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Misan, Gary M. H. "Hospital drug usage evaluation /." Cover title, title page, table of contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm6776.pdf.
Повний текст джерелаReimche, Leanne D. "Potential drug-drug interactions in a Canadian tertiary-care hospital." Thesis, University of Ottawa (Canada), 2008. http://hdl.handle.net/10393/27724.
Повний текст джерелаDavies, Emma Clare. "Adverse drug reactions in hospital inpatients." Thesis, Liverpool John Moores University, 2008. http://researchonline.ljmu.ac.uk/5900/.
Повний текст джерелаRamos, Gregg (Gregg Allen). "Reducing preventable adverse drug events in hospital settings." Thesis, Massachusetts Institute of Technology, 2007. http://hdl.handle.net/1721.1/40113.
Повний текст джерелаIncludes bibliographical references (leaves 51-53).
It has been estimated that on average, every patient admitted to a hospital is subject to at least one medication error per day (IOM, 2006). Errors may occur during various stages of the Medication Use System; a system composed of various tasks performed from the point of prescribing medication to the point in which a patient is monitored for adverse effects. Studies have shown that a majority of the errors that occur during the Medication Use System have little if any adverse effect on patients. However, there are classes of medication errors known as Adverse Drug Events (ADE's) which can cause significant harm to a patient. ADE's are not only dangerous but they have been estimated to cost the health care industry and the public in excess of $3.5 billion dollars per year (IOM, 2007). While extensive, current literature that exists on preventable ADE's varies greatly in regards how prevalent the issue is. The lack of a nationwide information system for identifying and defining ADE's only exacerbates the problem. In addition, when significant errors do occur, the repercussions for clinicians and hospitals are far from proportional. Several studies suggest that over one quarter of all medication related injuries are preventable (IOM, 2007).
(cont.) Many industry observers have long touted computerized information systems as the Holy Grail for reducing medication errors. While there is little question that computerized systems can reduce ADE's, hospitals and clinicians frequently ignore other solutions that can offer greater impact in improving the level of care that is being provided. The health care industry has long been touted as fostering a culture that supports at risk behavior and shuns the use of standardized processes. The lack of transparency into the health care industry coupled with an unwillingness to embrace cultural change continues to be one of the largest barriers in reducing the number of preventable ADE's. This paper recommends 4 different solutions that will change the culture of the health care industry, incent hospitals to focus on reducing preventable ADE's, improve the processes already in place for providing patient care and provide clinicians with the most up to date health care information available.
by Gregg Ramos.
M.Eng.in Logistics
Terry, Allan Keith 1952. "National survey of hospital drug-use evaluation programs." Thesis, The University of Arizona, 1992. http://hdl.handle.net/10150/291364.
Повний текст джерелаHoward, Rachel. "The underlying causes of preventable drug-related hospital admissions." Thesis, University of Nottingham, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.437084.
Повний текст джерелаMeiring, Jillian A. "Antimicrobial resistance patterns in a Port Elizabeth hospital." Thesis, Rhodes University, 1993. http://hdl.handle.net/10962/d1004104.
Повний текст джерелаGreen, Christopher Francis. "Hospital pharmacists and their role in adverse drug reaction reporting." Thesis, Liverpool John Moores University, 2000. http://researchonline.ljmu.ac.uk/5124/.
Повний текст джерелаRübesam, Tim. "Drug funding decision-making in hospital formulary committees in Germany." Thesis, University of Gloucestershire, 2015. http://eprints.glos.ac.uk/3432/.
Повний текст джерелаMinn, Minn Soe. "Drug resistant tuberculosis in patients with AIDS at Bamrasnaradura hospital /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-MinnMinnSoe.pdf.
Повний текст джерелаOo, Aung Myat Punnee Pitisuttithum. "Drug resistant tuberculosis in patients with AIDS at Bamrasnaradura hospital /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-AungMyatOO.pdf.
Повний текст джерелаAnsari, Faranak. "Evaluation and management of hospital antibiotic use." Thesis, University of Dundee, 2010. https://discovery.dundee.ac.uk/en/studentTheses/917390eb-a8ea-477a-8cc8-58b6babac813.
Повний текст джерелаDean, Bryony Sandra. "Hospital medication administration errors - their simulation, observation and severity assessment." Thesis, University College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.322040.
Повний текст джерелаKou, Maybelle Antonia Maria. "Quantitative and qualitative drug utilization studies in a university teaching hospital in Hong Kong." Thesis, [Hong Kong : University of Hong Kong], 1994. http://sunzi.lib.hku.hk/hkuto/record.jsp?B14436711.
Повний текст джерелаSaunders, Geoffrey Lance. "Beta-lactam antibiotic resistance in enterobacter cloacae isolated from Groot Schuur Hospital inpatients." Thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/25559.
Повний текст джерелаSaunders, G. L. (Geoffrey Lance). "Beta-lactam antibiotic resistance in enterobacter cloacae isolated from Groot Schuur Hospital inpatients." Master's thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/25557.
Повний текст джерелаChung, Wai-yee Ivis. "A study of the drug policy of the Hong Kong Hospital Authority." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B3644828X.
Повний текст джерелаSantos, Luciana dos. "Medicamentos potencialmente perigosos, não aprovados e de uso off label em prescrições pediátricas de um hospital universitário." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/16641.
Повний текст джерелаObjectives: Describe the use and determine the prevalence of high-alert medications, off label use and unlicensed drugs in prescriptions of general pediatric units of a university hospital in southern Brazil. Method: Cross-sectional study, performed from November 2007 to January 2008, involving patients up to 14 years of age, with admission period over 24 hours. Patients of intensive care and pediatric oncology units were excluded. The classification regarding the Food and Drug Administration approval criteria was performed according to the DrugDex-Micromedex tertiary source and the classification of high-alert medications according to the Institute for Safe Medication Practices. Results e discussion: In the study period, 342 prescriptions were analyzed. Males were more frequent (57%) and over half of the patients already presented chronic diseases for admission. Analgesic drugs were the most frequently prescribed therapeutic class of drugs (26.9%) and among the off-label drugs, antispasmodic drugs (31.5%) were the most prevalent. Around 39% of the analyzed prescriptions had at least one off-label use drug, especially in relation to therapeutic indication (38.4%) and age (21.9%), and 11.8% of the patients received unlicensed drugs. About 6% of the total items (2026) were classified as high-alert medications, such as opioid analgesic drugs (35%). No relation of association was observed between off-label use and high-alert medications. Conclusion: The frequency analyses found of off-label and unlicensed drugs are according to the literature and can be considered as high. The high-alert medications, although of low prevalence, offer risks due to negative effects that can occur in patients. Then, the drugs highlighted in this study constitute a constant concern in hospitals.
Bäckström, Martin. "Spontaneous reporting of adverse drug reactions : possibilities and limitations /." Umeå : Farmakologi och klinisk neurovetenskap, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-525.
Повний текст джерелаChung, Wai-yee Ivis, and 鍾慧儀. "A study of the drug policy of the Hong Kong Hospital Authority." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B3644828X.
Повний текст джерелаKoubaity, Majda. "Drug-Related Problems in Belgium: From community pharmacies to hospital: State of the situation and Impact." Doctoral thesis, Universite Libre de Bruxelles, 2019. https://dipot.ulb.ac.be/dspace/bitstream/2013/294510/3/TM.doc.
Повний текст джерелаDoctorat en Sciences biomédicales et pharmaceutiques (Pharmacie)
info:eu-repo/semantics/nonPublished
Ncube, Musawenkosi Genius. "Prescription patterns and drug duplication in specialist outpatient clinics at a tertiary hospital in the greater Tshwane metropolitan area." Diss., University of Pretoria, 2020. http://hdl.handle.net/2263/75041.
Повний текст джерелаDissertation (MSc)--University of Pretoria, 2020.
Pharmacology
MSc (Pharmacology)
Unrestricted
Gomes, Adriana Parente. "IncidÃncia de ReaÃÃes Adeversas a Medicamentos em Hospital de Ensino no Nordeste do Brasil." Universidade Federal do CearÃ, 2004. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=8453.
Повний текст джерелаINTRODUÃÃO: ReaÃÃes adversas a medicamentos - RAM constituem causa de morbi-mortalidade em pacientes hospitalizados, pÃem em risco a vida do paciente e representam aumento no tempo de internaÃÃo e nos custos hospitalares. OBJETIVOS: Determinar a incidÃncia de reaÃÃes adversas a medicamentos no Hospital UniversitÃrio Walter CantÃdio - HUWC, investigar quais os fatores que podem estar associados a esses eventos e propÃr medidas de prevenÃÃo ou reduÃÃo do impacto negativo dessas reaÃÃes. MÃTODOS: Estudo observacional, analÃtico, prospectivo, com monitorizaÃÃo intensiva de pacientes, determinaÃÃo da incidÃncia acumulada de RAM e avaliaÃÃo exploratÃria de seus determinantes. Eram incluÃdos no estudo, todos os pacientes internados nas clÃnicas mÃdicas do HUWC, de 01 de setembro de 2000 a 28 de fevereiro de 2001, os quais foram acompanhados desde o momento da internaÃÃo atà a alta hospitalar ou Ãbito, para a detecÃÃo e acompanhamento de reaÃÃes adversas. Foram realizadas visitas diÃrias Ãs clÃnicas mÃdicas do HUWC, registrando os medicamentos utilizados e investigaÃÃo sobre a ocorrÃncia de RAM. Os casos em que os pacientes apresentavam RAM eram avaliados seguindo a metodologia recomendada pela OrganizaÃÃo Mundial de SaÃde. As reaÃÃes eram classificadas conforme imputabilidade, gravidade e tipo. Os medicamentos foram classificados de acordo com o Anatomical-Therapeutical-Chemical â ATC, Classification Index e as reaÃÃes adversas atravÃs do WHO-ART tambÃm recomendado pela OrganizaÃÃo Mundial da SaÃde. RESULTADOS: Foram internados nas clÃnicas mÃdicas do HUWC um total de 970 pacientes destes, 54% eram mulheres e 46% homens, com idade variando de 9 meses a 97 anos. Todos os pacientes fizeram uso de medicamentos durante a internaÃÃo, variando de 1 a 20 medicamentos/paciente. Os grupos de medicamentos mais utilizados, (1 nÃvel ATC) foram medicamentos que atuam no sistema nervoso central (19,0%), medicamentos que atuam sobre o trato alimentar e metabolismo (17,0%), medicamentos que atuam no sistema cardiovascular (16,7%). Do total, oito (0,8%) tiveram como diagnÃstico de internaÃÃo alguma reaÃÃo adversa a medicamento. Durante o perÃodo do estudo foram verificadas 30 novas ocorrÃncias de RAM em pacientes hospitalizados. As manifestaÃÃes das reaÃÃes adversas compreendiam principalmente afecÃÃes da pele (65,0%) e distÃrbios do estado geral (25,0%). Quanto à gravidade, as reaÃÃes foram na sua maioria classificadas como moderadas (79,0%), seguidas das reaÃÃes leves (19,0%). A relaÃÃo de causalidade foi considerada provÃvel em 58,0% dos casos e definida em 24,5%. Os grupos farmacolÃgicos mais envolvidos foram antibiÃticos de uso sistÃmico (66,4%), seguido por medicamentos que atuam no sistema nervoso (7,7%), antineoplÃsicos e agentes imunomoduladores (7,7%). A incidÃncia de RAM entre os pacientes hospitalizados nÃo està associada ao sexo nem à idade. O nÃmero de dias de internaÃÃo interferiu na ocorrÃncia de RAM. CONCLUSÃO: Foram identificadas ocorrÃncias de reaÃÃes adversas como causa de internaÃÃo e durante a internaÃÃo hospitalar. Todos os pacientes admitidos com RAM apresentaram manifestaÃÃes dermatolÃgicas. Os antibiÃticos, principalmente a cefalotina, foram os medicamentos mais envolvidos com a ocorrÃncia de RAM em pacientes internados.
INTRODUCTION: Adverse drug reactions (ADR) constitute cause of morbidity in hospitalized patients, represent a risk for patients and an increase in the period patients stay in hospitals and the costs. OBJECTIVES: To determine the incidence of adverse drug reactions in the Walter CantÃdio University Hospital (WCUH), investigate what factors may be associated with these events and propose measures to prevent or reduce the negative impact of those reactions. METHODS: An observational, analytical, and prospective study, with intensive monitoring of patients, analysis of the cumulative incidence of ADR and an exploratory evaluation of its determinants. The study included all inpatients in the medical clinics of WCUH from September 1st, 2000 to February 28th 2001, which were assisted from admission until discharge or death, to detection and monitoring of adverse reaction. Daily calls were made to the clinics WCUH in order to register the use of drugs and the occurrence of ADR. Cases in which patients had ADRs were assessed according to the methodology proposed by the World Health Organization. The reactions were classified based on liability, severity and type. Drugs were classified according to the Anatomical-Therapeutical-Chemical (ATC), Classification Index and adverse reactions through the WHO-ART also recommended by the World Health Organization. RESULTS: 970 patients were admitted to the medical clinics of HUWC. Of those, 54% were women and 46% were men, ranging in age from 09 months to 97 years. All patients received medication during hospitalization, ranging from 1 to 20 drugs / patient. The most commonly used drug groups (1st level ATC) are drugs that act on central nervous system (19.0%), drugs that act on the digestive tract and metabolism (17.0%), and drugs that act on the cardiovascular system (16.7%). Of the total, in eight (8%) the diagnosis for admission was an adverse reaction to medication. During the study, 30 new cases of ADRs in inpatients were registered. The results of adverse reactions comprised mainly skin disorders (65.0%) and general disturbances (25.0%). About gravity, the reactions were mostly classified as moderate (79.0%), followed by mild reactions (19.0%). The relation of causality was considered probable in 58.0% of cases and set at 24.5%. Most involved pharmacological groups were antibiotics for systemic use (66.4%), followed by drugs that act on the nervous system (7.7%), antineoplastic and immunomodulating agents (7.7%). The incidence of ADR among inpatients is not associated with age or gender. The number of days of hospital admission interfered with the occurrence of RAM. CONCLUSION: Adverse reactions as cause of admission were identified. All inpatients with ADRs have skin manifestations. Antibiotics, especially cephalosporins, were drugs commonly involved with the occurrence of ADRs in inpatients.
Gouws, Stephanus Andries. "The impact of hospital surveillance programmes on the incidence of adverse drug reaction reporting in a South African teaching hospital." Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/27186.
Повний текст джерелаSablay, Hyder. "Prescribing practice at a tertiary level paediatric hospital in South Africa." University of the Western Cape, 2014. http://hdl.handle.net/11394/4357.
Повний текст джерелаThe objectives of the present study were to describe the type and frequency of prescribing errors and error frequency, to determine the error frequency for different drug classes, to identify potential drug interactions and drug-disease interactions to point out off-label prescribing and to evaluate risk factors of prescribing errors. Methods: This prospective cross sectional study was conducted over a period of 6 months from July 2012 to December 2012 in 2 specialist wards and 2 general medical wards at Red Cross War Memorial Children’s Hospital in Cape Town in South Africa. Only prescriptions generated by doctors in the above mentioned wards were assessed. Convenience sampling was used to select 200 prescription charts for analysis. Information relating to prescribing error, potential drug interaction, potential drug-disease interactions, off-label prescribing and potential risk factors of prescribing error were entered into excel spreadsheet and analysed using STATA versions 11&12. The mass of the patients was converted into weight-for-age z-score (WAZ) using WHO 2006 child growth standards. Univariate analysis and multiple logistic regression were used to identify risk factors of prescribing errors. Results: Of the 200 children on whom prescribing information was analysed, 40 (20%) were severely underweight and a further 25(12.5%) were moderately underweight. A total of 1402 prescribing errors were documented in 1282 drug items prescribed, a rate of 1.09 errors per drug item prescribed. Incomplete prescription information was the most common type of prescribing error, present in 65.6% of all drug items prescribed. The error frequency was high for all drug classes ranging from 57.9% of all respiratory drug items prescribed to 86.4% of all gastro intestinal system drug items prescribed. The number of potential drug-drug interactions was low i.e. 20 potential pharmacodynamics and 49 potential pharmacokinetic drug interactions were identified. The number of potential drug-disease interactions was also low i.e. 39 or 0.03% per drug item prescribed. Furthermore 57 off-label prescribing incidences were recorded. Senior doctors posed a significant risk factor for prescribing errors, an OR 1.95, 95% CI 1.46 – 2.61. Conversely, prescriptions written up in the general wards compared to the specialty wards (an OR 0.65. 95% CI 0.47-0.90) and prescribing during weekends compared to weekdays (an OR 0.71, 95% CI 0.53-0.96) were associated with lower prescribing error risk. Conclusion: This study provided valuable information about prescribing practices in children at RCWMCH. There is a need to improve prescribers’ practice at RCWMCH considering the type of errors observed viz. missing information, use of wrong drug name, abbreviations, legibility concerns and lack of clarity of the prescriptions, among others. Based on this study results further intervention studies are recommended to investigate the level of medical student’s training w.r.t prescribing practice.
Wenger, Mona L. "Status of bloodborne pathogen education for injection drug users in Indiana hospital emergency departments." Virtual Press, 2007. http://liblink.bsu.edu/uhtbin/catkey/1372056.
Повний текст джерелаDepartment of Physiology and Health Science
Al-Khateeb, Mohammed Jihad M. Jalal. "Investigation into the epidemiology of multi-drug resistance plasmids of hospital-associated coliform bacteria." Thesis, University of Liverpool, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243028.
Повний текст джерелаVasconcelos, Luciana Mabel Ferreira. "Clinical and laboratorial investigation in patients with suspected drug allergy in a tertiary hospital." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=7398.
Повний текст джерелаAllergic drug reactions account for 6.5% of hospital admissions, prolonged hospitalization 15.1% of patients and are severe in 6.7% of patients. There are difficulties in understanding the immune mechanisms, diagnosis and treatment of patients. Therefore, such reactions are considered a Public Health problem. The objective of this study was to describe the cases of patients with suspected allergic hypersensitivity to drugs and to evaluate the response of individuals to skin tests. A total of 63 patients were included in the study. The experimental design was a cross-sectional observational study from June 2008 to October 2011. We applied a questionnaire to investigate the clinical and laboratory informations. Eight patients received other diagnosis and three died due to other reasons, so that 52 patients completed the study. Most patients were men (56.36%), non atopic, with a median age of 52 year. The drugs most commonly implicated were NSAIDs and the oral administration was the most commonly route used. It was documented 69 suspected reactions; most of them were considered as delayed hipersensitivity. Maculopapular rash and erythema multiforme were the most frequent manifestations. According to the severity of the reactions, most was considered moderate (72.46%). The patch test was performed in 22 patients for investigation of delayed reaction. Seven cases were positive (31.81%), DRESS (rash with eosinophilia and systemic symptoms) caused by captopril (+), contact eczema by rifamycin (+ +), lichenoid eruption by captopril (+), maculopapular rash + ampicillin and cephalexin to angioedema (+), two cases of fotoeczema one by captopril and another by AAS, both with positive results (+) and one case of Stevens-Johnson syndrome caused by phenytoin (++). For immediate hypersensitivity, 3 in 10 patients have shown positive results for prick test with AAS diluted to 1/1000. It was possible to confirm the liability of the drug reactions in 19 (27.53%), which demonstrated the importance of application of skin tests in the clinical investigation of allergic drug reactions. As for causality, 26 reactions were considered possible, 20 defined, 13 probable, 9 and a conditional reaction was considered not related to drugs. Given its importance, the performance of skin tests with these patients has opened perspectives on the possibility to incorporate this service in routine outpatient Dermatology HUWC.
As reaÃÃes alÃrgicas medicamentosas sÃo responsÃveis por 6,5% das admissÃes hospitalares, prolongam a hospitalizaÃÃo de 15,1% dos pacientes e sÃo graves em 6,7% dos pacientes. Hà dificuldades quanto à compreensÃo dos mecanismos imunolÃgicos, diagnÃstico e tratamento dos pacientes. Portanto, tais reaÃÃes sÃo consideradas um problema de saÃde pÃblica. O objetivo deste trabalho foi descrever os casos de pacientes com suspeita de hipersensibilidade alÃrgica a fÃrmacos e avaliar a resposta desses indivÃduos aos testes cutÃneos. Um total de 63 pacientes foram incluÃdos no trabalho, cujo delineamento experimental foi de um estudo observacional descritivo transversal realizado entre junho de 2008 e outubro de 2011. Utilizou-se um questionÃrio para investigaÃÃo das informaÃÃes clÃnico-laboratoriais. Oito pacientes receberam outro diagnÃstico e trÃs foram a Ãbito por outros motivos, de forma que 52 pacientes completaram o estudo. A maioria dos pacientes era homem (56,36%), nÃo atÃpicos, com mediana de idade de 52 anos. Os fÃrmacos mais implicados foram os AINES (anti-inflamatÃrios nÃo esteroidais) e a via oral foi a mais utilizada. Foram documentadas 69 reaÃÃes suspeitas, a maioria do tipo tardia. Exantema maculopapuloso e eritema multiforme foram as manifestaÃÃes mais freqÃentes entre as reaÃÃes tardias. Quanto à gravidade, a maioria foi considerada moderada (72,46%). O teste de contato foi realizado em 22 pacientes para investigaÃÃo de reaÃÃo tardia. Em sete casos, houve resultado positivo (31,81%), ou seja, DRESS (Rash com eosinofilia e sintomas sistÃmicos) causado por captopril (+), eczema de contato por rifamicina (++), erupÃÃo liquenÃide por captopril (+), exantema maculopapuloso + angiodema para cefalexina e ampicilina (+), dois casos de fotoeczema, um por captopril e outro por Ãcido acetilsalicÃlico (AAS), ambos com resultado (+) e um caso de sÃndrome de Steven-Johnson por fenitoÃna (++). Foram realizados dez testes de puntura e em trÃs pacientes houve positividade para AAS diluÃdo a 1/1000. Foi possÃvel confirmar a imputabilidade do fÃrmaco em 19 reaÃÃes (27,53%), o que demonstra a importÃncia da aplicaÃÃo dos testes cutÃneos na investigaÃÃo clÃnica das reaÃÃes alÃrgicas a medicamentos. Quando à causalidade, 26 reaÃÃes foram consideradas possÃveis, 20 definidas, 13 provÃveis, 9 condicionais e uma reaÃÃo foi considerada nÃo relacionada com fÃrmacos. Dada a sua importÃncia, a realizaÃÃo dos testes cutÃneos com esses pacientes abriu perspectivas sobre a possibilidade incorporar esse serviÃo na rotina do ambulatÃrio de Dermatologia do HUWC.
Nchendia, Azia Ivo. "Barriers to adherence to antiretroviral treatment in a regional hospital in Vredenburg, Western Cape." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4483.
Повний текст джерелаBackground: South Africa has one of the most severe HIV epidemics globally, with an estimated 737,000 AIDS related deaths annually and over a million children rendered orphans due to AIDS in 2006. However in 2007, the South African government made a giant commitment to dealing effectively with the AIDS epidemic by implementing a National Strategic Plan (NSP), which had as one of its principal objectives the provision of antiretroviral medications to 80% of all people in need of the treatment by 2011. By the end of June 2011, the rollout of antiretroviral therapy continued to be successful with 1.4 million persons started on antiretroviral therapy and treatment initiation rates reaching 30, 000 per month. Patients have to subject to an uncompromising adherence of taking at least 95% of antiretroviral medication as prescribed, because poor adherence to ART leads to treatment failure, viral mutations and the development of drug resistance. Of major concern to ART programmes are the current obstacles that patients’ face in lieu of treatment. Aim: The aim of this study was to explore the barriers to adherence to antiretroviral treatment among patients in a public ART programme in Vredenburg, Western Cape. Methodology: An explorative qualitative study was conducted where data was collected through interviews with 18 patients receiving treatment from the Vredenburg hospital. Data was audio-tape recorded, transcribed in full and thematic content analysis done. Results: The study identified awareness of HIV status, disclosure, unemployment, lack of transport,insufficient feeding, disability grants, alcohol and alternative forms of therapy as well as stigma as major barriers to adherence. Whereas inadequate follow ups, recklessness in the way patients’ HIV results were handled, long waiting times and the fear of picking up other types of infections from other patients in the OPD also came under major criticisms from patients. Finally, the sharing of experiences at clinic visits, good healthcare provider’s patient relationships, believing in the treatment, good treatment literacy, being a parent and having children to take care of, the use of pill boxes, social and spiritual support from family members and friends were identified as factors that positively influenced adherence. Conclusion: HIV/AIDS has been a stigmatized illness since its onset in the early 1980s and, these results highlight that such stigma has yet to dissipate in Vredenburg. Therefore, stigma and disclosure must remain at the forefront of the ART programme implementation in Vredenburg; while long term projects that can support ART users economically should be created through partnerships with non-governmental organizations and the government of South Africa to optimize adherence in the community.
Ferrari, Michela De Luca 1978. "Resistencia aos farmacos antimicobacterianos em um hospital terciario : utilidade do metodo de microdiluição em placa com sal de tetrazolium." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311146.
Повний текст джерелаDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Os objetivos do presente estudo foram estimar a prevalência de resistência do M. tuberculosis aos fármacos de primeira linha entre pacientes com tuberculose diagnosticados no Hospital de Clínicas da Unicamp e avaliar o desempenho do método de microdiluição em placa com [3-(4,5-dimethylthiazol-2-yl)- 2,5diphenyl-tetrazolium bromide] (MTT) comparado ao Bactec MGIT 960®. No período foram notificados 360 casos de tuberculose. Destes 211 casos apresentaram cultura positiva para Mycobacterium sp, sendo incluídos 105 casos, nos quais foi identificado o M. tuberculosis. Dentre estes pacientes a apresentação pulmonar da TB ocorreu em 64,8% e co-infecção pelo HIV em 37,1%. A prevalência de resistência a qualquer fármaco foi de 6,7%; multidrogarresistência (RMP e INH) e resistência a INH e SM foram detectadas em 1%, em 3,8% e em 3,8% dos casos, respectivamente. Todos os isolados foram susceptíveis ao EMB. A resistência primária foi encontrada em quatro casos e resistência adquirida em três. Houve associação entre tratamento prévio e resistência (p=0,0181), as demais variáveis estudadas não foram associadas. Dentre os 119 isolados de M. tuberculosis incluídos para a avaliação do desempenho do MTT, ocorreu concordância de 100% para INH e EMB entre os métodos MTT e Bactec MGIT960®, de 99% para RMP (sensibilidade: 90%), enquanto que para SM houve concordância inferior aquela apresentada pelos outros fármacos (95,2%; sensibilidade: 90,9%). A prevalência de resistência entre os casos novos atendidos no Hospital de Clínicas da Unicamp no período de estudo foi de 3,8% para isoniazida, 1% para rifampicina, 3,8% para etambutol e 1% multidrogarresistente. Resistência a qualquer fármaco foi observada em 6,7% dos casos. O método colorimétrico com MTT apresentou bom desempenho e representa uma alternativa acurada, simples e de reduzidos custos, viável e sustentável para locais e países com limitados recursos.
Abstract: This cross-sectional, hospital-based study conducted between January 2006 and March 2008 sought to estimate the resistance of M. tuberculosis to first-line drugs among patients with tuberculosis confirmed by culture at a Brazilian hospital and evaluate the performance of the [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide] (MTT) microplate assay in comparison to the Bactec MGIT 960. During the study period were reported to the surveillance system 360 tuberculosis cases, 211 out of these were confirmed by positive culture for Mycobacterium sp and 105 out of these had M. tuberculosis isolated on culture and were included to the prevalence study. Pulmonary involvement was present in 64.8% of cases and HIV co-infection was found in 37.1%. The prevalence of M. tuberculosis resistance was 6.7%; multidrug-resistance [rifampin (RMP) and isoniazid (INH)] and resistance to INH and streptomycin (SM) were detected in 1%, in 3.8% and in 3.8% of cases, respectively. All isolates were susceptible to ethambutol (EMB). The resistance was primary in four cases and acquired in three cases. Previous treatment was associated with resistance (p=0.0181). Among 119 isolates of M. tuberculosis included to the MMTT performance evaluation, there was 100% observed agreement for INH and EMB between the MTT and Bactec MGIT 960¿ methods. For RMP, the observed agreement was 99% (sensitivity: 90%), and for SM, the level of agreement was lower (95.2%; sensibility 90.9%) than those of the other drugs. The prevalence of M. tuberculosis resistance among the new cases during the study period was 6.7%; multidrug-resistance and resistance to INH and streptomycin (SM) were detected in 1%, in 3.8% and in 3.8% of cases, respectively. The colorimetric method with tetrazolium (MTT) represents an accurate, simple and low cost alternative that is both viable and sustainable for settings with limited resources.
Mestrado
Ciencias Basicas
Mestre em Clinica Medica
Kongkaew, Chuenjid. "Drug-Related Hospital Admissions : An Epidemiological Assessment of Prevalence, Risk Factors, Nature and Clinical Significance." Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.503633.
Повний текст джерелаHAMAJIMA, NOBUYUKI, YOSHITOKU YOSHIDA, AMONOV MALIK, SALIM DAVLATOV, and ERKIN TOIROV. "HYPERTENSION-RELATED KNOWLEDGE, PRACTICE AND DRUG ADHERENCE AMONG INPATIENTS OF A HOSPITAL IN SAMARKAND, UZBEKISTAN." Nagoya University School of Medicine, 2014. http://hdl.handle.net/2237/20544.
Повний текст джерелаPayne, Linda Gail. "The experience of caring for women with drug or alcohol problems in the general hospital." Thesis, Florida Atlantic University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10154941.
Повний текст джерелаThe purpose of this study was to describe the lived experience of nurses who care for hospitalized women outside of an addiction treatment setting who have a problem with drugs and / or alcohol. The relational experiences of ten registered nurses who had cared for women with drug and alcohol problems were elicited. Heideggerian hermeneutic phenomenology was the method used to interpret the nurse participants’ meaning of their experience. The theoretical framework that was used to explore the nurses’ experience of caring for women who abuse or are dependent on alcohol was Boykin and Schoenhofer’s Nursing as Caring (1993). The relational themes that emerged were: Caring in the dark; Intentionally knowing the woman with AOD as a unique person; and Experiencing sisterhood.
Osho, Folasade Monisola. "Knowledge, attitudes and practices of adverse drug reaction reporting among nurses in a tertiary hospital in South West Nigeria." University of the Western Cape, 2018. http://hdl.handle.net/11394/6906.
Повний текст джерелаBackground: Healthcare providers are critical to collecting information on drug safety and successful adverse drug reaction (ADR) reporting. The roles of doctors and pharmacists have been recognized as important to voluntary ADR reporting and their roles are consistently being investigated. However, despite the strategic role of nurses in medicine administration, their role in ADR reporting has not been widely explored, particularly in sub-Saharan African countries. Aim: To assess the knowledge, attitudes and practice of ADR reporting amongst nurses in Lagos University Teaching Hospital (LUTH), a tertiary hospital located in Lagos; the economic centre of Nigeria, as well as the most populous city in the country. Methodology: A cross-sectional descriptive survey with analytical components was conducted among nurses in a tertiary institution. All nurses working in major specialties - out-patients’ clinics, theatre and clinical wards in the facility, were eligible to participate in the study. Student nurses undergoing training or postings in the facility were excluded from the study. A sample size of 124 nurses was calculated using OpenEpi sample size calculator based on an estimated study population of 400 with a 95% confidence interval and an assumed 5% of nurses reporting an ADR based on National Pharmacovigilance Centre database. A sample of 140 nurses was selected in an attempt to realize sample. Cluster sampling was used to randomly select clinics and wards and all nurses in the selected clusters were included in the study. A structured questionnaire consisting of close-ended questions was used. It comprised sections on nurses’ characteristics, knowledge of pharmacovigilance concepts, attitudes towards ADR reporting, and barriers to and practice of ADR reporting. Data collected were entered into an Excel spreadsheet and imported to the SPSS version 20 software for analysis. Descriptive analyses were conducted on all the variables and cross-tabulation between selected variables was explored to test for statistical significance using chi-squared test.
King, Ariel Rosita. "An evaluation of South Africa's national drug policy : standard treatment guidelines/essential drugs list and its impact on rational drug prescribing at public hospital oupatient clinics : a case study of the Northern Province." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2003. http://researchonline.lshtm.ac.uk/4646516/.
Повний текст джерелаSchutz, Charlotte. "Burden of antituberculosis and antiretroviral drug-induced liver injury at a secondary hospital in South Africa." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/12515.
Повний текст джерелаAims : 1. To determine the proportion of patients who present with TB treatment and or ART-associated drug-induced liver injury (DILI) amongst all patients presenting with significant liver injury to GF Jooste Hospital during the study period. 2. To describe base line clinical characteristics and management of TB treatment and or ART-associated DILI patients. 3. To describe the in-patient and 3-month mortality of TB treatment and or ART-associated DILI patients. Background and Rationale : GF Jooste Hospital is a public sector referral hospital and serves a densely populated area with a high burden of HIV and tuberculosis (TB). ART rollout in the Western Cape started in 2001/2002 at two pilot clinics and is now well established (1). Many patients are on concomitant TB treatment and ART. At ART clinics in the referral area 25 - 40% of patients are on TB treatment when they start ART (2, 3) . At GF Jooste hospital many HIV positive patients are seen who are on TB treatment and or ART, and present with symptomatic liver dysfunction. Patients are on multiple hepatotoxic drugs, may have multiple opportunistic infections, systemic sepsis and hepatic TB immune reconstitution disease also plays a role. Anecdotally, these patients are complex to manage, require frequent specialist input, spend a long time in hospital and have high mortality. Management guidelines are based on expert opinion and is not evidence based. In practice management relies heavily on the attending clinicians’ experience and clinical judgment and management often differ widely between clinicians. Mortality could be due to progression of TB and or HIV because of interruption of effective therapy, other opportunistic infections or hospital acquired infections. Few early liver biopsies are done and it is not known if early liver biopsies would aid by guiding management of these patients. Prospective studies are urgently needed to guide management in these patients. The burden of TB treatment and or ART-associated drug induced liver injury in this setting has not been described to our knowledge, neither has management, outcome or mortality. This study was performed to aid planning of prospective studies in this field.
Gulmez, Sinem. "EPIHAM Drug-induced liver injury leading to hospital admission : a study in national healthcare insurance databases." Thesis, Bordeaux, 2017. http://www.theses.fr/2017BORD0592.
Повний текст джерелаThe main objective of EPIHAM study is to identify the main drugs associated with drug induced liver injury leading to hospital admission (DILIH) in France and the event rates associated with DILIH. Three methodological approaches were defined. Principal approach is case-population. The others are case-crossover and case control analyses. Cases were identified among adult patients present in SNIIRAM database having a first hospitalization between 01/01/2010-2010/31/12/1204, the main diagnosis of which is toxic liver disease (diagnostic codes according to the International Classification of Diseases (ICD-10) K71.1, K71.2, K71.6, K71.9) orK72.0. Reference population was defined from the EGB. Index date (ID) was considered as the date of hospital admission for DILI. The dispensations of all treatments preceding the ID were studied by considering an exposure windowvarying from 7 to 60 days before ID. The most frequently found are classical: analgesics and firstly paracetamol, followed by drugs acting on digestive system (proton pump inhibitors, prokinetics, antispasmodics). The following were amoxicillinalone or combined with clavulanic acid, ibuprofen, codeine combinations, and furosemide. These results can inform health authorities, practitioners and patients about the acute hepatitis risk leading to hospitalisation associated with each of these molecules, both individually (absolute risk, attributable risk) and within a therapeutic drug family (relative risk) as well as more generally for the population and the health system (absolute number of attributable cases)
Segomotso, Nametso Patience. "Knowledge, attittudes and practices of healthcare professionals towards adverse drug reaction reporting in Mafikeng Provincial Hospital." Thesis, University of Limpopo ( Medunsa Campus), 2011. http://hdl.handle.net/10386/424.
Повний текст джерелаAbstract Background: Prevention, monitoring and reporting of adverse drug reactions is still a challenge among healthcare professionals. Even though some adverse drug reactions are minor and can be resolved quickly some can cause permanent disability or death. A recent South African study in a secondary hospital found that 6.3% of medical admissions were due to adverse drug reactions, which is similar to proportions found in developed countries. It is the responsibility of the healthcare professionals to detect, investigate, manage and report adverse drug reactions. Aim of the study: This study aimed to determine knowledge, attitudes and practices of healthcare professionals (doctors, nurses and pharmacists) regarding the reporting of patients‟ adverse drug reaction at Mafikeng Provincial Hospital. Methods: This was a descriptive quantitative study. A questionnaire was used to collect data from 29 doctors, 88 nurses and 5 pharmacists. Data was collected on demographic characteristics of the healthcare professionals, their knowledge, attitudes and practices towards ADR reporting. Data analysis was conducted using STATA (version 11) and Epi info (version 6). A test of association of selected variables was done using Pearson chi–square and logistic analysis to measure the association. Results: More than half of the participants were male (56.3%) and 53.8% percent of them were younger than 40 years. Majority of the respondents (72.27%) indicated that they do not know how to report ADRs. There was no significant difference in terms of knowledge by age category. None of the healthcare professionals have ever sent their ADR forms to the pharmacovigilance centre. Ninety-one percent (91.53%) felt that reporting of ADR can benefit the public health, 78.63% felt that filling of the ADR yellow form is useful and 98.29% felt that ADR should be compulsory. There was no significant association between knowledge of how to report and attitude towards reporting (X²=1.0, p= 0.317), no association between knowledge and practice (X²=0.974, p= 0.324). iv Conclusions: This study revealed that more than a third of the respondents (72.29%) did not have the knowledge of the procedure for reporting ADRs. Healthcare professionals had a positive attitude towards ADR; 98.29% of them said that ADR reporting should be compulsory. There was no significant association between knowledge, attitude and practice toward ADR reporting. Healthcare professionals' knowledge can be improved through educational interventions and trainings.
Turano, Helena Gabriela. "Alternativas terapêuticas para o tratamento de infecções por Pseudomonas aeruginosa multirresistentes endêmicas no Brasil." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/42/42132/tde-19042013-103459/.
Повний текст джерелаPseudomonas aeruginosa is a leading cause of nosocomial infections, which it has acquired an endemic status due to their intrinsic or acquired resistance to antibacterial agents commercially available. The aim of the study was to evaluate in vitro therapeutic options based on the synergistic activity. Ten clonally unrelated strains of P. aeruginosa, previously characterized as metallo-beta-lactamase (MbL) producers (i.e., SPM-1, VIM-1 and PA GIM-1) were evaluated. The synergistic effect was investigated by checkerboard and Time-Kill assays. The combinations [Piperacillin/Tazobactam x Aztreonam] and [Tigecycline x bilayer fragments of dioctadecyldimethylammonium bromide (DDA)] showed synergistic activity for 90 and 100% of the strains, respectively. The results support the use of combined therapy by using [Piperacillin/Tazobactam x Aztreonam] against infections produced by strains of P. aeruginosa producing MbLs, moreover, [DDA / Tigecycline] may be the basis for build a new pharmaceutical form for clinical use.
Bäckström, Martin. "Spontaneous reporting of adverse drug reactions : Possibilities and limitations." Doctoral thesis, Umeå universitet, Institutionen för farmakologi och klinisk neurovetenskap, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-525.
Повний текст джерелаMachado, Tatiane Araujo de Castro. "Identificação das potenciais interações medicamentosas com a varfarina e as intervenções do farmacêutico para o manejo de pacientes internados em um hospital universitário." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/36115.
Повний текст джерелаIntroduction: Inadequate anticoagulation may cause bleeding and thromboembolic events, representing a challenge for medicine. Warfarin, an oral anticoagulant in wide use, has severe adverse reactions, common in patients taking multiple drugs. Objectives: This study aims to evaluate potential drug interactions with warfarin; to describe and quantify pharmaceutical interventions in order to minimize them; to assess the degree of acceptability by the medical team in relation to interventions as well as the impact on the outcome of the INR. Method: A Cohort study, done between August 2009 and January 2010 involving hospitalized patients who started warfarin therapy in two internal medicine units in a university hospital located in southern Brazil. Potential pDDIs with warfarin with warfarin (major and moderate) were identified in the online system Drug-Reax, Micromedex Healthcare. Additional information was obtained directly from medical records. Interventions with medical team were through medical record notes or verbal information. The value of the INR (international normalized ratio) was continuously monitored and served as a measure of the outcome of the intervention. Results: Two hundred and two inpatients were followed. The total number of prescribed drugs was 2071, with mean of 10 (SD = 3.6) per patient. All inpatients had at least one potential moderate or severe pDDIs with warfarin, the mean was 3.6 (SD = 1.6) per patient. Patients with more than four potential drug interactions showed a higher risk for hemorrhagic problems (INR> 5 - RR = 3.00, 95% CI 1.59-5.70). For 737 pDDIs identified, 675 (91.5%) may result in increased anticoagulation activity and 29 (3.9%) may reduce this effect. The drugs most commonly involved in these pDDIs were enoxaparin (32.2%), simvastatin (27.6%), omeprazole (22.5%) and tramadol (21.5%). The medical team’s intervention were 116 (57.4%) through medical records and 86 (42.6%) were orally. For 32 patients (15.8%), interventions were not accepted and they had higher risk (RR = 2.17; 95% CI 1.10 – 4.27) for amended exam (INR > 5). Multivariate analysis showed that age, length of hospital stay, having four or more major or moderate potential interactions and unwillingness to accept pharmaceutical intervention contribute significantly to the patient current values of INR> 5, which implies a risk of bleeding. Conclusion: Major and moderate drug interactions involving warfarin are very common in hospitalized patients and are associated with patient’s high risk of having an INR outside the target range. The collaboration of pharmacists in the management of interactions with information and guidance to physicians showed a good acceptance and seems to contribute to patient safety.
Smith, Louise. "Resilience of the partners of long term hospitalised patients with multidrug-resistant (MDR) and extreme drug-resistant (XDR) tuberculosis (TB)." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1020913.
Повний текст джерелаSantos, Djanilson Barbosa dos. "Drug utilization profile and monitoring of adverse reactions in pediatric patients in the Hospital Infantil Albert Sabin." Universidade Federal do CearÃ, 2002. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=438.
Повний текст джерелаCoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
INTRODUÃÃO: A populaÃÃo pediÃtrica se ressente dos poucos estudos que relacionem o perfil de utilizaÃÃo e ocorrÃncia de reaÃÃo adversa a medicamentos (RAM) em crianÃas hospitalizadas. OBJETIVOS: Descrever e avaliar a utilizaÃÃo de medicamentos e a ocorrÃncia de reaÃÃes adversas em pacientes pediÃtricos internados no Hospital Infantil Albert Sabin na perspectiva de contribuir para a reduÃÃo dos agravos decorrentes do uso de medicamentos em crianÃas hospitalizadas. METODOLOGIA: Estudo observacional longitudinal prospectivo, de seguimento de pacientes pediÃtricos hospitalizados por mais de 24 horas, em um hospital pÃblico de referÃncia. Pacientes de 1-173 meses de idade foram incluÃdos no estudo no perÃodo de 01 de agosto a 31 de dezembro de 2001. Foram realizadas visitas diÃrias à enfermaria para inclusÃo ou acompanhamento de pacientes; entrevistas com as mÃes por meio de um questionÃrio estruturado para levantar caracterÃsticas sÃcio demogrÃficas e antecedentes patolÃgicos dos entrevistados, familiares e das crianÃas, revisÃo das prescriÃÃes e dos prontuÃrios, conversa com mÃdicos, enfermeiras e farmacÃuticos quando necessÃrio. As suspeitas de RAM foram avaliadas pelo CEFACE conforme a metodologia recomendada pelo Programa de FarmacovigilÃncia da OMS. Na anÃlise estatÃstica foram utilizados o teste exato de Fisher, Student (t) e wilcoxon, considerando-se o nÃvel de significÃncia p < 0,05. RESULTADOS: Durante o perÃodo de estudo ocorreram 272 admissÃes predominantemente de crianÃas entre 1 e 23 meses de idade (47,4%); com mÃes de 1o grau completo ou incompleto de escolaridade (70,6%); famÃlias de renda familiar entre 1 e 5 salÃrios mÃnimos (61,0%). Dentre as crianÃas admitidas, 265 foram expostas a medicamentos no hospital (97%), recebendo em mÃdia 6,4 (1-18) medicamentos; a mÃdia de permanÃncia hospitalar foi de 14,7 (2-67) dias. O diagnÃstico mais freqÃente foi pneumonia (30%), a classe terapÃutica mais prescrita foi Antiinfecciosos de Uso SistÃmico (25,9%). Foram detectados 420 eventos adversos; destes, 33 foram classificados como RAM. A incidÃncia acumulada de RAM foi 12,5% (33/265) e a densidade de incidÃncia 0,8% (33/4042 pacientes-dia monitorizados). A pele foi o ÃrgÃo mais afetado (48,9%). O grupo terapÃutico mais implicado foi Antiinfecciosos de Uso SistÃmico (53,2%). As RAM foram leves ou moderadas em 97,9% dos casos, 57,5% ProvÃveis e a maioria foi dose independente (55,3%). Na anÃlise multivariada as chances de uma crianÃa hospitalizada apresentar uma RAM cresceram com o nÃmero de medicamentos administrados, entre aqueles do sexo masculino, com menor idade (< 2anos) e internada anteriormente de 3 a 4 vezes. CONCLUSÃO: Foi significativa a proporÃÃo de crianÃas menores de 2 anos usando medicamentos. A predominÃncia do uso de antimicrobianos à esperado e determina o perfil de RAM detectados. A identificaÃÃo de fatores de risco associado a RAM possibilita a seleÃÃo de subgrupos de pacientes pediÃtricos que requereriam maior racionalizaÃÃo terapÃutica e avaliaÃÃo da seguranÃa de medicamentos. PALAVRAS-CHAVE: farmacoepidemiologia; medicamentos; pediatria.
Misan, Gary Michael. "Hospital drug usage evaluation." Thesis, 1997. http://hdl.handle.net/2440/80088.
Повний текст джерелаThesis (Ph.D.) -- University of Adelaide, Dept. of Clinical and Experimental Pharmacology, 1997
Hsu, Yu-Chin, and 徐裕欽. "Impact of hospital global budget and drug budget payment on hospital medication behaviors:Example of diabetic drug Sulfonyureas." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/56961126080409662677.
Повний текст джерела高雄醫學大學
醫務管理學研究所碩士在職專班
95
Purpose Since July 1, 2002, the Bureau of National Health Insurance implement the hospital total cost amount system to control the medical expenses and prevent health insurance deficit expanded continually. The medical expense has been risen year by year, the medication cost is the largest expenses of total medication cost. This paper will discuss how to reduce the medication cost, also the hospital total cost amount and medication total cost amount influence hospital medication. Method By using the material of people health insurance from National Health Research Institutes, we apply pre-test and per-test on the discussion. The first part:before implement hospital total cost amount system which from January, 2000 to December,2002; also after implement hospital total cost amount system from January,2003 to December,2005, in which we discuss about the use amount and expense cost influence of import drugs and the domestically produced drugs in the hospital. The second part: before implement hospital total cost amount system which from January, 2000 to December,2004; also after implement hospital total cost amount system from January,2005 to December,2005, in which we discuss about the use amount and expense cost influence of import drugs and the domestically produced drugs in the hospital; later we analyze and discuss the hospital particular; patient character and the relation between use amount and cost. Result A.The influence of before and after the hospital total amount system implementation to import drugs use amount and expense cost 1. After the hospital total amount implementation, both the import drugs and the domestically produced drugs use amount increase. 2. After the hospital total amount implementation, both the imports drugs and the domestically produced drugs expense cost increase. B.The influence of after the hospital drugs use total amount implement to the hospital medication 1. The import drugs use amount reduce but the domestically produced drugs amount of use increased after the hospital drugs use total amount implementation. 2. Both the imports drugs and the domestically produced drugs expense cost increase after the hospital drugs use total amount implementation. C.The influence of patient medication distribution between before and after the hospital total amount system implementation After the hospital total amount implementation, the use amount increase of ages under 44 group, but reduce of both age 45 to 64 years group and age above 65 years group. Three groups show increase of expense cost. D.The relation between hospital particular and both use amount and expense cost 1. The Class: From year 2000 to 2002 and before the hospital total amount implementation, the medical center shows the highest 35.01% annual average declaration quantity; the region hospital shows 33.03%; the local hospital shows 17.71%; and the local clinic shows 14.25%. From year 2003 to 2005, after the hospital total amount implementation, the region hospital shows the highest 33.80% annual average declaration quantity; the medical center shows 33.60%; the local hospital shows 18.18%; and the local clinic shows 14.42%. By above statistics, we find out after hospital total amount system implementation, the annual average declaration quantity of both medical center and the local clinic show reduce; but of both region hospital and local hospital show increase. Also by both while before and after the hospital total amount implementation, the medical center shows the highest 41.71% and 39.81% of average declaration cost. Above four different level medical institutes show increase of the average import drugs use cost the implementation, 2. The District: Before the hospital total amount implementation, the Taipei Branch of Bureau of National Health Insurance with the highest 33.16% average declaration quantity; the Eastern Region Branch of the Bureau of National Health Insurance with the lowest 2.28%. After the hospital total amount implementation, the Taipei Branch of Bureau of National Health Insurance with the highest 35.85% average declaration quantity; the Eastern Region Branch of the Bureau of National Health Insurance with the lowest 2.56%. Before the hospital total amount implementation, the Taipei Branch of Bureau of National Health Insurance with the highest average declaration cost 35.59%; and 39.93% after the implementation. 3. The Authority: Before the hospital total amount implementation, the legal foundation hospital shows the highest 41.18% average declaration quantity, also 41.61% after the implementation. Both public hospital and legal foundation hospital show the average declaration quantity reduce after the implementation, but private hospital shows increase. Before the implementing, the legal foundation hospital show the highest average declaration cost amount 48.19%, and 49.08% after the implementation. All three different authority hospitals show increase of the average declaration cost amount. E.Influence factor of use amount and total cost Include gender、age、hospital level、the sub-bureau of health insurance bureau and the drugs total amount all affect the import medicine use quantity and the cost amount Conclusion and Suggestion After the hospital total amount implementation, the import drugs quantity report drop year by year, but the domestically produced drugs amount grow rapidly. Also after the implementation, the declaration cost amount shows grow of both import and the domestically produced drugs. Year 2005, the National Health Insurance implement the total drug use amount, both the import drug amount declaration and total cost declaration drop down substantially. Which import drug effect the total drug amount of hospital total amount. Cause of the implementation, the domestically produced drugs also substituted for a partial import drugs. From this result, we find out that after the hospital total amount system implementation comprehensively, the average import drug use rate is about 67.87% in both medical center and region hospital. Compare to the scientific medicine, the import drug is more expensive and higher cost. For save medicine resources and prevent expenses lose therefore we suggest the chief organizations should seriously care about the hospital medication use and promote the scientific medicine use.
Lee, Yi-Hung, and 李逸鴻. "Pharmacoeconomic Application in Drug Selections for Hospital: Illustrated with Atypical Antipsychotic Drugs." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/22939390070283133947.
Повний текст джерела高雄醫學大學
藥學研究所碩士在職專班
94
The purpose of this study was to investigate the possibilities of applying pharmacoeconomics (PE) to the hospital formulary management using atypical antipsychotic drugs as the study drug. Cost-effectiveness analysis of PE was performed from the Pharmacy and Therapy Committee point of view. Twenty-six weeks therapy duration was set as the treatment course in this study. All possible costs resulted from 26-week chronic antipsychotic therapy, including total drug costs, costs of assumed 13 clinical visits and others, were taken into consideration when they were available to obtain. The efficacy data of these atypical antipsychotic drugs were obtained from a published systemic review reference, with PANSS or BPRS as the surrogate marker. Based on the currently published clinical research, differences of drug efficacy due to ethnicity were assumed to be so small that could even be ignored in this study. The unit drug price was obtained from the website of National Health Insurance, Taiwan, R.O.C., on the date of August 24, 2005. The selective treatment doses for these atypical antipsychotic drugs were based on the defined daily dose (DDD) published by WHO in 2005. Clozapine was not included for comparison, because it is the final drug of choice for antipsychotic therapy when others are failed. Sertindole was also excluded because of its withdrawal from marketplace. A sensitivity test was conducted based on drug cost resulted from 26-weeks therapy. The results obtained from C/E ratio are shown as following: zotepine (NT$3,258,846, the lowest C/E ratio), amisulpride (NT$3,552,182), risperidone (NT$4,470,612), olanzapine (NT$5,013,281), ziprasidone (NT$5,980,000), and quetiapine (NT$8,568,750 the highest). Compared with zotepine, the sequences from the lowest to the highest cost based on ICER was amisulpride (NT$8,636,666) followed by olanzapine (NT$12,615,833). The results of C/E ratio showed that the most cost-effective drug among these atypical antipsychotics was zotepine. To compare with zotepine, the best results of ICER was amisulpride. With result of this research the cost of drug was a major factor contributed to total medical costs. The results obtained from this study may be challenged when there is evidence shown that the drug efficacies are varied due to ethnical factor in the future. In conclusion, the PE analysis used in this study seems feasible to support the hospital formulary management for the selection of atypical antipsychotic drugs.
Mashishi, Kgabo Ambros. "Expiration of drugs in public hospital pharmacies of Sekhukhune District, Limpopo Province, South Africa." Thesis, 2015. http://hdl.handle.net/10386/1350.
Повний текст джерелаBackground Drugs expiration in public hospital pharmacies is a concern to health professionals as the Department of Health spends a lot of money to buy drugs. The number of drugs which expire in public hospital pharmacies can give an indication of how the drugs are used, and consequently reflect on the disease prevalence for which the drugs are indicated for. Drugs cannot be used beyond expiry date. The purpose of this study was to determine the cause or causes, extent and costs of expired drugs in public hospital pharmacies of Sekhukhune District in Limpopo Province of South Africa. Methods Sekhukhune District has seven public hospital pharmacies. Data collection involved interviews conducted by the researcher from thirty-five participants with each hospital having five participants. All interviews were recorded by the use of a laptop voice recorder. Participants in each hospital involved a pharmacy manager, an additional pharmacist who had twelve months or more working experience within the facility under study, a clinical manager, a nurse who attends the hospital Drug and Therapeutics Committee and a medical practitioner who had twelve or more working experience within the facility under study. Results and conclusion In this study it was identified that, overstocking; prescribing tendencies by medical practitioners; delivery of short-dated drugs from the supplier; poor stock rotation and unreliably minimum and maximum order levels were cited as some of the reasons for stock expiration. The study found drugs expiration value to be above the set limit of 0.05% of the expenditure in a financial year. An expired stock value of R86 815 was found based on the data collected for 2010/2011 financial year.
Jan, Kuan An, and 任冠安. "The Determinants of Drug Prescribing by Hospital Doctor-Using Drug Innovativeness as Moderators." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/21334840955281680895.
Повний текст джерела長庚大學
工商管理學系
99
The purpose of this study is to investigate the determinants of hospital doctors’ new drugs prescribing behavior. This study focuses on the social determinants of physicians’ new drug adoption behavior. This studies recognizing the importance of opinion leader and colleagues in the new drug diffusion process with analyzing the prescribing behavior of new drug adopted by colleagues and consultants. Furthermore, the novelty of the drugs is considered as moderating effect. The main argument of this research is that when a drug is in high novelty (i.e., drugs belong to the category of New Molecular Entity) physicians will be more rely on social cues to adopt this new drug. Specifically, physicians usually lack of knowledge and personal experience on a new drug, such as its curative effect, side effect or appropriate dosage. Under such an uncertain decision context and the presumed bounded rationality, physicians will rely on some simplified rule or social signals in making decisions. Contrastingly, prescribing less novel new drugs such as those in the category of New Combination of Two or More Drugs, social signals are less used. Academically, new product adoption or technology diffusion has attracted many scholars. This study will contribute to this research stream by apply the behavioral theory in the context of personal adoption decisions. To our best knowledge, all of the published studies regarding physicians’ prescription decision are conducted by interviews or case studies. The lack of large-sample empirical evidence in pior literature leads to a unclear generalizability of their findings. Thus, our study can bridge the empirical gap by providing systematic empirical evidence in use of National Health Insurance Research Database.
Rhemtula, Zuleika Goolam. "Drug related hospital admissions to the general adult medical wards at an academic hospital." Thesis, 2014.
Знайти повний текст джерелаYeh, Po-Hsien, and 葉柏顯. "Hospital Pharmacy Drug Label and Patient Perspective- Taking examples for District Hospital in Taiwan." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/49455137435540678907.
Повний текст джерела雲林科技大學
資訊管理系碩士班
97
Drug Labels on the return home after medical treatment is the most common medication guide,the current requirements of the Department of Health Drug Labels for major hospitals, must be 13 kinds of necessary marked with three kinds of proposals marked,the reference to domestic integrate the views of outside experts.Looking at other countries, there is no uniform standard Drug Labels notice,this article attempts to pharmacists by Pharmacy Department and Information Management''s point of view,the statutory notice and the information point of view self-disclosure to explore Drug Labels marked and patients the quality and quantity of knowledge,trust and the relationship between drug behavior and structural approach to empirical formula.To explore the 13+3 drug labels kinds of information while at the same time trying to model theoretical framework to verify the side effects of treatment with the patient behavior. Department of Health in May 8, 2002, executive order on the request must be marked drug labels and 13 marked three proposed projects,duo to increase drug safety.But people''s awareness drug labels and scholars to explore much of the literature.The Legislative Yuan on April 21, 2009, the Third Reading of law and medical law doctors amendment to require the delivery of public medical institutions Drugs should be marked and must be marked 13 marked three proposed projects. After amending the law regardless of the hospitals, clinics, traditional Chinese medicine or community pharmacies should comply with the law,After this time repairs the law, no matter the hospital, the clinic, the Chinese medicine or the community pharmacy should observe legally, violates heavily may impose 100,000 Yuan fines. When medicine bag announcement, as soon as populace''s cognition viewpoint''s discussion is worth searching. The empirical study of the Department of Medicine for the district hospital from the main population.This research uses the pharmacist questionnaire survey, the grand total sends out 300 questionnaire personally, recycling questionnaire altogether 252, the effective questionnaire produced a final response rate of 84%.After using structural equation model(SEM) to analyze returned questionnaires,the results show fine goodness of fit in measuring model and structure model.In addtion ,7 hypotheses are supported in p-value<0.05.the full support.The results showed that the public notice for drug labels information, medication safety awareness, treatment behavior, health beliefs and inseparable relationship between drug labels. In addition, the research discovered that the side effect the indication indeed will cause the populace regarding to seek medical help the behavior, the healthy faith change, this regarding will obey the doctor''s advice behavior also to have the influence. In conclusion,By way of this survey result, may learn that drug labels and the medication safety cognition the populace, and the confirmation side effect indication the influence which applies drugs to the populace,and the confirmation side effect indication the influence which applies drugs to the populace, and will provide in the future the drug labels revision direction. In addition when also provides each big hospital medicament department, the revision drug labels indication item, provides the ponder the direction.