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Heck J, Stichtenoth DO, Sabau R, Schröder C, Engeli S, Pape T, O'Connell N, Schumacher C, Krause O, Koop F. Clinical-pharmacological drug information center of Hannover Medical School: experiences and analysis from a tertiary care university hospital. Sci Rep 2022; 12:19409. [PMID: 36371467 PMCID: PMC9653451 DOI: 10.1038/s41598-022-24005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
Drug information centers (DICs) are institutions dedicated to provide objective, independent, and up-to-date information on drugs and their rational use. To overcome the lack of recent DIC reports from central Europe, we analyzed all queries (n = 594) submitted to the DIC run by the Institute for Clinical Pharmacology of Hannover Medical School between October 2018 and April 2022. Approximately one in three queries (31.1%; 185/594) was submitted by internists. 82.8% (492/594) of the queries were patient-specific, while the remaining 17.2% (102/594) were general queries. Adverse drug reactions (ADRs), indications/contraindications, and pharmacodynamic interactions (PDIs) represented the three most frequently addressed query categories, being involved in 44.8% (266/594), 43.3% (257/594), and 34.3% (204/594) of all queries, respectively (assignment of more than one category per query was possible). As compared to general queries, patient-specific queries were statistically significantly more often related to ADRs, PDIs, and pharmacokinetic interactions (PKIs) (ADRs: 35.3% vs. 46.7%, P = 0.034; PDIs: 14.7% vs. 38.4%, P < 0.001; PKIs: 20.6% vs. 31.5%, P = 0.028). To demonstrate the complexity of queries submitted to the clinical-pharmacological DIC, we present and comment on an illustrative selection of queries.
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Affiliation(s)
- Johannes Heck
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Dirk O Stichtenoth
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Drug Commissioner of Hannover Medical School (Dirk O. Stichtenoth); Head of Pharmacovigilance of Hannover Medical School (Christoph Schröder), Hannover, Germany
| | - Ruxandra Sabau
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Christoph Schröder
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Drug Commissioner of Hannover Medical School (Dirk O. Stichtenoth); Head of Pharmacovigilance of Hannover Medical School (Christoph Schröder), Hannover, Germany
| | - Stefan Engeli
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Institute for Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Thorben Pape
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Nina O'Connell
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | | | - Olaf Krause
- Institute for General Practice and Palliative Care, Hannover Medical School, Hannover, Germany
- Center for Medicine of the Elderly, DIAKOVERE Henriettenstift, Hannover, Germany
| | - Felix Koop
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Muralidharan H, Venkatesan A, Venati R, Dhanasekaran ID, Suthahar T, Ahmed A, Salhotra A, Nair BB, Krishnan M, Rajanandh MG. Barriers of healthcare professionals in utilizing the service of drugs and poison information Centre: A cross-sectional study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 6:100142. [PMID: 35586749 PMCID: PMC9108987 DOI: 10.1016/j.rcsop.2022.100142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background Health care professionals (HCPs) have been using drugs and poison information centre (DIC) less frequently in recent years. The purpose of this study was to identify the barriers that inhibit HCPs from using the DIC service in a tertiary care hospital, as well as the factors that assist HCPs in using DIC more effectively. Methods A cross-sectional study was conducted among HCPs in Sri Ramachandra Institute of Higher Education and Research, Chennai. HCPs were given a semi-structured questionnaire that was developed and validated by a subject expert, a public health expert, and a clinical psychologist, and their barriers and facilitators in accessing drug information services were recorded. Findings A total of 405 HCPs responded to the survey. Among the identified barriers, the top 3 were: HCPs found it easier to use mobile internet (31%) and the department's reference library (25%) instead of contacting DIC for any drug/poison information. In addition, 17% of HCPs stated that they were too busy. The factors that may assist HCPs utilize DIC more effectively were more awareness is required to demonstrate the functionalities of DIC (24%), and a mobile application is required (23%). Conclusion Today's HCPs have easy access to a variety of drug information resources, and many prefer to do their own drug/poison research. As current generation HCPs find it more convenient to use mobile internet than contacting DIC, the creation of a mobile application for drug information service may enhance the number of questions from HCPs.
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Affiliation(s)
- Harini Muralidharan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Arthi Venkatesan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Rishitha Venati
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Indrani Devi Dhanasekaran
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Teshini Suthahar
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Abrar Ahmed
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Arushi Salhotra
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Bijisha Baburaj Nair
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Mohana Krishnan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Muhasaparur Ganesan Rajanandh
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
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Tekalign TG, Shiferaw MS, Hailegiyorgis TT, Embiale YB, Abebe FA. Hospital-based ciprofloxacin use evaluation in Eastern Ethiopia: a retrospective assessment of clinical practice. Pan Afr Med J 2021; 38:62. [PMID: 33889228 PMCID: PMC8028369 DOI: 10.11604/pamj.2021.38.62.21626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION ciprofloxacin is a second-generation fluoroquinolone, which has been used as one of the top three antibacterial agents prescribed in Ethiopia. However, its use has deviated from the recommendation of standard treatment guidelines resulting in a gradual increase in antimicrobial resistance. Therefore, this study aimed to evaluate the annual use of ciprofloxacin in 2016 based on the standard Ethiopian treatment and World Health Organization guidelines, in governmental hospitals, in Eastern Ethiopia from 1st May to 30th June 2018. METHODS a hospital-based retrospective cross-sectional study was conducted to evaluate medical records of patients who had taken ciprofloxacin in 2016. The total sample size (n=522) was proportionally allocated to each hospital based on the respective consumption data. A simple random sampling method was employed to collect the required sample. The collected data were entered into SPSS version 21 and analyzed using descriptive analysis. RESULTS in this study, 522 medical records were reviewed, with a male to female ratio of 1.03: 1. Ciprofloxacin was indicated in 478 (91.6%) participants whose age was greater than eighteen years. The majority were treated in the medical and emergency outpatient departments (n=477, 91.4%). Urinary tract infections (n=224, 42.9%), acute febrile illnesses (n=68, 13.0%), and typhoid fever (n=54, 10.4%) were the top indications to which ciprofloxacin was prescribed. Non-steroidal anti-inflammatory drugs (NSAIDs) (n=241, 34.7%) and antimicrobials (n=135, 19.6%) were among the most frequently co-indicated agents. Based on the standard Ethiopian treatment guidelines, therapy was appropriate in 30% (n= 159) of patients. The major reason for inappropriate utilization (95%) was the wrong duration of antibiotic use (n=228). Evaluation based on World Health Organization criteria showed that indication, dose, and frequency were in line with the recommendation. CONCLUSION ciprofloxacin was primarily indicated for urinary tract infections. The drug was appropriately used in less than one-third of patients, with the wrong duration being the main reason for overall inappropriate utilization. This trend may potentially impose a high risk to the emergence of drug-resistant microorganisms. To this end, further studies addressing the susceptibility pattern of bacterial isolates towards ciprofloxacin should be carried out.
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Affiliation(s)
- Tigist Gashaw Tekalign
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Mekonnen Sisay Shiferaw
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Tewodros Tesfa Hailegiyorgis
- Department of Microbiology, Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Yohannes Baye Embiale
- Department of Pediatrics and Neonatal Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| | - Firehiwot Amare Abebe
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
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Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic is a major global threat affecting millions of lives throughout the world physically and psychologically. With the asymptomatic presentation of COVID-19 in many patients and the similarity of its symptoms with the common cold and influenza, the need for accurate information on the disease is very important for its identification and proper management. Accurate information on the disease, its prevention and treatment can be disseminated through drug information centers (DICs). DICs are usually staffed by pharmacists and/or clinical pharmacists/pharmacologists. DICs are a reliable source of current and unbiased information on COVID-19 and its associated complications, including management options for healthcare professionals and the public. In addition to health and drug information, pharmacists working in the DICs can be involved in the management of the patients' health by providing information on home care and safety, medication management of patients with chronic comorbid illnesses, and psychological advice. This article explores the possible additional roles DICs can play, besides providing drug information within the hospital or in the community.
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Tefera YG, Gebresillassie BM, Ayele AA, Belay YB, Emiru YK. The characteristics of drug information inquiries in an Ethiopian university hospital: A two-year observational study. Sci Rep 2019; 9:13835. [PMID: 31554837 PMCID: PMC6761201 DOI: 10.1038/s41598-019-50204-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 09/05/2019] [Indexed: 11/09/2022] Open
Abstract
The types of drug-related information request from patients and health professionals, the extent of inquiry and capability of existing drug information centers are seldom studied in Ethiopia. This study aimed to identify the types and potential areas of drug information inquiry at the Drug Information Center (DIC) of Gondar University specialized Hospital (GUSH), Ethiopia. An observational study was employed. The drug information query was collected by distributing the drug information queries in different hospital units through two batches of graduating undergraduate pharmacy students. Descriptive statistics used to describe, characterize and classify drug related queries. Binary logistic regression test was employed to identify predictor variables to type of drug information query. A total of 781 drug related queries were collected and 697 were included in the final analysis. Near to half (45.3%) of queries comes from the pharmacists followed by general practitioners (11.3%) and nurses (10.2%). Slightly greater than half of the queries (51.9%) were focused on therapeutic information. 39.6% of drug related queries related to infectious disease case scenarios, followed by cardiovascular cases in 21.3% of queries. More than half of (53.9%) and nearly one in five (19.4%) of the queries took 5 to 30 minutes and 30 minutes to 1 hour of literature searching to answer, respectively. Pharmacists (with odds ratio of 2.474(95% CI (1.373-4.458)) and patients (with odds ratio of 4.121(1.403-12.105)) ask patient-specific questions in their drug related queries higher than other group of health professionals. Pharmacists are the primary drug information users and frequent drug related information inquirers at the DIC. Most of the queries targeted therapeutic indications, adverse drug events, infectious or cardiovascular disease related requests. This is imperative that drug information services can assist the growing role of pharmacists in addressing the patient specific drug related needs.
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Affiliation(s)
- Yonas Getaye Tefera
- Department of Clinical pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.
| | - Begashaw Melaku Gebresillassie
- Department of Clinical pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
| | - Asnakew Achaw Ayele
- Department of Clinical pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
| | - Yared Belete Belay
- Department of pharmaceutics, unit of Social Pharmacy, Mekelle University, Mekelle, Ethiopia
| | - Yohannes Kelifa Emiru
- Department of pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
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Hailu HG, Gobezie MY, Yesuf TA, Workneh BD. Critical evaluation of the validity of drug promotion materials in Ethiopia. Drug Healthc Patient Saf 2019; 11:47-54. [PMID: 31440103 PMCID: PMC6664250 DOI: 10.2147/dhps.s200487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/03/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study was conducted to evaluate the validity of drug promotion materials (DPMs) in Ethiopia. METHODS A cross sectional document review was done. DPMs were evaluated for fulfilment of the World Health Organization's (WHO) criteria for ethical promotion of drugs. They were also evaluated for font size, type of formulation, claims made, pictures depicted, retrievability and source of references used. RESULTS A total of 235 DPMs were collected from the community and hospital pharmacies. Documents promoting devices and equipment, orthopedic appliances, reminder cards and drug lists were excluded, leaving 173 promotional materials. Antimicrobials were the most promoted drugs (27.2%) followed by respiratory drugs (11.0%) and gastrointestinal drugs (9.8%). Brand name was written in all of the DPMs while approved generic names, indication and active ingredient per dosage form were written in 94.8%, 92.5% and 62.4% respectively. Side effects and contraindications were written in 27.2% and 18.5% of the DPMs. A total of 223 claims were made. Efficacy was the dominant claim (62.3%) followed by safety (8.5%). Pictorial demonstrations were used in 84.4% of the DPMs. Almost half of the pictures depicted, 47.3%, were the cover of the drug products. Only 48.6% of the DPMs has supported their claims with references. Review articles account for 23.3% of the references. Only 5.8% of the journal articles were published after the year 2013. CONCLUSION We conclude that the design and content of studied drug promotional materials are most effective as sales materials rather than thorough informational vehicles. The WHO and Food, Medicine and Health Care Administration and Control Authority of Ethiopia recommendations are rarely met.
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Affiliation(s)
| | - Mengistie Yirsaw Gobezie
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Teshager Aklilu Yesuf
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Birhanu Demeke Workneh
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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