objeCtives: Drugs retail outlets constitute a major source of malaria treatment in developing countries requiring regular and accurate information for enhancing strategies for improving the use of Artemisinin-based Combination Therapy (ACT). The study analyzed the demand and sales pattern of antimalarial drugs in private retail outlets to assess the current state of compliance to policy. Methods: A prospective cross-sectional survey of randomly selected drugs retail outlets in Enugu urban, south east Nigeria, was conducted between May and August, 2013, to determine the types, range, prices and sales pattern of antimalarial drugs as well as concomitant medications, from pharmacies and patent medicine outlets. Data was collected and analysed for antimalarial drugs demanded for and sold by selfmedication, treatment by retail outlets and prescription from hospitals. Results: With a total of 1,321 dispensed antimalarial drugs, ACTs accounted for 72.7% while monotherapy was 27.3%. AMFm drugs contributed 32.7% (n = 314) of ACTs. 46.5% (614) of the drugs were dispensed from self-treatment by patients. Treatment by the retail outlets accounted for 35.8% (n = 473) while 17.7% of the drugs were dispensed from hospital prescriptions.
HIV treatment guidelines recommend that HIV patients initiate first-line antiretroviral therapy (ART) with one of four "preferred" regimens: efavirenz/tenofovir/emtricitabine (EFV/TDF/FTC), ritonavir-boosted atazanavir + tenofovir/emtricitabine (ATV/r+TDF/FTC), ritonavir-boosted darunavir + tenofovir/emtricitabine (DRV/r+TDF/FTC), or raltegravir + tenofovir/emtricitabine (RAL+TDF/FTC). Adherence is critical to the success of ART in suppressing viral load and avoiding virological failure and development of drug resistance. This study compared ART adherence between preferred ART regimens in a real-world setting. METHODS: Retrospective study using U.S. Medicaid administrative health care claims from 15 states. Subjects were HIV patients aged 18-64 years who were enrolled in Medicaid and initiated, between January 1, 2007 and September 30, 2011, a first-line ART regimen "preferred" under U.S. DHHS HIV treatment guidelines published in March 2012. Patients were classified by ART regimen and were required to 4be continuously enrolled for 6 months before and ≥3 months following ART initiation. Follow up lasted from ART initiation until a ≥30 day gap in initiated ART, introduction of a new ART medication, or disenrollment. Adherence, defined as the proportion of days covered by ART medication during follow up (dichotomized at ≥80%), was evaluated using multivariable logistic regressions that adjusted for demographic and clinical factors. RESULTS: Sample included 1,979 patients initiating EFV/TDF/FTC (n=1,259), ATV/r+TDF/FTC (n=498), DRV/r+TDF/FTC (n=143), or RAL+TDF/FTC (n=79); mean age by regimen ranged from 40.1 to 42.1 years and proportion male from 44.1% to 55.4%. Compared with patients initiating EFV/TDF/FTC, odds of adherence ≥80% were significantly lower in DRV/r+TDF/FTC patients (odds ratio [OR]=0.56, p=0.045) and trended lower in RAL+TDF/FTC patients (OR=0.666, p=0.273) and ATV/r+TDF/FTC patients (OR=0.904, p=0.610). CONCLUSIONS: Among patients initiating a DHHS guideline-preferred first-line ART regimen, the odds of adherence were not the same for all regimens. Further research should explore the reasons for differences in adherence levels between "preferred" ART regimens.
Objectives:The main aim of the study was to assess and evaluate the Clinical Pharmacist's interventions in health care i.e., Health technology assessment and its application to improve and optimize patient care through pharmaceutical care and to achieve accuracy in patient treatment. MethOds: A prospective, observational and interventional study. Ethical approval was obtained before starting the present study. The inpatient medication charts and orders drug related problems were identified, analysed and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services, using the parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, resulting clinical interventions made. Results: out of 360 clinical pharmacist interventions followed, male (71.66%) predominance was noted over females (28.33%). Most of the DRP observed were dispensing errors(26.11%),improper drug selection (17.22%),followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing(26.11%), and drug change (18.05%). The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Clinical pharmacists have greater potential in preventing and/or minimizing the DRPs. cOnclusiOns: Technology assessment in health care is a multidisciplinary field of policy analysis which studies ethical, social, medical and economic implications of development, diffusion and use of health technology. From the multidisciplinary health technology assessment the methods followed for this study were found to be useful for not only enhancing the appropriate use of drugs in a clinical setting but also sow a seed for the evolvement of Health Technology Assessment in India with clinical pharmacist as its pathfinder.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.