scholarly journals Pharmacoepidemiology and Drug-Drug interactions in various regions of Andhra Pradesh

2021 ◽  
Vol 12 (1) ◽  
pp. 248-253
Author(s):  
Bothiraj M ◽  
Alagusundaram M ◽  
Chandra Sekhar K B
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Health Care Providers ◽  
Andhra Pradesh ◽  
Statistical Significance ◽  
Monitoring Program ◽  
General Medicine ◽  
P Value ◽  
Care Providers ◽  
A Prospective Study

Pharmacoepidemiology deals with the use and effects of medications in a large number of population—the combination of epidemiology principles to the effects of drug and its usage. Pharmacoepidemiology helps in optimal utilization of medicines and assist health care providers in making better decisions on drug therapy that will tend to curtail the Drug-Drug interactions, thereby prevents alteration in the pharmacological activity of one drug by another. Among all types of interaction, Drug-Drug interaction causes a higher rate of mortality. A prospective study conducted with 653 prescriptions that were collected from the various regions of Andhra Pradesh like Kadapa, Proddatur, Pulivendula, Kurnool are checked in interaction checker, results are projected in 4 categories a) Age and Sex preponderance(Demographics) rate of drugs interaction b) Interaction rate of major/minor type c) Department wise - General medicine (72.37%), Gynaec (69.02%), Pediatric (29.33%), Ophthalmology (75%) d) Most common interacting pairs of various department Ex: Ceftriaxone & Furosemide, Diclofenac & Furosemide, Albuterol & Losartan are observed in General Medicine. Statistical significance (P-value 0.00002) is obtained based on One Way ANOVA. This study elucidates the significance of pharmacoepidemiology; however, this requires much efforts to prevent causation effects of drugs. It is helpful to locate them by the establishment of “Drug interaction monitoring program” or by establishing “Pharmacoepidemiological centres” in every hospital for the screening of prescriptions by “Pharmacist” and thereby edify doctors and public for better medication use.

Knowledge of Herbal Medicines and Herb-drug Interaction Among Medical and Pharmacy Students of the University of Lagos, Nigeria

2020 ◽  
Vol 16 (1) ◽  
pp. 61-70
Author(s):  
O.U. Amaeze ◽  
O.A. Olugbake ◽  
M. Lawal
Keyword(s):  
Drug Interaction ◽  
Herbal Medicine ◽  
Drug Interactions ◽  
Health Care Providers ◽  
Statistical Significance ◽  
Herbal Medicines ◽  
Pharmacy Students ◽  
Care Providers ◽  
Medical Undergraduate ◽  
The University

Background: Concurrent use of herbal and orthodox medicines can result in herb-drug interaction, which could remain unidentified due to the limited knowledge of health care providers on herbal medicines effects and safety.Objectives: This study aimed to assess the knowledge of medical and pharmacy students of the University of Lagos on herbal medicines and herb-drug interactions.Method: The study was a cross-sectional survey of final year pharmacy and medical undergraduate students (422) of the University of Lagos. Data was collected using a validated, previously developed, and standardized self-administered questionnaire. Descriptive statistics was used to evaluate the students’ demographics, knowledge of herbal medicines and herb-drug interactions, types and uses of herbal medicines, while inferential statistics was employed to assess the association between the students’ demographics and their knowledge of herb-drug interactions. Statistical significance was set at P<0.05.Results: The response rate was 97%. The students (98.0%) knew that herbs can be used as medicines; common uses of herbal medicines reported by the students include malaria (11.4%), pain (24.6%), and fever (36.2%). There was no association between the students’ demographics and their knowledge about herbal medicine. Age was significantly associated with knowledge of herb-drug interaction (P<0.05). The students (96.8%) knew that herbs can interact with conventional drugs when administered concurrently. The sources of the students’ knowledge about herbal medicine and herb-drug interaction include lectures (52.2%), literature (14%) and personal experience (13.9%).Conclusion: The students had good knowledge of herbal medicines; however, the subject of herbal medicines and their effects should be given more attention in the medical and pharmacy program curriculum, in order to enhance the students’ knowledge base of herbal medicines and interactions, and equip the future physicians and pharmacists adequately for better patient care. Keywords: Herbal medicines, Herb-drug interaction, Pharmacy students, Medical students

scholarly journals A Comparison of Tertiary Drug Resources’ Consistency Regarding Drug-Drug Interactions of Adjunctive Analgesics

2020 ◽  
pp. 875512252095133
Author(s):  
Andrew Lang ◽  
Michael A. Veronin ◽  
Justin P. Reinert
Keyword(s):  
Health Care ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Patient Care ◽  
Health Care Providers ◽  
Drug Information ◽  
Interaction Analysis ◽  
Information Resources ◽  
Care Providers ◽  
Drug Drug Interaction

Background: Health care providers routinely rely on tertiary drug information resources to affirm knowledge or proactively verify the safety and efficacy of medications. Though all patient care areas are affected, the reliability of these resources is perhaps nowhere as poignant as it is in high-acuity settings, including the emergency department and the intensive care unit. As providers seek to identify adjunctive analgesics for acute pain in these areas, they must be able to rely on the integrity to whichever resource their institution has granted access. Objective: To determine the congruency of drug-drug interaction information found on 3 tertiary drug resources. Methods: A drug-drug interaction analysis was conducted on Micromedex, Lexicomp, and Medscape. Adjunctive analgesics included dexmedetomidine and ketamine, which were compared with the intravenous opioid products morphine, fentanyl, and hydromorphone. Results: Significant discrepancies were appreciated with regard to the severity of drug-drug interactions. In addition, the heterogeneity in which reaction severity and likelihood are described by each respective resource makes direct comparisons difficult. Interaction warnings for dexmedetomidine and fentanyl included a “major interaction” from Micromedex, whereas Lexicomp did not identify a risk and Medscape only recommended increased monitoring on the grounds of respiratory and central nervous system depression. Conclusions: Health care providers must remain vigilant when reviewing tertiary drug information resources. Pharmacists possess the training and skills necessary to assist interdisciplinary medical teams in providing optimal patient care through evaluating and applying the information gleaned from these resources.

scholarly journals The Relationship Between Language Barrier in Non-Arabic Nurses and Anxiety in Cardiovascular Patients: A Cross-Sectional Descriptive Study

2021 ◽  
Vol 8 ◽  
pp. 237437352198924
Author(s):  
Jassem Almualem ◽  
Amal Darwish ◽  
Ahmed AlFaraj
Keyword(s):  
Health Care Providers ◽  
Care Delivery ◽  
Descriptive Study ◽  
Language Barrier ◽  
P Value ◽  
Care Providers ◽  
Cross Sectional ◽  
Related Information ◽  
Arabic Speakers ◽  
Arabic Speaking

Patients with cardiac conditions may suffer from anxiety related to prognosis and further rehabilitation. Anxiety could be exacerbated by different factors including miscommunication, which could be attributed to the linguistic barrier, that exists among health care providers. At Saud Al-Babtain Cardiac Center (SBCC), nurses who are non-native Arabic speakers could have difficulty communicating disease-related information at different stages of nursing care. Is it possible to identify the language barrier as a source of anxiety for admitted patients with cardiac diseases? In this cross-sectional, descriptive study, 50 patients were included following the diagnosis of cardiac disease and post-cardiac surgery. A questionnaire that measures anxiety level showed that patients who were handled by Arabic-speaking nurses reported less collective mean for the anxiety domain statements of (20.08) versus those who were handled by Non-Arabic-speaking nurses (28.55, P value = .041). Our finding indicates that anxiety levels increased when there was a language barrier between nurses and patients, which could affect the quality of care delivery at SBCC.

Digital Health Engagement in the US Population: Insights From the 2018 Health Information National Trends Survey

2021 ◽  
pp. e1-e4
Author(s):  
Chelsea L. Ratcliff ◽  
Melinda Krakow ◽  
Alexandra Greenberg-Worisek ◽  
Bradford W. Hesse
Keyword(s):  
Public Health ◽  
Health Information ◽  
Health Care Providers ◽  
Digital Health ◽  
Smart Device ◽  
P Value ◽  
Care Providers ◽  
Cross Sectional ◽  
The Us ◽  
National Trends

Objectives. To examine prevalence and predictors of digital health engagement among the US population. Methods. We analyzed nationally representative cross-sectional data on 7 digital health engagement behaviors, as well as demographic and socioeconomic predictors, from the Health Information National Trends Survey (HINTS 5, cycle 2, collected in 2018; n = 2698–3504). We fitted multivariable logistic regression models using weighted survey responses to generate population estimates. Results. Digitally seeking health information (70.14%) was relatively common, whereas using health apps (39.53%) and using a digital device to track health metrics (35.37%) or health goal progress (38.99%) were less common. Digitally communicating with one’s health care providers (35.58%) was moderate, whereas sharing health data with providers (17.20%) and sharing health information on social media (14.02%) were uncommon. Being female, younger than 65 years, a college graduate, and a smart device owner positively predicted several digital health engagement behaviors (odds ratio range = 0.09–4.21; P value range < .001–.03). Conclusions. Many public health goals depend on a digitally engaged populace. These data highlight potential barriers to 7 key digital engagement behaviors that could be targeted for intervention. (Am J Public Health. Published online ahead of print May 20, 2021: e1–e4. https://doi.org/10.2105/AJPH.2021.306282 )

scholarly journals Comparison of efficacy of myringoplasty in dry and wet ears in chronic otitis media of tubotympanic type

2017 ◽  
Vol 3 (3) ◽  
pp. 705 ◽  
Author(s):  
Yogeshwar Chandrashekar ◽  
Ravishankar Chandrashekar
Keyword(s):  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Inflammatory Cells ◽  
P Value ◽  
Hearing Improvement ◽  
Female Ratio ◽  
Fascia Graft ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the outcome of myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done in department of ENT Bangalore Medical College and Research Institute during the study period of November 2014 to May 2016, wherein a total of 60 patients of tubotympanic type COM with 30 cases each of dry and wet ears, aged 15-60 years were included. The hearing impairment was assessed and recorded by pure tone audiometry (PTA). After obtaining informed written consent the patients underwent myringoplasty (temporalis fascia graft, underlay technique). Microbiological examination of discharge in wet ears was done and histopathology of the excised remnant TM analyzed in both groups. Both groups of patients were followed up for 3 months and assessed for graft uptake and hearing improvement. PTA was repeated at 3 months postoperatively.  </p><p class="abstract"><strong>Results:</strong> Our study included 60 patients of tubotympanic type of COM with 30 cases each with dry and wet ears who underwent myringoplasty. Majority of our patients were in second decade in both the groups. There was slight female preponderance in our study with male to female ratio of 0.93:1. Discharge from ears in wet ears was mucoid in consistency and were culture negative. Histopathology of excised remnant TM in wet ears revealed evidence of inflammatory cells and vascularization within stroma of fibroblasts while these were absent in dry ear cases. The overall successful graft uptake following myringoplasty was 88.3% with 86.7% for wet ears and 90% for dry ears with no statistical significance (p value of 0.688&gt;0.05) between the two groups. With respect to hearing improvement post-operatively there was significant hearing improvement in both the groups when compared to preoperative hearing with a mean hearing gain (dB) of 3.43±2.81 in wet ear cases to 3.85±3.05 in dry ear cases, but when compared between the two groups, there was no significant statistical difference (p value of 0.582&gt;0.05).</p><p><strong>Conclusions:</strong> The outcome is equally good for myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media with respect to graft uptake and hearing improvement. </p>

scholarly journals Economic implications of polypharmacy in Nepal: Multicenter community-based study

2020 ◽  
Author(s):  
Binaya Sapkota ◽  
Suraj Shakya ◽  
Saroj Sah ◽  
Narendra Chaudhary ◽  
Bijendra Tamang ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Age Groups ◽  
Pharmacoeconomic Evaluation ◽  
Secondary Outcome ◽  
P Value ◽  
Cross Sectional ◽  
Economic Implications ◽  
Total Cost

Objective:Improper management of polypharmacy in community and hospital pharmacies may lead to adverse effects and drug interactions in patients of all age groups, especially children and the elderly. This study aimed to determine the scenario of polypharmacy in multiple communities in Nepal and the costs associated with them. Design: Cross-sectional study Setting:Local communities of nine districts in Nepal Participants:Total 400 patients of all age groups, who were consuming medicines and who fulfilled inclusion criteria from May 2017 to August 2018 Primary and secondary outcome measures:A semi-structured questionnaire, based on the prescription optimization method, was used for data collection. Multinomial logistic regression was performed to analyze the statistical significance of polypharmacy with the predictor variables (e.g., age, education level, occupation, diagnosis, total cost of medicines). The p-value <0.05 was considered statistically significant at 95% confidence interval. Polypharmacy cases and their economic implications were reported. Results:Eighty-one patients (20.3%) with an age group of 22-31 years with female patients (219, 54.8%) reported more polypharmacy events. There were 216 patients (54%) with prescriptions of five medicines i.e., moderate polypharmacy. Total number of medicines consumed by all 400 patients was 2269, with a mean, SD 5.67, 1.08. Total expenditure by all 400 patients was USD 3409.54 during the study period, with a mean, SD 8.66, 6.04. Both moderate and severe polypharmacy cases were non-significantly related with age, gender and total cost of medications. They had significant relationship in almost all levels of education and occupation and showed mixed type of significance and non-significance with the diagnosis of the respondents. Conclusion: Polypharmacy cases can be minimized, considering adverse drug reactions and drug interactions. Further studies are warranted in medication utilization and avoidable polypharmacy along with detailed pharmacoeconomic evaluation.

scholarly journals Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea

2020 ◽  
Author(s):  
Betiel Yihdego Kidanemariam ◽  
Traudl Elsholz ◽  
Laban L. Simel ◽  
Eyasu H. Tesfamariam ◽  
Yonatan Mehari Andemeskel
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Health Care Providers ◽  
Work Experience ◽  
Statistical Significance ◽  
Demographic Data ◽  
Postoperative Pain Management ◽  
Perceived Barriers ◽  
Care Providers ◽  
Cross Sectional

Abstract Background: Pharmacological methods are widely used for postoperative pain management however, poorly controlled pain continues to pose a significant challenge. Non pharmacological methods could contribute to the unresolved postoperative pain management in assisting nurses’ routine care and reducing the need for medication. This study aimed to assess nurses’ utilization of non-pharmacological methods in postoperative pain and the perceived barriers for their implementation at the National Hospitals.Methods: This was a descriptive cross sectional study conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization of selected non-pharmacological methods and the perceived barriers for the implementation was used to collect data. Descriptive statistics for the demographic data, independent samples t-test, one way ANOVA and factorial ANOVA were used to analyze the data. Statistical significance level was set at P < 0.05.Results: The study found out that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were mostly used while, cognitive-behavioral (5.9%) and physical methods (5.8%) were hardly used. The results also showed that, characteristics such as, age (p=0.013), level of education (p=0.012), work experience (p=0.001) and place of work (p=0.001), were significantly related to the use of non-pharmacological methods at bivariate level. However, hospitals were the only determinants of the non-pharmacological methods at multivariable level with a statistical significance of (p<0.001). On the perceived barriers; heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), patient’s uncooperative behavior (57.1%), language difference (64.4%), nurse’s lack of knowledge (50%) and experience (40.3%) were identified.Conclusion: The use of non-pharmacological methods in the studied hospitals varied greatly on the knowledge and experience of the nurses. Therefore, it is recommended that exposure and training for all health care providers at all level is a paramount importance in order to appreciate the benefits of non-pharmacological methods applicable to postoperative pain management. This could be achieved through on job training, seminars, scientific conferences and other brainstorming forums.

scholarly journals Observational analysis of medication related errors by clinical pharmacists in a South Indian hospital

2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Syamprashanth Pedada ◽  
Jyotsna Allamsetty ◽  
Meena Ujwala Garikapati ◽  
Navya Burreddy ◽  
Umasankar Viriti
Keyword(s):  
Medication Errors ◽  
Health Care Providers ◽  
Clinical Pharmacist ◽  
General Medicine ◽  
Case Report Form ◽  
Care Providers ◽  
Prescribing Errors ◽  
Standard Case ◽  
Patient Interview ◽  
South Indian

Present work was done to evaluate the occurrence of medication errors in general ward of institute of medical sciences to assess the role of clinical pharmacist in error management. The study was conducted for 9 months and Data was acquired from inpatients of general medicine dept by using standard case report form through direct patient interview. The collected data was to identify medication errors by using drug information tools such as , drug interaction checker and reputed journals and statistical interpretations were done. 400 prescriptions were and in that 300 prescriptions were presented with medication errors. 202 were found to be Prescribing errors, 111 Administration errors,45 were dispensing errors, Monitoring errors were 123. Interaction errors (81.18%), prescription in small letters (34.65%), wrong frequency of administration error (32.43%) and wrong time administration of medicine (85.58%), Dispensing wrong quantity of drug (95.5%) were the major medication errors that were observed. Medication errors have been occurring frequently in the general medicine department out of which prescribing errors were more common. Clinical Pharmacist could act as an medical staff by performing consciousness and teaching to medical professionals and by maintaining positive collaboration with other health care providers for patients.

scholarly journals Community-Based Intervention to Increase Usage of Medication Disposal Bins

2019 ◽  
Author(s):  
Sanjhavi Agarwal ◽  
Jordan Burr ◽  
Charis Darnell ◽  
Brett Ellison ◽  
Amir El-Khalili ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Healthcare Providers ◽  
Health Centers ◽  
P Value ◽  
Care Providers ◽  
Community Based ◽  
Before And After ◽  
Provider Knowledge ◽  
Informational Intervention ◽  
Medication Disposal

Despite the existence of medical waste disposal sites, many patients do not know how to discard their unused and expired medications. The goal of this project is to assess health care providers’ knowledge regarding proper medication disposal (PMD) and to measure the effectiveness of a brief provider informational intervention regarding PMD. Changes in knowledge were evaluated using paper pre and post surveys. The surveys were administered anonymously before and after the presentation. Principal findings: A total of 55 healthcare providers (Clinic A n = 25, Clinic B n = 28) received the PMD presentation. 52 (95%) completed the pre and post surveys. Pre-intervention knowledge of PMD was higher in Clinic B where there was an existing medication disposal box (92% accuracy) compared to Clinic B which did not have a medical disposal bin (52% accuracy). Surveys results showed improvement in 36% of Clinic A participants and 14.3% of Clinic B participants (p value = 0.0086). Based on these findings, we can conclude that the presence of a medication disposal bin is positively correlated with provider knowledge regarding PMD. This may be used to encourage the institution of medication disposal bins in more health centers and an increase in medical staff knowledge of the practice.

Breaking bad news in the oncologic population: Residents' perspective.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24113-e24113
Author(s):  
Vihitha Thota ◽  
Mahati Paravathaneni ◽  
Sudheer Konduru ◽  
Bohdan Baralo ◽  
Sana Mulla ◽  
...  
Keyword(s):  
Patient Care ◽  
Health Care Providers ◽  
Confidence Level ◽  
Statistical Significance ◽  
Further Education ◽  
Bad News ◽  
Care Providers ◽  
Prior Training ◽  
Oncologic Patients ◽  
Delivering Bad News

e24113 Background: Delivering bad news to patients is a delicate but required skill for doctors as part of patient care. There has been evidence that good communication from health care providers can improve patients' compliance to treatment as well as be beneficial emotionally. While many studies have been done in regards to patients' perceptions of receiving bad news, there are limited studies looking at a physicians' perspective, and even more so concerning residents' perceptions. In community hospitals, many patients are diagnosed with cancer, and resident physicians are often responsible for informing the patients and their families regarding the diagnosis. The manner in which the news is delivered is important, however it is unclear how much training is provided to residents before they are required to break bad news to patients. The lack of training can often result in improper delivery and poor patient care. Methods: We surveyed Internal Medicine and General Surgery residents at Mercy Catholic Medical Center, a conglomeration of two community teaching hospitals in Philadelphia, about prior training, confidence level, attitudes, and need for further education on delivering bad news to oncologic patients using a survey created after extensive research. The factors associated with confidence level were analyzed using paired T-test and ANOVA methods. Results: A total of 65 residents (72%) participated. No statistical significance was seen between American versus foreign medical graduates, MD vs. DO residents, or among those in different specialties when assessing their confidence in delivering bad news. Though only 62% of participants reported having had prior training in delivering bad news, residents with previous training (p1) or who have had to deliver bad news previously (p2) reported higher confidence when it came to delivering a new diagnosis of cancer (p1 0.03, p2 0.001), delivering news regarding the progression of cancer (p1 0.03, p2 0.02), delivering news regarding the recurrence of cancer (p1 0.04, p2 0.002), and delivering news regarding end-stage cancer with little to no treatment options left (p1 0.04, p2 0.003). 100% of participants thought communicating bad news is an important skill for a physician, and 92% of participants thought further education would help prepare them for similar scenarios in the future. Simulated patient scenarios (64%), grand rounds lectures/presentations (59%), and feedback from faculty after actual patient scenarios (57%) were the most requested whereas pamphlets/brochures (17%) and online training courses (20%) were less popular. Conclusions: Our study highlights the importance of prior training or exposure among residents in being able to deliver bad news to patients effectively. We propose that implementing further training in the form of simulated scenarios and lectures can improve residents' confidence at delivering bad news and result in a better physician-patient relationship.

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