paediatric outpatient department of Universal College of Medical Sciences, Bhairahawa. Data were collected by reviewing the prescription paper and the required information was recorded using a structured data collection sheet prepared for study. The prescribing pattern was assessed by using the World Health Organization (WHO) Prescription Indicators and off-label use was assessed using the WHO Children Formulary 2010.
Result Among 413 total prescriptions, only 5.56% of drugs were found to be prescribed by generic name, 16.7% of prescriptions were found to be antibiotic and 57.62% of prescribed drugs were from essential drug list. Out of 413 prescribed drugs, 16.46% of drugs were found to be off-label. The maximum extent of off-label prescribing was 51.47% in the child, followed by infants (42.6%) and neonates (5.8%). Fexofenadine; antihistaminic (23.56%), Amoxicillin+clavulanic acid; antibiotic (22.06%) had higher off-label use. Off-label dose (71.8%) was the most common cause of off-label prescribing.
Conclusion Off-label prescribing among pediatric patients is common. More eminence data on the safety and efficacy of off-label medicines must be generated to rationalize paediatric pharmacotherapy.
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Ramadaniati, Hesty Utami, Heni Safarini, and Aishah A. Regine. "Off-Label Prescribing in Pediatric Inpatients With Pneumonia in a Children's Hospitaal." JURNAL ILMU KEFARMASIAN INDONESIA 16, no. 1 (April 27, 2018): 25. http://dx.doi.org/10.35814/jifi.v16i1.433.
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Off-label is a term used in which a drug prescribed outside the official information of the marketing authorization. Off-label prescribing may occur as the result of several factors including lack of clinical trials data involving pediatrics and suitable formulations for medicines commonly prescribed to this fragile population. Objective: This study aimed to estimate the nature and prevalence of off-label prescribing in pediatric inpatients with pneumonia. Material and Methods: a retrospective study was conducted in a study hospital using medical records from pediatric inpatients with pneumonia during the period of January-December 2015. Patient and prescribing data were collected, and drugs were classified as on-label or off-label based on the Indonesia National Drug Information (IONI) and British National Formulary for Children (BNFC). Thereafter, off-label drugs were categorized with a hierarchical system of age, indication, route of administration and dosage. Results: There were 1141 drugs with 77 different types of drug were administered to 207 patient during the study period. The data uncovered that 405 (35,5%) of the drug prescriptions were used off-label based on IONI, and 319 (28%) of the drug were used off-label based on BNFC. Based on IONI and BNFC, most off-label drugs were from anti infection drugs. Conclusion: The prevalence of off-label use in pediatric inpatients with pneumonia is not high. The off-label prescribing may not be necessarily be considered irrational, yet this fact reveals that the use of drugs does not comply with the drug label. Clinical trials for pediatric drugs are essential to provide complete product information for pediatric use.
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Ingle, Satyashil A., Sujeet A. Divhare, Rajesh S. Hiray, and Sujata Shingare. "Determination of the drug utilization patterns of antimicrobial agents used in the department of ear, nose and throat at a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 11, no. 5 (August 24, 2022): 453. http://dx.doi.org/10.18203/2319-2003.ijbcp20222142.
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Background: Pharmacoepidemiology deals with the epidemiological aspects of clinical use of and effects of drugs over a large population with intentions to have a rationalised prescription practices while using various drugs preferably anti-microbial agents. Objective of the research was to study the prescribing patterns of drugs in ear, nose and throat (ENT) department and to evaluate prescriptions according to World Health Organization (WHO) drug use indicators.Methods: A cross sectional, observational study was conducted in the department of ENT. Data was collected from the prescriptions of patients in outpatient (OPD) and inpatient department (IPD) both.Results: Total number of 250 prescriptions were analysed in which 1038 drugs were prescribed, with average number of drugs prescribed per prescription were 3.6 and 4.6 drugs among OPD and IPD group respectively. Anti-histaminic class of drugs were most prescribed drugs in OPD while in IPD, all anti-microbial agents were most prescribed class of drugs. There was a statistically significant difference between drugs prescribed by generic and branded names. When compared statistically, it was found that 1%, 59% and 40% prescribed drugs in OPD were from desirable, essential and vital class respectively. While 3%, 62% and 36% of prescribed drugs in IPD were from desirable, essential and vital class respectively.Conclusions: It is vital to aware prescribers about the importance of rationalised prescribing and avoid polypharmacy. A need for the development of prescribing guidelines and educational initiatives to encourage the rational and appropriate use of drugs, in order to give the inputs to the prescribing doctors.
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Sharma, Jay Kumar, Shailesh P. Parmar, and Hiren R. Trivedi. "A study of prescribing pattern of antihypertensive drugs in hypertensive patients with co morbid diabetes in a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 7, no. 3 (February 22, 2018): 375. http://dx.doi.org/10.18203/2319-2003.ijbcp20180486.
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Background: Hypertension and diabetes mellitus are among the commonest non-communicable diseases. Co-existence of hypertension and diabetes increases morbidity and mortality. So co-existence of these diseases requires attention and rational management. Studying current prescribing pattern of drugs provide data for recommendations and decisions regarding rational practice. We undertook this study to study prescribing pattern.Methods: It was cross sectional, observational, descriptive study in outdoor patients suffering from hypertension and type 2 diabetes mellitus for duration of one year. Data of 601 patients were analyzed using descriptive statistics to determine prescribing pattern of drugs.Results: In this study, 71.55% patients were above 50 years age. Female patients were 56.57%. Average duration of hypertension was 4.08 years. Commonly prescribed antihypertensive drug groups were angiotensin converting enzyme (ACE) inhibitors (85.36%) followed by β receptor blockers (33.44%) and calcium channel blockers (29.95%). Enalapril (85.36%) followed by amlodipine (29.95%) and atenolol (21.46%) were commonly prescribed antihypertensive drugs. Single antihypertensive drug was prescribed in 292 (48.59%) prescriptions. The most common monotherapy drug was enalapril (82.19%). Two antihypertensive drugs were prescribed in 231 (38.43%) prescriptions. The most common two drug combination was ACE inhibitors + β receptor blockers (40.69%). Four antihypertensive drugs were prescribed in only 1.50% prescriptions.Conclusions: From this study, the results suggest that the prescribing pattern of antihypertensive drugs reflects recommendations of current guidelines and practices. However, β receptor blockers were prescribed more commonly. There is room for improvement in choice of drugs.
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Amorha, K. C., O. N. Isiogugu, and E. C. Nsionu. "Drug utilization pattern among paediatric asthma patients attending the respiratory clinic of a Nigerian tertiary hospital: a five-year retrospective survey." Tropical Journal of Health Sciences 29, no. 4 (November 27, 2022): 14–19. http://dx.doi.org/10.4314/tjhc.v29i4.3.
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Drug prescribing indicators can assess prescribing performance. This study assessed the drug utilization pattern among paediatric asthma patients in University of Nigeria Teaching Hospital (UNTH). The study protocol for this five-year retrospective survey (1st January, 2015 to 31st December, 2019) was approved by the Health Research and Ethics Committee of UNTH. Eligibility criteria included folders of the paediatric asthma patients within the period under review. Descriptive statistics summarized the data and World Health Organization (WHO)/International Network of Rational Use of Drugs (INRUD) core prescribing indicators.
The result presented that 272 prescriptions were extracted from the 68 folders. Majority of the patients were ≤ 10 years old (n = 167, 61.4%) and allergic rhinitis (n = 62, 22.8%) was the most common comorbidity. Antihistamines (n = 1407, 35.5%) were the most commonly prescribed class of drugs. Salbutamol (n = 156, 100.0%) was the only prescribed short-acting beta agonist (SABA) inhaler. The average number of drugs per encounter was 2.92 (reference range: 1.6 – 1.8). The percentage of drugs prescribed by generic name and from the essential drugs list were 66.2% and 18.1%, respectively (expected compliance: 100%). The percentage of encounters with inclusion of prescription of an antibiotic was 22.1% (reference range: 20.0% – 26.8%). The percentage of encounters with inclusion of prescription of an injection was 9.6% (reference range: 13.4% – 24.1%).
Our conclusion was that there is need for rational prescribing in asthma settings, with focus on prescribing drugs using their generic name and also from the essential drugs list, while avoiding unnecessary polypharmacy.
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Dey, Saborni, Vivek Sinha, and Poonam Kachhawa. "Prescribing trends in patients of the pain-clinic in a tertiary care teaching hospital, Hapur, Uttar Pradesh." Asian Journal of Medical Sciences 10, no. 4 (June 20, 2019): 55–60. http://dx.doi.org/10.3126/ajms.v10i4.24214.
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Background: The drug utilization research is a significant constituent of medical audit which helps in monitoring, evaluating and building required modifications in the prescribing practices to attain a rational and cost effective medical care.
Aims and Objective: The objective of this study was to evaluate drug utilization design of Nonsteroidal anti-inflammatory drugs (NSAIDs) in a tertiary care teaching hospital, SIMS, Hapur.
Material and Methods: This prospective, observational study was conducted in the outpatients of the Pain clinic during six months period to evaluate the prescribing pattern of analgesics in a tertiary care teaching hospital. After getting approval by Institutional Ethical committee, random prescriptions were collected from the OPD and scanned for the record purpose. The demographic data and the prescription were taken from 340 prescriptions. Data was analyzed as per WHO prescribing indicators.
Results: A total 340 prescriptions were analyzed. The result revealed that NSAIDs as Diclofenac (75.21%) and Paracetamol (14.88%) were the most commonly prescribed analgesics. Average number of drugs in the present study was found to be 2.29. Percentage of drugs prescribed generic name was (21.02%). Percentage of encounters with an antibiotic was 12.95%, The use of injectable preparation was around 7.20%. Out of all the medicines, 85.90% were found written from Essential Drug List.
Conclusion: The prescribing trend of NSAIDs indicate some deviation from the WHO recommendations. This touchstone data will be useful to plan more targeted research and to improve prescribing practices. These types of studies help to design policy for rational use of drugs and perioding training programs of physicians, establishing drug and therapeutic committee, drug information centres and regular educational interventions that can be beneficial for improving prescribing practice with rational drug usage.
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Yokoi, Masayuki, and Takao Tashiro. "The Role of Dispensing by Japanese Community Pharmacists in Reducing Medicine Costs." Global Journal of Health Science 9, no. 3 (February 6, 2017): 248. http://dx.doi.org/10.5539/gjhs.v9n3p248.
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This study investigated the economic efficacy of separation of drug prescribing and dispensing (separation system). We examined whether daily medical expenses on prescriptions for former drugs, generic drugs, medical devices, and the number of drugs are curtailed due to the separation system, whose function is to separate the manager between prescribing and dispensing drug, and the effect of mutual check between prescribing doctors and dispensing pharmacists. Participation in the separation system is legally optional for Japanese medical institutions. It causes that the growth rate of the separation system in administrative districts is wide range. Furthermore, this study investigated the separation system in Japanese administrative districts with available open public data. We examined the separation system effect using National Healthcare Insurance data for 2011–2015. We tested whether the separation system growth rate for each Japanese administrative district was correlated to former drug significantly, generic drug, medical device price, and the number of drugs on prescriptions. The results show that growth of the separation system influenced the daily expense of prescribed former drugs and medical devices and the correlations were significant. Contrastively, the number of drugs and the expense of generic drugs on prescriptions were not significantly correlated with the separation system growth rate. Therefore, the separation system was effective at curtailing expenses of daily former drugs and medical devices but little effective at curtailing the number of daily drugs and generic drugs expense.
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Warsame, Muktar Shekabdulahi. "Drug use pattern using WHO prescribing indicators at Sheikh Sultan Hassan Yabere Referral Hospital, Eastern Ethiopia: A cross sectional study." Journal of Drug Delivery and Therapeutics 10, no. 4-s (August 15, 2020): 34–38. http://dx.doi.org/10.22270/jddt.v10i4-s.4207.
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Introduction: In order to enhance rational drug use, it is very important to assess the prescribing pattern of the facilities using standard prescribing checklists. Hence, the aim of this study was to assess drug use pattern using WHO prescribing indicators at Sheikh Hassan Sultan Yabere Referral Hospital, Eastern Ethiopia.
Objective: the objective of this study is to assess drug use pattern using WHO prescribing indicators at Sheikh Hassan Sultan Yabere Referral Hospital, Eastern Ethiopia 2019
Method: Retrospective study design was employed to assess the current drug prescribing pattern of Sheikh Hassan Sultan Yabere Referral Hospital.Six Month prescription papers from December 1, 2018 to May 31, 2019 were surveyed. A total of 600 prescriptions that were selected using systematic random sampling were reviewed. Data was collected from prescriptions at outpatient pharmacy. The data was entered to excel and analyzed and presented with tables and charts.
Results: The average number of drugs prescribed per encounter or mean was 1.98 with a range between one and six drugs. The percentage of encounters in which an antibiotic or injection prescribed were 60 % (n=600) and 2.5 % (n=600) respectively. The percentage of drugs prescribed by generic name and from an essential drug list were 89.5 % (n=600) and 98.99% (n=600). The commonly prescribed forms of antibiotics were Amoxicillin (19.15%), Amoxicillin/Clavulunate (17.41) and Azithromycin (16.83%).The most commonly prescribed injection was Ceftriaxone (52.14%).
Conclusion: This study revealed major deviation from standard WHO recommended rational prescribing practice with regard to antibiotic use. The study also showed deviation from WHO standard with regard to use of generic name and prescribing from national formulary/Essential drug list.
Keywords: Rational drug use, prescribing pattern, WHO prescribing indicators Jigjiga, Somali Region.
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Azis, Nur, Herwanto Herwanto, and Fathurrahman Ramadhani. "Implementasi Speech Recognition Pada Aplikasi E-Prescribing Menggunakan Algoritme Convolutional Neural Network." JURNAL MEDIA INFORMATIKA BUDIDARMA 5, no. 2 (April 25, 2021): 460. http://dx.doi.org/10.30865/mib.v5i2.2841.
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The process of manually prescribing drugs by doctors can cause several problems, including doctors not knowing what drugs are available and it takes time to find out what drugs are available in the pharmacy. Speech recognition is now widely used in various ways, which can help facilitate work. The application of speech recognition can be done in the e-prescribing application with the neural network method using the Convolutional Neural Network (CNN) algorithm, which is the basic method of deep learning. This study aims to facilitate physicians in filling out drug data in e-prescribing applications using speech recognition. The data used in this study were obtained from the open source dataset provided by Google and collected independent datasets. From the results of experiments that have been carried out, the accuracy achieved with 40 epochs and 40 direct impressions with different words is 90%. Where words are successfully recognized 36 words out of 40 words
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Shakeel, Sadia, Shagufta Nesar, Hina Rehman, Khizra Jamil, Imran Ahsan Mallick, Muhammad Shahid Mustafa, Mudassir Anwar, and Shazia Jamshed. "Patterns and Predictors of Off-Label Drug Prescribing in Psychiatric Practice: A Qualitative Study." Pharmacy 9, no. 4 (December 20, 2021): 203. http://dx.doi.org/10.3390/pharmacy9040203.
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Off-label drug prescribing (OLDP) must be based on strong scientific evidence to make sure that patients get the optimum therapeutic outcomes. Adherence to the prerequisites is determined by the physicians’ attitude and knowledge. In this context, the present study was conducted with the goal of investigating psychiatrists’ perceptions of the use of OLDP in their clinical practice. A total of 14 psychiatrists were interviewed using a semi-structured interview guide. Thematic content analysis was performed. Data saturation was achieved at the 12th interview. Six major themes and fifteen subthemes emerged from qualitative interviews. Among the major themes were knowledge and concepts about the off-label drugs, attitude and current practice of prescribing off-label drugs, and rationale of prescribing and suggestions for reducing the use of off-label drugs. Almost all of the respondents interviewed provided detailed comments concerning the OLDP concept, depicted an optimistic approach and deemed that OLDP is quite common in psychiatry. Off-label usage of benzodiazepines such as clonazepam, diazepam and lorazepam in mania, depression, and obsessive–compulsive disorder were commonly reported. It was observed that the majority of the respondents did not inform the patients before prescribing off-label drugs. The present findings revealed that respondents had awareness; however, they depicted diverse attitudes towards prescribing off-label drugs. Further education and sensitization in regions with impoverished knowledge would certainly assist in preventing the risks associated with the use of OLDP.
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Jorige, Archana, Lohitha B., and Lavanya S. L. "A cross sectional study on prescribing pattern for children at primary health care clinics." International Journal Of Community Medicine And Public Health 7, no. 8 (July 24, 2020): 3149. http://dx.doi.org/10.18203/2394-6040.ijcmph20203392.
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Background: Rational prescribing for pediatrics is very essential as there is increased risk from the use of medicines in them due to multiple reasons ranging from altered pharmacokinetics to long-term side effects. Drug related needs of children must be assessed on individual basis to meet appropriate health care out comes. This cross-sectional descriptive study aimed at assessing drug use pattern and rationality in prescribing pattern as per World Health Organization (WHO) core prescribing indicators.Methods: A cross-sectional and prospective study was carried out in private primary health care clinics of Hyderabad, Telangana State. A total number of 300 prescriptions for children were reviewed. Patients' demographic characters, diagnosis, and drugs prescribed were recorded in a pre-structured and validated data collection form.Results: Average number of drugs per prescription is 1.92. Fever and upper respiratory tract infections were found to be common complaints in this age group. Paracetamol is the mostly prescribed medication and among prescribed antibiotics, Fluroquinolones occupied major part. 67.3% of drugs were from the WHO model list of essential medicines for children. The percentage of drugs prescribed with generic names is very less.Conclusions: In this study it was found that the prescription pattern in the selected primary healthcare centers in Hyderabad was in compliance with the WHO prescribing indicators except the generic prescribing practice.
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Rabie, Dalia, and Salah I. Kheder. "Assessment of Prescribing and Dispensing Practices Based on WHO Core Prescribing Indicators in Hospital and Community Pharmacies in Khartoum State - Sudan." Journal of Medical Informatics and Decision Making 1, no. 3 (July 29, 2020): 1–11. http://dx.doi.org/10.14302/issn.2641-5526.jmid-20-3493.
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Background Rational drug management has become an increasingly important topic in order to make optimal use of the drug budget to offer health services of the highest possible standard. It is important that continuous assessment for rational prescribing and use of drug have to be carried. Objective of this study was to gather data on existing drug prescription and dispensing practices and to evaluate the prescribing and dispensing indicators as described by the WHO. Method Observational, cross-sectional, prospective study was designed and conducted to evaluate the performance of hospital and community pharmacies in Khartoum state, related to rational drug use and prescribing and dispensing practices during the period from November 2018 to March 2019. 297 Hospital and community pharmacies from public and private sectors were contacted for carrying out this study survey and the collected data were analysed against WHO standards for core drug use indicators. Results The average number of drugs per encounter was 3.98 drugs. Hospital pharmacies had a higher (4.18±1.516) number of drugs prescribed than community pharmacies (3.87±1.331) with significance difference between mean of two types of pharmacies (P = 0.015). The percentage of antibiotic per prescription was (53.7%). Antibiotic prescribing was much higher (54.0%) in the hospital pharmacies compared to (48.6 %) in community pharmacies. The average percentage of injections per prescription at the facilities was found to be (57.6%). The percentage of prescription with written diagnosis was (26%.0) and the percentage of prescriptions with written dose was (78%.0). The average dispensing time was (1.75) minutes, The Percentage of drugs actually dispensed was (55.99%), the average adequacy of labelling of drugs was (30.4%). Overall prescribing and dispensing indicators were higher than WHO standard. Conclusion The degree of poly pharmacy was greater than of WHO criteria. The completeness and rationality of prescription was found suboptimal and components were missed.
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Saleem, Adil, M. Asim Farooq, Mufti Maratab Ali, Fahad Qureshi, and Ahmad Amin. "Prescribing patterns: a key factor in rational use of drugs in Lahore, Pakistan." International Current Pharmaceutical Journal 5, no. 12 (November 18, 2016): 118–19. http://dx.doi.org/10.3329/icpj.v5i12.30414.
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Prescribing pattern is the trending topic now days to promote rational use of drug and to make the drug therapy effective. Many factors like lack of knowledge, improper guidelines and personal interest affects the prescribing behaviour of a physician. To access the prescribing pattern and its relevant features which modulates it in the sector of Lahore, A survey was conducted in which physicians of different expertise were engaged from top hospitals of public and private sector. A questionnaire was designed and 100 physicians were interviewed as per structured questionnaire. The collected data was analysed by using analytical software SPSS 22. Pharmacological factors, cost effectiveness, efficacy of drug, recommended guidelines, psychological expectations and patient adherence are some factors which a prescriber keeps in his mind while prescribing a drug. Personal benefits and polypharmacy is strongly prohibited by physicians. physicians of Lahore prefer patient benefits upon their own in prescribing a drug but there are still some drawbacks like socio-economic factor and social culture which cause hindrance for a physician while prescribing.Saleem et al., International Current Pharmaceutical Journal, November 2016, 5(12): 118-119http://www.icpjonline.com/documents/Vol5Issue12/04.pdf
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Bhadury, A., U. K. Roy, T. Ghosh, D. Barman, and P. Mandal. "Assessment of Prescribing Pattern and Safety Profile of Drugs Used in Intranasal Route in Paediatric Age Group of Patients in a Tertiary Care Hospital." Kathmandu University Medical Journal 19, no. 1 (March 31, 2021): 62–68. http://dx.doi.org/10.3126/kumj.v19i1.49540.
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Background Recently there has been an increased preference for intranasal delivery of drugs due to highly vascular nasal mucosa, bypassing first pass metabolism and the blood brain barrier (BBB) lead in quick drug absorption to the systemic circulation and direct access to brain from olfactory region. For pediatric patients this route offers significant benefits over injections or oral routes, like increased compliance, easy administration, and minimal side effects.
Objective Assessment of prescription pattern of drugs and safety profile of drugs used by intranasal route in paediatric age group.
Method Our study was a prospective observational study paediatric age group of patients conducted in the departments of Pharmacology, Paediatrics and Otorhinolaryngology of Burdwan Medical College and Hospital, Burdwan. Data were collected in CRF and frequency distribution of collected data done. Microsoft Excel 2010 was used for analysis.
Result Common age group was infants. Males were more in number. Most common indication was epistaxis. Intranasal drugs per prescription were 1.05. Most commonly prescribed intranasal drug was nasal saline. Nasal decongestant was the most common prescribed medication. Nasal drops were the most common dose formulation.
Conclusion Intranasal drug prescribing in our study was mainly aimed for treating local problems, very few being for systemic action. Some prescribing indicators like prescribing by generic name and prescribing from national essential drug lists were acceptable with scope for improvement. Average number of drugs per prescription and antibiotic use was high. Adverse events after intranasal drug use were primarily local and nose related.
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Dolan, Catherine, Sami Omer, Deirdre Glynn, Michelle Corcoran, and Geraldine McCarthy. "Benzodiazepine and Z-drug Prescribing for Elderly People in a General Hospital: A Complete Audit Cycle." Irish Journal of Psychological Medicine 29, no. 2 (2012): 128–31. http://dx.doi.org/10.1017/s0790966700017444.
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AbstractBackground: Use of benzodiazepines and Z-drugs in the elderly is associated with adverse outcomes such as increased risk of falls and fractures and cognitive impairment. We aimed to assess the prescribing practice of benzodiazepine and Z-drugs in those aged over 65 years in a general hospital against evidence based standards and to examine the effects of multidisciplinary feedback, as well as determine the prevalence of usage.Methods: All case-notes and medication charts of patients over the age of sixty five on surgical and medical wards in Sligo General Hospital (SGH) were retrieved and analysed over a two-day period in 2008. Data was collected in relation to benzodiazepine and Z-drug prescribing. We followed up on this initial data collection by screening discharge summaries at six weeks to assess benzodiazepine and Z-drug prescribing on discharge. Audit results were disseminated together with consensus guidelines on the prescribing of these medications in older adult population to all general practitioners in County Sligo. Educational sessions were held for both doctors and nurses in SGH. The audit cycle was completed by a re-audit of benzodiazepine and Z-drug prescribing six months from original study using identical methods.Results: We found a high prevalence of benzodiazepine and Z-drug use in original audit, 54% (38/70) of the group audited. The prevalence fell to 46% (32/70) at the re-audit post intervention. This result was not statistically significant. The percentage of patients commenced on benzodiazepine and Z-drugs prior to admission fell from 36% (25/70) at the initial audit to 23% (16/70) at the re-audit.Conclusion: Prescribing practices were not in keeping with consensus guidelines as highlighted by this relatively basic audit cycle. Multidisciplinary feedback and letters to GPs resulted in some reduction in the number of patients prescribed benzodiazepines and Z-drugs. Ongoing educational strategies aimed at relevant health care workers with regular audit of medication use within the general hospital setting is pertinent to further improve prescribing practice.
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Srinivasa, Jyothsnya, Vijaya Rajendran, Pratibha Nadig, and Shubhatara Swamy. "Prescribing pattern of antibiotics in ENT outpatient department in a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 9, no. 12 (November 25, 2020): 1892. http://dx.doi.org/10.18203/2319-2003.ijbcp20205129.
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Background: Antibiotics are the most commonly used and misused of all drugs. Patterns of antibiotic resistance widely follows local patterns of antibiotic prescribing and usage. Periodic data collection and analysis of antibiotic prescriptions at regional level are essential to understand and combat antibiotic resistance. Objective of the study was to study the prescribing pattern of antibiotics in outpatient department of Otorhinolaryngology in a tertiary care teaching hospital. Methods: A prospective observational study of prescribing pattern of antibiotics was conducted in the department of Otorhinolaryngology. Data of antibiotic utilization in outpatient department was collected through duplicate copies of the prescriptions. The data obtained was analyzed and the conclusions were drawn using descriptive analysis.Results: A total of 606 prescriptions were collected and analyzed during the study. Average number of antibiotics prescribed per prescription was 1.24 most of the antibiotics were prescribed for a duration of 1 to 5 days. Commonly prescribed antibiotic class was penicillin (48.1%) followed by quinolone (18.3%). Most of the antibiotics were prescribed by their brand names (98.8%).Conclusions: The present study highlights the wide use of extended spectrum antibiotics, along with brand names for prescribing. Interventions for prescribing of generic drugs from the essential drug list needs to be encouraged among physicians.
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GLUSHKOVA, E. F., and T. N. SUROVENKO. "FEATURES OF PRESCRIBING ANTIHISTAMINES IN PEDIATRIC PRACTICE." Medical Council, no. 9 (July 18, 2017): 120–23. http://dx.doi.org/10.21518/2079-701x-2017-9-120-123.
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Objective of the Review: Illustrate the use of antihistamines in the treatment of allergic diseases in children.Key Points: Due to the increasing frequency of occurrence of allergic diseases in the population, including among children, the questions of approaches to therapy and the choice of effective and safe drugs acquire particular urgency. Today the usual drugs of choice are antihistamines of the second generation. Their efficacy was proven over the years, and a large amount of data ontheir use has been accumulated. They have firmly occupied their niche in the pharmacotherapy of allergic diseases. And yet antihistamines of the first generation still find their use in certain clinical situations in pediatrics.Conclusion: This article is devoted to the review of the first generation of antihistamines and their use in pediatric practice.
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P., Shobha, and Messaline Sunitha. "Evaluation of rational drug use pattern using WHO prescribing indicators in a medical intensive care unit of a tertiary teaching hospital in Kerala, India." International Journal of Basic & Clinical Pharmacology 6, no. 6 (May 23, 2017): 1328. http://dx.doi.org/10.18203/2319-2003.ijbcp20172111.
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Background: ICU patients are exposed to more number of life saving drugs and face drug related problems like therapeutic failure, drug interactions and frequent adverse drug reactions. The cost of ICU hospitalisation and money spent on medicines is also a huge burden on these patients. A study of prescribing pattern in an ICU set up will serve as a medical audit to monitor and evaluate the prescribing practices to make it more rational and cost effective.Methods: A prospective observational study was carried out in a medical ICU of a tertiary care hospital. All the inpatients admitted in the medical ICU during the study period of 2 months were included in the study. The data obtained from the case sheets were used to assess the prescribing pattern and rationality of drug use.Results: A total of 101 patients were admitted in 2 months. The most common illness for which the patients (22) were admitted was respiratory problems. Average number of drugs per prescription was 6.9. Cardiovascular system (23.9%) drugs were the most frequently prescribed. Pantoprazole (77) was the single most commonly prescribed drug. 40% of the drugs were prescribed from the essential drug list. The average cost of medicines incurred per person in our study was 5126.33 in INR.Conclusions: Polypharmacy and unwanted prescription of proton pump inhibitors can be avoided by prescribing more generics and drugs from essential drug list.
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Slathi, Indu, Pradeep R. Jadhav, Pooja Deb, and Shashwat Verma. "Drug utilization study in Cardiology outpatient department at a tertiary care hospital." International Journal of Basic & Clinical Pharmacology 6, no. 9 (August 22, 2017): 2276. http://dx.doi.org/10.18203/2319-2003.ijbcp20173759.
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Background: Cardiovascular diseases are the most frequent cause of morbidity and mortality throughout the world particularly in South Asian population. With advent of newer, highly efficacious heterogeneous drugs and changing treatment guidelines, there’s a need to identify the cardiologist preference and prescribing patterns for rational utilization.Methods: It was an open label, prospective, cross-sectional, descriptive type of study conducted in Cardiology Outpatients at a Tertiary care hospital, Navi Mumbai. The study included 100 patients suffering from cardiovascular diseases attending cardiology outpatient department from October 2016 to March 2017. Informed consent was obtained and the currently prescribed drug details were recorded from prescription. The data was analysed for WHO core prescribing indicators and different types of drugs prescribed.Results: The average number of drug products prescribed was 3.4. Most commonly prescribed drugs were Antiplatelets (23%) followed by Statins (19.71%), β blockers (16%), Nitrates (11.70%), Angiotensin converting enzyme inhibitors (8.03%), Calcium channel blockers (5.50%), Angiotensin receptor blockers (4.70%), Diuretics (2.55%), Anticoagulant (1.83%), α+β blocker (1.46%), Cardiac glycosides ((1.09%), Potassium sparing diuretic and central sympatholytics. Majority of drugs were prescribed as single drugs (79.88%) while 20.11% as fixed dose combination (FDC). The combination of Telmisartan + Hydrochlorthiazide was the commonest prescribed FDC. Majority drugs were prescribed from NEDL 2015, but documented low generic prescribing.Conclusions: Antiplatelet and Statins dominated the prescribing pattern with high prescribing trend from national essential drug list, but showed scope for improvement in encouraging the cardiologist to prescribe by generic name.