Pub Date : 2021-01-01DOI: 10.37532/0976-0105.2021.12(5).47
Amet Hacimu
{"title":"Editorial Note on Flavonoids","authors":"Amet Hacimu","doi":"10.37532/0976-0105.2021.12(5).47","DOIUrl":"https://doi.org/10.37532/0976-0105.2021.12(5).47","url":null,"abstract":"","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75263486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.37532/0976-0105.2021.12(5).44
Hisato Tyagi
{"title":"Prescribing Pattern and Potency of Anti-Diabetic Drugs in Diabetic Patients for Maintaining Optimal Glycemic Levels","authors":"Hisato Tyagi","doi":"10.37532/0976-0105.2021.12(5).44","DOIUrl":"https://doi.org/10.37532/0976-0105.2021.12(5).44","url":null,"abstract":"","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86817868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.37532/0976-0105.2021.12(5).43
Pavel Poreds
{"title":"Evaluation of Controlled Porosity Osmotic Pump for Oral Delivery of Ketorolac","authors":"Pavel Poreds","doi":"10.37532/0976-0105.2021.12(5).43","DOIUrl":"https://doi.org/10.37532/0976-0105.2021.12(5).43","url":null,"abstract":"","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75616396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Traditionally, cancer patients are managed mostly within the secondary healthcare system. As the burden of the disease increases, secondary care has to work with the primary care to provide good support for healthy population, the patients, etc. The community pharmacists are one of the primary care providers because they are the most accessible healthcare providers in the community. For this group to meet these demands of an evolving new role and improve the health outcomes, continuous professional development (CPD) is essential. This study was set to gather information about the professional practice of Ghanaian community pharmacists on cancer health, their interest and importance in receiving continuous education on cancer. Methods: A cross-sectional study was conducted using electronic questionnaires. Key Findings: Majority (67.1%) spent less than or ten minutes of their time interacting with patients and 70.8% referred patients who consistently request for medication to a hospital. Majority of participants (43.4%) have never attended cancer continuous education and 67.6% indicated their interest in receiving cancer continuous education in the future. There was statistically significant difference between the educational level and professional interaction with cancer patients (p=0.004). Provision of cancer printed materials (p=0.00) and interest in attending cancer continuous education in the future (p=0.007) were also significantly affected by educational level. ‘Handout/booklet with self- test’ was the preferred mode of delivery for cancer education. Conclusion: community pharmacists strongly play a significant role in cancer health through their professional practice. The challenges observed can be overcome through a well-organized cancer continuous education using participants preferred medium of delivery.
{"title":"Community Pharmacy Practice Towards Cancer Health and the Need for Continuous Cancer Education: Ghana Situation","authors":"K. Mensah, F. Oosthuizen, V. Bangalee","doi":"10.2139/ssrn.3287510","DOIUrl":"https://doi.org/10.2139/ssrn.3287510","url":null,"abstract":"Traditionally, cancer patients are managed mostly within the secondary healthcare system. As the burden of the disease increases, secondary care has to work with the primary care to provide good support for healthy population, the patients, etc. The community pharmacists are one of the primary care providers because they are the most accessible healthcare providers in the community. For this group to meet these demands of an evolving new role and improve the health outcomes, continuous professional development (CPD) is essential. This study was set to gather information about the professional practice of Ghanaian community pharmacists on cancer health, their interest and importance in receiving continuous education on cancer. Methods: A cross-sectional study was conducted using electronic questionnaires. Key Findings: Majority (67.1%) spent less than or ten minutes of their time interacting with patients and 70.8% referred patients who consistently request for medication to a hospital. Majority of participants (43.4%) have never attended cancer continuous education and 67.6% indicated their interest in receiving cancer continuous education in the future. There was statistically significant difference between the educational level and professional interaction with cancer patients (p=0.004). Provision of cancer printed materials (p=0.00) and interest in attending cancer continuous education in the future (p=0.007) were also significantly affected by educational level. ‘Handout/booklet with self- test’ was the preferred mode of delivery for cancer education. Conclusion: community pharmacists strongly play a significant role in cancer health through their professional practice. The challenges observed can be overcome through a well-organized cancer continuous education using participants preferred medium of delivery.","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77657405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.4103/0976-0105.195126
U. Masood, A. Sharma, S. Nijjar, B. Krenzer
A 57-year-old male with a history of alcoholism presented to the emergency room with abdominal pain, jaundice, transaminitis, and hyperbilirubinemia. Due to the history of alcoholism, it was initially presumed that the patient had alcoholic hepatitis but further investigation revealed that he was recently started on sulfasalazine for the treatment of rheumatoid arthritis. Upon cessation of the drug, the patient′s liver function tests significantly improved over a few days and eventually normalized within weeks. This case was interesting as the patient′s history of alcoholism disguised the actual diagnosis. Furthermore, the late presentation of sulfasalazine-induced liver injury is uncommon as it commonly presents 2-4 weeks after initiation of therapy.
{"title":"Unusual Case of an Alcoholic with Liver Injury from Sulfasalazine Use","authors":"U. Masood, A. Sharma, S. Nijjar, B. Krenzer","doi":"10.4103/0976-0105.195126","DOIUrl":"https://doi.org/10.4103/0976-0105.195126","url":null,"abstract":"A 57-year-old male with a history of alcoholism presented to the emergency room with abdominal pain, jaundice, transaminitis, and hyperbilirubinemia. Due to the history of alcoholism, it was initially presumed that the patient had alcoholic hepatitis but further investigation revealed that he was recently started on sulfasalazine for the treatment of rheumatoid arthritis. Upon cessation of the drug, the patient′s liver function tests significantly improved over a few days and eventually normalized within weeks. This case was interesting as the patient′s history of alcoholism disguised the actual diagnosis. Furthermore, the late presentation of sulfasalazine-induced liver injury is uncommon as it commonly presents 2-4 weeks after initiation of therapy.","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"70 1","pages":"38 - 39"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76111296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.4103/0976-0105.195097
L. L. Nwidu, B. Airhihen, A. Ahmadu
Background: In Niger Delta, ethnomedicine hydroalcoholic extract of Carpolobia lutea (CL) (Polygalaceae) is used to relieve inflammatory pains. Objectives: The purpose of this study is to evaluate the anti-inflammatory and antinociceptive effects of ethanolic stem extract (ESE) and to fractionate the ESE for the elucidation of bioactive molecules. Materials and Methods: The antinociceptive effects for ESE were tested against two noxious stimuli; chemical (acetic acid-induced writhing and formalin-induced pain) and thermal (hot plate) stimuli. The effects of paracetamol (130 mg/kg), indomethacin (10 mg/kg), and morphine (5 mg/kg) pretreatment were investigated. To isolate the bioactive compounds with anti-inflammatory effect, two doses (86.6 and 173.2 mg/kg) of four fractions (methanol fraction MTF, ethyl acetate fraction EAF, chloroform fraction CHF, and n-hexane fraction n-HF) obtained from fractionating ESE were utilized. Carrageenan, egg albumin, and capsaicin-induced edema of the hind paw of the rats were the models adopted. Paw volume was measured by a digital vernier caliper from 0 to 6 h after injection. This was compared to standard drugs. The results were subjected to statistical analysis. Results: The ESE decreased significantly (P < 0.001) the writhing of acetic acid-induced abdominal contractions and licking of formalin-induced pains but does not have any effects on the hot plate test. Of the four fractions obtained, the EAFs demonstrated a significant (P < 0.001) inflammatory inhibition of 98.97% and 41.91% at 86.6 and 173.2 mg/kg, respectively, compared to 65.75% inhibition demonstrated by the reference drug, acetylsalicylic acid (100 mg/kg) on the carrageenan model while 36.36% and 29.87% inhibition of inflammation at 86.6 and 173.2 mg/kg, respectively, on the egg albumin models; there was no significant effect on the capsaicin model. Conclusion: The isolation of quercetin and kaemferol from CL gave credence to its anti-inflammatory and antinociceptive effects.
{"title":"Anti-Inflammatory and Anti-Nociceptive Activities of Stem-Bark Extracts and Fractions of Carpolobia Lutea (Polygalaceae)","authors":"L. L. Nwidu, B. Airhihen, A. Ahmadu","doi":"10.4103/0976-0105.195097","DOIUrl":"https://doi.org/10.4103/0976-0105.195097","url":null,"abstract":"Background: In Niger Delta, ethnomedicine hydroalcoholic extract of Carpolobia lutea (CL) (Polygalaceae) is used to relieve inflammatory pains. Objectives: The purpose of this study is to evaluate the anti-inflammatory and antinociceptive effects of ethanolic stem extract (ESE) and to fractionate the ESE for the elucidation of bioactive molecules. Materials and Methods: The antinociceptive effects for ESE were tested against two noxious stimuli; chemical (acetic acid-induced writhing and formalin-induced pain) and thermal (hot plate) stimuli. The effects of paracetamol (130 mg/kg), indomethacin (10 mg/kg), and morphine (5 mg/kg) pretreatment were investigated. To isolate the bioactive compounds with anti-inflammatory effect, two doses (86.6 and 173.2 mg/kg) of four fractions (methanol fraction MTF, ethyl acetate fraction EAF, chloroform fraction CHF, and n-hexane fraction n-HF) obtained from fractionating ESE were utilized. Carrageenan, egg albumin, and capsaicin-induced edema of the hind paw of the rats were the models adopted. Paw volume was measured by a digital vernier caliper from 0 to 6 h after injection. This was compared to standard drugs. The results were subjected to statistical analysis. Results: The ESE decreased significantly (P < 0.001) the writhing of acetic acid-induced abdominal contractions and licking of formalin-induced pains but does not have any effects on the hot plate test. Of the four fractions obtained, the EAFs demonstrated a significant (P < 0.001) inflammatory inhibition of 98.97% and 41.91% at 86.6 and 173.2 mg/kg, respectively, compared to 65.75% inhibition demonstrated by the reference drug, acetylsalicylic acid (100 mg/kg) on the carrageenan model while 36.36% and 29.87% inhibition of inflammation at 86.6 and 173.2 mg/kg, respectively, on the egg albumin models; there was no significant effect on the capsaicin model. Conclusion: The isolation of quercetin and kaemferol from CL gave credence to its anti-inflammatory and antinociceptive effects.","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"2 1","pages":"25 - 32"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85073456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.4103/0976-0105.195079
Supriya Sonowal, Chetna K. Desai, Jigar Kapadia, M. Desai
Objectives: To evaluate the knowledge, attitude and practice of consumers in India about disposal of unused medicines. Materials and Methods: A questionnaire comprising 11 questions evaluating the Knowledge (2), Attitude (3) and Practice (6) of unused medicines was prepared and pre validated before administering to 200 consumers of medicines attending the outpatient department of Civil Hospital Ahmedabad, a tertiary care teaching hospital in Western India. Requisite permissions from Institutional Ethics Committee and informed consent were obtained prior to recruiting them for the study. Responses were recorded, in Microsoft Excel® spreadsheet and evaluated for percentage response. Results: Majority of the respondents (136, 68%) stored unused medicines at home. Analgesics (26.5%) were the most common unused medicine stored. Safe disposal of medicine was considered necessary by majority respondents (160, 80%) for different reasons like prevention of illegal/unintended use (84, 42%), prevention of environmental pollution (32, 16%) or possible ADR caused by old drugs (54, 27%). Only 78 (39%) respondents were aware of appropriate methods of disposal. Disposal in household trash (61, 30.5%) was the most common method used. Majority of respondents felt the need for a facility or programme to collect unused medicines (152, 76%) and an increased awareness among consumers regarding hazards and methods of disposal of unused medicines (154, 77%). Conclusion: Majority of consumers are aware about the need for safe disposal of unused medicines. But the right attitude for and practice of safe disposal of medicines is lacking. A need for increased awareness regarding safe disposal of medicines is acknowledged by majority of consumers.
{"title":"A Survey of Knowledge, Attitude, and Practice of Consumers at a Tertiary Care Hospital Regarding the Disposal of Unused Medicines","authors":"Supriya Sonowal, Chetna K. Desai, Jigar Kapadia, M. Desai","doi":"10.4103/0976-0105.195079","DOIUrl":"https://doi.org/10.4103/0976-0105.195079","url":null,"abstract":"Objectives: To evaluate the knowledge, attitude and practice of consumers in India about disposal of unused medicines. Materials and Methods: A questionnaire comprising 11 questions evaluating the Knowledge (2), Attitude (3) and Practice (6) of unused medicines was prepared and pre validated before administering to 200 consumers of medicines attending the outpatient department of Civil Hospital Ahmedabad, a tertiary care teaching hospital in Western India. Requisite permissions from Institutional Ethics Committee and informed consent were obtained prior to recruiting them for the study. Responses were recorded, in Microsoft Excel® spreadsheet and evaluated for percentage response. Results: Majority of the respondents (136, 68%) stored unused medicines at home. Analgesics (26.5%) were the most common unused medicine stored. Safe disposal of medicine was considered necessary by majority respondents (160, 80%) for different reasons like prevention of illegal/unintended use (84, 42%), prevention of environmental pollution (32, 16%) or possible ADR caused by old drugs (54, 27%). Only 78 (39%) respondents were aware of appropriate methods of disposal. Disposal in household trash (61, 30.5%) was the most common method used. Majority of respondents felt the need for a facility or programme to collect unused medicines (152, 76%) and an increased awareness among consumers regarding hazards and methods of disposal of unused medicines (154, 77%). Conclusion: Majority of consumers are aware about the need for safe disposal of unused medicines. But the right attitude for and practice of safe disposal of medicines is lacking. A need for increased awareness regarding safe disposal of medicines is acknowledged by majority of consumers.","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"8 1","pages":"4 - 7"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85721183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.4103/0976-0105.195086
Nwani Paul Osemeke, O. Hart, Nwosu Maduaburochukwu Cosmas, Isah Ambrose Ohumagho
Objectives: To assess the medications prescribed for elderly inpatients on specific days during hospital admission with a view to detecting areas of irrational prescription. Methods: It was a prospective study of all patients aged 65 years and above admitted to the medical wards of a Nigerian tertiary hospital over a 12-month period. The World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) drug use indicators were used to assess drug prescriptions on various days of admission. Results: A total of 1513 patient encounters involving 345 patients aged between 65 and 92 years were assessed on hospital days 1, 3, 5, 7, 14, and 28. The average number of medicines per encounter ranged from 6.1 ± 2.5 on hospital day 1 to 7.8 ± 2.4 on hospital day 28. This difference was statistically significant (F = 14.42; P < 0.05). The percentage of encounters with an antibiotic prescribed ranged from 50.4% on hospital day 1 to 62.9% on hospital day 28 while the percentage of encounters with an injection prescribed decreased from 72.8% on hospital day 1 to 50.0% on day 28. Conclusions: This study suggests some degree of irrational prescribing as evident by the high average number of medicine per encounter and the high percentages of encounters with an antibiotic or injection prescribed. However, there is a need to develop standard values for the WHO/INRUD indicators based on the recently published national treatment guidelines for common elderly diseases which will serve as yardsticks to assess elderly inpatients prescriptions using WHO/INRUD core indicators in future studies.
{"title":"Geriatric Prescription in a Nigerian Tertiary Hospital","authors":"Nwani Paul Osemeke, O. Hart, Nwosu Maduaburochukwu Cosmas, Isah Ambrose Ohumagho","doi":"10.4103/0976-0105.195086","DOIUrl":"https://doi.org/10.4103/0976-0105.195086","url":null,"abstract":"Objectives: To assess the medications prescribed for elderly inpatients on specific days during hospital admission with a view to detecting areas of irrational prescription. Methods: It was a prospective study of all patients aged 65 years and above admitted to the medical wards of a Nigerian tertiary hospital over a 12-month period. The World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) drug use indicators were used to assess drug prescriptions on various days of admission. Results: A total of 1513 patient encounters involving 345 patients aged between 65 and 92 years were assessed on hospital days 1, 3, 5, 7, 14, and 28. The average number of medicines per encounter ranged from 6.1 ± 2.5 on hospital day 1 to 7.8 ± 2.4 on hospital day 28. This difference was statistically significant (F = 14.42; P < 0.05). The percentage of encounters with an antibiotic prescribed ranged from 50.4% on hospital day 1 to 62.9% on hospital day 28 while the percentage of encounters with an injection prescribed decreased from 72.8% on hospital day 1 to 50.0% on day 28. Conclusions: This study suggests some degree of irrational prescribing as evident by the high average number of medicine per encounter and the high percentages of encounters with an antibiotic or injection prescribed. However, there is a need to develop standard values for the WHO/INRUD indicators based on the recently published national treatment guidelines for common elderly diseases which will serve as yardsticks to assess elderly inpatients prescriptions using WHO/INRUD core indicators in future studies.","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"43 1","pages":"20 - 24"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81384677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.4103/0976-0105.195078
P. Sakharkar
1 The Seventh Asia‐Pacific Conference of the International Society for Pharmacoeconomics and Outcomes Research was held in Singapore this year from September 3, 2016, to September 06, 2016. “Pharmacoeconomics and Outcomes Research in Asia‐Pacific: Challenges, Opportunities, and Future Direction” was the theme of this conference. This occasion presented a perfect opportunity to discuss some of the challenges that are unique to Asian countries in terms of their health‐care and decision‐making processes. This is especially true for a country like India, the world’s third‐largest economy, whose new National Health Policy (NHP) is likely to decide the trajectory of its health‐care system over the next few years. In developed countries, the political debate over economic issues is often seen as a clash between free market principles and government control. Developing regulatory policies in such an environment is an ongoing battle between the public and private sector. Such battles are often seen spilling over in health‐care policy‐making. In India, the fundamental health‐care issues are at the bottom of the list of any political discourse; occasionally they surface to the forefront led by interest groups that have bigger political clout and their own special interest. Issues such as conditions of hospitals, doctors’ compensations, corruption within professional and accreditation bodies draw more public interest and attention than vital questions such as “why do some parts of the country still suffer from diseases like malaria or tuberculosis?” or “why is there a constant shortage of essential drugs in government hospitals?” or “why do drugs and treatment costs vary significantly within the same geographical region?” These kinds of vital questions rarely lead to any public or political discourse. The new government under Prime Minister Modi plans to offer universal health care under its recently released NHP draft.[1] One can sense the intentions of this government from this draft policy as it states, “It is a declaration of the determination of the government to leverage economic growth to achieve health outcomes and an explicit acknowledgement that better health contributes immensely to improved productivity as well as to equity.” While discussing the current situation of health care in India, this NHP draft further acknowledges several challenges that it needs to confront, including inequities in health outcomes, quality of care, growing disease burdens, increasing health‐care costs, inadequate investment and financing of health care, shortage of health‐care professionals, paucity of health services research, and poor regulatory framework.[1] Among all other objectives listed in this draft policy that the government wants to focus on, one of the important objectives – organizing and financing health‐care services – deserves special attention from economists, health outcomes researchers, and health‐care professionals, including pharmacists and policy
国际药物经济学与结果研究学会第七届亚太会议于2016年9月3日至9月6日在新加坡举行。本次会议的主题是“亚太地区的药物经济学和成果研究:挑战、机遇和未来方向”。这一场合为讨论亚洲国家在卫生保健和决策过程中所特有的一些挑战提供了一个绝佳的机会。对于像印度这样的世界第三大经济体来说尤其如此，其新的国家卫生政策(NHP)很可能决定其卫生保健系统在未来几年的发展轨迹。在发达国家，有关经济问题的政治辩论往往被视为自由市场原则与政府控制之间的冲突。在这样的环境下制定监管政策是公共部门和私营部门之间的一场持久战。这样的斗争经常在医疗保健政策制定中蔓延开来。在印度，基本的卫生保健问题在任何政治讨论的清单中都处于最底层;偶尔，它们会在拥有更大政治影响力和自身特殊利益的利益集团的领导下浮出水面。医院条件、医生报酬、专业和认证机构内部腐败等问题比"为什么该国某些地区仍有疟疾或结核病等疾病"等重要问题更能引起公众的兴趣和关注?或者“为什么公立医院的基本药物总是短缺?”或“为什么同一地理区域内的药物和治疗费用差异很大?”这类至关重要的问题很少会引发任何公共或政治讨论。莫迪总理领导下的新政府计划在最近发布的国家健康计划草案中提供全民医疗保健。[1]人们可以从这份政策草案中感受到政府的意图，因为它指出，“这是政府决心利用经济增长来实现健康成果的宣言，并明确承认更好的健康对提高生产力和公平做出了巨大贡献。”在讨论印度卫生保健现状的同时，这份NHP草案进一步承认了印度需要面对的几个挑战，包括卫生结果的不平等、卫生保健质量、疾病负担的增加、卫生保健成本的增加、卫生保健投资和融资不足、卫生保健专业人员的短缺、卫生服务研究的缺乏以及监管框架的薄弱。[1]在这份政策草案中列出的所有其他目标中，政府希望重点关注的一个重要目标——组织和资助卫生保健服务——值得经济学家、健康结果研究人员和卫生保健专业人员(包括药剂师和政策制定者)特别关注。人们不能忽视这样一个事实，即印度国家方案提供的所有卫生服务对所有公民都是免费的，并且普遍可以获得，今后，这些服务很可能会扩大，正如本政策草案所述，这将增加社会的税收负担。目前在印度，私营部门提供70%-80%的医疗保健服务，而且它不分担提供免费医疗的任何成本负担，几乎没有任何法规。[2]按照建议实施这一政策，将需要进一步注入约500亿美元(3125亿卢比)，以达到卫生支出占国内生产总值(GDP) 2.5%的水平，为政府拟议的扩张提供资金。根据政府自己的估计和政策草案中所述，每年有超过6300万人因医疗费用而脱离贫困。2014年，公共资助医疗保险计划的人口覆盖率预计将增加到约3.7亿人，其中近三分之二(1.8亿)的受益人生活在贫困线以下。根据2015年的估计，大约2.88亿人(2880亿人)享有医疗保险，不到印度人口的五分之一。在那些有某种形式保险的人中，67%的人参加了中央政府健康计划、雇员国家保险计划和拉什特里亚·斯瓦斯蒂亚·比玛·约加纳的公共保险。[3]2014年，印度在医疗保健方面的支出占GDP的1.04%，约占政府总支出的4%，对于一个被吹捧为世界第三大经济体的国家来说，这是无法与全球标准相比的。我国在卫生保健方面的支出占国内生产总值的百分比是东南亚地区国家中最低的之一。印度的支出仅略高于缅甸，是金砖国家(巴西、俄罗斯、中国和南非)中最低的。 [4]证据进一步表明，各国至少需要花费其国内生产总值的5%-6%来满足其人口的基本卫生保健需求。[5]印度政府在该政策草案中表示，它承诺在未来5-7年内将医疗保健支出占GDP的比例提高到2.5%。然而，现实情况是，它的主要承诺之一是开设3000家Jan Aushadhi商店，旨在以负担得起的价格为人们提供仿制药，但迄今为止只开了310家商店。[6]印度的药品定价是由国家药品定价局控制的。根据这份政策草案，政府希望将诊断和设备纳入某种形式的价格控制之下。该政策草案还建议仿照英国国家临床卓越研究所(NICE)的工作建立一个监管框架。NICE为卫生、公共卫生和社会保健从业人员提供循证指导和建议，为提供和委托卫生、公共卫生和社会保健服务的人员制定质量标准和绩效指标，并为卫生和社会保健领域的专员、从业人员和管理人员提供一系列信息服务。NICE最重要的角色之一是进行技术评估，以评估新药和生物制药产品的临床和成本效益，包括程序、设备和诊断试剂，并确保使用英国国家医疗服务体系(NHS)的患者能够公平地获得最具临床和成本效益的治疗。NICE的技术评估建议是基于临床(治疗效果如何)和经济(是否代表物有所值)证据。为了考虑技术的成本效益，NICE多年来一直使用隐含的成本效益阈值，其范围在每个质量调整生命年(QALY)获得20,000至30,000英镑之间。[7]这一门槛一直受到挑战，甚至受到司法审查，受到辉瑞(Pfizer)和卫材(Eisai)等制药公司的煽动，并受到下议院卫生特别委员会(House of Commons Health Select Committee)的调查。[8]然而，它仍然是衡量成本效益的门槛，也是英国NHS资源分配的基础。目前使用的其他成本效益门槛包括$50,000 EDITORIAL
{"title":"Draft National Health Policy of India and Determining Cost-effectiveness Threshold","authors":"P. Sakharkar","doi":"10.4103/0976-0105.195078","DOIUrl":"https://doi.org/10.4103/0976-0105.195078","url":null,"abstract":"1 The Seventh Asia‐Pacific Conference of the International Society for Pharmacoeconomics and Outcomes Research was held in Singapore this year from September 3, 2016, to September 06, 2016. “Pharmacoeconomics and Outcomes Research in Asia‐Pacific: Challenges, Opportunities, and Future Direction” was the theme of this conference. This occasion presented a perfect opportunity to discuss some of the challenges that are unique to Asian countries in terms of their health‐care and decision‐making processes. This is especially true for a country like India, the world’s third‐largest economy, whose new National Health Policy (NHP) is likely to decide the trajectory of its health‐care system over the next few years. In developed countries, the political debate over economic issues is often seen as a clash between free market principles and government control. Developing regulatory policies in such an environment is an ongoing battle between the public and private sector. Such battles are often seen spilling over in health‐care policy‐making. In India, the fundamental health‐care issues are at the bottom of the list of any political discourse; occasionally they surface to the forefront led by interest groups that have bigger political clout and their own special interest. Issues such as conditions of hospitals, doctors’ compensations, corruption within professional and accreditation bodies draw more public interest and attention than vital questions such as “why do some parts of the country still suffer from diseases like malaria or tuberculosis?” or “why is there a constant shortage of essential drugs in government hospitals?” or “why do drugs and treatment costs vary significantly within the same geographical region?” These kinds of vital questions rarely lead to any public or political discourse. The new government under Prime Minister Modi plans to offer universal health care under its recently released NHP draft.[1] One can sense the intentions of this government from this draft policy as it states, “It is a declaration of the determination of the government to leverage economic growth to achieve health outcomes and an explicit acknowledgement that better health contributes immensely to improved productivity as well as to equity.” While discussing the current situation of health care in India, this NHP draft further acknowledges several challenges that it needs to confront, including inequities in health outcomes, quality of care, growing disease burdens, increasing health‐care costs, inadequate investment and financing of health care, shortage of health‐care professionals, paucity of health services research, and poor regulatory framework.[1] Among all other objectives listed in this draft policy that the government wants to focus on, one of the important objectives – organizing and financing health‐care services – deserves special attention from economists, health outcomes researchers, and health‐care professionals, including pharmacists and policy ","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"26 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83076395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.4103/0976-0105.195100
S. Datta
Aim: Hypertension represents a major health problem primarily because of its role in contributing to the initiation and progression of major cardiovascular diseases. Concerns pertaining to hypertension and its sequelae can be substantially addressed and consequent burden of disease reduced by early detection and appropriate therapy of elevated blood pressure. This cross-sectional observational study aims at analyzing the utilization pattern of antihypertensives used for the treatment of hypertension at a tertiary care hospital in perspective of standard treatment guidelines. Materials and Methods: Prescriptions were screened for antihypertensives at the medicine outpatient department of a tertiary care teaching hospital. Medical records of the patients were scrutinized after which 286 prescriptions of patients suffering from hypertension were included. The collected data were sorted and analyzed on the basis of demographic characteristics and comorbidities. Results: The calcium channel blockers were the most frequently used antihypertensive class of drugs (72.3%). Amlodipine (55.6%) was the single most frequently prescribed antihypertensive agent. The utilization of thiazide diuretics was 9%. Adherence to the National List of Essential Medicines (NLEMs) was 65%. The combination therapy was used more frequently (51.5%) than monotherapy (48.8%). The use of angiotensin-converting enzyme inhibitors/angiotensin 2 receptor blockers (ACE-I/ARB) was 41.4% in diabetes. Conclusions: The treatment pattern, in general, conformed to standard treatment guidelines. Few areas, however, need to be addressed such as the underutilization of thiazide diuretics, need for more awareness of drugs from the NLEMs and enhanced use of ACE-I/ARB in diabetic hypertensives.
{"title":"Utilization Study of Antihypertensives in a South Indian Tertiary Care Teaching Hospital and Adherence to Standard Treatment Guidelines","authors":"S. Datta","doi":"10.4103/0976-0105.195100","DOIUrl":"https://doi.org/10.4103/0976-0105.195100","url":null,"abstract":"Aim: Hypertension represents a major health problem primarily because of its role in contributing to the initiation and progression of major cardiovascular diseases. Concerns pertaining to hypertension and its sequelae can be substantially addressed and consequent burden of disease reduced by early detection and appropriate therapy of elevated blood pressure. This cross-sectional observational study aims at analyzing the utilization pattern of antihypertensives used for the treatment of hypertension at a tertiary care hospital in perspective of standard treatment guidelines. Materials and Methods: Prescriptions were screened for antihypertensives at the medicine outpatient department of a tertiary care teaching hospital. Medical records of the patients were scrutinized after which 286 prescriptions of patients suffering from hypertension were included. The collected data were sorted and analyzed on the basis of demographic characteristics and comorbidities. Results: The calcium channel blockers were the most frequently used antihypertensive class of drugs (72.3%). Amlodipine (55.6%) was the single most frequently prescribed antihypertensive agent. The utilization of thiazide diuretics was 9%. Adherence to the National List of Essential Medicines (NLEMs) was 65%. The combination therapy was used more frequently (51.5%) than monotherapy (48.8%). The use of angiotensin-converting enzyme inhibitors/angiotensin 2 receptor blockers (ACE-I/ARB) was 41.4% in diabetes. Conclusions: The treatment pattern, in general, conformed to standard treatment guidelines. Few areas, however, need to be addressed such as the underutilization of thiazide diuretics, need for more awareness of drugs from the NLEMs and enhanced use of ACE-I/ARB in diabetic hypertensives.","PeriodicalId":15046,"journal":{"name":"Journal of Basic and Clinical Pharmacy","volume":"58 1","pages":"33 - 37"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80026009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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