Pharmacoepidemiological Analysis of Pharmacotherapy for Burn Injuries in Real Clinical Practice

2020 ◽  
pp. 70-79
Author(s):  
Olga Vyacheslavovna Zhukova ◽  
Ekaterina Sergeevna Nekaeva ◽  
Elena Sergeevna Khoroshavina ◽  
Ekaterina Alexeevna Kozlova ◽  
Yulia Alexandrovna Dudukina ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Average Cost ◽  
Burn Injury ◽  
General Structure ◽  
Burn Injuries ◽  
Antimicrobial Drugs ◽  
Positive Tendency ◽  
Defined Daily Doses ◽  
Duration Of Hospitalization ◽  
Real Clinical Practice

Objective: to conduct pharmacoepidemiological analysis and analysis of the costs of pharmacotherapy, taking into account the actual consumption of drugs in the real inpatient clinical practice at the federal center in Russia. Materials and methods. Data from the medical records of 14 patients with burn injury, who were hospitalized in 2018, was analyzed. Patients’ age was from 23 to 67 years (44,93 ± 14,66). Duration of hospitalization was from 17 to 62 days (35,93 ± 14,17). We calculated rate of prescription foe each drug and its share in general structure of all utilized drug courses (n = 460). We performed frequency analysis of prescription structure, DDD (defined daily doses) analysis, DU90% (Drug Utilization 90%) analysis, ABC-analysis and analysis of average cost of pharmacotherapy. Results. Most frequently used drugs, prescribed in 75-100% of all hospital cases, included 15 names, e.g. 2 antimicrobial drugs (vancomycin and amikacin), 19 were used commonly, including 4 antimicrobial drugs (co-trimoxazole, cefoperazone/sulbactam, tigecyclin and cefepime). Other drugs were used in less than 25% of cases. 33 drugs made 90% of all consumed NDDD, including 5 antimicrobial drugs (vancomycin, amikacin, co-trimoxazole, cefoperazone/sulbactam and tigecyclin). These drugs comprised 70,24% in the prescription structure. The cost of one DDD in DU90% segments (512,33 rubles) is 1,4 higher than in DU10% segment (649,34 rubles). Average cost of drugs included in DU90% group was 4735,89 rubles vs 4966,80 rubles for drugs from DU10% group. This finding shows positive tendency of burn injuries pharmacological treatment. Conclusion. We obtained the data, which can be used for comparison of real clinical practice costs with a current payment rates for medical care.

scholarly journals Burn infections characteristics: A review

2021 ◽  
Vol 16 (1) ◽  
pp. 32-41
Author(s):  
Andra-Luana LAZARESCU ◽  
◽  
Andreea GROSU-BULARDA ◽  
Mihaela-Cristina ANDREI ◽  
Adrian FRUNZA ◽  
...  
Keyword(s):  
Burn Injury ◽  
Opportunistic Infections ◽  
Infectious Complications ◽  
Burn Injuries ◽  
Resistant Bacteria ◽  
Multiple Sources ◽  
Infectious Risk ◽  
Proven Efficacy ◽  
Duration Of Hospitalization ◽  
Severe Burn Injuries

Burn injuries are unique in comparison to other types of trauma because of their severity and major systemic impact produced by extensive lesions with disfunctions that can persist even several years after the injury. Multiple complications can occur during burn injury evolution, from which infections are the most severe and the most frequently encountered, requiring adequate diagnosis and treatment. In most burn centers, increased mortality rates associate with severe burn injuries aggravated by the development of sepsis. There are multiple sources of infections in burned patients: lungs, wounds, catheters, gastrointestinal and urinary tract. Pathogens are often multi-resistant bacteria but also fungi and viruses appear as opportunistic infections. The main goal is represented by prevention of organ dysfunction development through specific supportive measures that avoid its onset. Early excision of the burn eschar and wound grafting is essential for patient outcome, decreasing duration of hospitalization, infectious risk and mortality. As a principle, antibiotic treatment in burn infectious complications is started empirically, with broad spectrum agents if the results of microbiological cultures are not available and immediately after the antibiogram is available, targeted antibiotic is introduced. De-escalation strategy is promoted in order to prevent antimicrobial resistance: narrow spectrum drugs with proven efficacy on determined germs are administered, avoiding if possible, reserve antibiotics.

A cross- sectional survey of health professionals across Australia and New Zealand to determine what outcome measures are important from a clinical perspective post hand burn injury

2021 ◽  
Author(s):  
Andrea Mc Kittrick ◽  
Louise Gustafsson
Keyword(s):  
Clinical Practice ◽  
Outcome Measures ◽  
Health Professionals ◽  
Allied Health ◽  
Burn Injury ◽  
Assessment Tools ◽  
Burn Injuries ◽  
Routine Practice ◽  
Sample Population ◽  
Cross Sectional

Abstract Outcome measures are used in healthcare to evaluate clinical practice, measure efficiencies and to determine the quality of health care provided. The Burns Trauma Rehabilitation: Allied Health Practice Guidelines advocates for the collection of outcome measures post burn injuries across different time points. These guidelines recommend multiple tools which can be utilised when measuring outcomes post burn injuries. The aim of this study was to gather information from specialist clinicians regarding their clinical practice and the outcome measurement tools used post hand burn injuries. This cross-sectional study used a survey design to collect data at one given point in time across a sample population. A total of 43 clinical specialists allied health professionals responded to the survey. Respondents indicated that their patients considered hand dexterity was the most important outcome. Three months post burn injury was the most common timepoint for measurement (n= 31, 72.1%) followed by six months (n=27, 62.8%). Patient report of hand function (n=42, 97.7%) and observation (n=41, 95.3%) were the most frequently reported assessment methods. The Jamar Dynamometer (n=40, 93%), goniometer (n=39, 90.7%) and pinch gauge (n=36, 83.7) were the most frequency cited assessment tools. The findings of this study suggest that clinical specialist allied health collect some outcome measures in their routine practice. Based on the respondent’s perceptions of barriers when using outcome measures and lack of reliable/ validated tools to measure hand burn outcomes, there is a need for further studies in this area.

In real clinical practice osteoporosis drugs are taken for a very short period: analysis of persistence in the campania region

2013 ◽  
Author(s):  
Giovanni Iolascon ◽  
Annarita Capaldo ◽  
Valentina Orlando ◽  
Enrica Menditto ◽  
Francesca Gimigliano
Keyword(s):  
Clinical Practice ◽  
Campania Region ◽  
Period Analysis ◽  
Short Period ◽  
Real Clinical Practice

PCSK9 inhibitors as an add on for the treatment of dislipemia in real clinical practice

2018 ◽  
Author(s):  
Carmen Hernandez Garcia ◽  
Cristina Maria Diaz Perdigones ◽  
Miguel Damas Fuentes ◽  
Clara Estaun Martinez ◽  
Andrea Sanchez Ramos ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pcsk9 Inhibitors ◽  
Real Clinical Practice

Comprehensive assessment of drug consumption as a basis for pharmacotherapy optimization

2019 ◽  
pp. 22-31
Author(s):  
Olga Vyacheslavovna Zhukova
Keyword(s):  
Clinical Practice ◽  
Treatment Options ◽  
Comprehensive Assessment ◽  
Drug Consumption ◽  
Treatment Standards ◽  
Disease Epidemiology ◽  
Efficacy Analysis ◽  
Epidemiological Monitoring ◽  
Guidelines Development ◽  
Real Clinical Practice

This article describes the rationale for methodology of comprehensive assessment of drug consumption in real clinical practice. The proposed methodology includes three stages: 1) epidemiological monitoring – disease epidemiology assessment; assessment of the role of factors leading to the disease; 2) pharmacoepidemiological monitoring – assessment of pharmacotherapy in real clinical practice; clinical efficacy analysis of drugs; cost-effectiveness analysis; 3) long-term clinical and economical evaluation of various treatment options. Comprehensive assessment of drug consumption should result in optimal pharmacotherapy regimens, decrease of the drug load, increasing of the therapy effectiveness and cost reduction. The scheme of comprehensive assessment of drug consumption is universal and can be used for clinical guidelines development, treatment standards, for the optimal formation of drugs lists at the federal level. Separate stages and sub-steps of an integrated assessment also can be used at the territorial and local levels, medical institution, to optimize pharmacotherapy.

scholarly journals Insulin doses requirements in patients with type 1 diabetes using glargine U300 or degludec in routine clinical practice

2021 ◽  
pp. jim-2020-001633
Author(s):  
Florentino Carral San Laureano ◽  
Mariana Tomé Fernández-Ladreda ◽  
Ana Isabel Jiménez Millán ◽  
Concepción García Calzado ◽  
María del Carmen Ayala Ortega
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Practice ◽  
Retrospective Study ◽  
Real World ◽  
Glycosylated Hemoglobin ◽  
Routine Clinical Practice ◽  
Insulin Analogs ◽  
Total P ◽  
Real Clinical Practice

There are not many real-world studies evaluating daily insulin doses requirements (DIDR) in patients with type 1 diabetes (T1D) using second-generation basal insulin analogs, and such comparison is necessary. The aim of this study was to compare DIDR in individuals with T1D using glargine 300 UI/mL (IGlar-300) or degludec (IDeg) in real clinical practice. An observational, retrospective study was designed in 412 patients with T1D (males: 52%; median age 37.0±13.4 years, diabetes duration: 18.7±12.3 years) using IDeg and IGla-300 ≥6 months to compare DIDR between groups. Patients using IGla-300 (n=187) were more frequently males (59% vs 45.8%; p=0.004) and had lower glycosylated hemoglobin (HbA1c) (7.6±1.2 vs 8.1%±1.5%; p<0.001) than patients using IDeg (n=225). Total (0.77±0.36 unit/kg/day), basal (0.43±0.20 unit/kg/day) and prandial (0.33±0.23 unit/kg/day) DIDR were similar in IGla-300 and IDeg groups. Patients with HbA1c ≤7% (n=113) used significantly lower basal (p=0.045) and total (p=0.024) DIDR, but not prandial insulin (p=0.241), than patients with HbA1c between 7.1% and 8% and >8%. Patients using IGla-300 and IDeg used similar basal, prandial and total DIDR regardless of metabolic control subgroup. No difference in basal, prandial and total DIDR was observed between patients with T1D using IGla-300 or IDeg during at least 6 months in routine clinical practice.

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