scholarly journals Analysis of the potential inappropriate use of medications in pediatric outpatients in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Cui ◽  
Lei Zhao ◽  
Xianghong Liu ◽  
Mengyujie Liu ◽  
Lihong Zhong
Keyword(s):  
Drug Use ◽  
Cross Sectional Study ◽  
Inappropriate Drug ◽  
Cross Sectional ◽  
Study Objective ◽  
Off Label ◽  
Inappropriate Use ◽  
Academic Center ◽  
Pediatric Outpatients ◽  
Inappropriate Prescriptions

Abstract Background The appropriate use of medications is essential in children. Yet, detailed information on how drugs are being prescribed and dispensed to pediatric populations is not documented in China. Aim The study objective was to analyze the details of medicine use and categorize the types of inappropriate use of medications on children. Methods A retrospective cross-sectional study was conducted on the prescriptions of pediatric outpatients aged < 18 years from 2019 to 2020 at a major Chinese tertiary academic center. Each age group’s demographic and clinical characteristics were collected, and the ratios of inappropriate prescriptions were analyzed. Results The total number of pediatric outpatients was 652,152, and 49.37% (322000) were prescribed medications, in which the most widely used medicines were respiratory, anti-infectives, and Traditional Chinese Medicines (TCMs). The prevalence rate of inappropriate prescriptions reached 20.49%, and in 2019 it was higher (21.71%) than that in 2020 (18.36%). The top three common inappropriate categories were indication-related off-label drug use, improper administration frequency, and overdosing, accounting for 67.93, 17.80 and 11.06% of all inappropriate prescriptions, respectively. The inappropriate prescriptions were more likely seen in patients aged 2–5 years and respiratory medicines. Conclusions The study findings indicate that inappropriate drug use in pediatric outpatients is still common, and great attention needs to be paid. More prospective trials are required to identify the effectiveness, safety, and necessity of off-label drug use of medicines in children.

scholarly journals Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 327
Author(s):  
Thao H. Nguyen ◽  
Vy T. T. Le ◽  
Dung N. Quach ◽  
Han G. Diep ◽  
Nguyet K. Nguyen ◽  
...  
Keyword(s):  
Treatment Effectiveness ◽  
Cross Sectional Study ◽  
Inappropriate Drug ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
System Disease ◽  
Respiratory System Disease ◽  
Pediatric Outpatients ◽  
The Impact ◽  
Outpatient Prescriptions

Background: Our study was conducted to determine the prevalence of drug-related problems (DRPs) in outpatient prescriptions, the impact of DRPs on treatment efficacy, safety, and cost, and the determinants of DRPs in prescribing for pediatric outpatients in Vietnam. Methods: A retrospective cross-sectional study was conducted on pediatric outpatients at a pediatric hospital in Can Tho, Vietnam. DRPs were classified according to the Pharmaceutical Care Network Europe classification (PCNE) of 2020. The study determined prevalence of DRPs and their impacts on efficacy, safety, and cost. Multivariate regression was used to identify the determinants of DRPs. Results: The study included 4339 patients (mean age 4.3, 55.8% male), with a total of 3994 DRPs, averaging 0.92 DRP/prescription. The proportion of prescriptions with at least one DRP was 65.7%. DRPs included inappropriate drug selection (35.6%), wrong time of dosing relative to meals (35.6%), inappropriate dosage form (9.3%), inappropriate indication (7.1%), and drug-drug interactions (0.3%). The consensus of experts was average when evaluating each aspect of efficiency reduction, safety reduction, and treatment cost increase, with Fleiss’ coefficients of 0.558, 0.511, and 0.541, respectively (p < 0.001). Regarding prescriptions, 50.1% were assessed as reducing safety. The figures for increased costs and decreased treatment effectiveness were 29.0% and 23.9%, respectively. Patients who were ≤ 2 years old were more likely to have DRPs than patients aged 2 to 6 years old (OR = 0.696; 95% CI = 0.599–0.809) and patients aged over 6 years old (OR = 0.801; 95% CI = 0.672–0.955). Patients who had respiratory system disease were more likely to have DRPs than patients suffering from other diseases (OR = 0.715; 95% CI = 0.607–0.843). Patients with comorbidities were less likely to have DRPs than patients with no comorbidities (OR = 1.421; 95% CI = 1.219–1.655). Patients prescribed ≥ 5 drugs were more likely to have DRPs than patients who took fewer drugs (OR = 3.677; 95% CI = 2.907–4.650). Conclusion: The proportion of prescriptions in at least one DRP was quite high. Further studies should evaluate clinical significance and appropriate interventions, such as providing drug information and consulting doctors about DRPs.

Only 10% of the psychotropic drug use for neuropsychiatric symptoms in patients with dementia is fully appropriate. The PROPER I-study

2016 ◽  
Vol 28 (10) ◽  
pp. 1589-1595 ◽  
Author(s):  
Klaas van der Spek ◽  
Debby L. Gerritsen ◽  
Martin Smalbrugge ◽  
Marjorie H. J. M. G. Nelissen-Vrancken ◽  
Roland B. Wetzels ◽  
...  
Keyword(s):  
Nursing Home ◽  
Drug Use ◽  
Psychotropic Drug ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Psychotropic Drug Use ◽  
Nursing Home Patients ◽  
Sum Score

ABSTRACTBackground:This study explores the appropriateness of psychotropic drug (PD) use for neuropsychiatric symptoms (NPS) in nursing home patients with dementia.Methods:A cross-sectional study on 559 patients with dementia residing on dementia special care units in Dutch nursing homes was conducted. Appropriateness of PD use was assessed using the Appropriate Psychotropic drug use In Dementia (APID) index. The APID index score is calculated using information about individual PDs from patients’ medical records. The index encompasses seven (different) domains of appropriateness, i.e. indication, evaluation, dosage, drug-drug interactions, drug-disease interactions, duplications, and therapy duration.Results:A total of 578 PDs were used for NPS by 60% of the nursing home patients. Indication, evaluation, and therapy duration contributed the most to inappropriate use. Ten per cent of the PDs scored fully appropriate according to the APID index sum score, 36% scored fully appropriate for indication, 46% scored fully appropriate for evaluation, and 58% scored fully appropriate for therapy duration. Antidepressants were used the most appropriately, and antiepileptics the most inappropriately.Conclusions:The minority of the PD use was fully appropriate. The results imply that PD use for NPS in dementia can be improved; the appropriateness should be optimized with a clinical focus on the appropriate indications, evaluations, and therapy duration.

scholarly journals A cross-sectional study of psychotropic drug use in the elderly: Consuming patterns, risk factors and potentially inappropriate use

2019 ◽  
pp. ejhpharm-2019-001927
Author(s):  
María Isabel Santos-Pérez ◽  
Inmaculada Fierro ◽  
M Esther Salgueiro-Vázquez ◽  
María Sáinz-Gil ◽  
Luis H Martín-Arias
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Psychotropic Drug ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Psychotropic Drug Use

Risk Minimization Measures in Off-Label Drug Use: A Survey of Community Pharmacists in Malaysia

2020 ◽  
Vol 15 (3) ◽  
pp. 181-189
Author(s):  
Omotayo Fatokun
Keyword(s):  
Informed Consent ◽  
Drug Use ◽  
Perceived Risk ◽  
Adverse Drug Events ◽  
Community Pharmacists ◽  
Risk Minimization ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Off Label ◽  
Written Informed Consent

Background: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists’ beliefs regarding these measures in Malaysia. Objectives: This study examined community pharmacists’ beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures. Methods: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia. Results: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002). Conclusion: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

Evaluation of Drug Use Based on WHO Prescribing Indicator in Mizan- Tepi University Teaching Hospital, south Western Ethiopia: A Cross Sectional Study

2020 ◽  
Vol 15 ◽  
Author(s):  
Solomon Hambisa ◽  
Rediet Feleke ◽  
Ameha Zewudie ◽  
Mohammed Yimam
Keyword(s):  
Drug Use ◽  
World Health Organization ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
University Teaching ◽  
World Health ◽  
Sectional Study ◽  
Hospital Data ◽  
Cross Sectional ◽  
Health Organization

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.

scholarly journals Factors Associated with Streptococcus pneumoniae Nasopharyngeal Carriage and Antimicrobial Susceptibility among Children Under the Age of 5 Years in the Southwestern Colombia

2021 ◽  
Author(s):  
Gustavo Gámez ◽  
Juan Pablo Rojas ◽  
Santiago Cardona ◽  
Juan David Castillo Noreña ◽  
María Alejandra Palacio ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Indigenous Communities ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Nasopharyngeal Carriage ◽  
Cross Sectional ◽  
Benzyl Penicillin ◽  
Factors Associated ◽  
Pediatric Outpatients

Abstract Objective This work aims to evaluate the factors associated with Streptococcus pneumoniae nasopharyngeal colonization and antimicrobial susceptibility among pediatric outpatients in southwestern Colombia, 2019. Methods A cross-sectional study was performed using survey-based interviews and the collection of nasopharyngeal-swab specimens for microbiological characterization and antimicrobial susceptibility testing. Logistic regression analyses were performed for factors associated with nasopharyngeal carriage. Results A total of 452 children under the age of 5 years were examined in which 41.8% carried S. pneumoniae. Higher pneumococcal carriage frequencies were observed among participants aged <2 years and in individuals belonging to indigenous communities, which were lacking established pneumococcal-conjugated vaccine-10 immunization schemes. Additionally, children attending childcare institutions were also highly colonized by pneumococci. S. pneumoniae showed 57.7% nonsusceptibility to benzyl-penicillin (meningitis-cut); 45.5% intermediate-sensitivity to benzyl-penicillin (oral-cut) and 21.7% to cefotaxime; and resistance to erythromycin (40.7%), tetracycline (36.0%), trimethoprim/sulfamethoxazole (24.9%), clindamycin (24.3%), and ceftriaxone (27.0%). Conclusion The 41.8% of participants carrying S. pneumoniae show a scenario with the presence of multidrug and extensively drug-resistant strains, which constitutes important reservoirs of bacterial transmission by children aged <5 years in Colombia, leading to an onset of pneumococcal diseases. Hence, there is an urgent need to expand conjugate pneumococcal immunization in the community and ensure compliance with established immunization schedules.

scholarly journals Knowledge, attitude, and utilization of drugs toward COVID-19 pandemic among Bale Zone residents, Southeast Ethiopia

2021 ◽  
Vol 9 ◽  
pp. 205031212110343
Author(s):  
Ayele Mamo ◽  
Mesud M Hassen ◽  
Ahmednur Adem ◽  
Zinash Teferu ◽  
Musa Kumbi ◽  
...  
Keyword(s):  
Drug Use ◽  
Severe Acute Respiratory Syndrome ◽  
Good Practice ◽  
Binary Logistic Regression ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Health Problems ◽  
P Value ◽  
Cross Sectional ◽  
Bale Zone

Background: Coronavirus disease is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2, which poses therapeutic dilemmas. Some suggestions for drug treatment seem problematic. Beliefs about the causes of health problems are determinants of treatment seeking decisions. Hence, one of the alternatives for the solution of health problems is employing traditional medicine to prevent coronavirus disease 19. Objective: To assess the knowledge, attitude, and utilization of drugs toward the coronavirus disease 19 pandemic among Bale zone residents. Methods: Community-based cross-sectional study was conducted among the Bale Zone population from May 30 to June 30, 2020. Eight hundred fifty-four participants were selected using a single population formula, and a multistage sampling technique was employed. Data were analyzed using SPSS version 25.0. Descriptive and binary logistic regression was used to analyze the outcomes. A p value ⩽ 0.05 was considered statistically significant. Results: Out of the total 854 respondents, about 534 (62.5%) got information about coronavirus disease 19 from TV/radio. More than two-thirds (71.9%) of the respondents have known that severe acute respiratory syndrome coronavirus 2 has no curative drugs, and 65.4% had a more appropriate attitude toward overall drug use in coronavirus disease 19. Level of education and, attitude towards drug use were singnificantly associated with knowledge of drugs, source of information about coronavirus disease 19 and having good practice were significantly associated with atittude toward drug utilization. Conclusion: One out of two study participants have good knowledge regarding drugs to the coronavirus disease 19 pandemic. Illiterate people in the community were identified to have poor knowledge about drugs, hence community educuation program is important to improve the knowledge about drugs towards the coronavirus disease 19 pandemic.

Prescription Drug and Healthcare Use Among Swedish Patients Treated with Antidepressants

1995 ◽  
Vol 29 (6) ◽  
pp. 566-572 ◽  
Author(s):  
Kerstin Al Bingefors ◽  
Dag Gl Isacson ◽  
Lars Von Knorring ◽  
Björn Smedby
Keyword(s):  
Drug Use ◽  
Ambulatory Care ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Antidepressant Treatment ◽  
Antidepressant Drugs ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prescription Drug Use

Objective: To analyze healthcare and prescription drug use among patients taking and those not taking antidepressant drugs in a Swedish community. Design: Cross-sectional study. Setting: General population of the rural Swedish municipality Tierp of approximately 20 000 inhabitants. Participants: All residents of Tierp aged 25 years or older during 1988. Main Outcome Measures: Mean number of ambulatory care visits, hospital bed days, and prescriptions per person; proportion of those taking prescription drugs in different pharmacologic classes. Results: Patients treated with antidepressant drugs had a significantly (p < 0.05) greater use of ambulatory care, hospital care, and prescription drugs than those who did not take antidepressants in the study population. They also had an increased frequency of use of prescription drugs from virtually all pharmacologic classes. Furthermore, the risk for polypharmacy was high in patients treated with antidepressant medications. Conclusions: Those who took antidepressant drugs consumed more health services and prescription drugs than did those not taking an antidepressant. Patients receiving antidepressant treatment may be at serious risk for iatrogenic disease and should be evaluated carefully with respect to concomitant drug use.

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