scholarly journals Potential Drug-Drug Interactions among Medications Prescribed to Adult Filipinos at a Primary Care Clinic in a Government Teaching Hospital

2020 ◽  
Vol 54 (3) ◽  
Author(s):  
Shiela Marie S. Laviña ◽  
Regie A. Layug
Keyword(s):  
Primary Care ◽  
Drug Interactions ◽  
Teaching Hospital ◽  
Medical Records ◽  
Primary Care Clinic ◽  
Adverse Outcomes ◽  
Drug Prescriptions ◽  
Potential Drug ◽  
Care Clinic ◽  
Pharmacokinetic Interactions

Background. A drug-drug interaction (DDI) is a pharmacologic or clinical response to the administration of a drug that can result in adverse outcomes. DDIs are considered preventable adverse drug reactions because these interactions can be learned, predicted and recognized. Objective. To determine potential drug-drug interactions (pDDI) among medications prescribed to adult patients consulting at a primary care clinic in a government teaching hospital. Methods. This was a 6-month retrospective cross-sectional study of drug prescriptions based on medical records of adult Filipinos who were seen and managed at a primary care clinic in a government teaching hospital. Medical charts were systematically selected based on a sampling frame with inclusion and exclusion criteria. Results. A total of 1,490 medical records of adult Filipino patients were included in the study. There were a total of 261 unique prescriptions based on generic formulations and an overall total of 5,978 drugs for a 6-month period of clinic consultations. An average of 4 medications (SD±1.63) were prescribed for every consultation recorded in the medical chart. From the charts that were reviewed, 23% of all adults were given a prescription of 4 drugs (N=348/1490), 26% had 3 drug prescriptions (N=386/1490) and 18% had two drugs, respectively, per clinic visit. Overall, 714/9054 (7.88%) medication pairs were seen to have potential drug interactions. The top three most common drug pairs with pDDI were amlodipine-simvastatin, losartan/hydrochlorothiazide-metformin and aspirin-furosemide. Five hundred twenty-five drug pairs had pharmacodynamic interactions (525/714) while 94 drug pairs (15%) had pharmacokinetic interactions. Conclusion. Potential drug-drug interactions were observed in 8% of medications prescribed to adult Filipinos seen at Family Medicine Clinic in a government hospital. Seventy-four percent (74%) of the drug pairs with pDDIs were pharmacodynamic and 15% were pharmacokinetic interactions.

Vision Screening Among Primary Care Clinic Patients

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 93A-93A
Author(s):  
Lwbba Chait ◽  
Angeliki Makri ◽  
Rawan Nahas ◽  
Gwen Raphan
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Vision Screening ◽  
Care Clinic

scholarly journals Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

2021 ◽  
Vol 12 ◽  
pp. 215013272110350
Author(s):  
Pasitpon Vatcharavongvan ◽  
Viwat Puttawanchai
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Clinical Decision ◽  
Cross Sectional Study ◽  
Study Data ◽  
Patient Specific ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Care Clinic ◽  
Inappropriate Medications

Background Most older adults with comorbidities in primary care clinics use multiple medications and are at risk of potentially inappropriate medications (PIMs) prescription. Objective This study examined the prevalence of polypharmacy and PIMs using Thai criteria for PIMs. Methods This study was a retrospective cross-sectional study. Data were collected from electronic medical records in a primary care clinic in 2018. Samples were patients aged ≥65 years old with at least 1 prescription. Variables included age, gender, comorbidities, and medications. The list of risk drugs for Thai elderly version 2 was the criteria for PIMs. The prevalence of polypharmacy and PIMs were calculated, and multiple logistic regression was conducted to examine associations between variables and PIMs. Results Of 2806 patients, 27.5% and 43.7% used ≥5 medications and PIMs, respectively. Of 10 290 prescriptions, 47% had at least 1 PIM. The top 3 PIMs were anticholinergics, proton-pump inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). Polypharmacy and dyspepsia were associated with PIM prescriptions (adjusted odds ratio 2.48 [95% confident interval or 95% CI 2.07-2.96] and 3.88 [95% CI 2.65-5.68], respectively). Conclusion Prescriptions with PIMs were high in the primary care clinic. Describing unnecessary medications is crucial to prevent negative health outcomes from PIMs. Computer-based clinical decision support, pharmacy-led interventions, and patient-specific drug recommendations are promising interventions to reduce PIMs in a primary care setting.

scholarly journals 140. Symptoms and Situations Predispose Patients to Use Antibiotics Without Medical Advice

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S200-S200
Author(s):  
Michael Hansen ◽  
Barbara Trautner ◽  
Roger Zoorob ◽  
George Germanos ◽  
Osvaldo Alquicira ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Departments ◽  
Primary Care Clinic ◽  
Antibiotic Use ◽  
Safety Net ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Primary Care Patients ◽  
Emergency Department Patients

Abstract Background Use of antibiotics without a prescription (non-prescription use) contributes to antimicrobial resistance. Non-prescription use includes obtaining and taking antibiotics without a prescription, taking another person’s antibiotics, or taking one’s own stored antibiotics. We conducted a quantitative survey focusing on the factors that impact patients’ decisions to use non-prescription antibiotics. Methods We surveyed patients visiting public safety net primary care clinics and private emergency departments in a racially/ethnically diverse urban area. Surveys were read aloud to patients in Spanish and English. Survey domains included patients’ perspectives on which syndromes require antibiotic treatment, their perceptions of health care, and their access to antibiotics without a prescription. Results We interviewed 190 patients, 122 from emergency departments (64%), and 68 from primary care clinics (36%). Overall, 44% reported non-prescription antibiotic use within the past 12 months. Non-prescription use was higher among primary care clinic patients (63%) than the emergency department patients (39%, p = 0.002). The majority felt that antibiotics would be needed for bronchitis (78%) while few felt antibiotics would be needed for diarrhea (30%) (Figure 1). The most common situation identified “in which respondents would consider taking antibiotics without contacting a healthcare provider was “got better by taking this antibiotic before” (Figure 2). Primary care patients were more likely to obtain antibiotics without prescription from another country than emergency department patients (27% vs. 13%, P=0.03). Also, primary care patients were more likely to report obstacles to seeking a doctor’s care, such as the inability to take time off from work or transportation difficulties, but these comparisons were not statistically significant. Figure 1. Patients’ agreement that antibiotics would be needed varied by symptom/syndrome. Figure 2. Situations that lead to non-prescription antibiotic use impacted the two clinical populations differently Conclusion Non-prescription antibiotic use is a widespread problem in the two very different healthcare systems we included in this study, although factors underlying this practice differ by patient population. Better understanding of the factors driving non-prescription antibiotic use is essential to designing patient-focused interventions to decrease this unsafe practice. Disclosures All Authors: No reported disclosures

scholarly journals Cross-Cultural Comparisons of Subjective Cognitive Complaints in a Diverse Primary Care Population

2021 ◽  
pp. 1-11
Author(s):  
Danelly Rodríguez ◽  
Emmeline Ayers ◽  
Erica F. Weiss ◽  
Joe Verghese
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
African Americans ◽  
Primary Care Clinic ◽  
Depression Scale ◽  
Cognitive Complaints ◽  
Care Clinic ◽  
Primary Care Population ◽  
Subjective Cognitive Complaints

Background: Very few studies have explored the utility of subjective cognitive complaints (SCCs) in primary care settings. Objective: We aim to investigate associations between SCCs (item-level), objective cognitive function (across domains and global), and mood in a diverse primary care population, including subjects with mild cognitive impairment. Methods: We studied 199 (75.9%females; 57.8%Hispanics; 42.2%African Americans) older adults (mean age 72.5 years) with memory concerns at a primary care clinic. A five-item SCC questionnaire, and objective cognitive assessments, including the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale, were administered. Results: Logistic regression analyses showed associations between SCC score and depressive symptoms. A memory-specific (“memory worsening”) SCC predicted scores on the MoCA (p = 0.005) in Hispanics. Conclusion: SCCs are strongly linked to depressive symptoms in African Americans and Hispanics in a primary care setting; a specific type of SCC is related to global cognitive function in Hispanics.

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