Assessment of Drug related problems Encountered in Patients with Psychiatric disorders in a Secondary Care Hospital.

2021 ◽  
pp. 6089-6094
Author(s):  
Javedh Shareef ◽  
Padma GM Rao ◽  
Itaf Mohamad Ayman Al-Bonni ◽  
Riadh Khudhaier
Keyword(s):  
Drug Therapy ◽  
Psychiatric Disorders ◽  
Secondary Care ◽  
Psychiatric Illness ◽  
Care Hospital ◽  
Drug Related Problems ◽  
Male Predominance ◽  
Minor Significance ◽  
Level Of Significance

Introduction: Patients with psychiatric disorders receives multiple medications associated with their comorbid conditions and mental illness increasing the risk of drug related problems leading to frequent hospitalization, healthcare expenditure and reduced quality of life. Aim/Objective: To assess and evaluate the Drug Related Problems (DRPs) encountered in patients with psychiatric disorders in a Secondary Care Hospital in Ras Al-Khaimah. Methodology: A prospective observational study was carried out for a period of six months in the department of psychiatry of a secondary care teaching hospital. All the necessary details including the demographics, drug therapy and laboratory parameters were collected from the patient case records. The patient medication orders were reviewed and screened for any DRPs. The identified DRPs were documented and later evaluated to identify the types, frequency, class of drugs involved and for the level of clinical significance by using the descriptive statistics. Results: A total of 61 DRPs were identified from 50 patients. Male predominance was noted over females. DRPs were commonly seen in patients aged between 21-40 years of age. Schizophrenia (42%) was the most common psychiatric illness identified in the study. The most common DRPs was found to be drug-drug interaction (36.06%) followed by adverse drug reaction (27.86%) and medication non-adherence (24.59%). The level of significance of DRPs was found to be ‘minor’ significance in the grade. Conclusion: The study identifies the DRPs in patients with psychiatric illness and necessitates the need for a regular medication review which will help to rationalize the drug therapy, achieve better therapeutic outcomes and improved quality of patient care.

scholarly journals Trends and practices in prescribing anti-psychotropic medications in hospitalized patients with psychiatric disorders in a secondary care hospital in Ras al Khaimah

2020 ◽  
Vol 9 (12) ◽  
pp. 1784
Author(s):  
Javedh Shareef ◽  
Padma G. M. Rao ◽  
Itaf Mohamad Ayman
Keyword(s):  
Psychiatric Disorders ◽  
Secondary Care ◽  
Demographic Data ◽  
Psychotropic Medications ◽  
Hospitalized Patients ◽  
Mood Stabilizers ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Rational Drug

Background: Advances in the psycho-pharmacotherapy enhance the development of newer and better drugs in the management of psychiatric disorders. However, their proper utilization, safety and efficacy and adverse effects in the clinical practice needs continuous study. The study aimed to assess the trends and practice of prescribing psychotropic medications in hospitalized patients in a secondary care hospital in Ras Al Khaimah.Methods: A prospective observational study was carried out for a period of six months in a psychiatry department. All the patient details including the demographic data and prescribing pattern of antipsychotic medication were collected from the patient case records and were later analysed by using descriptive statistics.Results: A total of 50 patient’s prescription were analysed during the study period. Male (54%) predominance was noted over females (46%) with majority (64%) of patients were in the age group of 21-40 years. Schizophrenia (35.8%) was the most common psychiatric disorders followed by affective disorders (30.86%). The average number of psychiatric drugs per prescription was found to be 3.38±1.23. Antipsychotics (43.36%) were the commonly prescribed class of medications followed by mood stabilizers (12.38%) and anxiolytics (11.06%) with olanzapine (n=26), sodium valproate (n=21) and clonazepam (n=9) being frequently prescribed medications. Escitalopram (n=9) was the most commonly used anti-depressants. Combination therapy (86%) is preferred over monotherapy (14%).Conclusions: This study helps to assist in ensuring rational drug therapy and reducing the incidence of drug related problems and medication errors and thereby enhancing the quality of care in patients with psychiatric disorders.

scholarly journals Assessment of clinical efficacy of nefopam hydrochloride in lumbar disc prolapse patients in secondary care hospital

2021 ◽  
Vol 9 (7) ◽  
pp. 1935
Author(s):  
Suligeri Samarpana ◽  
Yerukala Chamundeswari ◽  
K. Jagadeesh ◽  
C. Venkatesh ◽  
G. Vinod ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Drug Therapy ◽  
Secondary Care ◽  
Lumbar Disc ◽  
Care Hospital ◽  
Low Back ◽  
Disc Prolapse ◽  
Lumbar Disc Prolapse ◽  
Pain Patients

Background: In this study assessing the efficacy of 30 mg of nefopam hydrochloride in lumbar disc prolapse patients.Methods: This was a prospective observational study. This study was carried out about 6 months in secondary care hospital. 100 patients are involved in this study. Patient documentation forms, visual analogue scale, patient counselling forms are the materials for this study. In this study patients visiting the Hospital with low back pain patients are included in the study. Pregnancy patients and failed back syndrome are excluded in the study. Results: In this study different age groups of patients as follows 21 patients in 20-30 years of age, 31 patients in 30-40 years of age, 37 patients in 40-60 years of age, 11 patients in 60-80 years of age.Percentage of pain relief of Nefopam hydrochloride drug therapy as follows, 23 patients in 10-20%, 16 patients in 20-40%, 38 patients in 40-60%, 16 patients in 60-80%, 7 patients in 80-100%. Assessing pain intensity in no. of patients after nefopam hydrochloride drug therapy are as follows 10patients has no pain, 28patients has mild pain, 34patients moderate pain, 15 patients has severe pain, 13 patients are worst pain.Conclusions: In current study demonstrated that the analgesic efficacies of nefopam hydrochloride in low back pain patients. Nefopam shows better action in mild, moderate, severe and worst pain. Nefopam shows high efficacy.

Development and Validation of the Turkish Version of the Attitude Toward Professional Autonomy Scale for Nurses

2021 ◽  
pp. JNM-D-20-00115
Author(s):  
Nilufer Demýrsoy ◽  
Aysun Ture
Keyword(s):  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Internal Consistency ◽  
Secondary Care ◽  
Professional Autonomy ◽  
Care Hospital ◽  
Turkish Version ◽  
Sample Group ◽  
Confirmatory Factor

Autonomy in nursing practice is one of the recurring fields in literature of research. For nurses to be autonomous is considered to have a great importance on the quality of healthcare services. This study aimed to examine the validity and reliability of the Turkish version of the Attitude Toward Professional Autonomy Scale for Nurses. This methodological study adopted a descriptive cross-sectional design. The study was done in a secondary care hospital. Sample group includes 199 nurses that work at a secondary care hospitals. It was carried out while culturally adjusted and it also included two-way translations of English version of the Attitude Toward Professional Autonomy Scale for Nurses. To evaluate its validity, LISREL statistics software was used to make confirmatory factor analysis. Internal consistency was evaluated by using Cronbach’s α and total-item correlations. Average age of the sample group was found 28.35 ± 6.16. Confirmatory factor analysis yielded t-scores, which were significant for all the 18 items (p < .05). Fit indices of the model, resemblance rate chi-square statistics were identified as 𝜒2/df = 198.01/132 = 1.50. The Cronbach’s alpha of the scale (.918) was indicative of strong internal consistency. The scale demonstrated strong validity and internal consistency. This scale can be used to assess perceptions of nursing practices that enhance the quality of nursing care.

scholarly journals Determinants of quality of life among people with epilepsy attending a secondary care rural hospita in south India

2013 ◽  
Vol 04 (S 01) ◽  
pp. S62-S66 ◽  
Author(s):  
M Ashwin ◽  
PS Rakesh ◽  
Ruby A Pricilla ◽  
K Manjunath ◽  
KS Jacob ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Secondary Care ◽  
Univariate Analysis ◽  
Female Gender ◽  
Social Consequences ◽  
Outpatient Department ◽  
World Health ◽  
Care Hospital ◽  
Factors Associated

ABSTRACT Context: Epilepsy is associated with profound physical, psychological, and social consequences. Aims : To assess the quality of life (QOL) among people with epilepsy attending the outpatient department of a secondary care hospital and to determine the various social and demographic factors affecting it. Materials and Methods: The QOL of 100 people with epilepsy attending the outpatient department of a community-based secondary care hospital was assessed using the WHOQOL-BREF (WHOQOL: World Health Organization QOL) questionnaire. Univariate analysis and logistic regression was done to determine the factors associated with poor QOL. Results: The QOL scores for all the domains ranged between 15.7 and 74.55 with a mean score of 51.49 [standard deviation (SD) 12.3]. The mean scores in the physical, psychological, social, and environmental domains were 55.7, 37.92, 57.75, and 50.56, respectively. Age more than 30 years [odds ratio (OR): 4.33, 95% confidence interval (CI): 1.73-10.82], female gender (OR: 2.90, 95% CI: 1.16-7.28), and currently married (OR: 3.82, 95% CI: 1.21-12.11) were the factors significantly associated with lower QOL scores. Conclusions: The QOL among people with epilepsy was lower in the psychological domain. Age more than 30 years, female gender, and being married were identified as the factors associated with poor QOL scores among people with seizure disorders.

scholarly journals Non-Opioid Analgesics Consumption At The Surgery Departments Of A Secondary Care Hospital In General Hospital In Kraljevo, Serbia

2015 ◽  
Vol 16 (3) ◽  
pp. 229-233
Author(s):  
Dejan Aleksic ◽  
Andriana Bukonjic ◽  
Srdjan Stefanovic
Keyword(s):  
General Hospital ◽  
Secondary Care ◽  
Anatomical Therapeutic Chemical ◽  
National Level ◽  
Opioid Analgesics ◽  
Scientific Data ◽  
Care Hospital ◽  
The Individual ◽  
Average Consumption

Abstract The aim of this study was to determine the amount of non-opioid analgesics consumed at the surgical departments of a secondary care hospital in Serbia, a developing country undergoing a socioeconomic transition that thus lacks sufficient funds to finance and invest in the healthcare system. At the departments of gynaecology, urology, otolaryngology, general surgery and orthopaedics with traumatology at the General Hospital, Kraljevo from 2010 to 2012, six different non-opioid analgesics were used: diclofenac, ketorolac, ibuprofen, metamizole sodium, paracetamol (for per os and parenteral use), and meloxicam (for parenteral use only). Drugs in the M01 Anatomical Therapeutic Chemical classification group were consumed statistically significantly more than drugs in the N02 group (U=0.000; p<0.001). With regard to the average consumption amounts of all monitored drugs, diclofenac was consumed the most, followed by ketorolac. Meloxicam was the least used drug. There were significant differences in the average annual consumption of ibuprofen between surgical departments, but this was not the case for the other non-opioid analgesics. The differences in the average consumption between the individual drugs were significant for each year of observation. Due to the incongruity of the results of previous studies related to non-steroidal anti-inflammatory drug consumption at different surgery wards, additional research in different geographical areas of our country is necessary to enhance the quality of prescription patterns on a national level and adjust them based on the latest scientific data and European trends.

Assessment of Quality of Life (QoL) in Systemic Lupus Erythematosus Patients at a Tertiary Care Hospital in Egypt

2019 ◽  
Vol 15 (4) ◽  
pp. 304-311
Author(s):  
Mervat E. Behiry ◽  
Sahar A. Ahmed ◽  
Eman H. Elsebaie
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Tertiary Care ◽  
Damage Index ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Systemic Lupus

: Systemic Lupus Erythematosus (SLE) has a profound impact on quality of life. Objective: The objective of this study was to explore the quality of life among Egyptian SLE patients and to assess its relationships with demographic and clinical features. Methods: One hundred sixty-four SLE patients were recruited for this study. Demographic information; clinical parameters; disease activity, as evaluated by the systemic lupus erythematosus Disease Activity Index; and organ damage, as assessed by the systemic lupus international Collaborative Clinics/American College of Rheumatology Damage Index, were reported. Quality of life was assessed with a quality of life questionnaire specifically designed for patients with systemic lupus erythematosus; the questions are grouped in the following six domains: physical function, sociooccupational activities, symptoms, treatment, mood, and self-image. Higher values indicate poorer quality of life. Conclusion: Poor quality of life among Egyptian SLE patients and disease activity are strongly related to impaired lifestyles in these patients.

Sustainability Failure in the Antimicrobial Stewardship Program in a Secondary Care Hospital from Cuba: A Historical Review of 30 Years and 3 Shots

2020 ◽  
Vol 18 ◽  
Author(s):  
Humberto Guanche Garcell ◽  
Juan José Pisonero Socias ◽  
Gilberto Pardo Gómez
Keyword(s):  
Antimicrobial Stewardship ◽  
Historical Review ◽  
Original Data ◽  
Care Hospital ◽  
Antimicrobial Stewardship Program ◽  
Continuous Quality ◽  
Stewardship Program ◽  
History Of ◽  
Health Organization

Background: During the last 30 years an antimicrobial stewardship program (ASP) was implemented in a facility with periods of weakness. We aim to describe the history of the sustainability failure in the local ASP. Methods: A historical review was conducted using original data from the facility library and papers published. An analysis of factors related to the failure was conducted based on the Doyle approach. Results: The first ASP was implemented from 1989 to 1996 based on the international experiences and contributes to the improvement in the quality of prescription, reduction of 52% in cost and in the incidence of nosocomial infection. The second program restarts in 2008 and decline in 2015, while the third program was guided by the Pan-American Health Organization from 2019. This program, in progress, is more comprehensive than previous ones and introduced as a novel measure the monitoring of antibiotic prophylaxis in surgery. The factors related to the sustainability were considered including the availability of antimicrobials, the leader´s support, safety culture, and infrastructure. Conclusions: The history behind thirty years of experiences in antimicrobial stewardship programs has allowed us to identify the gaps that require proactive strategies and actions to achieve sustainability and continuous quality improvement.

scholarly journals Assessment of implementation of antibiotic stewardship program in surgical prophylaxis at a secondary care hospital in Ras Al Khaimah, United Arab Emirates

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hessa Saleh Alshehhi ◽  
Areeg Anwer Ali ◽  
Duaa Salem Jawhar ◽  
Essam Mahran Aly ◽  
Srinivas Swamy ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
United Arab Emirates ◽  
Antibiotic Stewardship ◽  
Secondary Care ◽  
Care Hospital ◽  
Surgical Prophylaxis ◽  
Patient Profile ◽  
Stewardship Program ◽  
Prescribing Practice ◽  
Surgical Antibiotic Prophylaxis

AbstractAntibiotic overuse is a major factor for causing antibiotic resistance globally. However, only few studies reported the implementation and evaluation of antimicrobial stewardship programs in Gulf Cooperation Council. This study was conducted within 8-months periods to evaluate the effect of the newly implemented antibiotic stewardship program on improving the prescribing practice of surgical antibiotic prophylaxis in a secondary care hospital in the United Arab Emirates by releasing local hospital guidelines. The data of 493 in patients were documented in the predesigned patient profile form and the prescribing practice of surgical antibiotic prophylaxis for clean and clean-contaminant surgical procedures was compared and analyzed two months’ prior (period A) and post (period B) the implementation of antibiotic stewardship program. The 347 patient’s data (PD) were analyzed during period A and 146 PD during period B. The prescription of piperacillin/tazobactam was decreased from 2.4% from all surgical prophylaxis antibiotic orders in period A to 0% in period B. The appropriateness of the antibiotic therapy was found to differ non significantly for the selection of prophylactic antibiotic (p = 0.552) and for the timing of first dose administration (p = 0.061) between A and B periods. The total compliance was decreased non significantly (P = 0.08) from 45.3 to 40.2%. Overall, the guidelines have improved the prescribing practice of antibiotics prior to surgery. However, further improvement can be achieved by initiating educational intervention via cyclic auditing strategy.

Proton pump inhibitor use and appropriateness analysis: a snapshot from a secondary care hospital

2021 ◽  
Author(s):  
Sukaina Salim Damji ◽  
Syed Arman Rabbani ◽  
Padma G M Rao ◽  
Ain-ur Rashid Butt
Keyword(s):  
United Arab Emirates ◽  
Proton Pump ◽  
Secondary Care ◽  
Stress Ulcer ◽  
Risk Category ◽  
Care Hospital ◽  
High Prevalence ◽  
Potential Risks ◽  
Internal Medicine Wards ◽  
Ulcer Prophylaxis

Abstract Objectives Proton pump inhibitors (PPIs) have become one of the most frequently prescribed drugs since their introduction 30 years ago. Effectiveness and safety profile of PPIs has led to their overutilization and has exposed patients to a number of potential risks. The objective of this study was to evaluate the use of PPIs in a secondary care hospital in the United Arab Emirates. Methods This prospective observational drug-utilization study was conducted in patients receiving treatment with PPIs and admitted to internal medicine wards of the study site. Electronic patient case records were reviewed and data on PPI prescribing was collected and analysed. Appropriateness of PPI use was assessed as per international guidelines. Key findings Out of 172 patients enrolled, 53.5% were females with median age of 57 years (34.3, 71.0). Four different PPIs were prescribed to study patients, pantoprazole (86.6%), esomeprazole (5.8%), rabeprazole (4.1%) and omeprazole (3.5%). Ninety-two (53.5%) patients were prescribed intravenous PPI, whereas 80 (46.5%) patients were given PPI in oral form. Overall, 103 (59.9%) patients had inappropriate PPI prescriptions. Of these inappropriate prescriptions, 22 patients had no clear indication for PPI use and for 16 patients; PPIs were indicated for stress ulcer prophylaxis in low-risk category. Corticosteroid use [odds ratio (OR): 4.34, 95% confidence interval (CI): 1.22–15.46; P = 0.023] was significantly associated with greater odds of inappropriate PPI use. Conclusions We report a high prevalence of inappropriate PPI prescribing among the hospitalized patients in our study. Inappropriate PPI prescribing is a concerning issue and collective efforts should be made to check and minimize the same.

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