Isha Patel

An evaluation of knowledge, attitude and practice of Indian pharmacists towards adverse drug reaction reporting: A pilot study.

Background: Pharmacovigilance is a useful to assure the safety of medicines and protect consumers from their harmful effects. Healthcare professionals should consider Adverse Drug Reaction (ADR) reporting as part of their professional obligation and participate in the existent pharmacovigilance programs in their countries. In India, the National PV Program was re-launched in July 2010. Objectives: This survey was conducted in order to assess the knowledge, attitude and practice of Indian pharmacists with the aim of exploring the pharmacists’ participation in ADR reporting system, identifying the reasons of under reporting and determining the steps that could be adopted to increase reporting rates. Materials and Methods: A cross-sectional survey was carried out among the pharmacists in India using a pretested questionnaire with 33 questions (10 questions on knowledge, 6 on attitude, 7 on practice, 7 on future of ADR reporting in India and 3 on benefits of reporting ADRs.). The study was conducted, over a period of 3 months from May 2012 to July 2012. Results: Out of the 600 participants to whom the survey was administered, a total of 400 were filled. The response rate of the survey was 67%. 95% responders were knowledgeable about ADRs. 90% participants had a positive attitude towards making ADRs reporting mandatory for practicing pharmacists. 87.5% participants were interested in participating in the National Pharmacovigilance program, in India. 47.5% respondents had observed ADRs in their practice, and 37% had reported it to the national pharmacovigilance center. 92% pharmacists believed reporting ADRs immensely helped in providing quality care to patients. Conclusion: The Indian pharmacists have poor knowledge, attitude, and practice (KAP) towards ADR reporting and pharmacovigilance. Pharmacists with higher qualifications such as the pharmacists with a PharmD have better KAP. With additional training on Pharmacovigilance, the Indian Pharmacists working in different sectors can become part of ADR reporting system.

Medication error management around the globe: An overview

Medical mistakes that include medication errors have raised concerns about medication safety. Due to high consumption of medicines and self-treatment by all, especially the aging population, the issue of proper medication use and safety is at the forefront of public health concerns globally. Each country has a different approach towards medication event monitoring that is compliant with its own health care system. This paper focuses on the efforts and endeavors of some of the countries around the world to create an efficient error reporting systems to ensure public safety. Our analysis indicates that there are established and effective medication vigilance systems in many developed countries. The different countries undertake activities which range from collecting information about prescriptions, surveying physicians about adverse drug events, and conducting sophisticated post-marketing surveillance studies. There is still need for such sophisticated system in India; however recent promising developments are occurring towards building a medication vigilance system. Development of these systems may eventually contribute to a global medication vigilance system, which could reduce concern with medication errors and safety.

Evaluation of self medication practices in rural area of town sahaswan at northern India.

Background: Many of the studies have investigated the prevalence and nature of self-medication. It is a common type of self-care behavior among the populace of various countries. World Health Organization promotes the practice of self-medication for effective and quick relief of symptoms without medical consultations to reduce the burden on health-care services, which are often understaffed and inaccessible in rural and remote areas. Aim: The aim of the study was to determine the extent and pattern of self-medication among the population (patients) attending pharmacies at study sites and to note the association of self-medication variables with demographic factors. Subjects and Methods: The present study was a community based cross sectional study aimed to gather information about the prevalence of self-medication in the rural town of Sahaswan, Uttar Pradesh from June 2012 to July 2012. The sample size comprised of 600 respondents. Data were collected through a prepared questionnaire. All descriptive data were coded, entered and analyzed using the statistical package for Social sciences program version 17.0 (Chicago, IL, USA). Descriptive data analysis was conducted and reported as frequencies and percentage. Results: The percentage of patients who were seeking self-medication was approximately 50% (300/600). Most of the patients were seeking self-medication for headache and other pain (23.3% [140/600]), fever (14.5% [87/600]), urinary tract infections (9.7% [58/600]) and respiratory tract infections (11.7% [70/600]). The drugs most commonly purchased for practicing self-medication were non-steroidal anti-inflammatory drugs (25.3% [152/600]), medications used for gastro intestinal problems (20.8% [125/600]) and antibiotics (16.7% [100/600]). Conclusion: Prevalence of self-medication was high primarily among illiterate males aged above 15 years with a low income. Patient health awareness programs, assistance by community pharmacists and pharmacist continuing education are necessary for controlling self-medication. There is a need for planning interventions to promote rational self-medication through mass medias such as newspaper, magazine and TV.

Knowledge, attitude and practice of B.Sc. Pharmacy students about antibiotics in Trinidad and Tobago

Objective: The aim of this study was to assess the knowledge, attitude and practice of B.Sc. Pharmacy students about usage and resistance of antibiotics in Trinidad and Tobago. Methods: This was a cross-sectional questionnaire-based study involving B.Sc. Pharmacy students. The questionnaire was divided into five components including Demographics data, knowledge about antibiotic use, attitude toward antibiotic use and resistance, self-antibiotic usage and possible causes of antibiotic resistance. Data were analyzed by employing Mann-Whitney and Chi-square tests using SPSS version 20. Findings: The response rate was 83.07%. The results showed good knowledge of antibiotic use among students. The overall attitude of pharmacy students was poor. About 75% of participants rarely use antibiotics, whereas self-decision was the major reason of antibiotic use (40.7%) and main source of information was retail pharmacist (42.6%). Common cold and flu is a major problem for which antibiotics were mainly utilized by pharmacy students (35.2%). Conclusion: The study showed good knowledge of pharmacy students regarding antibiotic usage. However, students′ attitude towards antibiotic use was poor. The study recommends future studies to be conducted with interventional design to improve knowledge and attitude of pharmacy students about antibiotic use and resistance.

Comparing the lifetime risks of TNF-alpha inhibitor use to common benchmarks of risk

Abstract Objective: The study aims to illustrate the range of lifetime risks of lymphoma, tuberculosis (TB), and demyelinating diseases with TNF-α inhibitors in psoriasis patients. Methods: Previously published data and online resources were used to determine the risk of the TB, demyelinating disease, and lymphoma with and without TNF-α inhibitor treatment. Lifetime risks for heart disease and stroke were collected using a Medline search. All cancer, trauma, and environmental statistics were obtained from the data published by National Cancer Institute, National Safety Council, and the National Oceanic and Atmospheric Administration, respectively. Results: The lifetime risks of TNF-α-inhibitor-linked conditions and comparators are as follows: TNF-α inhibitor-linked conditions: lymphoma with: without TNF-α inhibitors (0.5–4.8%:2.3%), TB with:without TNF-α inhibitors (0–17.1%:0.3%), and demyelinating disease with:without TNF-α inhibitors (0.1–1.7%:0.15%). Comparators: cancer (40.4%), heart disease (36.2%), stroke (18.4%), accidental death (3.0%), motor vehicle death (1.2%), and lightning strike (0.033%). Limitations: Much of the data on lifetime risks of disease with TNF-α inhibitor were for patients with rheumatoid arthritis and not psoriasis. Conclusions: The risks of lymphoma, demyelinating diseases, and tuberculosis with TNF-α inhibitors are lower than risks patients face on a regular basis. Screening reduces the risk of tuberculosis in patients receiving TNF-α inhibitors.

Improving adherence to acne treatment: the emerging role of application software.

Objective To examine recent studies on the effect of mobile and electronic (ME)-health technology on adherence to acne treatment. Background With emerging use of ME-health technology, there is a growing interest in evaluating the effectiveness of the tools on medication adherence. Examples of ME-health technology-based tools include text message-based pill reminders and Web-based patient education. Methods MEDLINE, Cochrane Library, and Web of Science were searched for articles on adherence to acne treatment published through November 2013. A combination of search terms such as “acne” and “adherence” or “compliance” were used. Results Adherence to oral acne medication was higher than for topical acne medication. The frequency of office visits was also an influencing factor for acne treatment adherence. The telephone-based reminders on a daily basis did not improve acne patients’ medication adherence, whereas the Web-based educational tools on a weekly basis had a positive effect on medication adherence in acne treatment. Conclusion In using ME-health interventions, factors such as medication dosage forms, frequency of intervention, and patients’ preferences should be taken into consideration. Developing disease-specific text message reminders may be helpful to increase adherence rates. In addition, a combination of text message reminders with another type of intervention may improve medication adherence.

Clinical pharmacy practice in developing countries: Focus on India and Pakistan

Clinical pharmacy practice is undergoing unprecedented changes as standard profession of pharmacy practice by means of pharmaceutical care. Although, the clinical pharmacy is well recognized in developed countries, but the implementation of clinical pharmacy practice is still at nascent stage in developing countries. Hence, this article is focused on the variations in implementation of clinical pharmacy education and practice in developing countries, specially focusing on highly populous countries like India and Pakistan perspectives.

A Study on Drug Safety Monitoring Program in India

Pharmacovigilance is useful in assuring the safety of medicines and protecting the consumers from their harmful effects. A number of single drugs as well as fixed dose combinations have been banned from manufacturing, marketing and distribution in India. An important issue about the availability of banned drugs over the counter in India is that sufficient adverse drug reactions data about these drugs have not been reported. The most common categories of drugs withdrawn in the last decade were nonsteroidal antiinflammatory drugs (28%), antidiabetics (14.28%), antiobesity (14.28%), antihistamines (14.28%), gastroprokinetic drugs (7.14%), breast cancer and infertility drugs (7.14%), irritable bowel syndrome and constipation drugs (7.14%) and antibiotics (7.14%). Drug withdrawals from market were made mainly due to safety issues involving cardiovascular events (57.14%) and liver damage (14.28%). Majority of drugs have been banned since 3-5 years in other countries but are still available for sale in India. The present study compares the drug safety monitoring systems in the developed countries such as the USA and UK and provides implications for developing a system that can ensure the safety and efficacy of drugs in India. Absence of a gold standard for a drug safety surveillance system, variations in culture and clinical practice across countries makes it difficult for India to completely adopt another countrys practices. There should be a multidisciplinary approach towards drug safety that should be implemented throughout the entire duration spanning from drug discovery to usage by consumers.

Job satisfaction among Indian pharmacists

We conducted a pilot study to measure, the perception about the job satisfaction among Indian pharmacists and future suggestions as to improve the same.Across‑sectional survey was carried out among the pharmacists in India using a pretested questionnaire in English with 24 questions (6 questions on demographic, 10 on satisfaction and 8 on future improvement). The questionnaire was made available to the pharmacists at their work place by email and through social networking sites. A four‑point scale was used for some questions with responses ranging from very good, good, moderate to dissatisfied and for the remaining questions, the responses were dichotomous (yes or no). The study was conducted over a period of 3 months from November 2012 to January 2013. Data were analyzed using the Statistical Package for Social Sciences (SPSS Inc. Released 2008. SPSS Statistics for Windows, Version 117.0. Chicago: SPSS Inc).The response rate of the survey was 37.83%. Nearly, 82% pharmacists were males and 91% were aged 18‑30 years. The starting salary of B.Pharm graduates working in the pharmaceutical industry, ranged from Rs. 4000/per month to Rs. 10,000/month, where as the salaries of diploma holders working in the community or hospital pharmacies ranged from only Rs. 6000/per month to Rs. 8000/per month. Compared with previous studies, on an average, Indian pharmacists had job satisfaction of 67%. About 48% pharmacists had moderate satisfaction where 38% were dissatisfied. Main reasons for poor job satisfaction were salary status (21%), governmental policies that hamper employment opportunities for pharmacists compared with other professionals (67%), less promotion opportunities (42%), lack of promotion opportunities (40%) and % for other reasons(working conditions, job security and affecting personal life etc.).

Racial Health Disparities Among Special Health Care Needs Children With Mental Disorders Do Medical Homes Cater to Their Needs

Background: A health care reform has been taking place to provide cost-effective and coordinated care. One method of achieving these goals is a patient-centered medical home (PCMH) model, which is associated with provision of quality care among children belonging to racial/ethnic minorities. Despite the potential of the PCMH for children of minority backgrounds, little is known about the extent to which minorities with mental disorders have the PCMH. Objective: The study examined racial/ethnic disparities among children with mental disorders in accessing care from the PCMH. Methods: The 2009-2010 National Survey of Children with Special Health Care Needs (CSHCN) was used for this analysis. Multivariate logistic regressions were applied to capture the racial/ethnic disparities and to analyze a composite outcome of the PCMH. Results: An estimated population size of 4 677 904 CSHCN with mental disorders was included. Among them, 59.94% of children reported to have received medical homes. Compared with white children, the odds of receiving any medical home services decreased among Hispanic children (odds ratio [OR] = 0.69; P < .05) and black children (OR = 0.70; P < .05). The likelihood of having a medical home was lower for Hispanic children than white children, when they had attention deficit hyperactivity disorder (ADHD; OR = 0.57; P < .05) and development delay (OR = 0.73; P < .05). Compared with white children with ADHD or depression having a medical home, the odds of black children with ADHD (OR = 0.63; P < .05) and depression (OR = 0.68; P < .05) having a medical home were lower. Conclusions: There were significant racial/ethnic disparities among CSHCN with mental disorders, indicating several sizeable effects of each of the 5 components on Hispanic, black, and other children compared with white children. These differences could be a potential to improve racial/ethnic disparities.