Background-Adverse drug reactions and non-compliance are important causes of admissions in the elderly to medical clinics. The contribution of adverse drug reactions and non-compliance to admission by the medical emergency department was analysed. Methods-A total of 578 consecutive elderly patients admitted to the medical emergency department were interviewed to determine the percentage of admissions due to adverse drug reactions or noncompliance with medication regimens, their causes, consequences, and predictors. Results-Eighty three (14.4%) of the 578 admissions were drug related: 39 (6.7%) caused by adverse drug reactions and 44 (7.6%) caused by non-compliance with medication. One hundred ninety two (33.2%) patients had a history of noncompliance. Factors associated with an increased risk of admission because of an adverse drug reaction were patients with diabetes or neoplasms, and patients using numerous diVerent medications. Factors associated with a higher risk of hospitalisation because of non-compliance were poor recall of the medication regimen, seeing numerous physicians, female sex, polypharmacy, drug costs, and switching over to non-conventional forms of treatment. Conclusion-Many elderly admissions are drug related, with non-compliance accounting for a substantial fraction of these. Elderly people at high risk of suVering a drug related medical emergency are identified and suitable interventions may be planned by the healthcare policymakers to target them. (Postgrad Med J 2001;77:703-707)

Background: Diabetes mellitus (DM) is an important public health problem in developing countries. Drug utilisation study of antidiabetic agents is of paramount importance to promote rational drug use in diabetics and make available valuable information for the healthcare team. The aim of study was to investigate the drug utilization pattern in type-2 diabetic patients. Methods: A prospective, cross-sectional study was carried out in medicine outpatient clinic of tertiary care hospital, Ahmedabad for eight weeks. Patients with type-2 diabetes and on drug therapy for at least one month were included. Patients’ socio-demographic and clinical data were noted in a pre-designed proforma. Data was analysed by using SPSS version 20 and Excel 2007. Results: Total 114 patients were enrolled with mean (± standard deviation) age and duration of diabetes of 56.8 ± 10.5 and 8.3 ± 9.4 years respectively. Male: Female ratio was 0.72:1. Mean fasting and postprandial blood glucose levels were 147.5 ± 73.1 and 215.6 ± 97.3 mg/dl respectively. Most common symptom was weakness/fatigue (77.2%). Hypertension (70.2%) was most common co-morbid illness. Mean number of drugs prescribed were 7.8 ± 2.5. Total numbers of patients receiving more than five drugs were 89.5%. Most commonly used drug group was biguanides (87.7%) followed by sulphonylureas (68.4%). Conclusion: Metformin (biguanide) was the most utilized (87.7%) antidiabetic drug for type-2 diabetes. This study revealed that the pattern of antidiabetic prescription was rational and largely compliant with NICE (National Institute for Health and Clinical Excellence) guidelines. [Int J Basic Clin Pharmacol 2013; 2(4.000): 485-491

Objective:To evaluate prevalence, types, and severity of potential adverse drug-drug interaction in medicine out-patient department.Materials and Methods:A single-point, prospective, and observational study was carried out in medicine OPD. Study began after obtaining approval Institutional Ethics Committee. Data were collected and potential drug-drug interactions (pDDIs) were identified using medscape drug interaction checker and were analyzed.Result:A total of 350 prescriptions with mean age 52.45 ± 14.49 years were collected over a period of 5 months. A total of 2066 pDDIs were recorded with mean of 5.90 ± 6.0. The prevalence of pDDI was 83.42%. Aspirin was most frequently prescribed drug in 185 (10.15%) out of total of 1821 drugs It was also the most frequent drug implicated in pDDI i.e. in 48.16%. The most common pDDI identified was metoprolol with aspirin in 126 (6.09%). Mechanism of interactions was pharmacokinetic in 553 (26.76%), pharmacodynamic in 1424 (68.92%) and 89 (4.30%) having an unknown mechanism. Out of all interactions, 76 (3.67%) were serious, 1516 (73.37%) significant, and 474 (22.94%) were minor interaction. Age of the patients (r = 0.327, P = 0.0001) and number of drugs prescribed (r = 0.714, P = 0.0001) are significantly correlated with drug interactions.Conclusion:Aspirin being the most common drug interacting. The use of electronic decision support tools, continuing education and vigilance on the part of prescribers toward drug selection may decrease the problem of pDDIs.

Introduction:Assessment for practical skills in medical education needs improvement from subjective methods to objective ones. An Objective Structured Practical Examination (OSPE) has been considered as one such method. This study is an attempt to evaluate the feasibility of using OSPE as a tool for the formative assessment of undergraduate medical education in pharmacology.Materials and Methods:Students of second year MBBS, at the end of the first term, were assessed by both the conventional practical examination and the Objective Structured Practical Examination (OSPE). A five-station OSPE was conducted one week after the conventional examination. The scores obtained in both were compared and a Bland Altman plot was also used for comparison of the two methods. Perceptions of students regarding the new method were obtained using a questionnaire.Results:There was no significant difference in the mean scores between the two methods (P = 0.44) using the unpaired t test. The Bland Altman plot comparing the CPE (conventional practical examination) with the OSPE showed that 96% of the differences in the scores between OSPE and CPE were within the acceptable limit of 1.96 SD. Regarding the students’ perceptions of OSPE compared to CPE, 73% responded that OSPE could partially or completely replace CPE. OSPE was judged as an objective and unbiased test as compared to CPE, by 66.4% of the students.Conclusion:Use of OSPE is feasible for formative assessment in the undergraduate pharmacology curriculum.

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