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Abstract
Introduction: This systematic review aimed to assess efficacy and safety for skin-applied formulations containing CBD. Methods: Bibliographic and clinical trial registries were searched for interventional human trials using cutaneously administered CBD or reported plasma CBD concentrations (any species). Results: Eight of 544 articles fitted the selection criteria: 3 placebo-controlled randomized and 5 single-arm trials. Eleven more studies were found in clinical trial databases but not accessible. Symptoms targeted were dermatopathologies or safety (two studies), pain (two), and behavior (one). Doses were 50-250 mg or 0.075-1.0% CBD, but coformulated with other ingredients. Risk of bias was high and reporting deficiencies further compromised data reliability. Diverse methodologies and formulations hampered syntheses for CBD dose, efficacy, and safety. Plasma CBD levels in dogs and rodents were 0.01-5 μM translating to <100 nM free, unbound CBD in humans. Adverse events were uncommon and mild, but meaningless without CBD's contribution to efficacy data. Achievable free CBD plasma concentrations ∼100 nM can interact predominantly with high-affinity CBD targets, for example, TRPA1 and TRPM8 membrane channels that are abundantly expressed in pathological conditions. Even if reached, higher CBD concentrations on less susceptible targets risk complex and unsafe CBD therapy. A conceptual framework is proposed where dermal capillary loops create sinking for topical CBD demonstrating parallels between topical and transdermal CBD administration. Conclusions: Users risk generalizing inadequately designed trials to all CBD preparations. New clinical trials are urgently needed: they must demonstrate that outcomes are solely from CBD pharmacology, are reliable, unbiased, safe, and comparable. Measurements of sustained plasma CBD levels are mandatory, irrespective of administration route for successful translation from in vitro systems that express human molecular targets. Placebos must be appropriate. Transcutaneous and topical formulations need preliminary in vitro studies to optimize CBD skin penetration. Then, users can rationally balance efficacy against potential harms and cost-effectiveness of CBD formulations.
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Affiliation(s)
- C N Scholfield
- Akkhraratchakumari Veterinary College, Walailak University, Thai Buri, Nakhon Si Thammarat, Thailand
| | - Neti Waranuch
- Cosmetics and Natural Products Research Center, Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, Thailand
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
- The Research Centre for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
- Department of Practice and Policy Research, School of Pharmacy, University College London, London, United Kingdom
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Abdel-Qader DH, Abdel-Qader H, Silverthorne J, Kongkaew C, Meslamani AZA, Hayajneh W, Alwahadneh AM, Hamadi S, Abu-Qatouseh L, Awad R, Al Nsour M, Alhariri A, Shnewer K, Da'ssan M, Obeidat NM, Nusair KE, Jalamdeh MS, Hawari F, Asad M, AbuRuz S. Real-World Effectiveness of Four Types of COVID-19 Vaccines. Vaccines (Basel) 2023; 11:vaccines11050985. [PMID: 37243089 DOI: 10.3390/vaccines11050985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND There is a scarcity of evidence regarding the real-world effectiveness of coronavirus disease 2019 (COVID-19) vaccines. This was the first study to evaluate the effectiveness of four types of vaccines against asymptomatic and symptomatic infection, and COVID-19 outcomes among the general population. METHODS This was a matched comparison group quasi-experimental study conducted in Jordan between 1 January and 29 August 2021. In the first part of the study, 1200 fully vaccinated individuals were matched with 1200 unvaccinated control participants. In order to measure vaccine effectiveness, the infection rates of both vaccinated and unvaccinated groups were calculated. The second part of the study included measuring specific anti-SARS CoV-2 immune cells and antibodies. RESULTS BNT162b2 (Pfizer, New York, NY, USA) showed a significantly higher effectiveness against asymptomatic COVID-19 infection (91.7%) and hospitalization (99.5%) than BBIBP-CorV (Sinopharm, Beijing, China) (88.4% and 98.7%, respectively) and ChAdOx1 nCoV-19 (AstraZeneca, Cambridge, UK) (84.3%, and 98.9%, respectively). The effectiveness rates of the Sputnik V (Gamaleya Research Institute, Moscow, Russia) vaccine against asymptomatic, symptomatic, and hospitalization were 100%, 100%, and 66.7%, respectively. The highest median anti-spike (S) IgG values were seen in individuals who received BNT162b2 (2.9 AU/mL) and ChAdOx1 nCoV-19 (2.8 AU/mL) vaccines. The levels of anti-S IgG were significantly decreased after 7 months of vaccination with BNT162b2 and BBIBP-CorV. There were significant decreases in the median number of neutralizing antibodies one month and seven months after receiving BNT162b2 (from 88.5 to 75.2 4 Bioequivalent Allergen Unit per milliliter/mL), BBIBP-CorV (from 69.5 to 51.5 BAU/mL), and ChAdOx1 nCoV-19 (from 69.2 to 58.BAU/mL) vaccines. The highest percentage of T cells specific to COVID-19 vaccine was found in individuals who received BNT162b2 (88.5%). CONCLUSION All four vaccines evaluated in this study showed effectiveness against asymptomatic COVID-19 infection, symptomatic infection, hospitalization, and death. Furthermore, BNT162b2, BBIBP-CorV, and ChAdOx1 nCoV-19 induced high levels of immunology markers within one month of vaccination.
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Affiliation(s)
- Derar H Abdel-Qader
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
- Al Rashid Hospital Center, Amman 11623, Jordan
| | | | - Jennifer Silverthorne
- Division of Pharmacy & Optometry, The University of Manchester, Manchester M13 9PL, UK
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Naresuan University, Phitsanulok 65000, Thailand
| | - Ahmad Z Al Meslamani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi P.O. Box 112612, United Arab Emirates
- College of Pharmacy, Al Ain University, Abu Dhabi P.O. Box 64141, United Arab Emirates
| | - Wail Hayajneh
- School of Medicine, St. Louis University, St. Louis, MO 63104, USA
- School of Medicine, Jordan University of Science & Technology, Irbid 3030, Jordan
| | | | - Salim Hamadi
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Luay Abu-Qatouseh
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Riad Awad
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan
| | - Mohannad Al Nsour
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11195, Jordan
| | | | | | | | - Nathir M Obeidat
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | | | | | - Mohammad Asad
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11195, Jordan
| | - Salah AbuRuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, The United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan
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Dechanont S, Jedsadayanmata A, Butthum B, Kongkaew C. Hospital Admissions Associated With Medication-Related Problems in Thai Older Patients: A Multicenter Prospective Observational Study. J Patient Saf 2021; 17:15-22. [PMID: 31738194 DOI: 10.1097/pts.0000000000000627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to estimate the prevalence rate and risk factors of medication-related problems (MRPs) leading to hospital admissions in Thai older patients. METHODS A prospective observational study was carried out in nine hospitals in Lower Northern Thailand. Participants admitted to internal medicine units were screened for suspected MRPs by clinical pharmacists using medical record review and patient interview. Three experts evaluated suspected MRPs independently using the following four criteria: contribution of MRPs to hospital admissions, causality, severity, and preventability. RESULTS Of 1776 patients admitted during the study period, 56 patients (3.2%) were deemed to have causal MRPs; 24 (42.9%) were judged as preventable. The medication groups most commonly associated with MRPs were those targeting the endocrine system, especially antidiabetic medications, such as metformin and glipizide. Preventable MRPs were usually manifest as hypoglycemia (n = 15, 62.5%). The variables that contributed to hospital admissions associated with MRPs were age (odds ratio = 1.92; 95% confidence interval [CI] = 1.06-3.47), starting a new drug within 1 week (odds ratio = 2.31; 95% CI = 1.08-4.95), or within 1 month (odds ratio = 2.17; 95% CI = 1.05-4.48). CONCLUSIONS Hospital admissions associated with MRPs in Thai older patients continue to burden the Thai healthcare system of which nearly half were preventable. Further studies should consider analysis of costs and include hepatic and renal function status of participants.
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Affiliation(s)
- Supinya Dechanont
- From the Center for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok
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Kongkaew C, Methaneethorn J, Mongkhon P, Dechanont S, Taburee W. Drug-Related Problems Identified at Patients' Home: A Prospective Observational Study in a Rural Area of Thailand. J Patient Saf 2021; 17:8-14. [PMID: 28662001 DOI: 10.1097/pts.0000000000000404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to examine the prevalence rates, nature, and predictors of drug-related problems (DRPs) experienced in participants living at home in a rural Thailand. METHOD A cross-sectional observational study was undertaken during December 2015 to January 2016. Drug-related problems were identified within a rural township having a population of 5256 by means of home visits by pharmacists. All suspected cases were then assessed for severity and preventability by clinical specialists. Drug-related problems were categorized according to Pharmaceutical Care Network Europe classification (revised 2010).v.6.2. RESULTS From a systematically recruited cohort of 359 participants, suspected DRPs were identified in 160 participants. After detailed reviews by clinical specialists, 141 cases (39.3%) were deemed to have DRPs. Types of DRPs with prevalence rates were the following: problems of treatment effectiveness (3.7% of DPRs), adverse reactions (15.3%), treatment cost (28.4%), nonadherence to drugs (42.1%), and poor drug storage (10.5%). The most common drug to involve DRPs was those treating cardiovascular disease, especially simvastatin. CONCLUSIONS Nearly half of community living participants experienced DRPs, especially nonadherence to drugs, and has implications for other rural elderly persons of low education attainment for similar rural economies around the globe. Appropriate interventions should focus on reducing polypharmacy, providing outreach programs, and rigorous pharmacovigilance.
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Affiliation(s)
- Chuenjid Kongkaew
- From the Center for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok
| | - Janthima Methaneethorn
- From the Center for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok
| | | | - Supinya Dechanont
- From the Center for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok
| | - Watcharaporn Taburee
- Department of Family medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
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Dechanont S, Jedsadayanmata A, Butthum B, Kongkaew C. Hospital Outpatient Visits Associated With Medication-Related Problems in Thailand: A Multicenter Prospective Observational Study. J Patient Saf 2021; 17:1-7. [PMID: 28230579 DOI: 10.1097/pts.0000000000000367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aims of the study were to investigate the prevalence of hospital visits associated with medication-related problems (MRPs, i.e., adverse drug events [ADEs], adverse drug reactions [ADRs], nonadherence [NA] to medication, and medication error) and to identify the medications involved in hospital visits associated with MRPs in outpatient departments (OPDs). METHODS A prospective observational study was carried out in OPD of 11 hospitals in the lower northern region of Thailand. Patients visiting OPDs were screened for suspected MRPs by clinical pharmacists using medical record review supplemented by patient interview. Three experts evaluated suspected MRPs using the following 3 criteria: causality, severity, and preventability. RESULTS Of the 3069 patients who visited the OPDs during the study period, 113 (3.7%) were deemed to have causal MRPs. Nearly half of the causal MRPs (n = 49, 43.4%) were preventable. The following 4 types of causal MRPs were identified: ADEs (n = 112, 3.7%), ADRs (n = 65, 2.1%), NA to medications (n = 48, 1.6%), and medication errors (n = 1, 0.03%). In nonelective patients (n = 764), 35 patients (4.6%) were judged to have causal MRPs. Of the nonelective patients who experienced causal MRPs, 25 (71.4%) were preventable. The medications commonly associated with ADEs and NA to medication were those targeting the cardiovascular system (especially enalapril, amlodipine, and hydrochlorothiazide), whereas the medications involving ADRs involved the cardiovascular and endocrine systems (especially, enalapril, amlodipine, and metformin). CONCLUSIONS Outpatient department visits associated with MRPs, particularly in nonelective patients, were preventable. Effective strategies are needed for reducing visits to hospital OPD associated with preventable MRPs.
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Affiliation(s)
- Supinya Dechanont
- From the Center for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok
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Subsoontorn P, Lohitnavy M, Kongkaew C. The diagnostic accuracy of isothermal nucleic acid point-of-care tests for human coronaviruses: A systematic review and meta-analysis. Sci Rep 2020; 10:22349. [PMID: 33339871 PMCID: PMC7749114 DOI: 10.1038/s41598-020-79237-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/04/2020] [Indexed: 02/01/2023] Open
Abstract
Many recent studies reported coronavirus point-of-care tests (POCTs) based on isothermal amplification. However, the performances of these tests have not been systematically evaluated. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy was used as a guideline for conducting this systematic review. We searched peer-reviewed and preprint articles in PubMed, BioRxiv and MedRxiv up to 28 September 2020 to identify studies that provide data to calculate sensitivity, specificity and diagnostic odds ratio (DOR). Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was applied for assessing quality of included studies and Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) was followed for reporting. We included 81 studies from 65 research articles on POCTs of SARS, MERS and COVID-19. Most studies had high risk of patient selection and index test bias but low risk in other domains. Diagnostic specificities were high (> 0.95) for included studies while sensitivities varied depending on type of assays and sample used. Most studies (n = 51) used reverse transcription loop-mediated isothermal amplification (RT-LAMP) to diagnose coronaviruses. RT-LAMP of RNA purified from COVID-19 patient samples had pooled sensitivity at 0.94 (95% CI: 0.90-0.96). RT-LAMP of crude samples had substantially lower sensitivity at 0.78 (95% CI: 0.65-0.87). Abbott ID Now performance was similar to RT-LAMP of crude samples. Diagnostic performances by CRISPR and RT-LAMP on purified RNA were similar. Other diagnostic platforms including RT- recombinase assisted amplification (RT-RAA) and SAMBA-II also offered high sensitivity (> 0.95). Future studies should focus on the use of un-bias patient cohorts, double-blinded index test and detection assays that do not require RNA extraction.
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Affiliation(s)
- Pakpoom Subsoontorn
- Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, 65000, Thailand.
| | - Manupat Lohitnavy
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
- Center of Excellence for Environmental Health and Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, 65000, Thailand
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
- Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, 65000, Thailand
- Research Department of Practice and Policy, UCL School of Pharmacy, 29-39 Brunswick Square, London, WC1N 1AX, UK
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Kongkaew C, Meesomperm P, Scholfield CN, Chaiwiang N, Waranuch N. Efficacy and Safety of Centella Asiatica ( L.) Urb. on Wrinkles: A Systematic Review of Published Data and Network Meta-Analysis. J Cosmet Sci 2020; 71:439-454. [PMID: 33413787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Centella asiatica has many applications in cosmetics, including wrinkle treatments, but its effectiveness remains to be clarified. This systematic review study aimed to demonstrate the efficacy and safety of C. asiatica for reducing facial wrinkles. PubMed, Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of clinical trials, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Thai Library Integrated System, and Thai university database/journals were searched until May 2019. Five double-blinded randomised controlled trials, including 172 Asian females, were included. Endpoints were wrinkling measured by visual score, image analysis, and participant satisfaction. Two placebo-controlled studies applied gel/creams containing C. asiatica or asiaticoside for 12 w to periorbital skin. Two studies applied tretinoin or Pueraria mirifica contralaterally and by network meta-analysis C. asiatica appeared more effective than P. mirifica but possibly less than tretinoin. Asiaticoside applied as a lipstick for 8 w reduced lip wrinkling. Skin hydration was markedly raised by C. asiatica but not tretinoin. One study reported 10 adverse events for C. asiatica and 35 for tretinoin. Cochrane risk of bias was generally low, reporting was weak, and lack of C. asiatica standardization prevents general application. From the reported data, it is possible to conclude that C. asiatica improved lip and periocular wrinkles, and may replace retinoids if its long-term safety is established and C. asiatica is standardized.
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Affiliation(s)
- Chuenjid Kongkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., C.N.S.), Department of Pharmacy Practice, Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., P.M., C.N.S.), Research Department of Practice and Policy, UCL School of Pharmacy, London WC1N 1AX, United Kingdom (C.K.), Medical Division of General Support Office, Armed Force Development Command, Bangkok, Thailand 10210 (P.M.), Faculty of Optometry, Ramkhamhaeng University, Bangkok 10240, Thailand (N.C.), Department of Pharmaceutical Technology, Cosmetics and Natural Products Research Center, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, 65000, Thailand (N.W.)
| | - Peerapong Meesomperm
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., C.N.S.), Department of Pharmacy Practice, Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., P.M., C.N.S.), Research Department of Practice and Policy, UCL School of Pharmacy, London WC1N 1AX, United Kingdom (C.K.), Medical Division of General Support Office, Armed Force Development Command, Bangkok, Thailand 10210 (P.M.), Faculty of Optometry, Ramkhamhaeng University, Bangkok 10240, Thailand (N.C.), Department of Pharmaceutical Technology, Cosmetics and Natural Products Research Center, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, 65000, Thailand (N.W.)
| | - C Norman Scholfield
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., C.N.S.), Department of Pharmacy Practice, Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., P.M., C.N.S.), Research Department of Practice and Policy, UCL School of Pharmacy, London WC1N 1AX, United Kingdom (C.K.), Medical Division of General Support Office, Armed Force Development Command, Bangkok, Thailand 10210 (P.M.), Faculty of Optometry, Ramkhamhaeng University, Bangkok 10240, Thailand (N.C.), Department of Pharmaceutical Technology, Cosmetics and Natural Products Research Center, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, 65000, Thailand (N.W.)
| | - Narttaya Chaiwiang
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., C.N.S.), Department of Pharmacy Practice, Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., P.M., C.N.S.), Research Department of Practice and Policy, UCL School of Pharmacy, London WC1N 1AX, United Kingdom (C.K.), Medical Division of General Support Office, Armed Force Development Command, Bangkok, Thailand 10210 (P.M.), Faculty of Optometry, Ramkhamhaeng University, Bangkok 10240, Thailand (N.C.), Department of Pharmaceutical Technology, Cosmetics and Natural Products Research Center, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, 65000, Thailand (N.W.)
| | - Neti Waranuch
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., C.N.S.), Department of Pharmacy Practice, Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., P.M., C.N.S.), Research Department of Practice and Policy, UCL School of Pharmacy, London WC1N 1AX, United Kingdom (C.K.), Medical Division of General Support Office, Armed Force Development Command, Bangkok, Thailand 10210 (P.M.), Faculty of Optometry, Ramkhamhaeng University, Bangkok 10240, Thailand (N.C.), Department of Pharmaceutical Technology, Cosmetics and Natural Products Research Center, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, 65000, Thailand (N.W.)
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Mongkhon P, Alwafi H, Fanning L, Lau WCY, Wei L, Kongkaew C, Wong ICK. Patterns and factors influencing oral anticoagulant prescription in people with atrial fibrillation and dementia: Results from UK primary care. Br J Clin Pharmacol 2020; 87:1056-1068. [PMID: 32643166 DOI: 10.1111/bcp.14464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 06/21/2020] [Accepted: 06/25/2020] [Indexed: 11/29/2022] Open
Abstract
AIMS Oral anticoagulant (OAC) is recommended for preventing stroke in atrial fibrillation (AF). However, the OAC utilisation in AF patients with dementia or cognitive impairment (CI) is limited. This study aimed to examine the prevalence of OAC prescriptions in AF patients with dementia/CI and to identify factors associated with OAC treatment within 180 days after dementia/CI diagnosis. METHODS Using The Health Improvement Network database, the annual trends of OAC between 2000 and 2015 were calculated. Multivariable logistic regression was performed to identify factors associated with OAC treatment. RESULTS The prevalence rate of OAC prescriptions increased from 6.1% in 2000 to 45.9% in 2015. Among OAC users, the proportion of direct oral anticoagulants (DOACs) use increased significantly from 0.1% in 2011 to 33.8% in 2015 (P-trend < 0.001), while the proportion of vitamin K antagonist use decreased by 28.6% from 100% in 2000 to 71.4% in 2015 (P-trend < 0.001). In the multivariable analysis, younger age, very old age, female sex, higher Charlson Comorbidity Index, having a HAS-BLED score ≥3, a history of intracranial bleeding, falls and polypharmacy were significantly associated with lower odds of receiving OAC. CONCLUSIONS In UK primary care, OAC use increased from 2000 to 2015 in AF patients with dementia/CI, with a substantial increase in use of DOACs. Characteristics related to frailty are associated with lower odds of OAC prescription. Given the increasing use of DOACs in patients with dementia/CI, further studies are needed to investigate the safety and effectiveness of DOACs in this important patient group.
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Affiliation(s)
- Pajaree Mongkhon
- Centre for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Thailand.,Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.,Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Hassan Alwafi
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - Laura Fanning
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.,Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Wallis C Y Lau
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.,Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Li Wei
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - Chuenjid Kongkaew
- Centre for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Thailand.,Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - Ian C K Wong
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.,Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.,Centre for Medication Optimisation Research and Education (CMORE), University College London Hospital, UK.,The University of Hong Kong Shenzhen Hospital, Shenzhen, Guangdong, China
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Tangamornsuksan W, Kongkaew C, Scholfield CN, Subongkot S, Lohitnavy M. HLA-DRB1*07:01 and lapatinib-induced hepatotoxicity: a systematic review and meta-analysis. Pharmacogenomics J 2019; 20:47-56. [PMID: 31383939 DOI: 10.1038/s41397-019-0092-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/28/2018] [Accepted: 07/18/2019] [Indexed: 01/21/2023]
Abstract
Associations between HLA-DRB1*07:01 and lapatinib-induced hepatotoxicity have been reported. To consolidate the results from all available reports in scientific databases, systematic review and meta-analysis techniques were used to quantify these associations. Studies investigating associations between HLA-DRB1*07:01 and lapatinib-induced hepatotoxicity were systematically searched in PubMed, Human Genome Epidemiology Network, and the Cochrane Library. Primary outcomes were the associations between HLA-DRB1*07:01 and lapatinib-induced hepatotoxicity. Overall odds ratios (ORs) with the corresponding 95%CIs were calculated using a random-effect model to determine the associations between HLA-DRB1*07:01 and lapatinib-induced hepatotoxicity. A clear association between HLA-DRB1*07:01 and lapatinib-induced hepatotoxicity was identified in our analyses. The summary OR was 6.23 (95%CI = 4.11-9.45). Similar associations were also found in the subgroup analyses by lapatinib treatment regimens. ORs were 10.04 (95%CI = 6.15-16.39), 8.65 (95%CI = 4.52-16.58), and 3.88 (95%CI = 2.20-6.82) in the lapatinib group, lapatinib + trastuzumab group, and lapatinib + chemotherapy or lapatinib + trastuzumab + chemotherapy group, respectively. Since HLA-DRB1*07:01 is associated with lapatinib-induced hepatotoxicity, genetic screening of HLA-DRB1*07:01 in breast cancer patients prior to lapatinib therapy is warranted for patient safety. In addition, further studies should define the risk of HLA-DRB1*07:01 and lapatinib-induced hepatotoxicity in specific ethnicities.
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Affiliation(s)
- Wimonchat Tangamornsuksan
- Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Chuenjid Kongkaew
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Centre for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Pharmacokinetic Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - C N Scholfield
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Suphat Subongkot
- Clinical Pharmacy Division, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Manupat Lohitnavy
- Center of Excellence for Environmental Health & Toxicology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand. .,Pharmacokinetic Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand. .,Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
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10
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Mongkhon P, Naser AY, Fanning L, Tse G, Lau WC, Wong IC, Kongkaew C. Oral anticoagulants and risk of dementia: A systematic review and meta-analysis of observational studies and randomized controlled trials. Neurosci Biobehav Rev 2019; 96:1-9. [DOI: 10.1016/j.neubiorev.2018.10.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 10/03/2018] [Accepted: 10/31/2018] [Indexed: 01/01/2023]
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11
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Suttajit S, Suwannaprom P, Supapaan T, Eakanunkul S, Tangkiatkumjai M, Kongkaew C, Anderson C, Wongpoowarak P. Are we on the right track? Answers from a national survey of Thai graduates' perceptions during the transition to the 6-year PharmD program. Adv Med Educ Pract 2018; 9:713-722. [PMID: 30310347 PMCID: PMC6167127 DOI: 10.2147/amep.s173014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To serve the higher demands of pharmaceutical services, pharmacy education in Thailand has shifted from 5-year BPharm program to 6-year PharmD program with two specialization tracks: pharmaceutical care (PC) and industrial pharmacy (IP). This study aimed to compare the perceptions regarding professional competencies, pharmacy profession, and planned workplace between graduates with 5-year BPharm and 6-year PharmD and between those with PC and IP specialty. METHODS A cross-sectional national survey using a paper-pencil self-administered questionnaire was distributed to all new graduates attending the pharmacy licensure examination in March 2015. RESULTS Of all 1,937 questionnaires distributed, 1,744 were returned and completed (90% response rate). Pharmacy graduates rated highest on their competencies in professional ethics, followed by PC services and system management. They rated low confidence in medication selection procurement and pharmaceutical industry competencies. The 6-year PharmD graduates showed higher confidence in ethics and professional pride than the 5-year BPharm graduates. Graduates with PC specialty rated higher perceived competency in PC, system management, primary care, and consumer protection domains, while the IP graduates were superior in IP and medication selection and procurement domains, and most graduates (PC and IP) intended to work mainly in a hospital or a community pharmacy. Hospital was preferred for the PC graduates, and the IP graduates were more likely to work in pharmaceutical industry, regulation and consumer protection, sales and marketing, and academia. CONCLUSION With some gaps still to be filled, the transition from 5-year BPharm to 6-year PharmD program with specialty tracks gave extra confidence to graduates in their specialty competencies and professional pride, leading to differences in preferred workplace. The findings of this study reflect that Thai pharmacy education continues to adjust to the needs of the society and the changing health care environments. Longitudinal monitoring to observe this transition is needed for both curriculum adjustment and competency of the graduates.
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Affiliation(s)
- Siritree Suttajit
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand,
| | - Puckwipa Suwannaprom
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand,
| | - Teeraporn Supapaan
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, Thailand
| | - Suntara Eakanunkul
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Mayuree Tangkiatkumjai
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Claire Anderson
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Payom Wongpoowarak
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
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12
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Kongkaew C, Lertsinthai P, Jampachaisri K, Mongkhon P, Meesomperm P, Kornkaew K, Malaiwong P. The Effects of Thai Yoga on Physical Fitness: A Meta-Analysis of Randomized Control Trials. J Altern Complement Med 2018; 24:541-551. [DOI: 10.1089/acm.2017.0257] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chuenjid Kongkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Research Center for Safety and Quality in Health, Naresuan University, Phitsanulok, Thailand
- Research Department of Practice and Policy, School of Pharmacy, University College London, United Kingdom
| | - Parinya Lertsinthai
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | | | - Pajaree Mongkhon
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Research Center for Safety and Quality in Health, Naresuan University, Phitsanulok, Thailand
- School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | - Peerapong Meesomperm
- Medical Division of General Support Office, Armed Forces Development Command, Bangkok, Thailand
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13
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Kongkaew C, Scholfield NC, Dhippayom T, Dilokthornsakul P, Saokaew S, Chaiyakunapruk N. Efficacy and safety of Pueraria candollei var. mirifica (Airy Shaw & Suvat.) Niyomdham for menopausal women: A systematic review of clinical trials and the way forward. J Ethnopharmacol 2018; 216:162-174. [PMID: 29409850 DOI: 10.1016/j.jep.2018.01.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 06/07/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Pueraria candollei var. mirifica (Airy Shaw & Suvat.) Niyomdham (commonly termed P. mirifica, PM) growing in upland Thailand has a long history as a postmenopausal rejuvenant therapy for indigenants. Its amelioration of menopause symptoms in clinical trials was assessed. MATERIALS AND METHODS International and Thai databases were searched from inception to February 2017. Clinical trials investigating effects of PM menopausal or postmenopausal women were included. Outcomes were self-reported menopausal symptoms, serum reproductive hormones, urino-genital tract function, and bone surrogates. Methodological quality was assessed by Cochrane risk-of-bias v2.0, and a 22-parameter quality score based on the CONSORT checklist for herbal medicines. RESULTS Eight studies (9 articles) used data from 309 menopausal patients. Five-studies demonstrated that PM was associated with climacteric scores reduced by ~50% compared to baseline. Other PM studies using limited numbers of placebo participants suggested improved vaginal and other urogenital tract symptoms. Bone alkaline phosphatase halved (suggesting lowered bone turnover). Variable serum reproductive hormone levels suggested menopausal status differed between studies. PM active ingredients and sources were not defined. Adverse event rates (mastodynia, vaginal spotting, dizziness) were similar in all groups (PM, conjugated equine estrogen, and placebos) but serum C-reactive protein doubled. These studies had design and reporting deficiencies, high risks of biases, and low quality scores. CONCLUSIONS The efficacy of PM on menopausal symptoms remains inconclusive because of methodological short-comings especially placebo effects inherent in self-assessment/recall questionnaires and no PM standardization. PM efficacy and safety need a fundamental re-appraisal by: (i) cohort (retro- and prospective) studies on current users to define its traditional use for rejuvenation; (ii) tightly coupling long-term efficacy to safety of well-defined PM and multiple end-points; (iii) using study design related to current understanding of menopause progression and estrogen pharmacology (iv) robust pharmacovigilance.
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Affiliation(s)
- Chuenjid Kongkaew
- Centre for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Research Department of Practice and Policy, School of Pharmacy, University College London, UK.
| | - Norman C Scholfield
- Centre for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Teerapon Dhippayom
- Centre for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Piyameth Dilokthornsakul
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Surasak Saokaew
- School of Pharmacy, Monash University Malaysia, Kuala Lumpur, Malaysia; Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia, Kuala Lumpur, Malaysia; Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA.
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14
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Mongkhon P, Ashcroft DM, Scholfield CN, Kongkaew C. Hospital admissions associated with medication non-adherence: a systematic review of prospective observational studies. BMJ Qual Saf 2018; 27:902-914. [DOI: 10.1136/bmjqs-2017-007453] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 03/19/2018] [Accepted: 03/24/2018] [Indexed: 11/04/2022]
Abstract
BackgroundMedication non-adherence in ambulatory care has received substantial attention in the literature, but less so as it affects acute care. Accordingly, we aimed to estimate the frequency with which non-adherence to medication contributes to hospital admissions.MethodsWe searched the Cochrane Library, EMBASE, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts and PubMed (until December 2017) to identify prospective observational studies that examined prevalence rates of hospital admissions associated with medication non-adherence. A quality assessment was performed using an expanded Crombie checklist. Data extraction covered patterns, circumstances, and patient and other key characteristics of non-adherence. Pooled estimates were obtained using a random-effect model.ResultsOf 24 included studies, 8 were undertaken in North America, 7 from Europe, 6 from Asia and 3 from Australia. Most studies (79%) were rated as low risk of bias. All but three studies used combination measures to detect non-adherence, but approaches to assess preventability varied considerably. Across the studies, there was high heterogeneity among prevalence estimates (χ2=548, df 23, p<0.001, I2=95.8%). The median prevalence rate of hospital admissions associated with non-adherence was 4.29% (IQR 3.22%–7.49%), with prevalence rates ranging from 0.72% to 10.79%. By definition, almost all of these admissions were considered preventable. The underlying causes contributing to these admissions included medication cost and side effects, and non-adherence most often involved cardiovascular medicines.ConclusionsHospital admissions associated with non-adherence to medication are a common problem. This systematic review highlights important targets for intervention. Greater attention could be focused on adherence to medication during the hospital stay as part of an enhanced medication reconciliation process. Standardisation in study methods and definitions is needed to allow future comparisons among settings; future studies should also encompass emerging economies.
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Janmano P, Chaichanawirote U, Kongkaew C. Analysis of medication consultation networks and reporting medication errors: a mixed methods study. BMC Health Serv Res 2018; 18:221. [PMID: 29587762 PMCID: PMC5872530 DOI: 10.1186/s12913-018-3049-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine characteristics of verbal consultation about medication within social networks of hospital inpatient medication system, and their associations with medication error reporting. METHOD The setting was a 90-bed provincial district hospital with 4 wards, 7 physicians, 5 pharmacists, 44 nurses, 5 pharmacist assistants, and 4 unskilled ancillary workers. A mixed method comprising (i) a prospective observational study for investigating incidences and the nature of reporting medication errors, and (ii) a social network analysis for patterns of interaction. RESULTS Out of 5296 prescriptions, 132 medication errors were reported during the one month study period: an incidence rate of 2.5%. Every incident of medication errors was formally documented through pharmacists. The most frequent medication errors were in pre-transcribing (n = 54; 40.9%). The pharmacists were central in the whole network of consultation on medication with the mean in-degree centrality of 35 (SD 14.9) and mean out-degree centrality of 15.4 (SD 11.1). Two bridging participants were identified who were influential communicators connecting the network (betweenness centrality). Medication error reporting were influenced by (i) participants whose advice is sought and viewed as trustworthy (in-degree centrality; p < 0.001), (ii) sex (p = 0.01), and (iii) level of education (p = 0.04). CONCLUSION In-degree centrality was the most important network characteristic. A culture of medication safety can be fostered by encouraging consultation about the medication of in-patients within the hospital network where reporting of medication errors is essential.
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Affiliation(s)
- Pattarida Janmano
- Department of Pharmacy, Phrasamutchedisawatyanon Hospital, Samutprakan, 10290, Thailand.,Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, 65000, Thailand
| | - Uraiwan Chaichanawirote
- Faculty of Nursing, Naresuan University, Phitsanulok, 65000, Thailand.,Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, 65000, Thailand
| | - Chuenjid Kongkaew
- Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, 65000, Thailand. .,Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
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16
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Chongmelaxme B, Sruamsiri R, Dilokthornsakul P, Dhippayom T, Kongkaew C, Saokaew S, Chuthaputti A, Chaiyakunapruk N. Clinical effects of Zingiber cassumunar (Plai): A systematic review. Complement Ther Med 2017; 35:70-77. [PMID: 29154071 DOI: 10.1016/j.ctim.2017.09.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/28/2017] [Indexed: 01/23/2023] Open
Abstract
Zingiber cassumunar Roxb. known locally as "Plai" in Thai, has been used for treating bruise, sprain and musculoskeletal pain. Several pre-clinical studies demonstrated the anti-inflammatory effect of Plai. However, current evidence of clinical effects of Plai is still unclear. This study aimed to determine the clinical efficacy and safety of Plai among all identified indications. Of the 808 articles identified by a systematic review, six studies were included. Four studies were randomized controlled trials, while two studies were quasi-experimental studies involving 178 patients in intervention group and 177 patients in control group. Duration of treatment ranged from 7days to 2 months. Our findings showed that 14% Plai cream had a strong trend of benefits in pain reduction for muscle pain and ankle sprain. However, evidence supporting the effects of Plai on acne vulgaris treatment and anti-histamine effect are still unclear.
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Affiliation(s)
- Bunchai Chongmelaxme
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Rosarin Sruamsiri
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Piyameth Dilokthornsakul
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Teerapon Dhippayom
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Chuenjid Kongkaew
- Center for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Thailand; Research Department of Practice and Policy, School of Pharmacy, UCL, UK.
| | - Surasak Saokaew
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.
| | - Anchalee Chuthaputti
- Department for Development of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand.
| | - Nathorn Chaiyakunapruk
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; School of Pharmacy, University of Wisconsin, Madison, USA; Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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Saokaew S, Wilairat P, Raktanyakan P, Dilokthornsakul P, Dhippayom T, Kongkaew C, Sruamsiri R, Chuthaputti A, Chaiyakunapruk N. Clinical Effects of Krachaidum ( Kaempferia parviflora): A Systematic Review. J Evid Based Complementary Altern Med 2016; 22:413-428. [PMID: 27694558 PMCID: PMC5871153 DOI: 10.1177/2156587216669628] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Kaempferia parviflora (Krachaidum) is a medicinal plant in the family Zingiberaceae. Its rhizome has been used as folk medicine for many centuries. A number of pharmacological studies of Krachaidum had claimed benefits for various ailments. Therefore, this study aimed to systematically search and summarize the clinical evidences of Krachaidum in all identified indications. Of 683 records identified, 7 studies were included. From current clinical trials, Krachaidum showed positive benefits but remained inconclusive since small studies were included. Even though results found that Krachaidum significantly increased hand grip strength and enhanced sexual erotic stimuli, these were based on only 2 studies and 1 study, respectively. With regard to harmful effects, we found no adverse events reported even when Krachaidum 1.35 g/day was used. Therefore, future studies of Krachaidum are needed with regards to both safety and efficacy outcomes.
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Affiliation(s)
- Surasak Saokaew
- 1 University of Phayao, Phayao, Thailand.,2 Monash University Malaysia, Kuala Lumpur, Malaysia.,3 Naresuan University, Phitsanulok, Thailand
| | | | | | | | | | | | | | - Anchalee Chuthaputti
- 4 Department for Development of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Nathorn Chaiyakunapruk
- 2 Monash University Malaysia, Kuala Lumpur, Malaysia.,3 Naresuan University, Phitsanulok, Thailand.,5 University of Queensland, Brisbane, Queensland, Australia.,6 University of Wisconsin-Madison, WI, USA
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Suwankesawong W, Dhippayom T, Tan-Koi WC, Kongkaew C. Pharmacovigilance activities in ASEAN countries. Pharmacoepidemiol Drug Saf 2016; 25:1061-9. [PMID: 27174034 DOI: 10.1002/pds.4023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 03/28/2016] [Accepted: 04/11/2016] [Indexed: 11/07/2022]
Abstract
PURPOSE This study aimed to explore the current landscape and identify challenges of pharmacovigilance (PV) among Association of Southeast Asian Nations (ASEAN) countries. METHODS This cross-sectional survey collected data from May 2014 to December 2015. Questionnaires seeking to collect information on resources, processes, roles and responsibility, and functions of PV systems were sent to relevant persons in the ASEAN countries. Functions of PV centers were measured using the minimum World Health Organization requirements for a functional national PV system. Performances of PV centers were measured by the following: (1) the indicators related to the average number of individual case safety reports (ICSR); (2) presence of signal detection activities and subsequent action; and (3) contribution to the global vigilance database. RESULTS Cambodia, Indonesia, Laos, Malaysia, the Philippines, Singapore, Thailand, and Vietnam completed the survey. PV systems in four surveyed countries (Indonesia, Malaysia, Singapore, and Thailand) achieved all aspects of the World Health Organization minimum requirement for a functional national PV system; the remaining countries were deemed to have unclear communication strategies and/or no official advisory committee. Average numbers of recent ICSR national returns ranged from 7 to 3817 reports/year/million population; three countries (Malaysia, Singapore, and Thailand) demonstrated good performance in reporting system and reported signal detection activities and subsequent actions. All participating countries had submitted ICSRs to the Uppsala Monitoring Center during the survey period (2013-2015). CONCLUSIONS Four participating countries had functional PV systems. PV capacity, functionality, and legislative framework varied depending on local healthcare ecosystem networks. Implementing effective communication strategies and/or technical assistance from the advisory committee are needed to strengthen PV in ASEAN. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Wimon Suwankesawong
- Health Product Vigilance Center, Thai Food and Drug Administration, Nonthaburi, Thailand
| | - Teerapon Dhippayom
- Pharmaceutical Care Research Unit, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Wei-Chuen Tan-Koi
- Vigilance, Compliance and Enforcement Division, Health Products Regulation Group, Health Sciences Authority, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
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Tangamornsuksan W, Lohitnavy O, Kongkaew C, Chaiyakunapruk N, Reisfeld B, Scholfield NC, Lohitnavy M. Association of HLA-B*5701 genotypes and abacavir-induced hypersensitivity reaction: a systematic review and meta-analysis. J Pharm Pharm Sci 2016; 18:68-76. [PMID: 25877443 DOI: 10.18433/j39s3t] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study aimed to systematically review and quantitatively synthesize the association between HLA-B*5701 and abacavir-induced hypersensitivity reaction (ABC-HSR). METHODS We searched for studies that investigated the association between HLA-B genotype and ABC-HSR and provided information about the frequency of carriers of HLA-B genotypes among cases and controls. We then performed a meta-analysis with a random-effects model to pool the data and to investigate the sources of heterogeneity. RESULTS From 1,026 articles identified, ten studies were included. Five using clinical manifestation as their diagnostic criteria, 409 and 1,883 subjects were included as cases and controls. Overall OR was 23.6 (95% CI = 15.4 - 36.3). Whereas, the another five studies using confirmed immunologic test as their diagnostic criteria, 110 and 1,968 subjects were included as cases and controls, respectively. The association of ABC-HSR was strong in this populations with HLA-B*5701. Overall OR was 1,056.2 (95% CI = 345.0 - 3,233.3). CONCLUSIONS Using meta-analysis technique, the association between HLA-B*5701 and ABC-HSR is strong in the studies using immunologic confirmation to identify ABC-HSR. These results support the US FDA recommendations for screening HLA-B*5701 allele before initiating abacavir therapy.
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Affiliation(s)
- Wimonchat Tangamornsuksan
- Center of Excellence for Environmental Health & Toxicology; Pharmacokinetic Research Unit; Department of Pharmacy Practice
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20
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Dhippayom T, Kongkaew C, Chaiyakunapruk N, Dilokthornsakul P, Sruamsiri R, Saokaew S, Chuthaputti A. Clinical effects of thai herbal compress: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2015; 2015:942378. [PMID: 25861373 PMCID: PMC4377500 DOI: 10.1155/2015/942378] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 11/18/2022]
Abstract
Objective. To determine the clinical effects of Thai herbal compress. Methods. International and Thai databases were searched from inception through September 2014. Comparative clinical studies investigating herbal compress for any indications were included. Outcomes of interest included level of pain, difficulties in performing activities, and time from delivery to milk secretion. Mean changes of the outcomes from baseline were compared between herbal compress and comparators by calculating mean difference. Results. A total of 13 studies which involved 778 patients were selected from 369 articles identified. The overall effects of Thai herbal compress on reducing osteoarthritis (OA) and muscle pain were not different from those of nonsteroidal anti-inflammatory drugs, knee exercise, and hot compress. However, the reduction of OA pain in the herbal compress group tended to be higher than that of any comparators (weighted mean difference 0.419; 95% CI -0.004, 0.842) with moderate heterogeneity (I (2) = 58.3%, P = 0.048). When compared with usual care, herbal compress provided significantly less time from delivery to milk secretion in postpartum mothers (mean difference -394.425 minutes; 95% CI -620.084, -168.766). Conclusion. Thai herbal compress may be considered as an alternative for osteoarthritis and muscle pain and could also be used as a treatment of choice to induce lactation.
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Affiliation(s)
- Teerapon Dhippayom
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 47500, Thailand
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 47500, Thailand
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand
- Center of Excellence for Environmental Health and Toxicology, Naresuan University, Phitsanulok, Thailand
| | - Nathorn Chaiyakunapruk
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand
- School of Pharmacy, Monash University Malaysia, Kuala Lumpur, Malaysia
- School of Population Health, University of Queensland, Brisbane, QLD 4006, Australia
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Piyameth Dilokthornsakul
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand
| | - Rosarin Sruamsiri
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand
| | - Surasak Saokaew
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
| | - Anchalee Chuthaputti
- Department for Development of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi 11000, Thailand
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Dechanont S, Maphanta S, Butthum B, Kongkaew C. Hospital admissions/visits associated with drug-drug interactions: a systematic review and meta-analysis. Pharmacoepidemiol Drug Saf 2014; 23:489-97. [DOI: 10.1002/pds.3592] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 01/13/2014] [Accepted: 01/14/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Supinya Dechanont
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences; Naresuan University; Phitsanulok Thailand
| | - Sirada Maphanta
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences; Naresuan University; Phitsanulok Thailand
| | - Bodin Butthum
- Faculty of Medicine; Naresuan University; Phitsanulok Thailand
| | - Chuenjid Kongkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences; Naresuan University; Phitsanulok Thailand
- Center of Pharmaceutical Outcomes Research, Faculty of Pharmaceutical Sciences; Naresuan University; Phitsanulok Thailand
- Center of Excellence for Environmental Health and Toxicology; Naresuan University; Phitsanulok Thailand
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Kongkaew C, Jampachaisri K, Chaturongkul CA, Scholfield CN. Depression and adherence to treatment in diabetic children and adolescents: a systematic review and meta-analysis of observational studies. Eur J Pediatr 2014; 173:203-12. [PMID: 23959326 DOI: 10.1007/s00431-013-2128-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 07/22/2013] [Accepted: 07/30/2013] [Indexed: 12/23/2022]
Abstract
UNLABELLED Depression compromises diabetes treatment in juveniles, and this study aimed to identify influential targets most likely to improve adherence to treatment and glycemic control. Prospective observational studies investigating associations between depression and treatment adherence in juveniles with type 1 diabetes were extracted from MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane Central. Nineteen studies comprising 2,935 juveniles met our criteria. Median effect sizes between depression and treatment adherence were 0.22 (interquartile range (IQR), 0.16–0.35) by patient and 0.13 (IQR, 0.12–0.24) caregiver report. Corresponding values for depression/glycemic control were 0.16 (IQR, 0.09– 0.23) and 0.08 (IQR, 0.04–0.14), respectively. Effect sizes varied with study design, publication year and assessment tools: CES-D yielded a higher effect size than other assessment tools for depression, where associations for depression and either adherence or glycemic control was investigated. Several behaviours influenced adherence and glycemic control. CONCLUSION This study showed moderate associations between depression and poor treatment adherence. Targeting behaviour and social environments, however, may ultimately provide more cost-effective health gains than targeting depressive symptoms.
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Fuangchan A, Dhippayom T, Kongkaew C. Intervention to promote patients' adherence to antimalarial medication: a systematic review. Am J Trop Med Hyg 2013; 90:11-9. [PMID: 24166045 DOI: 10.4269/ajtmh.12-0598] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Non-adherence as a major contributor to poor treatment outcomes. This study aimed to explore the effectiveness of existing interventions promoting adherence to antimalarial drugs by systematic review. The following databases were used to identify potential articles: MEDLINE, EMBASE, the Cochrane CENTRAL, and CINAHL (through March 2013). From 1,813 potential papers identified, 16 studies met the selection criteria comprising 9,247 patients. Interventions were classified as packaging aids, visual media, combined visual media and verbal information, community education, medication supervision, and convenient regimen. These interventions were shown to increase adherence to antimalarial drugs (median relative risk = 1.4, interquartile range 1.2-2.0). Although a most effective intervention did not emerge, community education and visual media/verbal information combinations may well have most potential to improve adherence to antimalarial medication. These interventions should be implemented in combination to optimize their beneficial effects. The current understanding on improved adherence would facilitate to contain outbreaks of malaria cost effectively.
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Affiliation(s)
- Anjana Fuangchan
- Faculty of Pharmaceutical Sciences, Naresuan University, Thailand; Pharmaceutical Care Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Thailand
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Kongkaew C, Hann M, Mandal J, Williams SD, Metcalfe D, Noyce PR, Ashcroft DM. Risk factors for hospital admissions associated with adverse drug events. Pharmacotherapy 2013; 33:827-37. [PMID: 23686895 DOI: 10.1002/phar.1287] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
STUDY OBJECTIVE To identify predictors of hospital admissions associated with adverse drug events (ADEs) and to determine the preventability of ADEs in patients admitted to two hospitals. DESIGN Prospective observational study. SETTING Medical admission units at two British National Health Service hospitals in the United Kingdom. PATIENTS 3904 adults age 16 years or older who were admitted to the two hospitals between June 2006 and November 2007. MEASUREMENTS AND MAIN RESULTS Clinical pharmacists identified hospital admissions associated with drug-related problems by using medical record review, supplemented by patient interview for those identified as having an ADE. The contribution of ADEs to hospital admission and the causality, severity, and preventability of the events were independently assessed by a multidisciplinary clinical team. Multivariate logistic regression was used to identify predictors of hospital admissions associated with ADEs, and a maximum-likelihood multinomial model was used to examine predictors of the preventability of ADEs. Of the 3904 patients included in the analysis, 439 (11.2%) were judged by the review panel to have experienced ADEs. Of these, 209 patients (47.6%) experienced preventable ADEs. Four independent variables were found to have significant relationships with ADE admissions and preventability of ADEs: patient age, length of time since starting new drug, total number of prescription drugs, and hospital site. Drug classes most commonly associated with preventable ADEs were antiplatelet drugs, anticoagulants, diuretics (loop and thiazide diuretics), angiotensin-converting enzyme inhibitors, and antiepileptic drugs. CONCLUSION Adverse drug events are an important cause of hospital admission. Better systems for health care practitioners to identify patients at high risk of preventable hospital admissions associated with ADEs (e.g., age > 65 years old, receiving more than five drugs, and starting new high-risk drugs) should be implemented in order to minimize the risks to patients and the burden on the health care system.
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Affiliation(s)
- Chuenjid Kongkaew
- Centre for Pharmacoepidemiology and Drug Safety Research, School of Pharmacy and Pharmaceutical Sciences, Manchester Academic Health Sciences Centre-MAHSC, University of Manchester, Manchester, UK
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Kongkaew C, Sakunrag I, Jianmongkol P. Non-compliance with digoxin in patients with heart failure and/or atrial fibrillation: a systematic review and meta-analysis of observational studies. Arch Cardiovasc Dis 2012; 105:507-16. [PMID: 23062482 DOI: 10.1016/j.acvd.2012.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 06/18/2012] [Accepted: 06/19/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Digoxin is highly potent and efficacious for treatment of heart failure (HF) and/or atrial fibrillation (AF) yet compliance is often poor. AIMS To examine prevalence rates of non-compliance with digoxin; variations between clinical settings, types of non-compliance and methods of detection; and potential factors influencing non-compliance with digoxin. METHODS This was a systematic review and meta-analysis of prospective observational studies of non-compliance with digoxin in patients with HF and/or AF, published in English. The studies were identified through these bibliographic databases: MEDLINE, EMBASE, CINAHL, IPA and Cochrane CENTRAL. Subgroup analysis examined the influence of clinical settings, types of non-compliance and methods of detection. RESULTS Ten studies met the inclusion criteria, comprising 1841 patients with HF and/or AF. The corresponding prevalence rates of non-compliance for outpatients, after hospital discharge and inpatients were 43.1% (interquartile range [IQR] 29-48%), 25% (95% confidence interval [CI] 12-37%) and 4.5%, respectively. In patients with HF and AF co-morbidities, the prevalence rate of non-compliance with digoxin was 38.7% (IQR 27-46%); the corresponding prevalence rates of overdosing and underdosing were 33.04% (IQR 22-49%) and 33.8% (95% CI 25-42%), respectively. Rates varied depending on the methods of detecting non-compliance. Regularity of prescribed dose, diuretic use, coronary artery bypass, implantable cardioverter-defibrillator, number of office visits and pill boxes demonstrated strong associations with non-compliance with digoxin. CONCLUSIONS Non-compliance with digoxin is prevalent among patients with HF and/or AF. A better understanding of the factors influencing compliance and improved intervention strategies are necessary to increase digoxin compliance.
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Affiliation(s)
- Chuenjid Kongkaew
- Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
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Kongkaew C, Sakunrag I, Chaiyakunapruk N, Tawatsin A. Effectiveness of citronella preparations in preventing mosquito bites: systematic review of controlled laboratory experimental studies. Trop Med Int Health 2011; 16:802-10. [PMID: 21481108 DOI: 10.1111/j.1365-3156.2011.02781.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This review aims to examine the effectiveness of citronella preparation used as a mosquito repellent. METHODS Multiple computerized databases such as MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL, and AMED, were searched for controlled laboratory experiments that compared the effectiveness of citronella products to control in repelling Aedes, Anopheles and Culex mosquitoes using the cage or room methods. Outcomes measures were protection time and percentage repellency. The weighted mean difference and 95% confidence interval were calculated comparing the outcomes in the citronella and control groups. Meta-analysis was performed using the DerSimonian and Laird method under a random-effects model. RESULTS Eleven studies met inclusion criteria. Based on a meta-analysis of studies using the cage method, protection time of the citronella oil for preventing Aedes mosquitoes was less than that in the DEET (N,N-diethyl-m-toluamide) group, with a difference in protection time of 253 min (95% confidence interval: 169-336). The combination of citronella oil and vanillin is likely to have a longer protection time compared with citronella oil alone. In studies using the room method, citronella oil and/or the combination of citronella oil and vanillin provided complete repellency at least 3 h. In Anopheles and Culex mosquitoes, a combination of citronella oil and vanillin product demonstrated a comparable protection time against DEET; however, it remained inconclusive due to a limited number of studies. CONCLUSIONS Citronella products are less effective than DEET products in terms of duration of protection. Adding vanillin to citronella oil products could prolong the protection time.
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Affiliation(s)
- C Kongkaew
- Faculty of Pharmaceutical Sciences, Naresuan Univerisity, Phitsanulok, Thailand
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Kongkaew C, Chaiyakunapruk N. Efficacy of Clinacanthus nutans extracts in patients with herpes infection: Systematic review and meta-analysis of randomised clinical trials. Complement Ther Med 2011; 19:47-53. [DOI: 10.1016/j.ctim.2010.12.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 11/02/2010] [Accepted: 12/15/2010] [Indexed: 11/29/2022] Open
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Kongkaew C, Noyce PR, Ashcroft DM. Hospital Admissions Associated with Adverse Drug Reactions: A Systematic Review of Prospective Observational Studies. Ann Pharmacother 2008; 42:1017-25. [DOI: 10.1345/aph.1l037] [Citation(s) in RCA: 406] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: To determine the prevalence of hospital admissions associated with ADRs and examine differences in prevalence rates between population groups and methods of ADR detection. Data Sources: Studies were identified through electronic searches of Cumulative Index to Nursing and Allied Hearth Literature. EMBASE, and MEDLINE to August 2007. There were no language restrictions. Study Selection and Data Extraction: A systematic review was conducted of prospective observational studies that used the World Health Organization ADR definition. Subgroup analysis examined the influence of patient age groups and methods of ADR detection on reported ADR admission rates. All statistical analyses were performed using STATA v 9.0. Data Synthesis: Twenty-five studies were identified including 106, 586 patients who were hospitalized; 2143 of these patients had experienced ADRs. The prevalence rates of ADRs ranged from 0.16% to 15.7%, with an overall median of 5.3% (interquartile range [IQR] 2.7–9.0%). Median ADR prevalence rates varied between age groups: for children, the ADR admission rate was 4.1% (IQR 0.16–5.3%), while the corresponding rates for adults and elderly patients were 6.3% (IQR 3.9–9.0%) and 10.7% (IQR 9.6–13.3%), respectively. ADR rates also varied depending on the methods of ADR detection employed in the different studies. Studies that employed multiple ADR detection methods, such as medical record review and patient interview, reported higher ADR admission rates compared with studies that used medical record review alone. Antiinfective drugs were most often associated with ADR admissions in children; cardiovascular drugs were most often associated with ADR admissions in adults and elderly patients. Conclusions: Approximately 5.3% of hospital admissions were associated with ADRs. Higher rates were found in elderly patients who are likely to be receiving multiple medications for long-term illnesses. The methods used to detect ADRs are also likely to explain much of the variation in the reported ADR prevalence rates between different studies.
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Affiliation(s)
- Chuenjid Kongkaew
- School of Pharmacy and Pharmaceutical Sciences, The University of Manchester, Manchester, UK
| | - Peter R Noyce
- Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, The University of Manchester
| | - Darren M Ashcroft
- Reader in Medicines Usage and Safety, School of Pharmacy and Pharmaceutical Sciences, The University of Manchester
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Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, Kongkaew C. The efficacy of aloe vera used for burn wound healing: A systematic review. Burns 2007; 33:713-8. [PMID: 17499928 DOI: 10.1016/j.burns.2006.10.384] [Citation(s) in RCA: 144] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Accepted: 10/10/2006] [Indexed: 10/23/2022]
Abstract
Aloe vera has been traditionally used for burn healing but clinical evidence remains unclear. We conducted a systematic review to determine the efficacy of topical aloe vera for the treatment of burn wounds. We electronically searched relevant studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Database, Chinese Databases, and several Thai local Databases (1918-June 2004). Only controlled clinical trials for burn healing were included. There were no restrictions on any language of publication. Two reviewers independently extracted data on study characteristics, patient characteristics, intervention, and outcome measure. Four studies with a total of 371 patients were included in this review. Based on a meta-analysis using duration of wound healing as an outcome measure, the summary weighted mean difference in healing time of the aloe vera group was 8.79 days shorter than those in the control group (P=0.006). Due to the differences of products and outcome measures, there is paucity to draw a specific conclusion regarding the effect of aloe vera for burn wound healing. However, cumulative evidence tends to support that aloe vera might be an effective interventions used in burn wound healing for first to second degree burns. Further, well-designed trials with sufficient details of the contents of aloe vera products should be carried out to determine the effectiveness of aloe vera.
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Affiliation(s)
- Ratree Maenthaisong
- Pharmacy Practice Unit, Department of Pharmacy Practice, Naresuan University, Phitsanulok, Thailand
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Simakachorn N, Pichaipat V, Rithipornpaisarn P, Kongkaew C, Tongpradit P, Varavithya W. Clinical evaluation of the addition of lyophilized, heat-killed Lactobacillus acidophilus LB to oral rehydration therapy in the treatment of acute diarrhea in children. J Pediatr Gastroenterol Nutr 2000; 30:68-72. [PMID: 10630442 DOI: 10.1097/00005176-200001000-00020] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Addition of a medication to the World Health Organization protocol for treatment of acute diarrhea in children is controversial. In this trial, the clinical efficacy of a medication (Lactéol Fort sachets; Laboratoire du Lactéol du Docteur Boucard, Houdan France) containing lyophilized heat-killed Lactobacillus acidophilus LB was assessed as an adjunct to oral rehydration therapy. METHODS Children aged 3 to 24 months with acute diarrhea and mild or moderate dehydration were enrolled in the study. Children received oral rehydration therapy for the first 4 hours. After this first rehydration phase, undiluted milk formula or breast milk was fed alternately with oral rehydration solution. Children were fed rice gruel as tolerated. They received either one sachet containing 10 billion of lyophilized heat-killed L. acidophilus LB or placebo at admission and at 12-hour intervals for five doses. RESULTS Seventy-three children (37 L. acidophilus LB, 36 placebo) were enrolled, of whom 40 (17 L. acidophilus LB, 23 placebo) received an antibiotic before inclusion. Rotavirus was identified in approximately 50% of the children in each group. After 24 hours of treatment, the number of rotavirus-positive children with watery stools was significantly lower (p = 0.012) in the L. acidophilus LB group. Mean duration of diarrhea was decreased (p = 0.034) with L. acidophilus LB (43.4 hours) versus placebo (57.0 hours). This decreased duration was particularly marked in children with no antibiotic therapy before inclusion (31.1 hours): 42.9 hours for the L. acidophilus LB group versus 74.0 hours for the placebo group (p = 0.016). CONCLUSIONS Addition of L. acidophilus LB to oral rehydration therapy was effective in the treatment of children with acute diarrhea by decreasing the duration of diarrhea.
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Affiliation(s)
- N Simakachorn
- Department of Pediatrics, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
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Simakachorn N, Pichaipat V, Ritthipornpisarn P, Kongkaew C, Ahmad S, Varavithya W. Comparison of efficacy of peptilose-base ORS (ORALNU) and WHO-ORS. J Med Assoc Thai 1993; 76 Suppl 2:42-8. [PMID: 7823005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We examined whether replacing glucose with Peptilose into standard ORS would be advantageous over WHO-ORS. A study was carried out on 134 diarrheal children with mild to moderate dehydration. They received either WHO-ORS or Peptilose-ORS by randomized selection. In only two cases in each group, diarrhea was caused by Vibrio cholerae non 0-1. Significant per cent weight gain was observed in patients with Peptilose-ORS compared to those treated with WHO-ORS (P = 0.046). The patients could voluntarily take a higher amount of Peptilose-ORS and had significantly less stool output in the combined mildly and moderately dehydrated patients. It is concluded that Peptilose-ORS is more advantageous and acceptable than the standard WHO glucose-ORS for treatment of non cholera and 2 cases of cholera dehydrating diarrhea in children.
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Affiliation(s)
- N Simakachorn
- Department of Pediatrics, Maharat Nakhon Ratchasima Hospital, Ratchasima, Thailand
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