Physicochemical equivalence of generic antihypertensive medicines (EQUIMEDS): protocol for a quality of medicines assessment

Redfern, Julie; Adedoyin, Rufus Adesoji; Ofori, Sandra N.; Anchala, Raghupathy; Ajay, Vamadevan S.; Andrade, Luciano de; Zelaya, Jose; Kaur, Harsimran; Sani, Mahmoud U

doi:10.1136/bmjgh-2016-000086

Cited by 4 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this cross sectional study, we sampled nifedipine, a calcium channel blocker with a preferred strength of 20 or 30 mg. Calcium channel blockers are the most commonly used antihypertensive drugs and their availability is widespread in Lagos State. [15],[16],[17],[18],[19]…”

Section: Methodsmentioning

confidence: 99%

Evaluating the quality of antihypertensive drugs in Lagos State, Nigeria

et al. 2019

View full text Add to dashboard Cite

Background As the burden of noncommunicable diseases grows, access to safe medical therapy is increasing in importance. The aim of this study was to develop a method for evaluating the quality of antihypertensive drugs and to examine whether this prevalence varies by socioeconomic variables. Methods We conducted a cross-sectional survey of registered pharmacies in 6 local government areas (LGAs) in Lagos State, Nigeria. In each LGA, we sampled 17 pharmacies from a list of all registered pharmacies derived from the Pharmacists Council of Nigeria. We assessed drug quality based on (1) the level of active pharmaceutical ingredients (APIs), which identified falsely labeled drug samples; and (2) the amount of impurities, which revealed substandard drug samples in accordance with the international pharmacopoeia guidelines. Good-quality drugs met specifications for both API and impurity. Results Of the 102 drug samples collected, 30 (29.3%) were falsely labeled, 76 (74.5%) were substandard,78 (76.5%) were of poor quality and 24 (23.5%) were of good quality.Among the falsely labeled drugs, 2 samples met standards set for purity while 28 did not. Among the 76 substandard drug samples, 28 were also falsely labeled. Of the falsely labeled drugs, 17 (56.7%) came from LGAs with low socioeconomic status, and 40 (52.6%) of the substandard drug samples came from LGAs with high socioeconomic status. Most of the good-quality drug samples, 14 (58.3%), were from LGAs with low socioeconomic status. Eighteen (60%) of the falsely labeled samples, 37 (48.7%) of the substandard samples, and 15 (62.5%) of the good-quality drug samples were from manufacturers based in Asia. The average price was 375.67 Nigerian naira (NGN) for falsely labeled drugs, 383.33 NGN for substandard drugs, and 375.67 NGN for good-quality drugs. The prevalence of falsely labeled and substandard drug samples did not differ by LGA-level socioeconomic status ( P = .39) or region of manufacturer ( P = .24); however, there was a trend for a difference by price ( P = .06). Conclusion The prevalence of falsely labeled and substandard drug samples was high in Lagos. Treatment of noncommunicable diseases in this setting will require efforts to monitor and assure drug quality.

show abstract

Section: Methodsmentioning

confidence: 99%

Evaluating the quality of antihypertensive drugs in Lagos State, Nigeria

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Despite the bene ts of hypertension management and the availability of safe and low-cost medications in reducing cardiovascular morbidity and mortality, evidence from medical literature shows that the burden of hypertension remains high, and control rates are poor in developing countries. Controlled hypertension is one of the priority areas identi ed by the WHF for action if the target of a 25% reduction in premature CVD mortality by 2025 is to be achieved (32).…”

Section: Discussionmentioning

confidence: 99%

Impact of Value-Based Care on Quality of Life, Clinical Outcomes, Patient Satisfaction, and Enhanced Financial Protection among Hypertensive Patients inGhana: A Protocol for a Mixed Method Evaluation, 2024

Dwomoh,

Sunkwa-Mills,

Antwi

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Hypertension remains a major public health concern in low and middle-income countries as most hypertensive patients are not adequately treated, and improper lifestyle modification and expensive and inadequate antihypertensive medications are among the few of the challenges that hinder effective hypertension management. Evidence on which hypertensive intervention is cost-effective is essential to inform strategy, policy development, practice, implementation, and resource allocation. Value-Based Care (VBC) is a healthcare delivery model that emphasizes improving patient outcomes while optimizing costs. It shifts the focus from the volume of services provided to the value delivered to patients. We hypothesize that innovative digital VBC intervention would be more cost-effective compared to standard care among individuals with poorly controlled hypertension. Methods This study in Ghana will employ a mixed-methods evaluation design, a comprehensive and thorough approach that combines quantitative and qualitative methods. The quantitative component will involve a quasi-experimental study to measure the impact of the VBC intervention on quality of life, improved clinical outcomes, patient satisfaction, and enhanced financial protection among hypertensive patients registered with the National Health Insurance Authority. We will use a difference-in-difference analytic approach and a generalized estimation equation model with cluster-robust standard errors to quantify the impact of VBC, accounting for potential confounding variables. The qualitative component will involve in-depth interviews and focus group discussions to gather insights into the experiences and perceptions of the patients, caregivers, and policymakers involved in the VBC intervention and the benefits, barriers, costs of treatment, and challenges associated with the VBC intervention. We aim to provide evidence that can significantly impact hypertension service delivery in Ghana, potentially leading to more cost-effective care for hypertensive patients. Discussions Despite the availability of safe treatment options for hypertension, most people with hypertension in LMICs do not have it controlled. There is currently a paucity of knowledge about the cost-effectiveness of VBC interventions in developing countries. This study aims to fill this knowledge gap and pave the way for more cost-effective hypertension treatment worldwide. The digital Ghana VBC intervention described in this paper is a pioneering approach to achieving safer, more consistent, and cost-effective care for hypertensive patients.

show abstract

“…In brief, corn seeds with very poor storage conditions, were separately grown on water-agar media (20 grams agar dissolved in one litre distilled water and supplemented with 10% NaCl for 10 days at 25 o C. The grown fungus was isolated and transferred into potato dextrose agar (PDA) media (200 g potato, 20 g dextrose and 20 g agar in one-litre distilled water) and kept at 25 o C for 12 days. (Redfern et al, 2016). For each plant, the dried collected part was exhaustively defatted with petroleum ether for three days at room temperature then dried in air.…”

Section: Methodsmentioning

confidence: 99%