Drug Use Evaluation Among Elderly Patients With History of Falling in Geriatric Assessment Clinic, Ramathibodi Hospital

Background: Drug use evaluation as an intervention approach for fall prevention has an effect on most drug-related outcomes. Geriatric assessment clinic provides comprehensive care in elderly patients. All prescribed or non-prescribed medications were evaluated by pharmacists. Objective: To study the drug and drug-related problem among elderly patients with history of falling. Methods: This is a cross-sectional study of elderly patients with history of fallings. Demographic data, health information, history of falls, and drugs use evaluation were obtained from their medical records in year 2010 to 2020. Linear regression model was used to examine the multivariate correlates to number of fallings. Results: A total of 183 patients with history of falling were studied. Of this, 97 had recurrent falls. Most patients (77%) had more than 5 underlying diseases and over half (55%) had dementia. Drug-related problem were found 69.4%, 4 in 5 of patients used 5 types of the medications or more. The diabetes drugs were found to increase risk of recurrent falls significantly (OR [95% CI], 2.11 [1.03 - 4.33]; P < .05). Conclusions: Most elderly patient with history of falling have drug-related problem (69.4%) and multiple morbidities including dementia. The diabetes drugs were 2 times significantly increased risk of recurrent falls. This study highlights the important of drugs management in this vulnerable group of elderly patients.

Drug Related Problems and Complications of Bacterial Meningitis Admitted to Pediatrics Ward in Developing Country

Background: Bacterial meningitis is considered a medical emergency and it is a life-threatening infection that requires immediate treatment. However, even with an early diagnostic approach and adequate treatment with effective antibiotics, death and different complications may occur.Objective: This study aimed to assess drug related problems and its association on bacterial meningitis related complication.Method: A prospective hospital-based observational study was conducted at the pediatric ward of Hiwot Fana Specialized teaching hospital, Harar. This study was conducted longitudinally for consecutive one year from December 30/2019-Juanuary 1/2021 admitted to pediatrics ward. All pediatrics admitted with the diagnosis of bacterial meningitis and fulfilled the inclusion criteria. To identify independent predictors of bacterial meningitis related complication, binary logistic regression model were used using STATA, version 14.2. Stastical significance was declared at p<0.05Result: After 1 year follow up, 384 children were included in this study with a response rate of 98.1%. Males(55.73%) outnumbered. The mean age and cerebrospinal fluid protein were 5.01±0.19 and 60.5±4.53 respectively. Nearly half of the child had co-morbidity in addition to admission diagnosis, meningitis. Two hundred twenty four(58.33%) patients exposed to at least one type of drug related problem. One hundred twenty one (31.51%) children were developed bacterial meningitis related complications. Drug related problem(AOR=6.26, 95%CI: 3.58-10.93), cerebrospinal fluid protein(AOR=9.38, 95%CI: 9.81.9-96), age(AOR=0.01, 95%CI: 0.13-0.19), duration of illness(AOR=) and co-morbidity(AOR=13.18, 95%CI: 1.81-5.6) were absolutely associated with the occurrence of complication. Conclusion: Drug related problem and associated complications were substantial among children admitted with meningitis. This study identified significant association between drug related problem and complication. Health professional shall prevent drug related problem to prevent associated complication.

Gambaran Tingkat Pengetahuan Swamedikasi Obat Analgesik Pada Mahasiswa-Mahasiswi Universitas Tadulako Di Kota Palu

Swamedikasi merupakan usaha seseorang dalam menolong dirinya sendiri berupa mengobati dirinya sendiri. Dalam menjalankannya, swamedikasi bisa menjadi masalah terkait obat (Drug related problem) karena pengetahuan yang terbatas mengenai obat dan penggunaannya. Analgesik merupakan obat yang berkhasiat untuk mengurangi atau menghilangkan rasa nyeri atau obat-obat yang digunakan untuk menghilangkan rasa sakit tetapi tidak menghilangkan kesadaran. Tujuan dari penelitian ini adalah mengetahui bagaimana gambaran tingkat pengetahuan swamedikasi obat analgesik pada mahasiswa Kesehatan dan Non Kesehatan Universitas Tadulako di Kota Palu. Penelitian ini menggunakan metode non eksperimental (observasional) dan bersifat cross sectional, dengan metode survei menggunakan kuesioner yang disebar melalului google form dengan jumlah mahasiswa kesehatan 349 responden dan mahasiswa Non kesehatan 396 responden. Teknik dalam pengambilan sampel yang digunakan pada penelitian ini yaitu purposive sampling. Hasil pengolahan data didapatkan hasil penelitian pengetahuan mahasiswa Kesehatan pada kategori baik sebesar 47,28 %, %, kategori cukup sebesar 49,28 % dan kategori kurang 3,44 %. Sedangkan pengatahuan mahasiswa non Kesehatan masuk kedalam kategori baik sebesar 16,16 %, ketegori cukup sebanyak 72,98 % dan kategori kurang sebanyak 10,86 %. Hasil uji mann-whitney diperoleh nilai signifikansi < 0,05 (0,00 < 0,05) maka hasil tersebut menunjukkan terdapat perbedaan yang signifikan antara tingkat pengetahuan mahasiswa Kesehatan dan Non Kesehatan. Kesimpulan mahasiswa kesehatan dan non kesehatan universitas tadulako memiliki tingkat pengetahuan yang cukup dan mahasiswa Kesehatan memiliki pengetahuan yang lebih baik dibandingkan mahasiswa non Kesehatan

Magnitude and determinants of drug-related problems among patients admitted to medical wards of southwestern Ethiopian hospitals: A multicenter prospective observational study

Background Drug-related problem (DRP) is an event involving drugs that can impact the patient’s desired goal of therapy. In hospitalized patients, DRPs happen during the whole process of drug use such as during prescription, dispensing, administration, and follow-up of their treatment. Unrecognized and unresolved DRPs lead to significant drug-related morbidity and mortality. Several studies conducted in different hospitals and countries showed a high incidence of DRPs among hospitalized patients. Despite the available gaps, there were scanties of studies conducted on DRPs among patients admitted to medical wards in Ethiopia. Therefore, this study assessed the magnitude of drug-related problems and associated factors among patients admitted to the medical wards of selected Southwestern Ethiopian hospitals. Patients and methods A multicenter prospective observational study was conducted at medical wards of Mettu Karl Hospital, Bedele General Hospital and Darimu General Hospital. Adult patients greater than 18 years who were admitted to the non-intensive care unit (ICU) of medical wards and with more than 48 h of length of stay were included. Identified DRPs were recorded and classified using the pharmaceutical care network Europe foundation classification system and adverse drug reaction was assessed using the Naranjo algorithm of adverse drug reaction probability scale. Hill-Bone Compliance to High Blood Pressure Therapy Scale was used to measure medication adherence. Multivariable logistic regression was used to analyze the associations between the dependent variable and independent variables. Result Of the 313 study participants, 178 (56.9%) were males. The prevalence of actual or potential DRPs among study participants taking at least a single drug was 212 (67.7%). About 125 (36.63%) patients had one or more co-morbid disease and the average duration of hospital stay of 7.14 ± 4.731 days. A total of 331 DRPs were identified with an average 1.06 DRP per patient. The three-leading categories of DRPs were unnecessary prescription of drugs 92 (27.79%), non-adherence (17.22%) and dose too high (16.92%). The most common drugs associated with DRPs were ceftriaxone (28.37%), cimetidine (14.88%), and diclofenac (14.42%). The area of residence (AOR = 2.550, 95CI%: 1.238–5.253, p = 0.011), hospital stay more than 7 days (AOR = 9.785, 95CI%: 4.668–20.511, p≤0.001), poly pharmacy (AOR = 3.229, 95CI%: 1.433–7.278, p = 0.005) were predictors of drug-related problem in multivariable logistic regression analysis. Conclusion The magnitude of drug therapy problems among patients admitted to the medical wards of study settings was found to be high. Therefore, the clinical pharmacy services should be established in hospitals to tackle the DTPs in this area. Additionally, healthcare providers of hospitals also should create awareness for patients seeking care from health facilities of the importance of rational drug usage.

EVALUASI KETEPATAN PEMILIHAN ANTIBIOTIK SEFTRIAKSON PADA PASIEN RAWAT INAP DI RSI SULTAN AGUNG SEMARANG

Latar Belakang : Seftriakson adalah antibiotik generasi tiga yang berasal dari golongan sefalosporin dan memiliki efek antibakterial dengan spektrum luas. Intensitas penggunaan antibiotik yang relatif tinggi menimbulkan berbagai permasalahan bagi kesehatan terutama resistensi bakteri terhadap antibiotik. Tujuan penelitian ini adalah mengetahui kejadian Drug Related Problem berdasarkan indikator pemilihan obat pada pasien rawat inap di RSI Sultan Agung Semarang yang menggunakan antibiotik seftriakson Metode : Penelitian ini bersifat deskriptif non eksperimental, dan pengambilan data secara retrospektif. Pemilihan pasien dilakukan secara purposive sampling, sampel yang diambil sebanyak 100 pasien Hasil: Ketepatan pemilihan obat berdasarkan PCNE sebanyak 8% pasien tidak tepat pemilihan obat dan 92% tepat pemilihan obat. Pemilihan obat dengan parameter sesuai pedoman/formularium 5% tidak tepat, tidak ditemukan obat yang dikontraindikasikan sehingga ketepatan pemilihan 100%, kombinasi obat-obatan yang tidak tepat sebanyak 3%, duplikasi obat pada kelompok terapeutik yang tidak tepat sebanyak 1%. Kesimpulan : Diagnosa terbanyak yang mendapatkan antibiotic seftriakson adalah demam tifoid. Ketepatan pemilihan obat sebanyak 92% pasien tepat pemilihan antibiotik seftriakson.

Drug-related problems in Ethiopian public healthcare settings: Systematic review and meta-analysis

Identification and prevention of drug-related problems have become the central role of patient-centered pharmacy practitioners. After the initiation of patient-oriented pharmacy service, many studies evaluating magnitude of drug-related problems at facility level in Ethiopia have been conducted, though the extent of the problem at a national level remains unknown. Hence, this systematic review and meta-analysis is undertaken with the aim of quantifying the prevalence of drug-related problems in Ethiopian public healthcare settings using Cipolle/Strand classification system. Electronic databases were searched including PubMed, EMBASE, Web of Science, MEDLINE and HINARI, Google Scholar and ResearchGate for both published and unpublished works. Data on study characteristics and outcomes were extracted using the format developed on Microsoft Excel. The primary measure was the pooled prevalence of drug-related problems. The meta-analysis was conducted using OpenMeta[Analyst].A total of 17 studies were included in this systematic review and meta-analysis. The pooled prevalence of drug-related problems of patients who experienced at least one drug-related problem during their therapy was found to be 69.4% (95% confidence interval: 61.5–77.4). The most frequently reported types of drug-related problems were “need for additional drug and “noncompliance,” together accounting for more than half of the drug-related problems. The most frequently reported factors associated with drug-related problems were patients’ age, polypharmacy, comorbidities and the number days of hospital stay.The prevalence of drug-related problems in Ethiopian public healthcare settings was found to be high. Inconsistent reporting of drug-related problems was observed across the studies. It is imperative to design and implement interventions aimed at reducing drug-related problems. Responsible stakeholders should adopt uniform drug-related problem classification approach to ensure uniform reporting of drug-related problems in Ethiopian healthcare settings

Analisis Drug Related Problem Terkait Dosis pada pasien Balita dengan Diagnosis Diare di Puskesmas Lumpatan Kabupaten Musi Banyuasin Periode Januari-Maret 2018

Diarrheal disease is an endemic disease in Indonesia and is also a potential illness of Extraordinary Occurrence (KLB) which is often accompanied by death. Puskesmas Lumpatan of Musi Banyuasin Regency which is one of the public health centers in Musi Banyuasin district where the number of samples in this study is 20 patients including 7 male patients and 13 female patients. Toodler patients with Neonate age (0-1 months) were 0 patients, in infants (1 month-2 years) as many as 14 patients while children (2 years-5years) were 6. The number of children under-five patients who received oralitic treatment were 4 patients, zinc as many as 11 patients and cotrimoxazole as many as 15 patients, where there are drug-related problems only at the drug delivery that is too low the zinc drug is 9,10%