Study on the Influence of Pharmaceutical Management on Rational Drug Use under Chinese Health Strategy

In order to better promote the implementation of the healthy China strategy and the innovation of public hospital system management, we can explore a modern public hospital management system that can meet the needs of the people in the new era from the aspects of medical service supply mode, collaborative governance design of public hospitals and internal management system of public hospitals. In this paper, 300 prescriptions in our hospital before and after May, 2020 were selected as research objects, and were randomly divided into two groups, one group was the control group (300 cases) without pharmaceutical management, and the other group was the observation group (300 cases) with pharmaceutical management. Then, the drug satisfaction, irrational drug use and inappropriate drug use of the two groups were compared. The results showed that the satisfaction of medication in the observation group was significantly better than that in the control group, and the irrational and inappropriate medication was lower than that in the control group, with statistical differences (P <0.05). It shows that the implementation of pharmaceutical management measures under the strategy of Healthy China can effectively improve patients' satisfaction with medication and prevent irrational medication.

A Propensity-Matched Nested Case-Control Study of Acute Coronary Syndrome Patients Genotyped for CYP2C19

Introduction Ticagrelor is widely considered superior to clopidogrel however a pharmacogenetic substudy of PLATO indicated that the majority of this difference is due to genetic nonresponders to clopidogrel. We evaluated patient outcomes following genotyping for CYP2C19 in a propensity matched acute coronary syndrome cohort treated with either clopidogrel, ticagrelor or aspirin monotherapy. Methods ICD10 coding identified 6,985 acute coronary syndrome patients at Waitemata District Health Board over a five year period (2012-2016). Ticagrelor was subsidised by The Pharmaceutical Management Agency of New Zealand in July 2013. Patients were genotyped for CYP2C19 *2, *3 and *17 alleles using the Nanosphere Verigene analyser and treatment was tailored accordingly. Logistic regression and nearest neighbour propensity matching was employed in a 1:3 fashion with each treatment group to balance patient characteristics. Results A total of 146 patients were genotyped and compared with 438 matched patients taking either clopidogrel, ticagrelor or aspirin monotherapy. Post July 2013 clopidogrel was prescribed more often in responders than in those without genotype information (68 vs 39%, X2 9, 95% CI 4 to 34, p=0.003). Conversely, ticagrelor was used more frequently in clopidogrel nonresponders. Mortality with personalised treatment was equivalent to ticagrelor (HR 0.8, 95% CI 0.3 to 1.8) but higher in those treated with clopidogrel (HR 2.3, 95 % CI 1 to 5.3). Readmissions with ACS were higher in nonresponders treated with clopidogrel versus those treated with genotype appropriate dual antiplatelet therapy (HR 3.9, 95% CI 0.8 to 18, p =0.03). Conclusion Personalised antiplatelet management was equivalent to ticagrelor with respect to all-cause mortality and ACS readmissions. It also led to more appropriate use of both clopidogrel and ticagrelor and potential cost savings.

Evaluation of a New Home Patient Services Practicum for Community Pharmacy Students in Japan

This study aimed to evaluate the usefulness of the practicum as well as assess the knowledge, skills, and various specific realizations that the students gained from it. A total of 244 students role-played a scenario in which a pharmacist visited a patient at home and provided pharmaceutical management services. After completing the practicum, the students completed (i) a questionnaire survey consisting of six questions that assessed their level of understanding of the role of pharmacists in home medical care and (ii) a rubric survey that evaluated their learning achievement. In addition, they submitted practicum portfolios describing the patients’ living conditions, physical conditions, and background as well as the services that required consideration of said variables. Their responses to the portfolio item “What were noticed through the practicum” were analyzed using the grounded theory approach. After the practicum, 45% and 53% of the students reported having a full and partial understanding of a pharmacists’ role in home medical care. The students’ mean ± standard deviation rubric score was 3.0 ± 0.4. They classified monitoring drug use, support for improving medication adherence, and observation to identify side effects early as major service categories in home medical care. The practicum led the students to perceive the need for communication with patients and various healthcare professionals to improve their readiness for practical training.

Assessment of consumption patterns for essential medicines: a study of the Nyeri county referral hospital

Background: Nyeri is one of the pilot Universal Health Coverage roll-out counties aimed at guaranteeing healthcare service access to all households in the region by 2022. The aim of the study was to provide management insights into ways of optimizing pharmaceutical management to ensure essential medicine are consumed by majority of population in need by 2022.Methods: A mixed-methods approach was used, combining quantitative and qualitative data collection techniques.Results: Amoxicillin had the highest (751,000) consumption over the study period. Other essential medicines with high consumption include paracetamol (432,000), metformin (280,264) and enalapril (111,800). The most cited reason for stock-outs was limited allocation of budget for medicines, a point that was mentioned by eight of the ten respondents.Conclusions: The study concludes that the stock-out frequency for essential medicines at the Nyeri County Referral Hospital is high. The frequent and persistent stock-out frequency for essential medicines is a problem considering the high consumption for essential medicines.

Understanding the pharmaceutical approach to pain management in canine osteoarthritis

Canine osteoarthritis was recently reclassified as a welfare concern by the Veterinary Companion Animal Surveillance System (VetCompass), an initiative run by the Royal College of Veterinary Surgeons, focused on improving companion animal health. This condition is a common cause for consultation in first opinion practice, with an estimated 35% of the canine population being affected. Chronic pain is complex and a multimodal approach is best for management, which includes pharmaceuticals employed in a methodical manner. This article provides an overview of the types of pain associated with canine osteoarthritis, as well as how to recognise them. Making reference to hypothetical cases, the appropriate pharmaceutical management is described. Further management strategies, as part of a multimodal approach, are summarised to ensure best practice.

Review on current concepts of myopia and its control strategies

Myopia poses a significant burden on the healthcare system, economy and quality of life. It is an emerging global public health challenge and requires interventions to delay or stop onset and progression. With changing times and evidence, the concepts of myopia are changing along with the treatment and control strategies. Behavioural modifications including increased outdoors time and reduced near work, optical and pharmaceutical management options are reviewed. This paper presents a current overview on the concepts of myopia, and is expected to summarize updates on myopia control methods.

Evaluasi Pengadaan Obat Berdasarkan Pelayanan Distributor Farmasi Di RSIA Kemang Medical Care Jakarta Selatan Periode Juli Desember 2019

Drug management is one of the pharmaceutical management in the Hospital which is very important in the overall service. Stages of drug management in the Hospital include the stages of selection, planning, procurement, receiving, storage, distribution, and use of drugs. Patnership with Pharmacy Wholesalers needs special attention because it can influence the procurement of pharmaceutical preparations in hospitals. This study aimed to the determine the process of prucurement of drugs based on distributor services (Pharmaceutical Wholesalers) at RSIA Kemang Medical Care. Retrospective data collection methods. The sample includes data on Drug Purchase Requests for the period July 1 - December 31 2019 for weekly defects made by the Pharmacy Installation of RSIA Kemang Medical Care every Monday, totaling 302 samples. Service Level based on the type / order item for 13 Pharmaceutical Wholesalers (PBF) 88,55% - 98,43% Supplier Service Level based on the precentage of the number of pharmaceutical preparations there are Pharmaceutical Wholesalers (PBF) that have never been in accordance with the requested shipment, ranging from 2% - 100%. The factors that cause incomepatibilty are empty stoc at distributors and there is a shortage in shipping pahrmaceutical preparations.Keywords: Service Level Supplier,Pharmaceutical WholesalersDrug management ABSTRAKPengelolaan obat merupakan salah satu management farmasi di Rumah Sakit yamg sangat penting dalam penyediaan pelayanan secara keseluruhan. Kemitraan dengan Pedagang Besar Farmasi perlu mendapat perhatian khusus karena dapat berpengaruh dalam pengadaan sediaan farmasi di Rumah Sakit. Penelitian ini ditujukan untuk mengetahui proses pengadaan obat berdasarkan pelayanan distributor (Pedagang Besar Farmasi) di RSIA Kemang Medical Care. Metode pengumpulan data secara Retrospektif. Sampel meliputi data Permintaan Pembelian obat periode 1 Juli – 31 Desember 2019 untuk defekta mingguan yang dibuat oleh Instalasi Farmasi RSIA Kemang Medical Care setiap hari senin, berjumlah 302 sampel. Service Level Supplier berdasarkan jeni / item pesanan untuk 13 Pedagang Besar Farmasi (PBF) adalah 88,55% - 98,43%. Service Level Supplier berdasarkan presentase jumlah sediaan farmasi terdapat Pedagang Besar Farmasi (PBF) pernah dalam pengiriman jumlahnhya tidak sesuai dengan yang diminta yaitu berkisar 2% - 100%. Faktor yang menyebabkan ketidak sesuaian yakni stok kosong pada distributor dan terdapat kekurangan dalam pengiriman sediaan farmasi.Kata Kunci: Kepuasan pasien;Tingkat pelayanan kefarmasian;Pengelolaan obat;

EFFICACY OF PANCHAKARMA IN SANDHIVATA W.S.R. TO KNEE ARTHRITIS

Inflammation of knee joint is called knee arthritis. Among various forms of knee arthritis common is degenerative type of knee osteoarthritis It is the major cause of loco motor disability in old age people particularly among women. Analgesics and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the current available pharmaceutical management of knee osteoarthritis which are associated with adverse side effects. Thus, there is need of research in traditional system of medicines for cost effective and long-term management of knee OA. Degenerative Knee osteo arthritis is almost similar to the Sandhivata describes in Ayuveda with respect to aetiology, pathology and clinical features. With the use of medicines Ayurveda also employs the prospective of Panchakarma in the various therapeutic measures, which is a kind of Shodhan Chikitsa. Panchakarma provides various therapeutic benefits as detoxification, improved circulation, spasm and pain relief. Hence objective of this review article is to describe the efficacy of Panchakarma in knee-arthritis with taking consideration of disease mentioned in Ayurvedic classics as Sandhivata