[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and ...[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.展开更多
Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major ...Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major problem worldwide. WHO reports that half of the patients do not use their drugs correctly. Methods: This cross-sectional study was conducted between 1 October 2017 and 30 November 2018 at Istanbul Fatih Family Health Center No 7. The sample size was determined as 301 people selected by systematic sampling method from patients aged 18 and older. Results: The mean age of the participants was 53.8% ± 16.8%, 59.8% were female, 62.5% were married, and 52.5% were primary school graduates. 63.9% of the participants knew the names of the drugs they used, and 79.9% of them knew the indication for use. 89% of individuals check the expiry date of the drugs before using them, and 83.1% read the drug prospectus. 84% of the participants support the prohibition of using over-the-counter drugs. Conclusion: The level of knowledge of the participants about the rational use of drugs is above the societal average. However, some issues need more awareness. The high level of rational use of drugs awareness of physicians and pharmacists will also strengthen the rational use of drugs and indirectly increase the awareness of the public.展开更多
The protection, restoration and sustainable use are key issues of all the wetlands worldwide. Ecological, agronomic, and engineering techniques have been integrated in the development of a structurally sound, ecologic...The protection, restoration and sustainable use are key issues of all the wetlands worldwide. Ecological, agronomic, and engineering techniques have been integrated in the development of a structurally sound, ecologically beneficial engineering restoration method for restoring and utilizing a degraded saline wetland in the western Songnen Plain of China. Hydrological restoration was performed by developing a system of biannual irrigation and drainage using civil engineering measures to bring wetlands into contact with river water and improve the irrigation and drainage system in the wetlands. Agronomic measures such as plowing the reed fields, reed rhizome transplantation, and fertilization were used to restore the reed vegetation. Biological measures, including the release of crab and fish fry and natural proliferation, were used to restore the aquatic communities. The results of the restoration were clear and positive. By the year 2009, the reed yield had increased by 20.9 times. Remarkable ecological benefits occurred simultaneously. Vegetation primary-production capacity increased, local climate regulation and water purification enhanced, and biodiversity increased. This demonstration of engineering techniques illustrates the basic route for the restoration of degraded wetlands, that the biodiversity should be reconstructed by the comprehensive application of engineering, biological, and agronomic measures based on habitat restoration under the guidance of process-oriented strategies. The complex ecological system including reeds, fish and crabs is based on the biological principles of coexistence and material recycling and provides a reasonable ecological engineering model suitable for the sustainable utilization of degraded saline reed wetlands.展开更多
This article describes the development of human potential interaction between society and nature. The environment, sustainable use of natural resources, prevention of adverse effects of human activities on the environ...This article describes the development of human potential interaction between society and nature. The environment, sustainable use of natural resources, prevention of adverse effects of human activities on the environment, and disturbances of dynamical ecological balance of the existing natural systems have received increased attention. The heed is introduced both on the state scale and in broad circles of science and society in The Azerbaijan Republic.展开更多
<strong>Background:</strong> The ultimate goal of AntiRetroViral Treatments (ART) is to achieve complete immune restoration and lasting viral suppression in the infected patient. In order to ensure the eff...<strong>Background:</strong> The ultimate goal of AntiRetroViral Treatments (ART) is to achieve complete immune restoration and lasting viral suppression in the infected patient. In order to ensure the efficacy, safety and accessibility of antiretroviral drugs (ARVs), it is recommended that they should be prescribed according to national guidelines;which are evolving with the various recommendations of the World Health Organization (WHO) and the arrival of newer, more effective and safer molecules. <strong>Objective:</strong> The objective of this study was to assess the rational use of Antiretrovirals in patients treated in Kinshasa before the use of Dolutegravir within the national program in order to assess the correct use of these molecules. <strong>Methods:</strong> This work is a descriptive cross-sectional study to assess the rational use of first-line ARVs among People Living with HIV (PLHIV) in different Centers of Treatment (ATCs) in Kinshasa before the introduction of Dolutegravir. The records of patients on ARVs were randomly and rationally selected in 12 different ATCs for HIV in Kinshasa according to three centers per district in the period from June to September 2018. Information on use and consumption of ARVs, compliance with guidelines, change of therapeutic combination as well as their reasons were consulted for the present study. <strong>Results:</strong> 507 files of PLHIV were collected in the various ATCs. 274 (54.1%) were from female patients. The most represented age group was 26 to 35 years with 192 patients (37.9%). The mean duration of first-line treatment for all patients included was 16.30 ± 5.85 months. The most widely used combination of ARVs overall was TDF + 3TC + EFV at 45.4%. 305 (60.2%) PLHIV kept the same first-line treatment molecule throughout the treatment period with an average treatment duration of 12.9 ± 2.77 months. The most common combination found in this population was TDF + 3TC + EFV (69.2%). 202 (39.8%) PLHIV changed treatment molecule yet respecting the first-line combinations. The average duration of treatment for those who changed molecules was 21.43 ± 7.25 months. Before the change, 112 (55.5%) of these patients were using the ZDV + 3TC + EFV combination. After switching, 105 (52%) of the patients used the TDF + 3TC + NVP combination. The first reason for changing molecules was its unavailability (53.3%) in the ATCs. <strong>Conclusion:</strong> Although some banned molecules are still available in some treatment centers, the guidelines on first-line treatments are respected in different centers in Kinshasa.展开更多
1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after inte...1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after intercourse.展开更多
The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results:...The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results: Choice of empiric and sensitivity-guided therapy was inadequate in > 80% and 59% of cases respectively. Inadequate antimicrobial therapy, whether empiric or sensitivity-guided, was positively correlated with bacterial resistance (r = 0.316;p = 0.001). Sensitivity testing revealed a 46.5% resistance rate to eight out of the ten most commonly used antibiotics. Multiple drug-resistant organisms were found in 40.8% of patients. A significant increase was observed in the number of multidrug-resistant samples between 2006/2007 and 2008 (r = 0.41, p = 0.006), (r = 0.598, p = 0.001), (r = 0.688, p = 0.00). Conclusion: We found a high rate of antibiotic misuse in the study sample. Inadequate therapy was correlated with resistance to antimicrobial agents.展开更多
Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hyp...Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.展开更多
Plateau is characterized by low oxygen,low pressure,strong radiation,cold and dryness,among which low oxygen is the main factor that affects the normal life activities of human body.Altitude hypoxia leads to significa...Plateau is characterized by low oxygen,low pressure,strong radiation,cold and dryness,among which low oxygen is the main factor that affects the normal life activities of human body.Altitude hypoxia leads to significant changes in the metabolic characteristics of drugs in vivo,which in turn affects the efficacy and adverse actions of drugs.This paper summarizes the present situation of rational drug use in plateau area and pinpoints the existing problems.Meanwhile,we posit the strategies and measures for realizing rational and precise pharmacotherapy of plateau residents.First,we need to acquire a panoramic view of differential and relative pharmacokinetics and pharmacodynamics in between plateau area and plain area by carrying out comparative studies on drug metabolisms and on comprehensive drug efficacies and mechanisms.Second,we must apply the findings from basic research to clinical practice and formulate guidelines and recommendations of drug use for plateau habitants.Finally,we should eventually achieve precise and individualized drug use for plateau habitants based on their characteristic etiology and pathogenesis.展开更多
Evidence based pharmaceutical interventions focusing on the characteristics of antibiotics use in primary hospitals were investigated to optimize the use of antibiotics. Four pharmaceutical interventions were set up i...Evidence based pharmaceutical interventions focusing on the characteristics of antibiotics use in primary hospitals were investigated to optimize the use of antibiotics. Four pharmaceutical interventions were set up in this study： 1） different levels of antibiotic management system were developed; 2） usage of antibiotics was reported in a monthly journal for the entire hospital; 3） early antibiotics warning system was started; 4） communication between pharmacists and physicians was strengthened. Use of antibiotics in 2007 （before intervention） and 2008 （after intervention） in department of respiratory medicine was analyzed. Significant differences （P〈0.01） in antibiotics use before and after intervention were observed. Use of antibiotics was changed from focusing on one category of drugs to a rotation of a wide range of agents. Evidence based, sound pharmaceutical interventions were effective means to ensure the rational use of antibiotics.展开更多
Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs...Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs). Though there is some early evidence on the NEMPs’ effects on RUMs in China, the evidence is scarce, and conclusions vary. In the present study, we aimed to evaluate the impacts of the NEMPs of China on the RUMs in the primary health care institutions(PHCs). A cross-sectional survey was conducted in 2010. A total of 201 PHCs from six provinces of China were selected, and 39 181 prescriptions were extracted from January to June, 2010. Six indicators were used and tested by independent-samples T test. We found that the average number of drugs per prescription in PHCs with NEMP implementation(the treatment group) was significantly higher than that of the group without NEMP implementation(the control group)(3.37 vs. 2.83, P<0.01). There was no significant difference in the average cost per prescription(81.43 vs. 75.02). The percentage of prescriptions, including an antibiotic(53.40% vs. 36.48%, P<0.01) or an injection(40.54% vs. 27.94%, P<0.01), was higher in the treatment group, and the percentage of drugs prescribed by general name was significantly lower(83.71% vs. 93.11%, P<0.01). For the percentage of drugs prescribed from essential medicines list, the treatment group exhibited the higher ratio(76.12% vs. 53.45%, P<0.01). From this study, the NEMPs were not likely to have a positive impact on RUMs. China still needed efforts to improve the selection, the absence of physicians’ active involvement, and the patients’ habits of irrational medication use.展开更多
Pharmacists are the implementers of clinical drug management, and they play an irreplaceable role in promoting the improvement of rational drug use. However, the current role of pharmacists in the supervision and prot...Pharmacists are the implementers of clinical drug management, and they play an irreplaceable role in promoting the improvement of rational drug use. However, the current role of pharmacists in the supervision and protection of rational drug use has not been fully exerted. This article is aimed to investigate the current situation of pharmacists’ work of rational drug use from the perspectives of pharmacists, physicians, and patients. It is found that the professional value of pharmacists in the rational drug use has not been valued by medical institutions, physicians, and patients. Pharmacists face problems such as workload, working conditions, and doctor-patient cooperation in the rational drug use. Suggestions are made for further exerting the professional value of pharmacists in promoting the level of rational drug use. Relevant managers should pay full attention to the professional value of pharmacists, and provide corresponding system and facility guarantees for pharmacists to carry out rational drug use.展开更多
Objective:To investigate the guiding role of pharmaceutical care in the treatment of bronchial asthma.Methods:Eighty patients with bronchial disease admitted to our hospital from November 2008 to December 1818 were en...Objective:To investigate the guiding role of pharmaceutical care in the treatment of bronchial asthma.Methods:Eighty patients with bronchial disease admitted to our hospital from November 2008 to December 1818 were enrolled in this research.The computer program was used to generate random numbers.The method was divided into two groups:control group and observation group,40 cases respectively.40 patients in the control group were treated with normal medication according to the doctor’s advice;40 patients in the observation group were enrolled in the pharmacological care on the basis of the control group,and the rational drug use was compared between the two groups.Results:The incidence of adverse reactions in the observation group and the control group were 5.00%and 17.50%,respectively,and the difference was statistically significant(P<0.05);the incidence of medication error events in the observation group was 7.50%,which was significantly lower than that of the control group,which was 25.00%,and the difference was statistically significant(P<0.05).The medication errors mainly include improper administration,incorrect dosage,and unscientific administration.Conclusion:The guiding role of pharmaceutical care in bronchial asthma rational drug use can reduce medication error events and ensure rational drug use,which is worthy of popularization in clinical practice.展开更多
Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in ...Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in society.The WHO recommends a physician to every 1000 people.According to the recent data from the Health Ministry in 2019,in which 1.16 million doctors are of active population with just 80%,or 0.9 million,practicing.As a result,a ratio of 0.68 doctors for every 1000 people,which is much below as per the WHO reports.This article describes history,types,WHO guidelines,need and purpose of DUE.Objective:The main aim of this paper is to provide information about the rational use of medication in outpatient and inpatient department with special emphasis of DUEs.It also provides awareness directly to healthcare professionals,researchers,academicians,pharmacist and nurses to reduce the irrationality of medicines.Methods:The method used to compile this review information gathered from websites,Google scholar,PubMed,Research gate,and studies published on DUE from July 20 to Oct 22 were included as source of information.Results:We studied more than 35 published study on DUE,that reveals most of the physicians prescribed branded drugs not generic drugs,but WHO prescribing indicator allows to prescribe generic drugs in the hospital pharmacy to maintain better inventory control.It may also help to prevent pharmacist misunderstanding during dispensing.Conclusion:The use of generic prescription names avoids the possibility of medication product duplication and lowers patient costs.It is important to remember that incorrect medication prescriptions have impact on both patients and their family members.WHO indicators identify irrational prescribing behaviours to make therapy more rational and cost-effective.展开更多
BACKGROUND Carbapenem antibiotics are a pivotal solution for severe infections,particularly in hospital settings.The emergence of carbapenem-resistant bacteria owing to the irrational and extensive use of carbapenems ...BACKGROUND Carbapenem antibiotics are a pivotal solution for severe infections,particularly in hospital settings.The emergence of carbapenem-resistant bacteria owing to the irrational and extensive use of carbapenems underscores the need for meticulous management and rational use.Clinical pharmacists,with their specialized training and extensive knowledge,play a substantial role in ensuring the judicious use of carbapenem.This study aimed to elucidate the patterns of carbapenem use and shed light on the integral role played by clinical pharmacists in managing and promoting the rational use of carbapenem antibiotics at Wenzhou Integrated Traditional Chinese and Western Medicine Hospital.AIM To analyze carbapenem use patterns in our hospital and role of clinical pharmacists in managing and promoting their rational use.METHODS We performed a retrospective analysis of carbapenem use at our hospital between January 2019 and December 2021.Several key indicators,including the drug utilization index,defined daily doses(DDDs),proportion of antimicrobial drug costs to total hospitalization expenses,antibiotic utilization density,and utilization rates in different clinical departments were comprehensively analyzed.RESULTS Between 2019 and 2021,there was a consistent decline in the consumption and sales of imipenem-cilastatin sodium,meropenem(0.3 g),and meropenem(0.5 g).Conversely,the DDDs of imipenem-cilastatin sodium for injection increased in 2020 and 2021 vs 2019,with a B/A value of 0.67,indicating a relatively higher drug cost.The DDDs of meropenem for injection(0.3 g)exhibited an overall upward trend,indicating an increasing clinical preference.However,the B/A values for 2020 and 2021 were both>1,suggesting a relatively lower drug cost.The DDDs of meropenem for injection(0.5 g)demonstrated a progressive increase annually and consistently ranked first,indicating a high clinical preference with a B/A value of 1,signifying good alignment between economic and social benefits.CONCLUSION Carbapenem use in our hospital was generally reasonable with a downward trend in consumption and sales over time.Clinical pharmacists play a pivotal role in promoting appropriate use of carbapenems.展开更多
This study evaluated the reduction of water consumption in a SIH （social interest housing） complex from the simulation of implanting a rainwater harvesting system. The methodology consisted of characterization of th...This study evaluated the reduction of water consumption in a SIH （social interest housing） complex from the simulation of implanting a rainwater harvesting system. The methodology consisted of characterization of the case study, survey data of water consumption and data of precipitation in the area, on-site visits to define the average consumption and monthly water distribution, and sizing of a rainwater harvesting tank following the Netuno Program. It was obtained 22.500 L as the ideal volume for the tank, supplying the demand for drinkingwater in 32%, although the reduction in the drinking water bills would be minor, since the object of the case study is considered SIH, and residents pay a fixed fee for consuming up to 10 m3 per month. Therefore, it becomes necessary to analyze this situation from a sustainable and environmental perspective, and the benefits are no longer only economic, but rather they take on a more comprehensive social dimension.展开更多
The first part of the article provides an overview of the theoretical evidence, the main provisions, and the implementation strategy of information support for bioresource and ecosystem research in the north-west Paci...The first part of the article provides an overview of the theoretical evidence, the main provisions, and the implementation strategy of information support for bioresource and ecosystem research in the north-west Pacific, which has been conducted over the past 20 years in the Russian Far East Research Institute TINRO-Center. In short, the concept consists of a combination of the following four assertions: 1) For the steady and sustainable development of the Russian Far East, the entire Russian Federation and the Asia-Pacific Region in general, environmental, food, economic, and other security is required, which cannot be achieved without the rational use of bioresources based on the ecosystem approach to the management of aquatic bioresources. 2) For the inventory, appraisal, monitoring, forecasting of the state of and management the natural water resources when applying this approach, statistically relevant quantitative information is required on the greatest possible number of constituents of marine biocenosis of the north-western Pacific for the longest possible period of time, which is only available at the TINRO-Center. 3) This valuable data should be organized into databases, based on which geo-information and other electronic information systems are prepared, and based on these map atlases and reference books on natural water resources, using automated workplaces created especially for this. 4) The resulting unique information support will be of great value not only for practical purposes, but also for science, both applied and fundamental. Next comes a summary of the many years of work on the practical implementation of this concept and the key achievements in this field obtained by the TINRO-Center by the end of 2015 are reviewed. At the end, some plans for the near future are outlined.展开更多
基金Supported by Science and Technology Innovation Plan for Medical Workers in Shandong Province(SDYWZGKCJH2023095)Clinical Pharmacy Research Project of Shandong Provincial Medical Association(YXH2022ZX010)+1 种基金Traditional Chinese Medicine Science and Technology Development Project of Shandong Province(2019-0400&2021Q097)Traditional Chinese Medicine Research Program of Qingdao City(2020-zyy031)Medical Research Guidance Plan of Qingdao City(2020-WJZD087).
文摘[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.
文摘Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major problem worldwide. WHO reports that half of the patients do not use their drugs correctly. Methods: This cross-sectional study was conducted between 1 October 2017 and 30 November 2018 at Istanbul Fatih Family Health Center No 7. The sample size was determined as 301 people selected by systematic sampling method from patients aged 18 and older. Results: The mean age of the participants was 53.8% ± 16.8%, 59.8% were female, 62.5% were married, and 52.5% were primary school graduates. 63.9% of the participants knew the names of the drugs they used, and 79.9% of them knew the indication for use. 89% of individuals check the expiry date of the drugs before using them, and 83.1% read the drug prospectus. 84% of the participants support the prohibition of using over-the-counter drugs. Conclusion: The level of knowledge of the participants about the rational use of drugs is above the societal average. However, some issues need more awareness. The high level of rational use of drugs awareness of physicians and pharmacists will also strengthen the rational use of drugs and indirectly increase the awareness of the public.
基金Under the auspices of National Natural Science Foundation of China (No. 41101469)National Key Technology Research and Development Program of China (No. 2009BADB3B02)Science and Technology Development Foundation of Jiilin Province (No. 20080402-1)
文摘The protection, restoration and sustainable use are key issues of all the wetlands worldwide. Ecological, agronomic, and engineering techniques have been integrated in the development of a structurally sound, ecologically beneficial engineering restoration method for restoring and utilizing a degraded saline wetland in the western Songnen Plain of China. Hydrological restoration was performed by developing a system of biannual irrigation and drainage using civil engineering measures to bring wetlands into contact with river water and improve the irrigation and drainage system in the wetlands. Agronomic measures such as plowing the reed fields, reed rhizome transplantation, and fertilization were used to restore the reed vegetation. Biological measures, including the release of crab and fish fry and natural proliferation, were used to restore the aquatic communities. The results of the restoration were clear and positive. By the year 2009, the reed yield had increased by 20.9 times. Remarkable ecological benefits occurred simultaneously. Vegetation primary-production capacity increased, local climate regulation and water purification enhanced, and biodiversity increased. This demonstration of engineering techniques illustrates the basic route for the restoration of degraded wetlands, that the biodiversity should be reconstructed by the comprehensive application of engineering, biological, and agronomic measures based on habitat restoration under the guidance of process-oriented strategies. The complex ecological system including reeds, fish and crabs is based on the biological principles of coexistence and material recycling and provides a reasonable ecological engineering model suitable for the sustainable utilization of degraded saline reed wetlands.
文摘This article describes the development of human potential interaction between society and nature. The environment, sustainable use of natural resources, prevention of adverse effects of human activities on the environment, and disturbances of dynamical ecological balance of the existing natural systems have received increased attention. The heed is introduced both on the state scale and in broad circles of science and society in The Azerbaijan Republic.
文摘<strong>Background:</strong> The ultimate goal of AntiRetroViral Treatments (ART) is to achieve complete immune restoration and lasting viral suppression in the infected patient. In order to ensure the efficacy, safety and accessibility of antiretroviral drugs (ARVs), it is recommended that they should be prescribed according to national guidelines;which are evolving with the various recommendations of the World Health Organization (WHO) and the arrival of newer, more effective and safer molecules. <strong>Objective:</strong> The objective of this study was to assess the rational use of Antiretrovirals in patients treated in Kinshasa before the use of Dolutegravir within the national program in order to assess the correct use of these molecules. <strong>Methods:</strong> This work is a descriptive cross-sectional study to assess the rational use of first-line ARVs among People Living with HIV (PLHIV) in different Centers of Treatment (ATCs) in Kinshasa before the introduction of Dolutegravir. The records of patients on ARVs were randomly and rationally selected in 12 different ATCs for HIV in Kinshasa according to three centers per district in the period from June to September 2018. Information on use and consumption of ARVs, compliance with guidelines, change of therapeutic combination as well as their reasons were consulted for the present study. <strong>Results:</strong> 507 files of PLHIV were collected in the various ATCs. 274 (54.1%) were from female patients. The most represented age group was 26 to 35 years with 192 patients (37.9%). The mean duration of first-line treatment for all patients included was 16.30 ± 5.85 months. The most widely used combination of ARVs overall was TDF + 3TC + EFV at 45.4%. 305 (60.2%) PLHIV kept the same first-line treatment molecule throughout the treatment period with an average treatment duration of 12.9 ± 2.77 months. The most common combination found in this population was TDF + 3TC + EFV (69.2%). 202 (39.8%) PLHIV changed treatment molecule yet respecting the first-line combinations. The average duration of treatment for those who changed molecules was 21.43 ± 7.25 months. Before the change, 112 (55.5%) of these patients were using the ZDV + 3TC + EFV combination. After switching, 105 (52%) of the patients used the TDF + 3TC + NVP combination. The first reason for changing molecules was its unavailability (53.3%) in the ATCs. <strong>Conclusion:</strong> Although some banned molecules are still available in some treatment centers, the guidelines on first-line treatments are respected in different centers in Kinshasa.
文摘1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after intercourse.
文摘The present study sought to assess the rational use of antimicrobial agents in a Brazilian intensive care unit (ICU) and its association with antimicrobial resistance in elderly patients admitted to the unit. Results: Choice of empiric and sensitivity-guided therapy was inadequate in > 80% and 59% of cases respectively. Inadequate antimicrobial therapy, whether empiric or sensitivity-guided, was positively correlated with bacterial resistance (r = 0.316;p = 0.001). Sensitivity testing revealed a 46.5% resistance rate to eight out of the ten most commonly used antibiotics. Multiple drug-resistant organisms were found in 40.8% of patients. A significant increase was observed in the number of multidrug-resistant samples between 2006/2007 and 2008 (r = 0.41, p = 0.006), (r = 0.598, p = 0.001), (r = 0.688, p = 0.00). Conclusion: We found a high rate of antibiotic misuse in the study sample. Inadequate therapy was correlated with resistance to antimicrobial agents.
文摘Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.
基金National Natural Science Foundation of China(81673508,81403004).
文摘Plateau is characterized by low oxygen,low pressure,strong radiation,cold and dryness,among which low oxygen is the main factor that affects the normal life activities of human body.Altitude hypoxia leads to significant changes in the metabolic characteristics of drugs in vivo,which in turn affects the efficacy and adverse actions of drugs.This paper summarizes the present situation of rational drug use in plateau area and pinpoints the existing problems.Meanwhile,we posit the strategies and measures for realizing rational and precise pharmacotherapy of plateau residents.First,we need to acquire a panoramic view of differential and relative pharmacokinetics and pharmacodynamics in between plateau area and plain area by carrying out comparative studies on drug metabolisms and on comprehensive drug efficacies and mechanisms.Second,we must apply the findings from basic research to clinical practice and formulate guidelines and recommendations of drug use for plateau habitants.Finally,we should eventually achieve precise and individualized drug use for plateau habitants based on their characteristic etiology and pathogenesis.
文摘Evidence based pharmaceutical interventions focusing on the characteristics of antibiotics use in primary hospitals were investigated to optimize the use of antibiotics. Four pharmaceutical interventions were set up in this study： 1） different levels of antibiotic management system were developed; 2） usage of antibiotics was reported in a monthly journal for the entire hospital; 3） early antibiotics warning system was started; 4） communication between pharmacists and physicians was strengthened. Use of antibiotics in 2007 （before intervention） and 2008 （after intervention） in department of respiratory medicine was analyzed. Significant differences （P〈0.01） in antibiotics use before and after intervention were observed. Use of antibiotics was changed from focusing on one category of drugs to a rotation of a wide range of agents. Evidence based, sound pharmaceutical interventions were effective means to ensure the rational use of antibiotics.
基金National Natural Science Foundation of China(Grant No.71303011,71774005)
文摘Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs). Though there is some early evidence on the NEMPs’ effects on RUMs in China, the evidence is scarce, and conclusions vary. In the present study, we aimed to evaluate the impacts of the NEMPs of China on the RUMs in the primary health care institutions(PHCs). A cross-sectional survey was conducted in 2010. A total of 201 PHCs from six provinces of China were selected, and 39 181 prescriptions were extracted from January to June, 2010. Six indicators were used and tested by independent-samples T test. We found that the average number of drugs per prescription in PHCs with NEMP implementation(the treatment group) was significantly higher than that of the group without NEMP implementation(the control group)(3.37 vs. 2.83, P<0.01). There was no significant difference in the average cost per prescription(81.43 vs. 75.02). The percentage of prescriptions, including an antibiotic(53.40% vs. 36.48%, P<0.01) or an injection(40.54% vs. 27.94%, P<0.01), was higher in the treatment group, and the percentage of drugs prescribed by general name was significantly lower(83.71% vs. 93.11%, P<0.01). For the percentage of drugs prescribed from essential medicines list, the treatment group exhibited the higher ratio(76.12% vs. 53.45%, P<0.01). From this study, the NEMPs were not likely to have a positive impact on RUMs. China still needed efforts to improve the selection, the absence of physicians’ active involvement, and the patients’ habits of irrational medication use.
文摘Pharmacists are the implementers of clinical drug management, and they play an irreplaceable role in promoting the improvement of rational drug use. However, the current role of pharmacists in the supervision and protection of rational drug use has not been fully exerted. This article is aimed to investigate the current situation of pharmacists’ work of rational drug use from the perspectives of pharmacists, physicians, and patients. It is found that the professional value of pharmacists in the rational drug use has not been valued by medical institutions, physicians, and patients. Pharmacists face problems such as workload, working conditions, and doctor-patient cooperation in the rational drug use. Suggestions are made for further exerting the professional value of pharmacists in promoting the level of rational drug use. Relevant managers should pay full attention to the professional value of pharmacists, and provide corresponding system and facility guarantees for pharmacists to carry out rational drug use.
文摘Objective:To investigate the guiding role of pharmaceutical care in the treatment of bronchial asthma.Methods:Eighty patients with bronchial disease admitted to our hospital from November 2008 to December 1818 were enrolled in this research.The computer program was used to generate random numbers.The method was divided into two groups:control group and observation group,40 cases respectively.40 patients in the control group were treated with normal medication according to the doctor’s advice;40 patients in the observation group were enrolled in the pharmacological care on the basis of the control group,and the rational drug use was compared between the two groups.Results:The incidence of adverse reactions in the observation group and the control group were 5.00%and 17.50%,respectively,and the difference was statistically significant(P<0.05);the incidence of medication error events in the observation group was 7.50%,which was significantly lower than that of the control group,which was 25.00%,and the difference was statistically significant(P<0.05).The medication errors mainly include improper administration,incorrect dosage,and unscientific administration.Conclusion:The guiding role of pharmaceutical care in bronchial asthma rational drug use can reduce medication error events and ensure rational drug use,which is worthy of popularization in clinical practice.
文摘Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in society.The WHO recommends a physician to every 1000 people.According to the recent data from the Health Ministry in 2019,in which 1.16 million doctors are of active population with just 80%,or 0.9 million,practicing.As a result,a ratio of 0.68 doctors for every 1000 people,which is much below as per the WHO reports.This article describes history,types,WHO guidelines,need and purpose of DUE.Objective:The main aim of this paper is to provide information about the rational use of medication in outpatient and inpatient department with special emphasis of DUEs.It also provides awareness directly to healthcare professionals,researchers,academicians,pharmacist and nurses to reduce the irrationality of medicines.Methods:The method used to compile this review information gathered from websites,Google scholar,PubMed,Research gate,and studies published on DUE from July 20 to Oct 22 were included as source of information.Results:We studied more than 35 published study on DUE,that reveals most of the physicians prescribed branded drugs not generic drugs,but WHO prescribing indicator allows to prescribe generic drugs in the hospital pharmacy to maintain better inventory control.It may also help to prevent pharmacist misunderstanding during dispensing.Conclusion:The use of generic prescription names avoids the possibility of medication product duplication and lowers patient costs.It is important to remember that incorrect medication prescriptions have impact on both patients and their family members.WHO indicators identify irrational prescribing behaviours to make therapy more rational and cost-effective.
文摘BACKGROUND Carbapenem antibiotics are a pivotal solution for severe infections,particularly in hospital settings.The emergence of carbapenem-resistant bacteria owing to the irrational and extensive use of carbapenems underscores the need for meticulous management and rational use.Clinical pharmacists,with their specialized training and extensive knowledge,play a substantial role in ensuring the judicious use of carbapenem.This study aimed to elucidate the patterns of carbapenem use and shed light on the integral role played by clinical pharmacists in managing and promoting the rational use of carbapenem antibiotics at Wenzhou Integrated Traditional Chinese and Western Medicine Hospital.AIM To analyze carbapenem use patterns in our hospital and role of clinical pharmacists in managing and promoting their rational use.METHODS We performed a retrospective analysis of carbapenem use at our hospital between January 2019 and December 2021.Several key indicators,including the drug utilization index,defined daily doses(DDDs),proportion of antimicrobial drug costs to total hospitalization expenses,antibiotic utilization density,and utilization rates in different clinical departments were comprehensively analyzed.RESULTS Between 2019 and 2021,there was a consistent decline in the consumption and sales of imipenem-cilastatin sodium,meropenem(0.3 g),and meropenem(0.5 g).Conversely,the DDDs of imipenem-cilastatin sodium for injection increased in 2020 and 2021 vs 2019,with a B/A value of 0.67,indicating a relatively higher drug cost.The DDDs of meropenem for injection(0.3 g)exhibited an overall upward trend,indicating an increasing clinical preference.However,the B/A values for 2020 and 2021 were both>1,suggesting a relatively lower drug cost.The DDDs of meropenem for injection(0.5 g)demonstrated a progressive increase annually and consistently ranked first,indicating a high clinical preference with a B/A value of 1,signifying good alignment between economic and social benefits.CONCLUSION Carbapenem use in our hospital was generally reasonable with a downward trend in consumption and sales over time.Clinical pharmacists play a pivotal role in promoting appropriate use of carbapenems.
文摘This study evaluated the reduction of water consumption in a SIH （social interest housing） complex from the simulation of implanting a rainwater harvesting system. The methodology consisted of characterization of the case study, survey data of water consumption and data of precipitation in the area, on-site visits to define the average consumption and monthly water distribution, and sizing of a rainwater harvesting tank following the Netuno Program. It was obtained 22.500 L as the ideal volume for the tank, supplying the demand for drinkingwater in 32%, although the reduction in the drinking water bills would be minor, since the object of the case study is considered SIH, and residents pay a fixed fee for consuming up to 10 m3 per month. Therefore, it becomes necessary to analyze this situation from a sustainable and environmental perspective, and the benefits are no longer only economic, but rather they take on a more comprehensive social dimension.
文摘The first part of the article provides an overview of the theoretical evidence, the main provisions, and the implementation strategy of information support for bioresource and ecosystem research in the north-west Pacific, which has been conducted over the past 20 years in the Russian Far East Research Institute TINRO-Center. In short, the concept consists of a combination of the following four assertions: 1) For the steady and sustainable development of the Russian Far East, the entire Russian Federation and the Asia-Pacific Region in general, environmental, food, economic, and other security is required, which cannot be achieved without the rational use of bioresources based on the ecosystem approach to the management of aquatic bioresources. 2) For the inventory, appraisal, monitoring, forecasting of the state of and management the natural water resources when applying this approach, statistically relevant quantitative information is required on the greatest possible number of constituents of marine biocenosis of the north-western Pacific for the longest possible period of time, which is only available at the TINRO-Center. 3) This valuable data should be organized into databases, based on which geo-information and other electronic information systems are prepared, and based on these map atlases and reference books on natural water resources, using automated workplaces created especially for this. 4) The resulting unique information support will be of great value not only for practical purposes, but also for science, both applied and fundamental. Next comes a summary of the many years of work on the practical implementation of this concept and the key achievements in this field obtained by the TINRO-Center by the end of 2015 are reviewed. At the end, some plans for the near future are outlined.
