Current landscape of pharmacovigilance in Pakistan

Drug Regularity Authority of Pakistan came into being in 2012 after multiple casualties were reported due to dispensation of counterfeit & adulterated drugs. The primary purpose was to address any quality & efficacy issues related to medicines and encourage healthcare professionals to play their role in provision of safe medication therapy by practicing pharmacovigilance. Currently, a Medicine Surveillance portal for reporting is available for ADR reporting along with ADR and Drug & Device complaint forms. A new mobile app, MedSafety was recently launched to encourage public to report.

Pharmacists’ Approach to Optimise Safe Medication Use in Paediatric Patients

Paediatric patients are unique, yet challenging patients to care for by pharmacists. Paediatric medicine use requires special consideration. Pharmacists play an important role in educating and counselling patients, carers, and healthcare workers. Further, pharmacists have the necessary knowledge and skills to optimise safe medicine use in paediatric patients. This article provides basic principles for safe practices in paediatric medicine by following the nine rights of medication administration.

Population-scale identification of differential adverse events before and during a pandemic

Adverse patient safety events, unintended injuries resulting from medical therapy, were associated with 110,000 deaths in the United States in 2019. A nationwide pandemic (such as COVID-19) further challenges the ability of healthcare systems to ensure safe medication use and the pandemic’s effects on safety events remain poorly understood. Here, we investigate drug safety events across demographic groups before and during a pandemic using a dataset of 1,425,371 reports involving 2,821 drugs and 7,761 adverse events. Among 64 adverse events identified by our analyses, we find 54 increased in frequency during the pandemic, despite a 4.4% decrease in the total number of reports. Out of 53 adverse events with a pre-pandemic gender gap, 33 have seen their gap increase with the pandemic onset. We find that the number of adverse events with an increased reporting ratio is higher in adults (by 16.8%) than in older patients. Our findings have implications for safe medication use and preventable healthcare inequality in public health emergencies.

Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study

ObjectivesThe aim of the study was to develop quality standards reflecting minimal requirements for safe medication processes in nursing homes.DesignIn a first step, relevant key topics for safe medication processes were deducted from a systematic search for similar guidelines, prior work and discussions with experts. In a second step, the essential requirements for each key topic were specified and substantiated with a literature-based rationale. Subsequently, the requirements were evaluated with a piloted, two-round Delphi study.SettingNursing homes in Switzerland.ParticipantsInterprofessional panel of 25 experts from science and practice.Primary and secondary outcome measuresEach requirement was rated for its relevance for a safer and resident-oriented medication on a 9-point Likert-Scale based on the RAND/UCLA method. The requirements were considered relevant if, in the second round, the median relevance rating was ≥7 and the proportion of ratings ≥7 was ≥80%.ResultsFive key topics with a total of 87 requirements were elaborated and rated in the Delphi study. After the second round (response rate in both rounds 100%), 85 requirements fulfilled the predefined criteria and were therefore included in the final set of quality standards. The five key topics are: (I) ‘The medication is reviewed regularly and in defined situations’, (II) ‘The medication is reviewed in a structured manner’, (III) ‘The medication is monitored in a structured manner’, (IV) ‘All healthcare professionals are committed to an optimal interprofessional collaboration’ and (V) ‘Residents are actively involved in medication process’.ConclusionsWe developed normative quality standards for a safer and resident-oriented medication in Swiss nursing homes. Altogether, 85 requirements define the medication processes and the behaviour of healthcare professionals. A rigorous implementation may support nursing homes in taking a step towards safer and resident-oriented medication.

EVALUATION OF EFFECTIVENESS OF SPIRIVA RESPIMAT FOR PATIENTS WITH OCCUPATIONAL COPD

Spiriva respimat proved to be an effective and safe medication for medical treatment of patients who suffer from moderately severe occupational COPD. Spiriva respimat has advantages of glycopyrronium bromide: functional indices (FEV1 forced expiratory volume during the first second), clinical data (dyspnea), quality of patients’ life, frequency of exacerbations, the period before the first exacerbation happens, and patient compliance.

Review on Drug Waste Management

Drug waste management is the alarming issue nowadays so provide more awareness from healthcare professionals and drug receiver. The pharmacist are in the admirable position to aware people about safe medication disposal. The safe medication disposal awareness in society leads to the sufficient good differences in public health and surroundings. the knowledge of the safe drug disposal is equally important that consumption of the medicines. The easiest solution to the drug pollution is to disposal of medicines properly. The aim of this review is the government have to maintain the drug disposal methods on the label of drugs and dosage forms. The collection of the drug is easier and they can authorize the collection in the take back program. The Indian government have to authorized the drug collection sites and registered business or various authorization for the collection of the drug safely, they also have to organize the various types of events like drug take back awareness events, awareness programs on the need of proper drug disposal and its conditions. The drug waste contains the expired and non-expired drugs.

Discussion on the Management of Safe Medication in the Treatment of Internal Diseases of Traditional Chinese Medicine

Objective: To discuss the management of safe medication in the treatment of internal diseases in traditional Chinese medicine. Methods: 124 patients with medical diseases were divided into experimental group and control group by random number table method, with 62 cases in each group. The experimental group implemented safe medication management, and the control group implemented routine medication management, all of which were treated for 4 consecutive weeks. The comparison of the improvement of the quality of life, the compliance rate of safe medication and the adverse drug reactions of the two groups after clinical treatment were compared. Results: After 8 weeks of treatment, there was a significant difference in clinical efficacy between the two groups of patients. In terms of quality-of-life scores, the scores of the experimental group were better than those of the control group. The living ability, condition, physical strength and other conditions of patients were significantly different. The t-values were 15.3427, 14.0275, and 7.7113, respectively, and P<0.01 was statistically significant. The compliance rates of patients in the experimental group and observation group were 95.16% and 70.96%, respectively, with significant differences (P<0.05). In terms of the incidence of adverse drug events, the experimental group was 3.22%, which was significantly lower than the observation group’s 8.06% (P<0.05). Conclusion: The implementation of safe medication management in the clinical treatment of TCM internal diseases can improve the quality of life of patients to a certain extent, increase their safe medication compliance rate, and reduce the incidence of adverse medication events. The clinical application value is extremely high, and it can be widely promoted and applied.

Self-Supervised Adversarial Distribution Regularization for Medication Recommendation

Medication recommendation is a significant healthcare application due to its promise in effectively prescribing medications. Avoiding fatal side effects related to Drug-Drug Interaction (DDI) is among the critical challenges. Most existing methods try to mitigate the problem by providing models with extra DDI knowledge, making models complicated. While treating all patients with different DDI properties as a single cohort would put forward strict requirements on models' generalization performance. In pursuit of a valuable model for a safe recommendation, we propose the Self-Supervised Adversarial Regularization Model for Medication Recommendation (SARMR). SARMR obtains the target distribution associated with safe medication combinations from raw patient records for adversarial regularization. In this way, the model can shape distributions of patient representations to achieve DDI reduction. To obtain accurate self-supervision information, SARMR models interactions between physicians and patients by building a key-value memory neural network and carrying out multi-hop reading to obtain contextual information for patient representations. SARMR outperforms all baseline methods in the experiment on a real-world clinical dataset. This model can achieve DDI reduction when considering the different number of DDI types, which demonstrates the robustness of adversarial regularization for safe medication recommendation.