scholarly journals Drug utilisation trends in a physical rehabilitation hospital

2019 ◽  
Vol 76 (12) ◽  
pp. 1261-1267
Author(s):  
Gordana Ljubojevic ◽  
Milan Mastikosa ◽  
Tanja Dostanic-Dosenovic ◽  
Snjezana Novakovic-Bursac ◽  
Natasa Tomic ◽  
...  
Keyword(s):  
Drug Utilisation ◽  
World Health Organisation ◽  
Prescribing Patterns ◽  
World Health ◽  
Defined Daily Dose ◽  
Thioctic Acid ◽  
Anatomic Therapeutic Chemical ◽  
Rehabilitation Hospital ◽  
Annual Change Rate ◽  
Prescribing Practice

Background/Aim. Drug utilisation monitoring could identify drug-related problems and hence improve the awareness of irrational drug use. The objective of this study was to analyse the drug utilisation patterns in a rehabilitation hospital over the period 2011?2016. Methods. The Anatomic Therapeutic Chemical classification/Defined Daily Dose (ATC/DDD) methodology was used to monitor the drug utilisation expressed as a number of DDD per 100 patient-days (HPD). The values of DDDs were obtained from the World Health Organisation (WHO) Collaborating Centre for Drug Statistics Methodology. Utilisation trends were analysed by means of the Compound Aggregate Growth Rate (CAGR), which is defined as an average annual change rate of some value during the period of interest. Results. The number of patient-days increased during the six years period; the CAGR being1.8% annually. At the same time, the total number of dispensed DDDs as well as the number of DDD/HPD decreased with the CAGR of -2.0% and -3.7% respectively. The average drug cost per patient-day varied from BAM 1.38 in 2013 to 0.95 in 2016; the CAGR being -1.8%. The most utilised drugs belonged to the ATC groups C, A, B, M and N and they contributed to an average of 77% of all drugs used each year. On the top of the list of most utilised drugs were: hydroxocobalamin, thioctic acid, enalapril, diclofenac, amlodipine, acetylsalicylic acid, pantoprazole, paracetamol and bromazepam. Conclusions. The overall drug utilisation in the hospital was modest and almost equal in 2016 compared to 2011. Besides the leading consumption of vitamin B12 and thioctic acid, this study points out some interesting prescribing patterns, such as predominant use of diclofenac over ibuprofen, and overuse of proton pump inhibitors. There is a need for educative interventions among physicians in order to improve their prescribing practice.

scholarly journals The Relevance of Defined Daily Dose concept in Drug Utilisation Research: A Review

2021 ◽  
Vol 11 (4-S) ◽  
pp. 162-165
Author(s):  
Agnus Baiju ◽  
Rosmin Jacob ◽  
K. Krishnakumar
Keyword(s):  
Drug Utilisation ◽  
Anatomical Therapeutic Chemical ◽  
Cost Effective ◽  
World Health Organisation ◽  
Economic Consequences ◽  
World Health ◽  
Special Focus ◽  
Defined Daily Dose ◽  
Rational Drug ◽  
Daily Dose

According to World Health Organisation (WHO), drug utilisation is defined as the marketing, distribution, prescription and the use of drugs in society with special focus on resulting medical, social and economic consequences and it has turned into a powerful scientific tool for ensuring the rational and cost-effective use of drugs. A standard method is required to identify and aggregate drug data. This manuscript provides an overview of the WHO Anatomical Therapeutic Chemical (ATC) classification and the associated measure, Defined Daily Dose (DDD), as a methodology for evaluating drug utilisation. Keywords: Drug utilisation research, Anatomical Therapeutic Chemical classification system, Defined Daily Dose, Rational drug use.

scholarly journals Defined Daily Dose and Appropriateness of Clinical Application: The Coxibs and Traditional Nonsteroidal Anti-Inflammatory Drugs for Postoperative Orthopaedics Pain Control in a Private Hospital in Malaysia

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 235
Author(s):  
Faizah Safina Bakrin ◽  
Mohd Makmor-Bakry ◽  
Wan Hazmy Che Hon ◽  
Shafeeq Mohd Faizal ◽  
Mohamed Mansor Manan ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Teaching Hospital ◽  
Pain Control ◽  
Orthopaedic Surgery ◽  
Prescribing Patterns ◽  
World Health ◽  
Defined Daily Dose ◽  
Daily Dose ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Introduction: Drug utilization of analgesics in a private healthcare setting is useful to examine their prescribing patterns, especially the newer injectable cyclooxygenase (COX)-2 inhibitors (coxibs). Objectives: To evaluate the utilization of coxibs and traditional nonsteroidal anti-inflammatory drugs (tNSAIDs) indicated for postoperative orthopaedic pain control using defined daily dose (DDD) and ratio of use density to use rate (UD/UR). Method: A retrospective drug utilization review (DUR) of nonsteroidal anti-inflammatory drugs (NSAIDs) at an inpatient department of a private teaching hospital in Seremban, Malaysia was conducted. Patients’ demographic characteristics, medications prescribed, clinical lab results, visual analogue scale (VAS) pain scores and length of hospital stay were documented. Orthopaedic surgeries, namely arthroscopy, reconstructive, and fracture fixation, were included. Stratified random sampling was used to select patients. Data were collected through patients’ medical records. The DDD per 100 admissions and the indicator UD/UR were calculated with the World Health Organization’s DDD as a benchmark. The inclusion criteria were patients undergoing orthopaedic surgery prescribed with coxibs (celecoxib capsules, etoricoxib tablets, parecoxib injections) and tNSAIDs (dexketoprofen injections, diclofenac sodium tablets). Data were analysed descriptively. This research was approved by the academic institution and the hospital research ethics committee. Result: A total of 195 records of patients who received NSAIDs were randomly selected among 1169 cases. In term of the types of orthopaedic surgery, the ratio of included records for arthroscopy:fracture fixation:reconstructive surgery was 55.4:35.9:8.7. Most of the inpatients had low rates of common comorbidities such as cardiovascular disease as supported by their baseline parameters. The majority were not prescribed with other concomitant prescriptions that could cause drug interaction (74.9%), or gastroprotective agents (77.4%). Overall, DDDs per 100 admissions for all NSAIDs were less than 100, except for parecoxib injections (389.23). The UD/UR for all NSAIDs were less than 100, except for etoricoxib tablets (105.75) and parecoxib injections (108.00). Discussion: As per guidelines, the majority (96.9%) received other analgesics to ensure a multimodal approach was carried out to control pain. From the UD/UR results, the arthroscopy surgery was probably the most appropriate in terms of NSAID utilization. Conclusion: The prescribing pattern of NSAIDs except parecoxib was appropriate based on adverse effect and concurrent medication profile. The findings of this DUR provide insight for a low-risk patient population at a private specialized teaching hospital on the recommended use of NSAIDs for postoperative orthopaedic pain control.

The Use of the World Health Organisation Anatomical Therapeutic Chemical/Defined Daily Dose Methodology in Canada

2004 ◽  
Vol 38 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Ingrid S. Sketris ◽  
Colleen J. Metge ◽  
Jennifer L. Ross ◽  
Mary E. MacCara ◽  
Danna G. Comeau ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
World Health Organisation ◽  
World Health ◽  
Defined Daily Dose ◽  
The World ◽  
Daily Dose

scholarly journals A systematic review to investigate the effect of digital antimicrobial stewardship tools on antimicrobial usage, length of stay, mortality and cost

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i50-i50
Author(s):  
N Trotter ◽  
R Karimi ◽  
C Tolley ◽  
S P Slight
Keyword(s):  
Antibiotic Resistance ◽  
Length Of Stay ◽  
Antimicrobial Stewardship ◽  
World Health Organisation ◽  
Digital Tools ◽  
World Health ◽  
Defined Daily Dose ◽  
Prescribing Practices ◽  
Antimicrobial Usage ◽  
The Impact

Abstract Introduction Antimicrobial drug resistance has been recognised by the World Health Organisation as ‘One of the biggest threats to global health today’.1 As the use of digital systems in the NHS increases, there is huge potential to use systems such as electronic prescribing and clinical decision support as part of Antimicrobial Stewardship Programmes (ASPs) i.e., initiatives to change prescribing practices to promote and monitor use of antimicrobials and preserve their future effectiveness. However, there is a lack of research that has investigated the impact of digital tools as part of ASPs. Aim We aimed to review the literature available on the use of digital antimicrobial stewardship tools on individual outcomes such as antimicrobial usage, length of stay, mortality and cost. Methods A systematic search was performed across three databases (Embase, MEDLINE and CINAHL) using MESH terms and key words relating to antimicrobial stewardship, hospitals, length of stay (LOS), clinical outcomes, cost and mortality. Duplicates were removed and articles screened at the title, abstract and full text stage by two authors (NT and RK) according to our inclusion and exclusion criteria. We included primary research articles that: had implemented an ASPs in an adult hospital setting for at least 6 months, reported antimicrobial usage as defined daily dose per 1000 patient days (DDD/1000) and at least one of the following outcomes: LOS, mortality or cost and discussed an ASP that included a digital component. Risk of bias assessment was performed using the Newcastle-Ottawa scale. We calculated the percentage change to determine the impact of digital ASPs across all outcomes using the formula (After - Before)/Before x 100 = % Change. Before=pre-implementation results; after= results post-implementation Results We identified 3997 papers across all databases, and included 14 full texts that explored the impact of ASPs including a digital component (Figure 1). Of these, 14 papers reported the DDD/1000, 7 on mortality, 8 on LoS and 6 reported on cost. All studies evaluating DDD/1000 reported a decrease in antimicrobial usage ranging from -8.42% to -61.30%. Reductions in mortality (0 to -79%), LoS (25 to -27%) and costs (-8.42% to -69.19%) were also found. All ASPs utilised a digital component alongside a range of other interventions, such as the creation of formularies, guidelines and education emphasising the importance of using a combined approach in antimicrobial stewardship. Different interventions were found to have their own advantages, for example, education was key to sustainability and feedback was essential to improve prescribing practices. Users of the digital tools found that the tools were generally simple and user friendly, which facilitated their acceptance. Conclusion Our found that ASPs including a digital component were associated with reductions in antimicrobial usage, mortality, length of stay and cost. The positive effects were seen when such tools were combined with other approaches such as education and feedback approaches. We were unable to perform a meta-analysis due to the absence of confidence intervals and odds ratios in many of the included studies. Further research is needed to evaluate the cost-benefit associated with digital ASPs and whether sharing ASPs across multiple sites could reduce the maintenance burden for individual organisations. References 1. World Health Organisation (2020), Antibiotic Resistance Factsheet, https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance [accessed on 18th October 2020]

scholarly journals Antibiotic use in Albania between 2011 and 2012

2015 ◽  
Vol 9 (01) ◽  
pp. 094-098 ◽  
Author(s):  
Iris Hoxha ◽  
Admir Malaj ◽  
Ledjan Malaj
Keyword(s):  
Antibiotic Use ◽  
World Health ◽  
Measurement Unit ◽  
Defined Daily Dose ◽  
Anatomic Therapeutic Chemical ◽  
Daily Dose ◽  
Health Institutions ◽  
Health Organization ◽  
Official Data

Introduction: Health institutions in Albania have recently reported an increase in antibiotic misuse and microbial resistance. Until now, there have been no comprehensive studies that analyzed the overall use of antibiotics in Albania. The aim of this study was to analyze the overall antibiotic use in Albania between 2011 and 2012, using standardized methodology of measurement, based on World Health Organization guidelines. Methodology: Data from 2011 and 2012 on antibiotic use from ambulatory and hospital sector were examined. Antibiotics were divided based on anatomic therapeutic chemical classification. Defined daily dose (DDD) for each drug was assigned, and DDD per 1,000 inhabitants per day (DID) was used as a measurement unit. In cases of antibiotic combinations for which DDD were not available, unit doses were assigned. Results: In 2011–2012, total antibiotic use decreased from 24.25 to 20.66 DID. Penicillin’s were the most used antibiotic class, with 10.62 DID (2011) and 10.51 DID (2012). Tetracycline use decreased from 5.45 DID (2011) to 0.98 DID (2012). Macrolides increased from 1.36 to 1.88 DID, quinolones from 1.72 to 2.51 DID. The overall antibiotic use was significantly higher than the reimbursed antibiotic use – 3.17 DID (2011) and 2.79 DID (2012) – based on the official data for the same period. Conclusions: This study enables policymakers to further analyze the quality of antibiotic prescriptions and draw comparisons to other countries. The analyzed data suggest there are different factors influencing out-of-pocket use of antibiotics and wrongly prescribed antibiotics. Further studies are necessary to evaluate these factors.

A Collaborative Study to Establish the Second International Standard for Streptokinase

1990 ◽  
Vol 64 (02) ◽  
pp. 267-269 ◽  
Author(s):  
A B Heath ◽  
P J Gaffney
Keyword(s):  
High Purity ◽  
Collaborative Study ◽  
World Health Organisation ◽  
World Health ◽  
Clot Lysis ◽  
Current Standard ◽  
International Standard ◽  
Accelerated Degradation ◽  
The World ◽  
International Collaborative Study

SummaryAn International Standard for Streptokinase - Streptodomase (62/7) has been used to calibrate high purity clinical batches of SK since 1965. An international collaborative study, involving six laboratories, was undertaken to replace this standard with a high purity standard for SK. Two candidate preparations (88/826 and 88/824) were compared by a clot lysis assay with the current standard (62/7). Potencies of 671 i.u. and 461 i.u. were established for preparations A (88/826) and B (88/824), respectively.Either preparation appeared suitable to serve as a standard for SK. However, each ampoule of preparation A (88/826) contains a more appropriate amount of SK activity for potency testing, and is therefore preferred. Accelerated degradation tests indicate that preparation A (88/826) is very stable.The high purity streptokinase preparation, coded 88/826, has been established by the World Health Organisation as the 2nd International Standard for Streptokinase, with an assigned potency of 700 i.u. per ampoule.

A Collaborative Study to Establish an International Standard for Alpha-Thrombin

1992 ◽  
Vol 67 (04) ◽  
pp. 424-427 ◽  
Author(s):  
P J Gaffney ◽  
A B Heath ◽  
J W Fenton II
Keyword(s):  
Elevated Temperatures ◽  
Collaborative Study ◽  
World Health Organisation ◽  
Significant Loss ◽  
Thrombin Inhibitors ◽  
World Health ◽  
Expert Committee ◽  
International Standard ◽  
Assay Procedure ◽  
And Control

SummarySince 1975 an International Standard for Thrombin of low purity has been used. While this standard was stable and of value for calibrating thrombins of unknown potency the need for a pure a-thrombin standard arose both for accurate calibration and for precise measurement of thrombin inhibitors, notably hirudin. An international collaborative study was undertaken to establish the potency and stability of an ampouled pure a-thrombin preparation. A potency of 97.5 international units (95% confidence limits 86.5-98.5) was established for the new a-thrombin standard (89/ 588) using a clotting-assay procedure. Stability data at various elevated temperatures indicated that the standard could be transported and stored with no significant loss of potency.Ampoules of lyophilised a-thrombin (coded 89/588) have been recommended as an International Standard for a-thrombin with an assigned potency of 100 international units per ampoule by the International Society for Thrombosis and Haemostasis (Thrombin and its Inhibitors Sub-Committee) in Barcelona, Spain in July 1990 while the Expert Committee on Biological Standardisation and Control of the World Health Organisation will consider its status at its next meeting in Geneva in 1991.

ANTARA SUNNAH DAN TRADISI (Khitan Muallaf Perempuan Baligh di Jayapura, Papua)

1970 ◽  
Vol 9 (2) ◽  
pp. 271-284
Author(s):  
Hendra Yulia Rahman
Keyword(s):  
World Health Organisation ◽  
World Health

Masyarakat Indonesia pada umumnya khususnya yang bergama Islam, memiliki kebiasaan mengkhitankan anak perempuannya dan memandang ini sebagai sunnah, hal ini juga dilakukan masyarakat di negara-negara lain yang memiliki penduduk pemeluk agama Islam. Pada umumnya masyarakat megkhitankan anak perempuannya, ketika masih bayi dan meyakininya sebagai bentuk kewajiban dari perintah agama. Badan kesehatan dunia World Health Organisation (WHO) melakukan pelarangan segala bentuk khitan pada perempuan, karena dianggap sebagai bentuk kekerasan pada perempuan dengan menyakiti dan merusak alat reproduksi perempuan. Khitan perempuan dianggap sebagai tradisi yang sudah lama ada tengah-tengah masyarakat baik yang muslim maupun yang non muslim, yang dalam pelaksanaannya lebih dimaksudkan sebagai upaya pengontrolan seksualitas perempuan. Muallaf perempuan baligh khususnya di wilayah kota Jayapura, Papua rata-rata melakukan khitan, yang menurut mereka merupakan bagian dari perintah agama. Bahwasanya khitan muallaf perempuan baligh di kota Jayapaura merupakan sebuah tradisi yang terus berlangsung, dan tradisi tersebut sejalan dengan sunnah.

Comparative docking of SARS-CoV-2 receptors antagonists from repurposing drugs

2020 ◽  
Author(s):  
Micael Davi Lima de Oliveira ◽  
Kelson Mota Teixeira de Oliveira
Keyword(s):  
World Health Organisation ◽  
World Health ◽  
Lung Cells ◽  
The Novel ◽  
High Modulation ◽  
Main Protease ◽  
The World ◽  
Novel Coronavirus ◽  
Viral Receptors ◽  
Theoretical Results

According to the World Health Organisation, until 16 June, 2020, the number of confirmed and notified cases of COVID-19 has already exceeded 7.9 million with approximately 434 thousand deaths worldwide. This research aimed to find repurposing antagonists, that may inhibit the activity of the main protease (Mpro) of the SARS-CoV-2 virus, as well as partially modulate the ACE2 receptors largely found in lung cells, and reduce viral replication by inhibiting Nsp12 RNA polymerase. Docking molecular simulations were performed among a total of 60 structures, most of all, published in the literature against the novel coronavirus. The theoretical results indicated that, in comparative terms, paritaprevir, ivermectin, ledipasvir, and simeprevir, are among the most theoretical promising drugs in remission of symptoms from the disease. Furthermore, also corroborate indinavir to the high modulation in viral receptors. The second group of promising drugs includes remdesivir and azithromycin. The repurposing drugs HCQ and chloroquine were not effective in comparative terms to other drugs, as monotherapies, against SARS-CoV-2 infection.

Osseointegrated Implants: A Comprehensive Review

2021 ◽  
Vol 2 (1) ◽  
pp. 24-30
Author(s):  
Matheus Marquez Cruvinel Santos ◽  
◽  
Flávio Barros da Silva ◽  
Idiberto José Zotarelli-Filho ◽  
Elias Naim Kassis ◽  
...  
Keyword(s):  
Dental Implants ◽  
Pharmacological Action ◽  
World Health Organisation ◽  
World Health ◽  
Density Level ◽  
Mineral Density ◽  
Osseointegrated Implants ◽  
Bone Mineral Density Level ◽  
The Mean ◽  
Normal Women

The most common bone disorder found by implant dentists is osteoporosis, which is a systemic skeletal disorder associated with aging, which is characterized by loss of bone mass, making bones fragile and more susceptible to fractures. The World Health Organisation has defined osteoporosis as a bone mineral density level greater than 2.5 standard deviations below the mean of young normal women. After 60 years of age, a third of the population have this disorder, it occurs twice as often in women than in men. It is estimated that 1.3 million fractures and 133,000 all hip fractures occur every year as a result of osteoporosis. This study aimed to discuss aspects of the pharmacological action of Bisphosphonates (BP) and their influence on the bone tissue when associated with treatment with dental implants. There are several types of treatments that prevent or prevent the progression of osteoporosis. So, BP, such as alendronate, are inhibitors of bone resorption. Act as controlling the development of osteoporosis by increasing the process of bone density and decrease its reabsorption, often acting as supporting the process of osseointegration of dental implants.

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