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Bardel, Annika. "Women's Health and Drug Utilization." Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8225.
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<p><b>Objectives</b>. To study medication utilization and adherence to prescribed therapy in a female population in central Sweden. To study usage of hormone replacement therapy (HRT) in this population and to assess how HRT users compare to non-users regarding symptom reporting, general health and other variables. To evaluate symptom prevalence adjusted for potential symptom affecting variables. </p><p><b>Material and methods</b>. A cross-sectional postal questionnaire study was performed in 1995 in seven counties in central Sweden. A questionnaire was sent to a random sample of 4,200 women aged 35-64, of whom 2,991 responded (71.2%). The questionnaire contained questions on psycho-socio-economic background, quality of life, self-reported health, height and weight, climacteric symptom prevalence, and menopausal status and symptoms. It also comprised questions on medication prescribed during the past year. </p><p><b>Results</b>. 40% used prescribed medication and 12% took four drugs or more. Age, educational level, self-rated health, and BMI remained significantly correlated to drug use in multivariate analysis. Adherence ranged from 15%-98% depending on age, a scheduled check-up, perceived importance of medication, concern about medication, taking cardiovascular and respiratory disease drugs. The highest adherence was found for hormonal medication the lowest for musculoskeletal medication. </p><p>HRT was used by 15% of the women. 13 % used other symptom relieving therapy. HRT users reported higher score of vasomotor symptoms, except for sweating during the daytime. </p><p>Prevalence of general symptoms did not necessarily increase with age. Especially symptoms related to stress-tension-depression decreased with age. Four different symptom prevalence patterns were found. </p><p><b>Conclusions</b>. Age, health status, educational level and body mass index (BMI) appear to affect drug use. Adherence to therapy is highest among elderly women who regard their medication as important and have a scheduled check-up. HRT relieves some vasomotor symptoms but does not affect other symptoms or self-rated health. Prevalence of symptoms related to Stress-tension-depression appears to decrease with age.</p>
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Pittrow, David, Wilhelm Kirch, Peter Bramlage, et al. "Patterns of antihypertensive drug utilization in primary care." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-105346.
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Background: In the treatment of hypertension, physicians’ attitudes and practice patterns are receiving increased attention as contributors to poor blood pressure (BP) control. Thus, current use of antihypertensive drugs in primary care was analyzed and the association with selected physician and patient characteristics was assessed.
Methods: The Hypertension and Diabetes Risk Screening and Awareness (HYDRA) study is a cross-sectional point prevalence study of 45,125 primary care attendees recruited from a representative nationwide sample of 1912 primary care practices in Germany. Prescription frequencies of the various antihypertensive drugs in the individual patients were recorded by the physicians using standardized questionnaires. We assessed the association of patient variables [age, gender; co-morbidities such as diabetes, nephropathy or coronary heart disease (CHD)] and physician variables (general practitioner vs internist, guideline adherence, etc.) with drug treatment intensity and prescription patterns.
Results: Of all 43,549 patients for whom a physician diagnosis on hypertension or diabetes was available, 17,485 (40.1%) had hypertension. Of these hypertensive patients, 1647 (9.4%) received no treatment at all, 1191 (6.8%) received non-pharmacological measures only, and 14,647 (83.8%) were given one or more antihypertensive drugs. Drug treatment rates were lower in young patients (16–40 years: 57.4%). BP control was poor: 70.6% of all patients were not normalized, i.e., had BP ≥140/90 mmHg. Antihypertensive treatment was generally intensified with increasing age, or if complications or comorbidities were present. The use of the different drug classes was rather uniform across the various patient subgroups (e.g., by age and gender). Individualized treatment with regard to co-morbidities as recommended in guidelines was not the rule. Adherence to guidelines as self-reported by physicians as well as other physician characteristics (region, training etc.) did not result in more differentiated prescription pattern.
Conclusions: Despite the broad armamentarium of drug treatment options, physicians in primary care did not treat hypertension aggressively enough. Treatment was only intensified at a late stage, after complications had occurred. Treatment should be more differentiated in terms of coexisting morbidities such as diabetes, nephropathy, or CHD.
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Sousa, Helena Alexandra Soares Gama de. "Drug utilization studies: Focus on questionnaire design." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2007. http://hdl.handle.net/10216/22094.
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Sousa, Helena Alexandra Soares Gama de. "Drug utilization studies: Focus on questionnaire design." Dissertação, Faculdade de Medicina da Universidade do Porto, 2007. http://hdl.handle.net/10216/22094.
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Al-Dhewalia, Hamad Mohammed 1955. "The quality of drug prescribing in a multinational medical setting." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/276834.
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The objectives of this study were to investigate the hypotheses that: (1) Job satisfaction is related to medical specialty, the physician's nationality, and length of tenure. (2) The physician's attitude toward the Drug Utilization Review (DUR) program is related to medical specialty, the place of residency training, length of tenure, and job satisfaction. (3) The quality of drug prescribing is related to medical specialty, the place of residency training, length of tenure, job satisfaction, and the physician's attitude toward the DUR program. The results indicated a significant relationship between the physician's nationality and job satisfaction (P = 0.001), and between job satisfaction and the physician's attitude toward the DUR program (P 0.001). Medical specialty was a strong independent predictor of the quality of drug prescribing (P = 0.002). However, the other independent variables of the locale of residency training, length of tenure, job satisfaction, and the physician's attitude toward the DUR program were not related to drug prescribing.
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Kou, Maybelle Antonia Maria. "Quantitative and qualitative drug utilization studies in a university teaching hospital in Hong Kong." Thesis, [Hong Kong : University of Hong Kong], 1994. http://sunzi.lib.hku.hk/hkuto/record.jsp?B14436711.
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Kamat, Siddhesh Ajit. "Development and validation of a measure to assess physician readiness to prescribe drug therapies for post myocardial infarction patients." Morgantown, W. Va. : [West Virginia University Libraries], 2003. http://etd.wvu.edu/templates/showETD.cfm?recnum=3291.
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Thesis (M.S.)--West Virginia University, 2003.<br>Title from document title page. Document formatted into pages; contains xi, 124 p. : ill. (some col.) Includes abstract. Includes bibliographical references (p. 94-104).
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Kiivet, Raul-Allan. "Drug utilization studies as support to decisions in drug policy in Estonia /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3639-0/.
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Pittrow, David, Wilhelm Kirch, Peter Bramlage, et al. "Patterns of antihypertensive drug utilization in primary care." Technische Universität Dresden, 2004. https://tud.qucosa.de/id/qucosa%3A26584.
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Background: In the treatment of hypertension, physicians’ attitudes and practice patterns are receiving increased attention as contributors to poor blood pressure (BP) control. Thus, current use of antihypertensive drugs in primary care was analyzed and the association with selected physician and patient characteristics was assessed.
Methods: The Hypertension and Diabetes Risk Screening and Awareness (HYDRA) study is a cross-sectional point prevalence study of 45,125 primary care attendees recruited from a representative nationwide sample of 1912 primary care practices in Germany. Prescription frequencies of the various antihypertensive drugs in the individual patients were recorded by the physicians using standardized questionnaires. We assessed the association of patient variables [age, gender; co-morbidities such as diabetes, nephropathy or coronary heart disease (CHD)] and physician variables (general practitioner vs internist, guideline adherence, etc.) with drug treatment intensity and prescription patterns.
Results: Of all 43,549 patients for whom a physician diagnosis on hypertension or diabetes was available, 17,485 (40.1%) had hypertension. Of these hypertensive patients, 1647 (9.4%) received no treatment at all, 1191 (6.8%) received non-pharmacological measures only, and 14,647 (83.8%) were given one or more antihypertensive drugs. Drug treatment rates were lower in young patients (16–40 years: 57.4%). BP control was poor: 70.6% of all patients were not normalized, i.e., had BP ≥140/90 mmHg. Antihypertensive treatment was generally intensified with increasing age, or if complications or comorbidities were present. The use of the different drug classes was rather uniform across the various patient subgroups (e.g., by age and gender). Individualized treatment with regard to co-morbidities as recommended in guidelines was not the rule. Adherence to guidelines as self-reported by physicians as well as other physician characteristics (region, training etc.) did not result in more differentiated prescription pattern.
Conclusions: Despite the broad armamentarium of drug treatment options, physicians in primary care did not treat hypertension aggressively enough. Treatment was only intensified at a late stage, after complications had occurred. Treatment should be more differentiated in terms of coexisting morbidities such as diabetes, nephropathy, or CHD.
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De, Young Paul. "Effect of Medicaid prior authorization on drug utilization." CONNECT TO ELECTRONIC THESIS, 2007. http://dspace.wrlc.org/handle/1961/4249.
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Yeneneh, Hailu. "Antimalarial drug utilization by women in central Ethiopia." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=56968.
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A survey was undertaken to assess the knowledge, attitudes and practices, with respect to malaria, of 300 women from six randomly selected rural communities in Central Ethiopia from December 1991 to February 1992. Eighty-five per cent were able to recognize one or more of the common symptoms of malaria. Transmission was generally misunderstood and only 23% believed it could be prevented. More women preferred to obtain antimalarials from government clinics than from private drug shops, mission clinics, unofficial injectors, open markets or from leftover sources. Children under five were identified as the most malaria-vulnerable group and given priority for treatment. Severity of illness was the principal determinant in seeking treatment. Decisions were generally made jointly by both parents.<br>As distance from a health unit increased, knowledge about transmissibility of malaria decreased (OR =.48; 95% CI.27,.86). Logistic regression analysis showed literacy and village to be the most important variables associated with knowledge of prevention.
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Wettermark, Björn. "Drug utilization 90 % : using aggregate drug statistics for the quality assessment of prescribing /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-048-6/.
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Mannheimer, Buster. "Drug-related problems with special emphasis on drug-drug interactions." Stockholm : Department of Clinical Science and Education, Karolinska Institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-602-6/.
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Oguntunde, Olugbenga Olalere. "Drug prescribing practices among primary healthcare providers in a local government area of Northwestern Nigeria." University of the Western Cape, 2011. http://hdl.handle.net/11394/5378.
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Master of Public Health - MPH<br>Background: Drugs are essential components of the health system and their rational use is vital to delivering quality and efficient healthcare services. However, inappropriate prescribing is a common rational drug use problem globally, particularly in developing countries including Nigeria. Despite measures to address this problem, inappropriate drug use continues to be a major public health problem in Nigeria. Aim: This study assessed rational drug use (RDU), with a focus on rational prescribing and factors affecting it, among primary healthcare providers working in primary healthcare facilities of a LGA in Northwestern Nigeria.
Methods: The study was a cross sectional descriptive study and it included retrospective review of patient encounters and interviews with prescribing healthcare providers in sampled health facilities. Stratified random sampling method was used to select 20 public primary healthcare facilities and 30 patient encounters were drawn by systematic random sampling from each facility. One hundred and sixty three prescribing healthcare providers in the health facilities were also included in the study. Adapted WHO's drug use study tools and a structured self-administered questionnaire were used to collect data. Data were analysed using Statistical Package for Social Sciences (SPSS Version 17) software and presented as contingency table with chi square test used to test for relationship between variables with statistical significance taken at p < 0.05. Ethical approval was obtained from the University of the Western Cape Research Ethics Committee and Kaduna State Ministry of Health, and permission from local stakeholders. Confidentiality of individual patients, healthcare providers and health facilities data was maintained. Results: The prescribing staff at the selected facilities were predominantly Nurses/Midwives and community health assistants with SCHEWs constituting the majority (60.8%). More than half (54.4%) of providers did not know about the concept of RDU. Similarly, the computed knowledge score of RDU revealed that the majority (74.4%) had poor knowledge of the concept. Knowledge was significantly associated with duration of service, providers' previous training in rational drug use and professional status (p<0.05), with the CHOs having better knowledge of RDU compared with other professional cadres. High antibiotic use (68.3% in retrospective review and 82.9% in survey) and injection use (9.5% in retrospective review and 12% in survey) were found in the study with significant proportions of providers admitting that all cases of URTI should receive antibiotics (72.3% ) and that patients could be prescribed injections if they requested for it (35.3%). The Standing Order was the main source of information for the majority (50.6%) of providers and it served as the major influence affecting prescribing practices. Conclusion: This study revealed a poor understanding and knowledge of RDU among healthcare providers. High antibiotic and injection use also reflected providers' poor attitude to rational prescribing of these commodities. To improve prescribing practices at the PHC level, adequate staff skill mix, including physicians should be established. Since RDU knowledge was associated with prior training, curriculum development towards RDU and opportunities for in-service training should be provided to build prescribers capacity, in addition to instituting a system of rational drug use monitoring. Further research into rational drug use among different cadres of PHC healthcare providers is also recommended.
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Pierre, Karen Lucie. "An Exploratory Study of Adherence to Prescribed Health Care Recommendations Among a Community Sample of Drug Users and Non-Drug Users from Similar Neighborhoods in Miami-Dade County." Scholarly Repository, 2009. http://scholarlyrepository.miami.edu/oa_dissertations/421.
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This dissertation had three specific aims: to estimate the prevalence of adherence among drug users, to determine whether drug use was directly associated with adherence, and to assess whether factors drawn from the Behavioral Model of Health Care Utilization (BMHCU) are associated with adherence. The self-reported prevalence of adherence to prescribed health care recommendations in the past 12 months among the community sample of drug users and non-drug users from similar low-income areas in the study sample ranged from 53%-74%. Non-drug users consistently had higher rates of adherence than drug users, except for adherence to female health care recommendations, yet this difference was insignificant at the bivariate level. In the multivariate analysis, when controlling for all other variables within the BMHCU, only non-injection drug use was significantly associated with adherence to mental health care recommendations. In exploring its predictive utility, the BMHCU accounted for a range of 17% to 54% of the variance for the adherence measures. Although percentages accounted for by the BMHCU were substantial the fact that very few predictor variables were significant may indicate multicollinearity and other severe limitations with the data, such as small sample size, and the conceptualization of the adherence measure. The conceptualization of adherence remains an issue in need of further delineation. Further studies are needed in order to develop appropriate measures of adherence. Qualitative studies may be needed to further understand adherence among drug users.
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Barnard, Adam Johannes. "An investigation of medicine usage patterns and psychological well-being of a sample of South African Police Service members / A.J. Barnard." Thesis, Potchefstroom University for Christian Higher Education, 2001. http://hdl.handle.net/10394/1512.
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Howerton, Franklin Ray. "Veteran dedication makes them more efficient in receiving directions on medication, driving veterans to be more medication compliant." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1749.
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The purpose of this study was to determine if there is a relationship between having military discipline, the military rank, the branch of service, the number of years served, reserve status and if these factors would affect a veterans' compliancy in taking daily medication.
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Bardel, Annika. "Women's health and drug utilisation /." Uppsala : Acta Universitatis Upsaliensis, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8225.
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Beresford, Kathie L. "Assessment of drug prescription in the community : utilization of criterion-based guidelines /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0032/MQ47436.pdf.
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Miracle, Tessa. "Physician’s knowledge, attitudes, and utilization of the Prescription Drug Monitoring Program." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1593171776627526.
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Solomon, Matthew D. "The effect of cost-sharing on the utilization of prescription drugs for chronically ill patients." Santa Monica, Calif. : Rand, 2005. http://www.loc.gov/catdir/toc/fy0612/2006279614.html.
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Joshua, Isaac B. "The impact of an intervention program for the treatment of malaria in children in Papua New Guinea." Thesis, Curtin University, 2003. http://hdl.handle.net/20.500.11937/2339.
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Malaria is more prevalent today and the death toll is on the increase annually. It is one of the leading causes of morbidity and mortality worldwide and most of these deaths are in the poorest regions of the world. About 500 million cases are reported annually with more than 2 million deaths, and most are children. It is the major killer in the tropics and a major public health problem in developing countries and Papua New Guinea (PNG) is no exception. Resistant strains have been reported. This may be enhanced by inappropriate human behaviour in the use of anti-malarial drugs. Human factors include inappropriate prescribing and patient behaviour in using anti-malarial drugs. Despite the establishment of the standard treatment guidelines for malaria in PNG, three out of every four patients have chloroquine-resistant falciparum malaria and malaria remains a major health problem. The aim of this study was to evaluate the influence of an education program on patients carers' understanding and effective use of anti-malarial drugs for the treatment of uncomplicated malaria in children in general health clinics in PNG. The trial design involved a pre-post intervention study with a control group. The study was undertaken in the National Capital District. Papua New Guinea using one Clinic as the intervention site and another as the control site. The two clinics were similar in characteristics as confirmed in the study by demographic data where there were no significant differences observed. The data collection took placed over the period February to April 2002. It included observation of drug provision at study sites and interviews of patient carers on the first day at the clinic and a follow up seven days later. Three questionnaires were developed to evaluate the process and outcomes of malaria drug treatment in the above health facilities.Prescribing data were collected from prescriptions and patient carers' interviewed prior to the intervention program. Following the provision of drug information to patient carers. similar drug information and compliance questioning was undertaken. Differences in the pre-post elements of the study and in the control group over the study period were evaluated using Chi-Squared, Kruskal-Wallis, Fisher's Exact or Student's t-tests as appropriate. In excess of 100 patients in the pre- and in the post intervention phases were evaluated for their understanding and effective use of the anti-malarial drugs. In addition, 100 clients were in the control group at another clinic. Patients had attended the clinic up to 8 times in the previous year with a median of 2 visits. Amodiaquine, Fansidar, albendazole and paracetamol made up a total of 60% of the drugs prescribed. The use of medicines was strongly supported with 94.4% indicating no problems with the medication. Only 3% of patients received herbal or local remedies for malaria treatment. 1n patients 10 years or less or their carers, it was found, there was a significant improvement in the carers understanding of the medications. There was a statistically significant improvement in patient outcomes from 57.9% to 92.3% reported as cured following the intervention program. The study has also identified low levels of appropriate administration of antibiotic suspensions in children by patient carers.For example, incorrect responses recorded for amoxycillin suspension were 80.8% (143). Septrim tablets 92% (23), Septrim suspension 86% (123), erythromycin suspension 100% (26), and chloramphenicol suspension 84.4% (38). In this study the face to face (one-to-one) education program was used to influence patient carers understanding and effective use of drugs. The intervention program involved advising, informing, encouraging, and counselling the patient carers verbally on the appropriate and effective use of medicines. The verbal message was reinforced by a suitable label typed in English and Pidgin-English where instructions were clear, simple and unambiguous. The label was then attached to the envelopes or containers containing the drugs. On feedback, the information on the understanding and effective use of drugs was re-emphasized to the carers to reinforce their understanding for future references. Results showed that the intervention program made an impact in improved patient carers understanding and effective use of drugs and children's health outcomes. In conclusion, it is evident that a patient intervention program designed to improve the dosages and frequency of administration of anti-malarial drugs in PNG had no statistically significant outcome. This may be because the current level of understanding was quite high (>70%) and the study experienced a ceiling effect. However, as shown in the results, the patient carers understanding on the appropriate and effective use of drugs was lower during the pre-intervention and control group.When compared clinic-pre with clinic-post, there was a significant difference (P < 0.05) in the cured group and the improved cure rate increases from 57.9% to 92.3%. When compared control pre with control post groups, there was no significant difference (P > 0.05) in the cured group. Therefore, the study identified an improvement in patient outcomes with respect to malaria. Hence. the simple intervention program in influencing patient carers understanding of the appropriate and effective use of medications led to a marked improvement in patient outcomes.
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Powell, Tammy Lynette. "A study of refill non-compliance and predictors of refill non-compliance to tricyclic and SSRI antidepressants in a population setting /." St. John's, NF : [s.n.], 1997.
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Thunander, Sundbom Lena. "The influence of gender and depression on drug utilization : Pharmacoepidemiological research in Sweden." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-330136.
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Background Drug use has increased over recent decades, and is especially great among women and among people with mental health problems. To take advantage of the full potential of drugs and to avoid drug-related problems, drug prescription needs to be correct and the drugs need to be taken according to the prescribed regimens. Research on drug utilization is thus important to the public health. Aim To study the influence of gender and depression on drug utilization, prescription of drugs and self-reported use of drugs, i.e. adherence. Methods The thesis included two population-based questionnaires and data from the Swedish Prescribed Drug Register (SPDR) covering Swedish citizens 18-84 years. The questionnaire in Study I and II included items on prescription drug use and adherence to treatment regimens; Study II also included the Hospital Anxiety and Depression Scale (HADS) for self-estimation of anxiety/depression. The questionnaire in Study III included the HADS and data from the SPDR on prescribed antidepressants. Study IV included data from the SPDR on all types of prescribed drugs. Results Men and women differed in non-adherent behaviours and reasons for non-adherence, for example, men were more likely to report forgetting to take the drug, while women were more likely to report adverse drug reactions (ADRs) as a reason for non-adherence. Further, both anxiety and depression were associated with non-adherence and with ADRs as a reason for non-adherence. In addition, men reported depression to a greater extent than women did but used antidepressants to a lesser extent, while women used antidepressants without reporting depression more often than men did, which may be a sign of under-treatment among men and over-treatment among women. Moreover, the associations between antidepressants and other types of drugs differed by gender; they were often specific, or stronger, in women than in men, which may be a sign of a gender difference in comorbidity between depression and other conditions. Conclusions Although the cross-sectional study design prevented confirmation of causality, the thesis found that gender and depression influence both prescription of drugs and adherence, and are thus important to pay attention to in clinical practice as well as research.
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Mabizela, Nontobeko. "Utilization of the Baylis-Hillman and related reactions in antiparasitic drug discovery." Master's thesis, University of Cape Town, 2003. http://hdl.handle.net/11427/6325.
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Bibliography: leaves 81-83.<br>Baylis-Hillman adducts and compounds containing quinoline moieties have been previously utilized extensively in the search for antiparasitic agents. Work in this dissertation describes a series of compounds based on the Baylis-Hillman and the related three-component aza Baylis-Hillman reactions synthesised for biological evaluation as potential inhibitors of two parasitic cysteine proteases (cruzain and Falcipain-2) and as antiparasitic agents. The utilization of polymer-supported bases in the Baylis-Hillman reaction is described. The use of ultrasound in combination with Lewis acids is also described in an attempt to improve the reaction rate.
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Giron, Maria Stella T. "The rational use of drugs in a population of very old persons /." Stockholm : [Karolinska institutets bibl.], 2002. http://diss.kib.ki.se/2002/91-7349-155-1.
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Williams, Kylie Anne. "Pharmacoepidemiology of nonprescription drugs." Thesis, The University of Sydney, 1998. https://hdl.handle.net/2123/27671.
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Background: In recent years there have been trends towards increased use of. nonprescription medicines and a greater number of products being switched from prescription-only to nonprescription status. When used properly nonprescription products can be safe and effective treatments, however it is not clear that patients do actually use these products in an appropriate
manner. Despite this, there is currently only low level monitoring of nonprescription medicines to assess their use, efficacy and safety under actual clinical conditions of use.
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Klarin, Inga. "Drug use in the elderly - are quantity and quality compatible /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-715-4/.
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Smart, Rosalind Vida May. "A study of the use of prescription and non-prescription drugs by an elderly population of the Southern Peninsular area of Cape Town." Master's thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/26567.
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The aims of this research were to establish the drug use patterns of an elderly population in the southern suburbs of the Cape peninsula and to determine the extent of knowledge with respect to their medicines. In addition, the relationship between drug use patterns and medication knowledge and the socioeconomic status of the elderly, the health care services utilised by them and the amount of information conveyed on medicine container labels was assessed. Two hundred and sixty non-institutionalised Caucasian elderly over the age of 65 years and living in old age residences were interviewed. The interviews were structured with 4 major components: 1. a questionnaire designed to collect participant particulars; 2. an interview schedule to collect information on drug use patterns and to assess participant knowledge of medicines used (Knowledge score). 3. a container label assessment schedule (Label score); 4. a cognitive function test to identify and exclude severely cognitively impaired elderly from the study population. Analysis of the data showed the majority of the participants were English-speaking women of social class 1 or 2. Approximately one fifth of all participants were male. The State-run health care services were utilised by 38% of the participants whilst 73% retained their own general practitioner. A total of 843 medicines were used with an average of 3.2 medicines per capita. Ninety-five percent of all participants took prescribed medicines, with diuretics, non-narcotic analgesics/antipyretics, and tranquillisers the 3 most frequently prescribed classes. A smaller percentage - 41.5% - of participants used self-prescribed medicines, of which non-narcotic analgesics, homeopathic and herbal medicines, and vitamins were taken most frequently. When assessed against container label directions approximitely one third of participants were non-compliant with their dosage regimens. The majority of all medicines had been used on a continuous basis for 1 to 10 years. Average knowledge score was 58%. The majority of participants had very little knowledge about interactions, side effects, and maximum permissible dose for their medicines. Just over one fifth of all participants could correctly state both the name and the strength of their medicine. Average knowledge score was found to decline with increasing age, but no relationships were found to exist with the other patient characteristics. Similarly, no relationship was found to exist between knowledge score and label score. Participants utilising the public health care services tended to have a lower knowledge score than those receiving treatment from the private sector. Twenty-six percent of all labels did not have specific usage directions. The private sector suppliers were most frequently culpable of omitting instructions. Label legibility also proved to be a problem for the elderly participants. The drug use patterns identified in this study are similar to those of the American and British elderly and should be of value in compiling a health care plan for the South African elderly, although further research involving other race and cultural groups is needed.
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Sanders-Bonelli, Anna. "Predicting drug treatment utilization among White, African American, and Latina women the contribution of desistance theories /." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file 0.23 Mb., 127 p, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3220715.
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Nordin, Jelina. "Polypharmacy in the elderly: A deeper analysis of drug utilization in Sweden and Germany." Thesis, Uppsala University, Department of Pharmaceutical Biosciences, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-167142.
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Introduction: If a person uses many different drugs at the same time it can be termed “polypharmacy”. Polypharmacy is mostly seen in the elderly and often associated with negative aspects of drug treatment. Some negative consequences of using many drugs are a higher risk of drug-drug interactions and side effects and a lower patient compliance. The number of drugs defining polypharmacy can vary. But what does the number really tell? Aim: The aim of this work is to get a better picture of the medication of the elderly in Sweden and Germany. Which are the most common drugs used by the elderly with excessive polypharmacy (use of 10 or more drugs) in Sweden and Germany? Materials and Methods: A cross-sectional observational study was done using individual based drug dispensing data on elderly 65 years and older from the Swedish Prescribed Drug Register (1,4 million elderly) and Germany’s (AOK) drug register (5,3 million elderly). Period prevalence for the time interval October to December 2010 was calculated. Results: Many interesting differences were found comparing the drug treatment of the elderly with excessive polypharmacy in Sweden and Germany. In Sweden the most common drugs for this population were paracetamol (56%), acetylsalicylic acid (52%) and furosemide (42%), in Germany the use of torasemide (35%), simvastatin (35%) and pantoprazole (33%) dominated. Differences between the countries can partly depend on how common a disease is in a country, but also which drugs are available as OTC-drugs, the availability of guidelines/formularies and how physicians in a country follow them and differences in the availability of drugs in the market. Conclusions: When assessing drug use in terms of polypharmacy, the focus should not lie on the amount of drugs; the importance is which drugs are administered. Through international comparisons strengths and weaknesses of different countries’ drug treatment of the elderly can be found. The countries should support each other and make interventions. Hopefully a better drug treatment will be reached.
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Goldberg, Carmelle R. L. "The relationship between prescription drug utilization and employment for single mothers on social assistance." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0015/MQ57285.pdf.
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Martens, Kelly A. "Utilization of extreme drug resistance testing in malignant melanoma new is not always better." Gold Coast, QLD : Bond University, 2005. http://epublications.bond.edu.au/theses/martens.
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Thesis (DHlthSc) -- Bond University, 2005.<br>"A thesis submitted to Bond University in fulfillment of the requirements for the degree of Doctor of Health Sciences"-- t.p. Bibliography: pages 379-442. Also available via the World Wide Web.
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Abughosh, Susan M. "Drug benefit plans for elderly under managed care and utilization of lipid lowering agents /." View online ; access limited to URI, 2003. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3112111.
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Luu, Huong T. T. "USING PRESCRIPTION DRUG MONITORING DATA TO INFORM POPULATION LEVEL ANALYSIS OF OPIOID ANALGESIC UTILIZATION." UKnowledge, 2018. https://uknowledge.uky.edu/epb_etds/21.
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Increased opioid analgesic (OA) prescribing has been associated with increased risk of prescription opioid diversion, misuse, and abuse. States established prescription drug monitoring programs (PDMPs) to collect and analyze electronic records for dispensed controlled substances to reduce prescription drug abuse and diversion. PDMP data can be used by prescribers for tracking patient’s history of controlled substance prescribing to inform clinical decisions.
The studies in this dissertation are focused on the less utilized potential of the PDMP data to enhance public health surveillance to monitor OA prescribing and co-prescribing and association with opioid overdose mortality and morbidity. Longitudinal analysis of OA prescribing and evaluation of the effect of recent policies and opioid prescribing guidelines require consensus measures for OA utilization and computational tools for uniform operationalization by researchers and agencies. Statistical macros and computational tools for OA utilization measures were developed and tested with Kentucky PDMP data. A set of covariate measures using mortality and morbidity surveillance data were also developed as proxy measures for prevalence of painful conditions justifying OA utilization, and availability of heroin and medication treatment for opioid use disorder. A series of epidemiological studies used the developed OA measures as outcomes, and adjusted for time-varying socio-demographic and health care utilization covariates in population-averaged statistical models to assess longitudinal trend and pattern changes in OA utilization in Kentucky in recent years. The first study, “Trends and Patterns of OA Prescribing: Regional and Rural-Urban Variations in Kentucky from 2012 to 2015,” shows significant downward trends in rates of residents with OA prescriptions. Despite the significant decline over time, and after accounting for prevalence of injuries and cancer, the rate of dispensed OA prescriptions among residents in Kentucky Appalachian counties remained significantly higher than the rest of the state. The second study, “Population-Level Measures for High-Risk OA Prescribing: Longitudinal Trends and Relationships with Pain-Associated Conditions,” shows significant reduction in high-risk OA prescribing (e.g., high daily dosage, long-term use, concurrent prescriptions for OA and benzodiazepines) from 2012 to 2016, significantly positive associations between high-risk OA prescribing and cancer mortality rates with no substantial change in the association magnitude over time, and declining strengths of positive associations between high-risk OA prescribing and acute traumatic injuries or chronic non-cancer pain over the study period. The third study, “A Reciprocal Association between Longitudinal Trends of Buprenorphine/Naloxone Prescribing and High-Dose OA Prescribing,” indicates a significant reciprocal relationship between high-dose OA prescribing and buprenorphine/ naloxone prescribing, and a clinically meaningful effect of buprenorphine/naloxone prescribing on reducing OA utilization.
The results from the studies advanced the understanding of the epidemiology of opioid use and misuse in Kentucky, and identified actionable risk and protective factors that can inform policy, education, and drug overdose prevention interventions. The developed operational definition inventory and computational tools could stimulate further research in Kentucky and comparative studies in other states.
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Rahman, M. M. Habibur Som-arch Wongkhomthong. "Factors affecting utilization of drug cooperatives in Kampang Sean district of Nakorn Pathom province, Thailand /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-M.M.HabiburR.pdf.
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Joshua, Isaac B. "The impact of an intervention program for the treatment of malaria in children in Papua New Guinea." Curtin University of Technology, School of Pharmacy, 2003. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=13852.
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Malaria is more prevalent today and the death toll is on the increase annually. It is one of the leading causes of morbidity and mortality worldwide and most of these deaths are in the poorest regions of the world. About 500 million cases are reported annually with more than 2 million deaths, and most are children. It is the major killer in the tropics and a major public health problem in developing countries and Papua New Guinea (PNG) is no exception. Resistant strains have been reported. This may be enhanced by inappropriate human behaviour in the use of anti-malarial drugs. Human factors include inappropriate prescribing and patient behaviour in using anti-malarial drugs. Despite the establishment of the standard treatment guidelines for malaria in PNG, three out of every four patients have chloroquine-resistant falciparum malaria and malaria remains a major health problem. The aim of this study was to evaluate the influence of an education program on patients carers' understanding and effective use of anti-malarial drugs for the treatment of uncomplicated malaria in children in general health clinics in PNG. The trial design involved a pre-post intervention study with a control group. The study was undertaken in the National Capital District. Papua New Guinea using one Clinic as the intervention site and another as the control site. The two clinics were similar in characteristics as confirmed in the study by demographic data where there were no significant differences observed. The data collection took placed over the period February to April 2002. It included observation of drug provision at study sites and interviews of patient carers on the first day at the clinic and a follow up seven days later. Three questionnaires were developed to evaluate the process and outcomes of malaria drug treatment in the above health facilities.<br>Prescribing data were collected from prescriptions and patient carers' interviewed prior to the intervention program. Following the provision of drug information to patient carers. similar drug information and compliance questioning was undertaken. Differences in the pre-post elements of the study and in the control group over the study period were evaluated using Chi-Squared, Kruskal-Wallis, Fisher's Exact or Student's t-tests as appropriate. In excess of 100 patients in the pre- and in the post intervention phases were evaluated for their understanding and effective use of the anti-malarial drugs. In addition, 100 clients were in the control group at another clinic. Patients had attended the clinic up to 8 times in the previous year with a median of 2 visits. Amodiaquine, Fansidar, albendazole and paracetamol made up a total of 60% of the drugs prescribed. The use of medicines was strongly supported with 94.4% indicating no problems with the medication. Only 3% of patients received herbal or local remedies for malaria treatment. 1n patients 10 years or less or their carers, it was found, there was a significant improvement in the carers understanding of the medications. There was a statistically significant improvement in patient outcomes from 57.9% to 92.3% reported as cured following the intervention program. The study has also identified low levels of appropriate administration of antibiotic suspensions in children by patient carers.<br>For example, incorrect responses recorded for amoxycillin suspension were 80.8% (143). Septrim tablets 92% (23), Septrim suspension 86% (123), erythromycin suspension 100% (26), and chloramphenicol suspension 84.4% (38). In this study the face to face (one-to-one) education program was used to influence patient carers understanding and effective use of drugs. The intervention program involved advising, informing, encouraging, and counselling the patient carers verbally on the appropriate and effective use of medicines. The verbal message was reinforced by a suitable label typed in English and Pidgin-English where instructions were clear, simple and unambiguous. The label was then attached to the envelopes or containers containing the drugs. On feedback, the information on the understanding and effective use of drugs was re-emphasized to the carers to reinforce their understanding for future references. Results showed that the intervention program made an impact in improved patient carers understanding and effective use of drugs and children's health outcomes. In conclusion, it is evident that a patient intervention program designed to improve the dosages and frequency of administration of anti-malarial drugs in PNG had no statistically significant outcome. This may be because the current level of understanding was quite high (>70%) and the study experienced a ceiling effect. However, as shown in the results, the patient carers understanding on the appropriate and effective use of drugs was lower during the pre-intervention and control group.<br>When compared clinic-pre with clinic-post, there was a significant difference (P < 0.05) in the cured group and the improved cure rate increases from 57.9% to 92.3%. When compared control pre with control post groups, there was no significant difference (P > 0.05) in the cured group. Therefore, the study identified an improvement in patient outcomes with respect to malaria. Hence. the simple intervention program in influencing patient carers understanding of the appropriate and effective use of medications led to a marked improvement in patient outcomes.
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Shang, Baoping. "The cost and health effects of prescription drug coverage and utilization in the medicare population." Santa Monica, Calif. [u.a.] : RAND, 2005. http://www.rand.org/pubs/rgs%5Fdissertations/2005/RAND%5FRGSD197.pdf.
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Zhang, Tingting. "Asthma drug regimen optimality and health services utilization : a population-based analysis in British Columbia." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/44726.
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Background: Drug therapy is the mainstay medical treatment for asthma patients. Many asthma patients (up to 70%) receive suboptimal drug therapy. Inadequate use of inhaled corticosteroids (ICS) has been associated with increased emergency department (ED) visits and hospital admissions for asthma. To understand patients’ asthma drug use in British Columbia (B.C.) and improve health outcomes, this study describes the burden of asthma, identifies patients who received suboptimal asthma drug regimens according to asthma clinical practice guidelines, and examines the link between regimen optimality and health services utilization for asthma in an entire population with treated asthma in BC from 1996 to 2009.
Methods: A cohort of 336,901 asthma patients between 5–55 years of age was identified using provincial health services utilization data from 1996 to 2009. Annual patient medication dispensings of short-acting bronchodilators (SABA) with or without ICS were categorized into optimal or suboptimal regimens based on the asthma clinical practice guidelines. The association between regimen optimality and health services utilization was examined in one-year, as well as during a 14-year study period, using logistic regression models and Cox Proportional regression models, respectively.
Results: The prevalence (~2%) and incidence (0.7%) of asthma was stable in patients 5-55 years of age in B.C. from 1996 to 2009. Asthma-related specialist visits, ED visits and hospital admissions declined by over 50% during the study period. In 2009, patients with suboptimal regimens had significantly greater risk of using health services than patients with optimal regimens of SABA and/or ICS. Over time, switching from a suboptimal to an optimal drug regimen was associated with a 30% reduction in the use of hospital services for asthma
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(hazard ratio (HR) 0.71; 95% CI 0.54 – 0.93), and a 50% reduction in the use of ED services for asthma (HR 0.49; 95% CI 0.33 – 0.73).
Conclusions: Much of the healthcare burden associated with asthma is preventable by optimizing drug therapy, in particular, with improved ICS adherence. Identifying patients with suboptimal asthma management practices is a critical step in reducing the burden of asthma on the healthcare system and ultimately improving the quality of life of asthma patients.
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Bezzon, Vinicius Danilo Nonato. "Dispersões sólidas de cloridrato de verapamil em matriz poliuretânica para aplicação em sistema de liberação controlada : caracterização estrutural e aplicação do método PDF /." Bauru, 2017. http://hdl.handle.net/11449/150687.
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Orientador: Carlos de Oliveira Paiva Santos<br>Coorientador: Humberto Gomes Ferraz<br>Banca: Gabriel Lima Barros Araujo<br>Banca: João Cardoso de Lima<br>Banca: Ariel Gomez Gonzalez<br>Banca: Anderson Andre Felix<br>Resumo: Medicamentos de liberação controlada (MLC) vêm ganhando destaque no mercado farmacêutico nacional e internacional pelos seus mais diversos benefícios, principalmente por manter a atividade do princípio ativo (PA) no organismo em uma faixa constante de eficiência. Dentre os sistemas MLC estão as dispersões sólidas amorfas (DSA), que possuem como componentes o fármaco e a matriz polimérica. Devido à complexidade da estrutura de liberação destas dispersões, são necessárias técnicas e metodologias analíticas mais sofisticadas para o controle e qualidade da formulação final. A técnica de espalhamento total de raios X (ETRX) e o método Pair Distribution Function (PDF) vêm sendo utilizados no estudo de materiais com estrutura com ordem de curto e intermediário alcance, incluindo fármacos amorfos e nanocristalinos, além de dispersões sólidas fármaco/polímero, sendo possível fazer a distinção entre as fases a nível intra e intermoleculares, o que representa as potencialidades do ETRX e o PDF para a caracterização estrutural de materiais. Nesse contexto, desenvolveu-se a análise estrutural das DSA's do cloridrato de Verapamil e resina poliuretânica derivada do óleo de mamona por meio das técnicas RMN, FTIR e difração de raios X convencional. Por meio dessas análises criou-se o embasamento necessário para aplicar o ETRX e método PDF e avaliar as potencialidades no estudo de sistemas complexos, como os que foram objetos de análise neste trabalho. Os resultados mostraram que fármaco e res... (Resumo completo, clicar acesso eletrônico abaixo)<br>Abstract: Controlled-Release Drugs (CRD) have increasingly been chased by the national and international pharmaceutical market because their different benefits, mostly by it can keep the activity of the Active Pharmaceutical Ingredient (API) in the body in a continuous range of efficiency. Among others, CRD systems are the amorphous solid state dispersions, which have API and polymer matrix as components of the systems. Due to complexity of the release structure of these dispersions, sophisticated analytical techniques and methodologies are required for the control and quality of the final formulation. The X-ray total scattering technique (XRTS) and the Pair Distribution Function (PDF) method have been used to study materials with short- and intermediaterange order structure, including amorphous and nanocrystalline drugs, as well as drug/polymer solid dispersions, making it possible to discriminate between phases at intra and intermolecular levels, which represents the potentialities of the XRTS and the PDF for the structural characterization of materials. In this context, the present work has developed the structural analysis of the amorphous solid dispersions of Verapamil Hydrochloride and polyurethane resin derived from castor oil using NMR, infrared spectroscopy and conventional X-ray diffraction techniques. Through this initial analysis, it was possible to create the necessary basis for the application of XRTS and PDF method and evaluate its potential to study complex systems, suc... (Complete abstract click electronic access below)<br>Doutor
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Morello, Manuela Roque Siani. "Medicamentos psicoativos na rede pública de saúde de RibeirãoPreto-SP: perfil de utilização e fatores associados." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/60/60137/tde-30102014-163819/.
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O crescente consumo de medicamentos psicoativos (MPA) pela população brasileira e mundial no século XXI, atrelado ao fato de que algumas dessas substâncias podem gerar dependência física e/ou psíquica nos sujeitos que os utilizam, apontam para a necessidade de desenvolver estudos epidemiológicos que forneçam subsídios para o planejamento de intervenções em saúde que garantam o uso racional desses medicamentos. Este estudo transversal visa estimar a prevalência e caracterizar o perfil de utilização de MPA entre usuários de medicamentos atendidos por todas as farmácias das unidades de saúde do município de Ribeirão Preto-SP, relacionando esses achados com fatores associados ao consumo dessas substâncias. Uma amostra de 1355 usuários de medicamentos (psicoativos ou não) foi entrevistada nas filas das referidas farmácias de setembro a dezembro de 2012. Os pesquisadores coletaram dados sociodemográficos e relacionados à saúde dos indivíduos, além de registrarem todos os medicamentos contidos nas prescrições. Em seguida, três instrumentos foram aplicados para avaliar as variáveis clínicas (i) conhecimento dos indivíduos sobre a farmacoterapia, (ii) adesão à farmacoterapia e (iii) qualidade de vida relacionada à saúde (QdV). A prevalência de uso de MPA foi 31,0% (n=420), sendo que os mais prescritos foram antidepressivos (53,5%) e benzodiazepínicos (24,6%). A maioria dos usuários de MPA era do gênero feminino (81,9%), vivia com companheiro (52,6%), não trabalhava (70,7%), possuía plano de saúde privado (69,2%) e renda per capita de até um salário mínimo (54,0%), não realizava acompanhamento com psicólogo (93,3%), não praticava atividade física regular (78,3%), consumia café diariamente (81,0%), não consumia álcool (86,7%), não fumava (81,4%) e não encontrava-se em polifarmácia (62,4%). A idade média foi 54,5 (DP 13,9) e a escolaridade média correspondeu ao Ensino Fundamental incompleto. Pouco mais da metade dos usuários de MPA exibiram conhecimento satisfatório sobre a farmacoterapia e foram considerados aderentes (57,8% e 53,0%, respectivamente) e a maioria não apresentou QdV satisfatória (73,1%). Houve diferença estatisticamente significativa (p<0,05) entre usuários de MPA e não usuários para as variáveis gênero, faixa etária, situação conjugal, moradia, situação profissional, cuidador, acompanhamento com psicólogo, atividade física regular, consumo de álcool, tabagismo, polifarmácia, conhecimento médio sobre a farmacoterapia, adesão média à farmacoterapia, QdV satisfatória, índice médio EQ- 5D e QdV autorreferida média. Os valores de odds ratio (OR) ajustados mostraram que os fatores associados positivamente com o uso de MPA foram gênero feminino (OR = 2,02; IC 95% 1,31; 3,11) e maior idade (ORref./idosos = 0,36; IC 95% 0,13; 0,99). Dentre os usuários de benzodiazepínicos, 51,1% relatou estar em uso desses MPA há dois anos ou mais, dos quais 55,1% eram idosos. Aproximadamente um em cada três indivíduos utilizava pelo menos um MPA no período estudado, sendo que idosos e mulheres apresentaram maiores chances de uso. Os MPA mais prevalentes foram os antidepressivos e os benzodiazepínicos, sendo a maioria dos usuários destes últimos estava em tratamento com esses MPA há mais de dois anos, dos quais mais da metade eram idosos<br>The increasing consumption of psychoactive drugs (PAD) in Brazil and worldwide, linked to the fact that some of these substances can cause physical and/or psychic dependence in their users, indicate the need to develop epidemiological studies providing support for planning of health interventions so as to ensure the rational use of these medicines. This cross-sectional study aims to estimate the prevalence and characterize the usage profile of PAD among drug users served by all health facilities\' pharmacies in Ribeirão Preto-SP, relating these findings with factors associated with the consumption of these substances. From september to december 2012, a sample of 1355 drug users (psychoactive or not) was interviewed while waiting in the pharmacies to get their medication. The researchers collected sociodemographic and health related data of individuals, in addition to registering all drugs contained in prescriptions. Then, three instruments were applied to assess the clinical variables (i) knowledge of pharmacotherapy, (ii) adherence to the pharmacotherapy and (iii) health related quality of life (QoL). The prevalence of PAD usage was 31,0% (n = 420), and the most prescribed were antidepressants (53,5%) and benzodiazepines (24,6%). Most PAD users were female (81,9%), lived with a partner (52,6%), did not have a job (70,7%), had a private health insurance (69,2%) and income per capita up to the minimum wage (54,0%), did not undergo follow-up with a psychologist (93,3%), did not practice regular physical activity (78,3%), consumed coffee daily (81,0%), did not consume alcohol (86,7%), did not smoke (81,4%) and were not found in polypharmacy (62,4%). The mean age was 54,5 (SD 13,9) and the average schooling corresponded to incomplete primary education. Over half of the users of MPA exhibited satisfactory knowledge about pharmacotherapy and were considered adherent (57,8% and 53,0%, respectively), and most showed no satisfactory QoL (73,1%). There was a statistically significant difference (p <0.05) between PAD users and nonusers for the variables gender, age, marital status, housing, employment status, caregiver, follow up with psychologist, regular physical activity, alcohol consumption, smoking, polypharmacy, average knowledge about pharmacotherapy, mean adherence to pharmacotherapy, satisfactory QoL, mean EQ-5D index and average self-reported QoL. The adjusted odds ratios (OR) showed that the factors positively associated with the PAD use were female gender (OR = 2,02; 95% CI 1,31; 3,11) and age (ORref./elderly = 0,36, 95% CI 0,13; 0,99). Considering benzodiazepines users, 51,1% reported being in use these PAD for at least two years, 55,1% of whom were elderly. Approximately one in three individuals used at least one PAD in the period studied, while the elderly and women were more likely to use. The most prevalent PAD were antidepressants and benzodiazepines, with most users of the latter receiving these MPA for over two years, of which more than half were elderly.
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Lukaševičius, Artūras. "Namų ūkio vaistų krepšelio tyrimas ir vaistų vartojimo patirties vertinimas." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140618_233507-38413.
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Tyrimo tikslas – įvertinti namų ūkio vaistų krepšelį ir vaistų vartojimo patirtis.
Tyrimo uždaviniai: įvertinti vaistų krepšelio vertę, nustatyti farmakoterapines grupes, vaistų laikymo sąlygas, įvertinti vaistų tinkamumo terminus, vaistų utilizavimo įpročius bei nustatyti vaistų vartojimo patirtis.
Metodai. Atliktas kiekybinis tyrimas: respondentams pateikta anketa sudaryta iš 34 klausimų. Tyrime dalyvavo 148 respondentai. Respondentai buvo lankomi jų namuose: jiems pateikta pildymui anketa, tyrėjas vaistų registracijos lape registravo turimus vaistus. Statistinė duomenų analizė atlikta, naudojant statistinę programą IBM SPSS Statistics 20 versiją. Statistinių ryšių įvertinimui naudotas susijusių požymių χ2 (chi kvadrato) kriterijus, laisvės laipsnių skaičius ir statistinis reikšmingumas (p). Gautų duomenų tikrinimui pasirinktas statistinio reikšmingumo lygmuo lygus 0,05.
Rezultatai. Vaistų krepšelio vidutinė vertė buvo 241,9 Lt. Vidutinė vieno vaisto kaina siekė 14,96 Lt. Įvertinus vaistų krepšelio sudėtį nustatyta, kad vaistų krepšelyje vidutiniškai buvo 16,2 vaisto. 70,25% visų vaistų sudarė nereceptiniai vaistai. Daugiausiai užregistruota kvėpavimo sistemą veikiančių vaistų (24,57%), virškinimo traktą ir metabolizmą veikiančių vaistų (14,63%), nervų sistemą veikiančių vaistų (13,87%), raumenų ir skeleto sistemą veikiančių vaistų (13,83%). Nustatytas receptinių ir nereceptinių vaistų santykis – atitinkamai 1:2,36. Įvertinus vaistų laikymo sąlygas nustatyta, kad 18,92%... [toliau žr. visą tekstą]<br>Objective: To evaluate home medication cabinet and to fix drug using experience.
Tasks: To evaluate home medication cabinet price, to set pharmacological groups, to estimate drug storage, drug expiry date, to evaluate habits of expired drug utilization and to fix drug using experience.
Methods: Was made a qualitative study: questionnaire with 34 questions were given for respondents. Were 148 participants in study. They were visited in their homes: respondents filled in the questionnaire and their home medication cabinet was inventoried. Statistical data analysis was performed using the statistical software IBM SPSS Statistics 20 version. Statistical relationships were used to estimate the relevant features χ2 (chi-square) test, degrees of freedom and statistical significance (p). For received data verification chosen statistical significance level of 0.05.
Results: An average price of 241,9 Lt were estimated per home medication cabinet. 14,96 Lt was at an average price of one drug package. A mean of 16,2 drug packages were identified per household. Prescription medications accounted 70.25% of all drugs. The most frequently encountered categories of registered medicines were respiratory system drugs (24.57%), alimentary tract and metabolism drugs (14.63%), nervous system drugs (13.87%), musculo-skeletal system drugs (13.83%). Ratio of prescription and non-prescription drug was 1:2.36. In 18.92% of the cases, the drug packages were not stored safely: 18.47% were not stored in... [to full text]
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Daw, Jamie Roberta. "Prescription drug utilization in pregnancy : a systematic review and population-based study in British Columbia, Canada." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/28286.
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Background – There is little evidence on the patterns of prescription drug use during pregnancy
in Canada. To address this knowledge gap, the primary objectives of this thesis were to: 1)
systematically review published antenatal drug utilization studies, and 2) provide the first
Canadian evidence on prescription drug utilization across the pregnancy period, overall, by
therapeutic category and fetal risk classification, in the province of British Columbia (BC). Methods - This thesis is comprised of two original studies. The first, a systematic review of antenatal drug utilization studies, was conducted according to an a priori protocol and included a double independent review process for the selection of articles and data abstraction. The second, a population-based empirical study in BC, was based on pharmacy claims records linked to
maternal hospital records. The period of pregnancy was constructed from the recorded gestational age and prescriptions filled before, during, and after this period were analyzed. Drugs were classified according to the World Health Organization Anatomical Therapeutic Classification System and US Food and Drug Administration risk categories indicating potential for fetal harm (categories D and X).
Results – Published drug utilization studies reveal wide variation in estimates of overall
prescription drug use in pregnancy (27% to 93% excluding vitamins and minerals). However,
estimates are difficult to compare due to differences in methodology, data sources, classification
of prescription medicines, and inadequate reporting. In BC, the majority of pregnant women
(63%) filled at least one prescription in pregnancy and approximately 1 in 12 filled a prescription for a drug with potential risks (category D or X). The most commonly used medicines were antiinfectives, doxylamine, dermatologicals, and drugs acting on the nervous system.
Conclusion - A methodological framework and template for reporting exposures in pregnancy
should be developed to improve the quality and comparability of antenatal drug utilization
studies. Evaluation of medicines with unknown risks that are commonly used in pregnancy
should be a priority for pharmacoepidemiological research. The use of drugs with potential risks
should be targeted by programs to improve appropriate prescribing in pregnancy.
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Minasian, Hunt Christina Marie. "Fidelity Assessment of the Hillsborough County South Drug Court." Antioch University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1523287441160945.
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Santos, Luciana dos. "Medicamentos potencialmente perigosos, não aprovados e de uso off label em prescrições pediátricas de um hospital universitário." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/16641.
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Objetivos: Descrever o uso e determinar a prevalência de medicamentos potencialmente perigosos e de uso off label e não aprovados em prescrições de unidades de pediatria geral de um hospital universitário no sul do Brasil. Método: Estudo transversal, realizado de novembro de 2007 a janeiro de 2008, envolvendo pacientes até 14 anos de idade, com período de internação superior a 24 horas. Pacientes de unidades de terapia intensiva e oncologia pediátrica foram excluídos. A classificação quanto aos critérios de aprovação da Food and Drug Administration foi realizada pela fonte terciária DrugDex-Micromedex e a classificação dos potencialmente perigosos, pelo Institute for Safe Medication Practices. Resultados e discussão: No período de estudo foram analisadas 342 prescrições de 342 pacientes. O sexo masculino foi o mais freqüente (57%) e mais da metade dos pacientes já apresentavam doenças crônicas à internação. Analgésicos foi a classe terapêutica mais prescrita (26,9%) e entre os off label, os antiespasmódicos (31,5%) foram os mais prevalentes. Das prescrições analisadas, aproximadamente 39% tiveram pelo menos um medicamento de uso off label prescrito, principalmente em relação à indicação terapêutica (38,4%) e à idade (21,9 %), e 11,8% dos pacientes fizeram uso de fármacos não aprovados. Do total de itens (2026), cerca de 6% foram classificados como potencialmente perigosos, destacando-se os analgésicos opióides (35%). Não houve relação de associação entre medicamentos de uso off label e os potencialmente perigosos. Conclusão: As frequências encontradas de medicamentos off label e não aprovados estão de acordo com a literatura e podem ser consideradas elevadas. Os potencialmente perigosos, apesar da baixa prevalência, oferecem risco pelos efeitos prejudiciais que possam vir a causar nos pacientes. Assim, os medicamentos em destaque neste estudo representam uma preocupação constante em hospitais.<br>Objectives: Describe the use and determine the prevalence of high-alert medications, off label use and unlicensed drugs in prescriptions of general pediatric units of a university hospital in southern Brazil. Method: Cross-sectional study, performed from November 2007 to January 2008, involving patients up to 14 years of age, with admission period over 24 hours. Patients of intensive care and pediatric oncology units were excluded. The classification regarding the Food and Drug Administration approval criteria was performed according to the DrugDex-Micromedex tertiary source and the classification of high-alert medications according to the Institute for Safe Medication Practices. Results e discussion: In the study period, 342 prescriptions were analyzed. Males were more frequent (57%) and over half of the patients already presented chronic diseases for admission. Analgesic drugs were the most frequently prescribed therapeutic class of drugs (26.9%) and among the off-label drugs, antispasmodic drugs (31.5%) were the most prevalent. Around 39% of the analyzed prescriptions had at least one off-label use drug, especially in relation to therapeutic indication (38.4%) and age (21.9%), and 11.8% of the patients received unlicensed drugs. About 6% of the total items (2026) were classified as high-alert medications, such as opioid analgesic drugs (35%). No relation of association was observed between off-label use and high-alert medications. Conclusion: The frequency analyses found of off-label and unlicensed drugs are according to the literature and can be considered as high. The high-alert medications, although of low prevalence, offer risks due to negative effects that can occur in patients. Then, the drugs highlighted in this study constitute a constant concern in hospitals.
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Fitton, Catherine Alexandra. "Identifying adverse outcomes in neonates and children following in utero exposure to medication." Thesis, University of Aberdeen, 2019. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=240861.
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Introduction: Many medications have an unproven safety profile for use during pregnancy, leading to issues when chronic diseases, such as hypertension and depression, present during pregnancy. The focus of this research programme is to determine whether in utero exposure to antihypertensive and antidepressant medication is associated with increased risk of adverse events at birth, and up to 27 months of age in the child. Methods: Two systematic reviews were performed to identify current published literature and knowledge gaps. Following this, using Scottish healthcare data, a cohort of 268,711 children born 2010-2014 were identified. Following cleaning of the data, multiple imputation was used to account for missing values. Poisson, linear and multinomial regressions were performed to identify the relationship between in utero medication exposure and child outcomes. Results: In utero antihypertensive exposure was associated with preterm birth, low birth weight, small for gestational age, but not developmental issues. However, untreated hypertension was associated with low birth weight, preterm birth, and small for gestational age. In utero antidepressant exposure was associated with preterm birth, low birth weight, small for gestational age, preeclampsia, having a special needs indicator at 10 days and 6-8 weeks post-birth, developmental issues at 27 months Conclusions: This research programme identified several adverse outcomes following in utero exposure to antihypertensive and antidepressant medication.
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Nakaoka, Sachiko. "Prescribing pattern of anti-Parkinson drugs in Japan: a trend analysis from 2005 to 2010." 京都大学 (Kyoto University), 2014. http://hdl.handle.net/2433/193574.
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Nakaoka S, Ishizaki T, Urushihara H, Satoh T, Ikeda S, et al. (2014) Prescribing Pattern of Anti-Parkinson Drugs in Japan: A Trend Analysis from 2005 to 2010. PLoS ONE 9(6): e99021. doi:10.1371/journal.pone.0099021<br>Kyoto University (京都大学)<br>0048<br>新制・課程博士<br>博士(社会健康医学)<br>甲第18649号<br>社医博第61号<br>新制||社医||8(附属図書館)<br>31563<br>京都大学大学院医学研究科社会健康医学系専攻<br>(主査)教授 髙橋 良輔, 教授 川上 浩司, 教授 松原 和夫<br>学位規則第4条第1項該当
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Crispo, James Alexander George. "Pharmacotherapies in Parkinson Disease: Investigating Trends and Adverse Health Outcomes." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/35065.
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Parkinson disease (PD) is the second most common neurodegenerative disease worldwide, with estimates suggesting that PD prevalence and incidence will increase with aging populations. Therapeutic options and clinical guidelines for PD have significantly changed over the past 15 years; however, pharmacoepidemiology data in PD are lacking, especially regarding adverse effects of non-ergot dopamine agonists (DAs) and outcomes associated with anticholinergic burden. The objectives of this doctoral research are threefold: 1) examine patterns of antiparkinson drug use in relation to clinical guideline publication, drug availability, and emerging safety concerns; 2) determine whether PD patients treated with non-ergot DAs are at increased risk of adverse cardiovascular or cerebrovascular outcomes; and 3) determine whether anticholinergic burden is associated with adverse outcomes in PD. Specific research questions were investigated using epidemiological methods and electronic health data from Cerner Health Facts®, an electronic medical record database that stores time-stamped patient records for more than 300 Cerner subscribing facilities across the United States. Findings from this work are reported in a series of manuscripts, all of which have been published. Key findings include: 1) DA use began declining in 2007, from 34% to 27% in 2012. The decline followed publication of the American Academy of Neurology’s practice parameter refuting levodopa toxicity, pergolide withdrawal, and pramipexole label revisions; 2) heart failure was the only adverse cardiovascular or cerebrovascular outcome that demonstrated a significant association with non-ergot DA use, mainly pramipexole; and 3) anticholinergic burden in PD was associated with the diagnosis of fracture and delirium, and significantly increased the risk of emergency department visit and readmission post inpatient discharge. Reported antiparkinson prescribing trends suggest that safety and best practice information may be communicated effectively in PD. Although findings warrant replication, individuals with PD and independent risk factors for or a history of heart failure may benefit from limited use of pramipexole. Similarly, individuals with PD may benefit from substituting non-PD medications with anticholinergic effects for equally effective non-anticholinergic agents. Additional pharmacovigilance studies are needed to better understand health risks and the impact of population health interventions in PD.
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Chalker, John C. "Interventions for improved prescribing and dispensing of medicines in Nepal, Thailand and Vietnam /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-690-1.
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Rodrigues, Aline Teotonio 1984. "Análise de interações medicamentosas em prescrições de unidade de terapia intensiva do Hospital das Clínicas - HC Unicamp : importância da farmácia clínica em terapia intensiva." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309469.
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Orientador: Priscila Gava Mazzola<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas<br>Made available in DSpace on 2018-08-22T22:31:21Z (GMT). No. of bitstreams: 1
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Previous issue date: 2013<br>Resumo: A incidência de interações medicamentosas em prescrições de unidades de terapia intensiva (UTI) é conhecidamente superior ao número de interações observado em outros setores hospitalares. O nível de complexidade tecnológica desta unidade, o elevado número de medicamentos a que os pacientes estão expostos e as dificuldades inerentes aos cuidados críticos são fatores que evidenciam a necessidade de elaborada avaliação da farmacoterapia utilizada em medicina intensiva. A atuação do farmacêutico clínico, composta entre outros fatores, pelo rastreamento e detecção de interações medicamentosas potenciais teóricas (IMPT), pode ser vista como uma colaboração importante para a qualidade do serviço e mais uma contribuição para a segurança no uso dos medicamentos em UTI. Este estudo baseia-se na avaliação de uma amostragem de prescrições médicas de UTI e tem por objetivo avaliar a incidência de IMPT em prescrições feitas na Unidade de Terapia Intensiva (UTI) de um hospital da rede pública de saúde (Hospital de Clínicas - UNICAMP), quantificá-las e classificá-las quanto ao seu grau de severidade, traçando com isso um perfil das IMPT presentes nas prescrições deste setor. No período de janeiro a dezembro de 2011 foram avaliadas prescrições de 369 pacientes, todos maiores de 18 anos, média de idade de 57,03 ± 14,62, internados por mais de 24 horas na UTI adulto. Foram prescritos no período avaliado 205 diferentes tipos de medicamentos, média de 13,04 ± 4,26 por prescrição. Entre as prescrições avaliadas 89% apresentaram interações medicamentosas potenciais teóricas, obtendo-se uma média por prescrição de 5,00 ± 5,06. Os 405 tipos de IMPT observadas nas prescrições foram classificadas, utilizando a base de dados Micromedex®, destacando-se a prevalência das IMPT moderadas e graves, presentes em 74% e 67% das prescrições, respectivamente. Além dos dados relativos ao perfil farmacoterapêutico da UTI em estudo, foi observada ainda na pesquisa correlação estatisticamente significativa entre as IMPT e tempo de internação em UTI dos pacientes e o número de medicamentos prescritos. Os resultados encontrados contribuem para o delineamento do perfil de risco relativo às IMPT em terapia intensiva, demonstrando que há uma elevada incidência de interações medicamentosas potenciais moderadas em prescrições de UTI. Ressalta-se com ele a necessidade de atuação do farmacêutico clínico nesta área, a fim de contribuir com a equipe multidisciplinar na redução de riscos provenientes da terapia medicamentosa<br>Abstract: The incidence of drug interactions in prescriptions of intensive care units (ICU) is known to exceed the number of interactions than the observed in other hospital settings. The level of technological complexity of this unit, the elevated number of drugs to which patients are exposed and the difficulties inherent in critical care are factors that highlight the need for elaborated evaluation of pharmacotherapy used in intensive care medicine. The role of the clinical pharmacist, composed among other factors, by tracking and detection of theoretical potential drug interactions (TPDI), can be seen as an important contribution to the quality of service and as another security barrier to the use of medication in the ICU. This study is based on the evaluation of a sample of medical prescriptions of ICU and aims to assess the existence of theoretical potential drug interactions in prescriptions made in the Intensive Care Unit (ICU) of a public health hospital (Clinic Hospital - UNICAMP), to quantify and classify them as to their degree of severity, tracing with it a profile of present TPDI in this setting. From January to December 2011, prescriptions of 369 patients were evaluated, all over 18 years old, mean age of 57.03 ± 14.62, hospitalized for more than 24 hours in adult ICU. Two hundred five different types of drugs were prescribed in the study period, average of 13.04 ± 4.26 per prescription. Among the evaluated prescriptions, 89% presented theoretical potential drug interactions, resulting in an average of 5.00 ± 5.06 per prescription. The 405 types of observed TPDI in the prescriptions were classified using database Micromedex ®, highlighting the prevalence of moderate and severe TPDI present in 74% and 67% of prescriptions, respectively. In addition to the data on pharmacotherapeutic profile of ICU under study, it was observed in the survey statistically significant correlation between TPDI and duration of hospital stay in the ICU and the number of prescription drugs. The results contribute to design the relative risk profile of TPDI in intensive care, showing that there is a high incidence of moderate potential drug interactions in prescriptions of ICU. The results emphasized the need for performance of the clinical pharmacist in this area, in order to contribute to the multidisciplinary team to reduce risks from drug therapy<br>Mestrado<br>Ciencias Biomedicas<br>Mestra em Ciências Médicas