جستجوی مقالات مرتبط با کلیدواژه "drug utilization" در نشریات گروه "پزشکی"

Assessing the utilization of intravenous immunoglobulin (IVIG) is crucial due to its high cost and limited availability. IVIG preparations are utilized in various disorders. This study aimed to investigate the prescribing and consumption patterns of IVIG at Kerman Afzalipour Hospital and to propose strategies for reducing drug expenditures.

Over one year, physician orders and patient charts of individuals treated with IVIG were reviewed to collect data. Descriptive statistics were employed for data analysis using SPSS software.

During the study period, 62 IVIG administrations were documented at the hospital, with 54.1% involving female patients. Of these, 51.4% were prescribed for labeled indications, while 48.6% were for off-label indications. No contraindications were observed, although precaution was warranted in 9.6% of cases, which was not consistently addressed, and laboratory parameters were not evaluated in any case.

This study reveals that IVIG infusions for off-label indications were nearly as frequent as those for labeled indications.

The rational use of drugs is a priority in health policy. Limited studies have been conducted about drug consumption in hospitals. Therefore, we evaluated the pattern of prescription and drug-drug interactions in cardiovascular and gastrointestinal wards. This retrospective study was conducted in a tertiary teaching hospital in Kerman. Data included demographic information and indicators such as type, category, and drug administration route. Diagnosis, outcome, and hospitalization days were other data extracted from the registered patients' information. An online interaction checker of Drug.com (IBM Micromedex) was used to detect drug interactions. Analysis was computed using SPSS V22. Our findings showed that 50.7% of the patients were male in the gastroenterology ward, and 49.3% were female. Patients aged 59±0.7 years and days of hospitalization ranged between 2 to 18 days. Proton pump inhibitors (PPIs) as pantoprazole (28.4%), antibiotics (23.3%) as ceftriaxone, metronidazole and anticoagulant (21.7%) as heparin were the most prescribed drug categories in gastroenterology ward. In the cardiovascular ward, 41.6% of the patients were male and 58.4% female, aged 57±1 years, and days of hospitalization ranged between 3 to 12 days. Anticoagulants/antiplatelets (29.1%), PPIs (13.8%), statins (11.9%), and beta blockers (10.7%) were the most prescribed drug categories in cardiovascular wards. No major drug interaction was seen in gastroenterology inpatients, but major interactions, mainly due to clopidogrel administration, were observed in 11% of cardiovascular ward inpatients. The pattern of drug prescription was based on diagnosis. No correlation was found between drug interaction with diagnosis, outcome, and sex in any of the departments, but a significant correlation was found between drug interaction with patients’ age. In conclusion, appropriate prescribing of drugs based on diagnosis was seen in both wards. The pattern of drug use was rational and comparable to similar documents. Also, lower potential drug interactions could be considered as a notable result.

Drug utilization studies are powerful exploratory tools for establishing the role of drugs in society and also effective methods for assessing the prescribing pattern of clinicians. Around 4-10% of children suffer at least one seizure episode at 16 years of age. Even after the availability of several Antiepileptic drugs (AEDs), choosing the correct drug with accurate dosing will produce seizure-free generation. Hence, this study aims to examine the prescription patterns of drugs in epileptic children. 

This study was a cross sectional observational study. Children <16 years old visiting neurology department with a history of epileptic seizures and already on antiepileptic drug therapy were included in the study. The data comprised of demographic details, disease history, type of seizure, diagnosis, investigations done, along with prescribed medication noted in case record form. The total study duration was 13 months. 

In this study, the maximum epilepsy encountering age in male and female children was   below the 12-year age group, male predominance was higher than females (male 60.83% vs. female 39.16%). The majority of children were diagnosed with generalized tonic colonic seizures, 54.17%, followed by focal/or partial seizures, 39.17%. Sodium valproate 19.16%, carbamazepine 14.17%, oxcarbazepine 16.67%, and levetriacetam 13.33% were the most commonly prescribed single drug regimens for treating both types of seizures, followed by clobazam added as second and third adjuvant drug in resistant epilepsy to valproate 12.5%, oxcarbazepine 6.67%, and levetriacetam plus carbamazepine combination 5% respectively. 

Monotherapy was majorly followed in 70% of pediatric patients for maintaining better patient compliance. Both old and new AEDs regimens are prescribed for maintaining the quality of life in patients.

Nowadays, due to the irrational and excessive use of antibiotics, antimicrobial resistance has become one of the main concerns of the medical community. Patients with burns are more prone to infections due to the loss of the skin's defense barrier and a weakened immune system. Therefore, proper antibiotic treatment is essential in these patients. In the present study, the rational use of antibiotics in the burn hospital of Imam Mousa Kazem in Isfahan was evaluated. 

This prospective cross-sectional descriptive study was performed on 102 hospitalized patients over 9 months (from January to September 2020). Adult burn patients who received at least one antibiotic were included in the study. All required information, including demographic data, the prescribed antibiotic, basis of administration (empiric vs. culture-based), dose and duration of use, microbial culture test, and treatment outcome were recorded in the data collection form by referring to patients’ medical profile and the hospital computer system. Judgments about the accuracy of the indication, dose, and duration of treatment, as well as the need for dose adjustment in renal or hepatic impairment were made using related guidelines and references. 

Among the 196 antibiotic prescriptions, cefepime (40.3%) was the most frequently used antibiotic, followed by vancomycin (17.9%) and meropenem (16.8%). Most prescriptions were empirical, while the antibiotics were administered based on the microbial culture results only in two cases (1.9%). The indication of use was correct in 52.6% of prescriptions (n = 103), of which 74.8% (n = 77) had correct dose. In addition, in 47 cases (45.6%), the duration of antibiotic therapy was correct. 6.8% of the patients died, 10.75 discharged with the patient's personal consent, and the rest of the them discharged in good condition. 

Prescribing antibiotics in Imam Moussa Kazem Hospital is associated with many errors in various aspects, including indication, dose, de-escalation, and duration of treatment.

Drug utilization Evaluation is the main tool to assess the clinical and economic effects of drug on health-care system. The aim of the current study is to evaluate the regimens of antibiotic prophylaxis in common gynecological surgeries in a referral teaching hospital 

This cross-sectional study was done in Alzahra hospital, Tabriz, Iran, from July 2017 to December 2017. Patients who received antibiotics as surgical site infection prophylaxis were enrolled. Data were collected from patients’ medical records and adherence rate to the American Society of Health-System Pharmacists (ASHP) guideline was studied as the primary endpoint. 

A total of 210 patients who undergoes common gynecological surgeries were evaluated. Cesarean section (58.6%) and total abdominal hysterectomy (28.1%) were the majority of surgeries. The type of administered antibiotic was adherent to guideline in 71.4%. Doses and duration of prescribed antibiotic (Cefazolin, the most prescribed antibiotic) were not in accordance with the guideline in 100%. Only in 58%, the time of antibiotic administration was corrected. 

In this study, the misuse of antibiotics in most cases was documented in terms of type, dose and duration of drug administration in Al-Zahra Hospital. It seems necessary to publish evidence-based guidelines and monitor their proper implementation, not only to reduce costs but also to combat antibiotic resistance.

drug utilization studies are necessary to evaluate the rational use and associated risks of anticoagulants. This study aimed to identify drug utilization pattern and possible drug interactions with the use of anticoagulants in a tertiary care hospital in Bangalore.

This prospective, observational study was conducted on 100 patients and anticoagulants utilization was assessed from Medicine ward of Bannerghatta Apollo hospital in Bangalore, India, during six months.

The most common indication for anticoagulants administration was ischemic heart disease (IHD) + acute coronary syndrome (ACS) with 47% and IHD alone with 22%. Most of the patients received single drug therapy, and parenteral drugs were more preferred than oral ones (91% vs. 6%). Among the medications, heparin (49%) followed by enoxaparin (29%) and fondaparinux (13%) were the most commonly prescribed drugs. Regarding laboratory tests, 29% of the patients were evaluated for the international normalized ratio (INR) and prothrombin time(PT). The finding showed that anticoagulants might interact with corticosteroids, some antibiotics such as piperacillin, azithromycin or other drugs such as tirofiban and losartan.

Anticoagulant drug utilization pattern followed very commonly American College of Clinical Pharmacy (ACCP) guidelines. The inappropriate utilization patterns of anticoagulants may compromise the patient’s  safety.

Drug Utilization Evaluation (DUE) studies are designed to assess drug usage appropriateness. This study aimed to evaluate the drug utilization of antibiotics in the intensive care units (ICUs) of a referral teaching hospital.

Patients hospitalized in ICU who received antibiotics were enrolled in this cross-sectional study. Patients’ medical charts were reviewed and data including indication of antibiotics, dosing, dose adjustment, and culture sensitivity test were recorded in a predesigned data collection form. Related guidelines and references were used for judgement about the correctness of these parameters.

Among 182 evaluated antibiotic prescriptions, 75.8% of the cases were prescribed empirically that for 31.88% of them, microbial culture and sensitivity test were requested. Indication was appropriate in 51.6%. Fifteen patients needed antibiotic dose adjustment that was performed just for 4 patients. Doses of antibiotics were correct in 58.5% of cases. Meropenem (15.9%), Metronidazole (15.9%), and vancomycin (11.5%) were the most frequently prescribed antibiotics.

Use of antibiotics in ICUs of our hospital is associated with high rate of errors especially in the aspects of medical indication and dosage.

Antibiotic resistance is the main threat to health all over the world. The consumption of antibiotics is one of the factors causing the emergence of multidrug resistance. The purpose of this study was to recognize the patterns, trends, and changes of consumption in Iran and to compare them with those of Organization for Economic Co-operation and Development (OECD) countries.

The data were collected from a national pharmaceutical wholesale data bank. Defined daily dose (DDD) or DDDs per 1000 inhabitants per day (DID) was calculated as a standard indicator for the consumption over 17 years.

Were benchmarked with the consumption of OECD countries. Drug utilization 90% (DU90%) method was used to assess the drug consumption pattern.

The antibiotic consumption jumped up from 33.6 DID to 60 DID from 2000 to 2016. Compared to the average consumption of OECD countries, Iran has consumed antibiotics almost triple times. There were 9–11 chemical substances in the DU90% list during these years. Changes in DU90% list occurred within antibiotics classes during the study period. Although the total consumption growth was equal to 79% during these years, consumption of some pharmacological subgroups such as sulfonamide and aminoglycosides has decreased.

Albeit the existence of surveillance system for health-related infectious diseases, the consumption of antibiotics has increased drastically, which illustrates the necessity of comprehensive and effective national antibiotic stewardship.

The aim of the study was to examine the prescription pattern of antihypertensive drugs used in a secondary care hospital in the United Arab Emirates (UAE).

It was a prospective, observational study carried out in 588 adult hypertensive patients presenting to medicine outpatient and inpatient departments of Dibba Hospital, Fujairah, UAE. The study was conducted for a period of 6 months from December 2017 to May 2018. Demographic and clinical data were collected from electronic patient case records and documented. Prescriptions were studied overall for drug use details and for specific types of antihypertensive drugs. The World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose methodology was further used to calculate utilization. Statistical analysis of data was performed using Statistical Package for the Social Sciences 24.0.

Of the 588 study participants, majority of the patients were on two‑drug combination antihypertensive therapy (n = 210, 35.5%) followed by monotherapy (n = 188, 32.1%) and three‑drug combination (n = 136, 23.1%). Calcium channel blockers were the most frequently (51%) prescribed class both in monotherapy and in combination therapy while angiotensin receptor blockers and angiotensin‑converting enzyme inhibitors (55.9%) were the most preferred agents for monotherapy. Among individual antihypertensive drugs, amlodipine was prescribed the most (266 prescriptions), irrespective of monotherapy or combination therapy.

Our study represents the current prescribing trends of antihypertensive drugs in a secondary care hospital in the UAE. The use of antihypertensive drugs largely conforms to international guidelines, but still, there is room for improvement in terms of rational drug utilization.

Up to 40% of global and 7.4- 41.3% of the Middle East population are affected by Allergic Rhinitis (AR). Patients with AR versus control group experience approximately twofold pharmaceutical expenditures and 1.8 fold number of visits. Since drug utilization can show various times of developing a disease in a country, it is used as an alternative for prevalence. In this study we try to examine and explain the consumption of anti-allergic medicines during the past 12 years to have a perspective view of these kinds of medicines.

in this descriptive and cross-sectional study that investigates anti-allergic medicines over a 12-year period (2006–2017) we used Iranian pharmaceutical statistical datasheet published by the Iranian Ministry of Health. According to treatment guidelines of AR and WHO ATC code, we categorized anti-allergic medicines into 5 groups (antihistamines, Beta 2 agonists, Corticosteroids, Fixed-dose and others), Then DIDs for these groups were calculated and analyzed.

Based on our findings in this study, cetirizine, Loratadine and Inhaled Salbutamol got the highest DID among all 5 groups, with 99.2, 65.4 and 57.6 retrospectively. Generally based on the third level of ATC code (second-generation anti-histamines, respiratory system drugs for obstructive airway disease, respiratory system nasal preparation and corticosteroid for systemic use) are faced with ascending market sales.

generally with the upward trend of anti-allergic medicines we can conclude that the incidence of AR in Iran during the past 12 years has increased and policymakers should follow this trend concerning a better supply chain.

Drug utilization research evaluates the appropriateness of the prescriptions which is important in clinical practice. Psychotropic polypharmacy is a major problem in psychiatric practice, which can lead to the development of adverse effects of those drugs in patients. Therefore, this study was carried out to evaluate the utilization of psychotropic drugs being prescribed for various psychiatric illnesses.

A prospective, cross sectional, observational study was carried out in patients visiting the Psychiatric Out-Patient Department of B J Government Medical College and Sassoon General Hospital, Pune, INDIA; from December 2016 to May 2018. A total of 500 prescriptions were analysed using WHO Drug Use indicators and some other indicators.

Average number of drugs per prescription was 3.14 ± 1.18; while average number of Psychotropic drugs per prescription was 2.27 ± 0.90. 84.35% of the total drugs prescribed by Generic name. 43.89% and 41.67% of the total drugs were prescribed from National List of Essential Medicines 2015 and WHO Model List of Essential Medicines 2017, respectively. Antipsychotics was the most commonly prescribed group of Psychotropic drugs, while Olanzapine was the most commonly prescribed Psychotropic drug. 64.25% of the total drugs were prescribed from the hospital drugstore.

In the present study, drugs were prescribed rationally and judiciously. But there was a need to increase the prescription of drugs from essential drug lists. Apart from that, there was found a need to increase the availability of the commonly prescribed Psychotropic drugs in the hospital drugstore of the study institution.

Dyslipidemia is responsible for great mortality and morbidity each year. Little data are available on the availability and affordability of Dyslipidemia medications in low and middle incomes countries. In a retrospective time-series study, we examined the utilization pattern and affordability of lipid-lowering medications in Iran as a lower middle-income country. We initially calculated the defined daily dose for 1000 inhabitants (DID) in different years and compared the results with OECD member countries in the same year. We also used 90% Drug Utilization method to rank and compare lipid lowering drugs with the WHO Essential Medicines List (EML). We measured the affordability by the minimum daily wage for one-month course of treatment. The use of lipid-lowering medications increased from 6.31 to 45.98 DID between 2005 and 2016. The utilization share of the subgroup of statins was above 80% of total utilization. Compared to OECD countries, Iran utilized 40% of the average utilization in 2015. In 2015, Atorvastatin was on 90% of DU medications. At the beginning of the study, only Lovastatin and Nicotinic acid were affordable in 2005, but at the end of the study, all lipid-lowering medications were affordable. The utilization of lipid-lowering medications, despite being affordable, was low. One of its possible reasons is the lack of proper management of patients with Dyslipidemia and low adherence of patients. Another possible cause is the high percentage of undiagnosed patients in the community. Therefore, comprehensive planning and policy-making should be taken to increase utilization and eliminate the related obstacles.

Self-medication is the use of drugs which have not been prescribed by health professionals. It is considered an important issue especially in developing countries because of side effects of irrational use of drugs and economic burden of disease. This study aim to analyze the prevalence of self-medication in Iran by provinces and socio economic and demographic factors that affect it. Data of Iranian household income and expenditures survey (HEIS) in 2016 (source Iranian Statistical Center) was used in this study. Multilevel mixed effect regression was used to find relation between explanatory variables and self-medication ratio. STATA SE v 14 was used to perform the analysis. the results of this study showed that income (coefficient = - 0.00286) and socioeconomic status had negative significant relationship with self-medication ratio, while self-medication ratio was higher in some provinces like Ardebil, Sistan va Baluchistan and Ilam and it was lower in some provinces like Khuzestan and Kurdistan. The prevalence of self-medication among Iranian people was relatively high and this ratio varies in provinces. In addition to promote population awareness about undesirable effects of the irrational drug consumption, developing strategies for drug consumption by improving prescribing pattern, OTC drugs and also increasing inspection of pharmacies is needed.

  This study aimed to investigate whether pre-operative dexamethasone could ameliorate transient hypoparathyroidism outcome through total thyroidectomy.

This randomized clinical trial study was conducted on 128 patients underwent total thyroidectomy from March 2014 to April 2015. Patients were randomly assigned to two groups of experimental receiving 8 mg IV of intravenous dexamethasone (n=45) 45 min before skin incision treatment and control (n=83). After the surgery, all patients were evaluated for clinical and laboratory hypocalcaemia.

Post-operative transient biochemical hypoparathyroidism and hypocalcaemia did not occur more often in the control group, compared to the dexamethasone group while controlling for the baseline variables. However, there was a significant difference in phosphorus level between the dexamethasone and control groups (P=0.028). A total of 50 (39.1%) patients developed hypocalcaemia after surgery. Moreover, post-operative symptomatic hypocalcemia occurred more frequently in the control group (68%) compared to the dexamethasone group (32%); however, this difference was not statistically significant (P=0.54).

The pre-operative administration of dexamethasone reduced post-operative hypocalcemia rate. It is essential to conduct future studies with validated means for better results.

Elderly people are more susceptible to common chronic diseases based on their age-related physiological changes and also use drugs more commonly, than younger people. The aim of the present study was to determine the pattern of drug use and related factors in elderly people who referred to the retirement centers covered by the national retirement fund in Rasht. This cross-sectional study was conducted on 381 consecutive randomly selected elderly people in Rasht during 2017. Data was collected using a questionnaire that included demographic characteristics, common chronic diseases, pattern of drug use, and medication adherence by face-to-face interviewing at the centers covered by the retirement fund. Data analysis was carried out using descriptive statistics and Chi-square tests. Of 381 people, 88.5% took drugs. The average number of drugs used and the self-medication frequency were 3.95 per day, and 35.7%, respectively. The most common causes of self-medication included previous use of the same drug and symptom recovery. The most commonly used drug group among the research groups included lipid-lowering agents (48.8%). Atorvastatin, Aspirin, and Losartan were the most commonly used drugs in the elderly that most of subjects (53.4%) had medium medication adherence. Since the elderly suffer from multiple diseases simultaneously, they often use several drugs. Therefore, self-medication and also medication adherence are the most important issues in this period. Educational interventions on the proper pattern of drug use among older people seem to be necessary

There is a relation between amounts of antibiotic uses and creation of resistant bacteria. Due to the critical role of antibiotics and increasing trend of resistance in developing countries, comprehensive methods of antibiotic use is necessary to limit the threat of resistant microorganisms. In this study we compare antibiotics consumption by Defined Daily Dose (DDD) per 100 bed-days in teaching and private hospitals during six months in Tabriz, Iran.
Four university hospitals and one private hospital were included in this study. Amount of their antibiotic consumption obtained from the hospital pharmacies. Anatomical Therapeutic Chemical (ATC) code J01 was explained as defined daily doses per 100 bed-days (DDD/100) according to the ATC/DDD classification. The amount of consumption was assessed with DDD per 100 bed-days in six months.
Total antibacterial consumption was higher in Emam reza (119.62 DDD/100) than other hospitals. Cephalosporins were the most widely used antibiotic in all five hospitals with the total DDD per 100 bed-days of 53.74, 58.51, 46.09, 19.75 and 15.16 for Emam reza, Shohada, Sina, Shahriar and Shahid madani ,respectively. Cefazoline had highest use among cephalosporins consumption in all hospitals except Shahriar. Ciprofloxacin was among the five most used antibiotics in all hospitals.
Although the pattern of antibacterial consumption was almost logical in different categories of hospitals, the total amount of DDD per 100 bed-days was dramatically more than developed countries. Specific strategies should be employed in infection control development and engage rational antibiotic utilization in order to reduce future resistant strains and increase antimicrobial efficacy.

Acute poisoning is a common medical emergency. This study was designed to investigate the pattern of drug utilization, poisoning agents, and outcome in patients with acute poisoning treated at a tertiary care teaching hospital in Vadodara, west of India.
This prospective cross sectional drug utilization study was carried out on patients with diagnosis of acute poisoning admitted to emergency department of Sir Shree Sayajirao General Hospital during October, 2013 to March, 2014.
During 6 months, 340 acute poisoning cases were enrolled, out of which 216 cases (63.5%) were men. Mean age of the patients was 31.9 ± 12.7 years. Commonest mode of poisoning was intentional (suicidal), which was observed in 62.1% of cases. Pesticides were the most common cause of poisoning (40%), followed by venomous animal exposures (25.9%). Fifty-six patients (16.5%) died. A significantly higher number of deaths was seen in intentional poisonings compared to accidental poisonings (24.2% vs. 3.9%; P Use of antimicrobial medicines for poisoned patients was too high and irrational. Due to high incidence of snakebites, hospital stockpiles should be regularly checked for availability of antivenom. Educational programs with emphasis on preventive measures for toxic exposures are necessary to create awareness among the general public.

Optimal reduction in blood pressure with antihypertensive agents helps to prevent microvascular and macrovascular complications of diabetes. The objective of the study was to evaluate the current utilization pattern of antihypertensive medications among patients with diabetes and coexistent hypertension as per the JNC seventh report guidelines. A Cross-sectional survey was conducted among patients with diabetes attending outpatient department of Internal Medicine at a hospital at Ajman. Medical records of patients were used to obtain diagnostic, demographic and drug use information. Univariate analysis was performed using Chi-square and t- test followed by logistic regression to compute independent predictors. Of 132 patients with diabetes, uncomplicated hypertension (HTN) was coexistent in 81% (107/132) of patients. Males constituted 49.5% (53/107) of the total. Mean (SD) age of patients with HTN was 55.1(10.1) years higher than those without HTN 49.6 (9.9) years (P<0.01). Higher number of patients with HTN had duration of diabetes < 5years than those >5 years (P=0.04). While adjusting the significant factors, only duration of diabetes was statistically significant (adjusted OR=1.06; CI 95% (1.003-1.116) P= 0.03 among patients with HTN. 63.6% (68/107) prescriptions contained one drug antihypertensive drug, 27.1 % (29/107) two drugs and 7.4% (8/107) no anti-hypertensive drug were prescribed. Angiotensin converting enzyme inhibitors/ Angiotensin receptor blockers (ACEI/ARBs) followed by diuretics were commonly prescribed drugs. ARBs with diuretics were the most frequent two drug combinations. The antihypertensive utilization pattern was similar in both gender and age groups. Results represent the current prescribing trend for anti-hypertensive agents among patients with diabetes that is in accordance with JNC-7 recommendations.

The expanding field of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Although psychotropic drugs have had a remarkable impact in psychiatry, their utilization, effectiveness, and side effects in the in clinical practice need continuous study. The present study was thus designed to analyze the pattern of psychotropic drugs prescription in a tertiary care teaching hospital in Eastern India. A 6-month prospective cross-sectional observational clinical study was carried. The study enrolled a total of 294 cases to investigate the prescribing pattern of psychotropic medications, using a predesigned format. Major depression was found to be the most common psychiatric disorder encountered (34.69%). The number of psychotropic drugs prescribed per patient averaged 3.39. Anti-anxiety drugs were the most frequently prescribed psychotropic drugs in various psychiatric disorders. Psychotropic fixed dose combinations were present in 18.36% of the prescriptions. A majority (83.09%) of medicines was prescribed by generic names. Psychotropic drugs accounted for 69.2% of drugs prescribed from the hospital drug schedule, of which 60.2% actually dispensed from the hospital drug store free of cost. Utilization of drugs from the national list of essential medicines of India (NLEM 2011) was 45.63%. This study provides a baseline data for carrying out further studies on prescribing pattern in a tertiary care unit which would help for improve psychotropic drugs utilization in mental health facilities.