Open Access

  • Prevalence of Plasmodium Falciparum Malaria and the Antenatal Health Care Utilization for Prevention Among Pregnant Women in a Secondary Health Facility in Enugu State, Nigeria

    Pregnant women in endemic areas are highly susceptible to malaria, and both the frequency and severity of the disease are higher in pregnant women than non- pregnant women.[1] In pregnancy, there is a transient depression of cell mediated immunity that allows foetal allograft retention but also interferes with resistance to various infectious diseases. Malaria infection during pregnancy is a major public health problem in the tropics and subtropics. It affects approximately 24 million pregnant women.[2] In the area of Africa with stable malaria transmission, plasmodium falciparum infection during pregnancy is estimated to cause as many as 10,000 maternal death each year, 8-14% of all low birth weight babies and 75,000-200,000 of all infant death.[3] In Nigeria, there is an estimated 25-30% of mortality in children under the age of five and 300,000 death each year due to malaria.[3] Studies have shown that 40% of pregnant African women start attending antenatal clinics in the first and second trimester of their pregnancy. [3] In addition, pregnant women are at immense risk of malaria due to natural immune depression in pregnancy. [4] The symptoms and complications of malaria during pregnancy differ with the intensity of malaria transmission and thus with the level of immunity the pregnant woman acquired. [5] Malaria cases and death have been increasing in the country mainly due to injudicious use of anti-malaria drugs, delayed health seeking and reliance on clinical judgment without laboratory confirmation in most of the peripheral health facilities. [6] There have been considerable numbers of reports about knowledge, attitude and practices relating to malaria and its control from different parts of Africa. Misconceptions concerning malaria still exist and the practices for the control of malaria have been unsatisfactory. [7] The promising news is that during the past decade, potentially more effective strategies for control of malaria…

  • The New Era of Pharmacists in Ambulatory Patient Care

    Pharmacy is evolving from a product-oriented to a patient-oriented profession. This role modification is extremely healthy for the patient, the pharmacist, and other members of the health-care team. However, the evolution will present pharmacists with a number of new challenges. Now, more than in the past, pharmacists must make the acquisition of contemporary practice knowledge and skills a high priority, to render the level of service embodied in the concept of pharmaceutical care. Pharmacy educators’ organizations and regulatory bodies must all work together to support pharmacists as they assume expanded health-care roles. Pharmacy and the health-care industry must work to ensure that the pharmacist is compensated justly for all services. But before this can happen it will be necessary for pharmacy to demonstrate value-added to the cost of the prescription. Marketing of the purpose of pharmacy in the health-care morass and of the services provided by the pharmacist is needed to generate an appropriate perceived value among purchasers and users of health-care services. Pharmacists should view themselves as dispensers of therapy and drug effect interpretations as well as of drugs themselves. Service components of pharmacy should be identified clearly to third party payers and be visible to consumers, so that they know what is available at what cost and how it may be accessed. In the future, pharmacy services must be evaluated on patient outcome (i.e., pharmaceutical care) rather than the number of prescriptions dispensed, and pharmacy must evolve toward interpretation and patient consultation, related to the use of medication technologies.

  • Assessment of Drug Prescribing in Jordan Using World Health Organization Indicators

    Background: Irrational drug use is a major public health problem worldwide. Patterns of prescribing of pharmaceuticals by physicians in Jordan have been scarcely studied. Objectives: To assess the drug prescribing patterns using World Health Organization Drug Use Indicators at 7 primary health care centers in Amman, the capital of Jordan. Methods: We prospectively evaluated 1055 prescriptions over a period of 2 months from May/2017 to July/2017, using the WHO prescribing indicators recommended protocol. Core prescribing indicators assessed in this study included the average number of drugs per prescription, the percentage of drugs prescribed by generic name, the percentage of prescriptions containing injections, the percentage of prescriptions containing antibiotics, and the percentage of drugs from the essential drugs list. Results: Our results showed that the average number of drugs per prescription was 3.0, the percentage of drugs written by generic name was 50.3%, the percentage of drugs written from essential drug list was 97.6%, and the percentages of prescriptions that contain injections and antibiotics were 7.1%, 61.0%, respectively. Conclusion: Three of the 5 indicators, namely, the average number of drugs per prescription, the percentage of drugs written by generic name, and the percentage of prescriptions that contain antibiotics, fell short of WHO optimal values indicating that there is a room for improvement in prescribing.

  • Pharmacovigilance and Managing ADRS in Bangladesh: Eccentric or Non-existent?

    Bangladesh became the 120th member of the WHO’s International Drug Monitoring Center (WHO-UMC). Through this membership, Bangladesh has gained international recognition and access to early worldwide information about potential safety risks. It was introduced in Bangladesh in 1999. However, due to a shortage of manpower and a lack of financial support, the program became dormant. It was revived in 2013 when the DGDA established the ADR Monitoring cell. Major advancements of the discipline of pharmacovigilance have taken place in the West, still, not much has been achieved in Bangladesh. The article highlights the various serious incidences ADRs, present health situation and broader scope of pharmacovigilance in Bangladesh.

  • Patient-Provider Relationship: Compliance with Care

    The Provider-Patient Relationship (PPR) is a novel concept of medical sociology in which patients voluntarily approach a doctor and thus become a part of a contract in which they tend to abide with the doctor’s guidance. It has been proposed that an ideal PPR has six components, namely voluntary choice, practitioner’s competence, good communication, empathy by the doctors, continuity, and no conflict of interest. In fact, a poor PPR has been proved to be a major obstacle for both doctors and patients, and has eventually affected the quality of healthcare and ability of the patients to cope with their illness. Owing to poor PPR, patients does not show compliance with doctor advice completely; opt for practitioner -shopping by changing their practitioner repeatedly; remain anxious; may choose quacks or other non-scientific forms of treatment; significant increase in direct and indirect medical expenses. Because of recurrent change in line of treatment as per the advice of different practitioner and non-completion of the entire course of drugs, there is a definite scope for the emergence of antimicrobial resistance, which further compounds the medical cost and anxiety, and finally may develop serious forms of disease or complications. From the practitioners’ perspective, they may ask for unnecessary investigations or may give over-prescriptions, just to be safe. There is also observed a remarkable decline in human touch or empathy; and a significant rise in unhealthy competition among doctors.

  • Pharmacovigilance: Present Scenario and Future Goals

    Melon Pharmacovigilance is the science and activity relating to the collection, detection, assessment, monitoring, and prevention of adverse effects with pharmaceutical products. Pharmacovigilance basically targets safety of medicine. Pharmacists have crucial role in health systems to maintain the rational and safe use of medicine for they are drug experts who are specifically trained in this field. The perspective of pharmacy students on pharmacovigilance and ADR reporting has also been discussed with an aim to highlight the need to improve content related to ADR reporting and pharmacovigilance in undergraduate pharmacy curriculum. Globally, although the role of pharmacists within national pharmacovigilance systems varies, it is very well recognized. Incorporation of ADR reporting concepts in education curriculum, training of pharmacists and voluntary participation of pharmacists in ADR reporting is very crucial in achieving the safety goals and safeguarding public health. Also, these knowledge gaps can be fulfilled through continuous professional development programs and reinforcing theoretical and practical knowledge in undergraduate pharmacy curriculums. Without adequately identifying and fulfilling training needs of pharmacists and other health care professionals, the efficiency of national pharmacovigilance systems is unlikely to improve which may compromise patient’s safety.

  • Patient Safety: A Nobody’s Concern

    Patient safety is a global concern and is the most important domains of health-care quality. Medical error is a major patient safety concern, causing increase in health-care cost due to mortality, morbidity, or prolonged hospital stay. A definition for patient safety has emerged from the health care quality movement that is equally abstract, with various approaches to the more concrete essential components. Patient safety was defined by the IOM as “the prevention of harm to patients.” Emphasis is placed on the system of care delivery that prevents errors; learns from the errors that do occur; and is built on a culture of safety that involves health care professionals, organizations, and patients. Patient safety culture is a complex phenomenon. Patient safety culture assessments, required by international accreditation organizations, allow healthcare organizations to obtain a clear view of the patient safety aspects requiring urgent attention, identify the strengths and weaknesses of their safety culture, help care giving units identify their existing patient safety problems, and benchmark their scores with other hospitals.

  • Patient Problem Solving and Preventive Care

    Medications are powerful tools that, if used correctly, can prevent or treat disease. If used incorrectly, there is potential to cause great harm to people who take them. These unintended effects, called adverse effects, can occur from any medication. As health care teams, which include physicians, pharmacists, and other health care providers, are making decisions about using specific medications to treat an individual patient, they must weigh the potential risks against the desired benefit of each medication to minimize the chance of harm to the patient. As important members of the health care team, pharmacists work collaboratively with patients’ other health care providers in all types of patient care settings ranging from community pharmacies to hospitals and long-term care facilities. Across these settings, pharmacists take specific actions that regularly contribute to improving patient safety. In addition to training on medications, pharmacist education and training includes assessing health status of patients, providing education and counseling, managing diseases, and using health care technologies. Pharmacists use this education and training to prevent medication errors, drug interactions, and other adverse medication events from reaching patients. With the expanding number and complexity of medications, pharmacists’ roles and responsibilities have expanded broadly beyond medication distribution. Pharmacists are providing patient care in almost all health care settings to help people of all ages get the most from the medications that are prescribed to them. Examples of pharmacists’ patient care services include providing health and wellness screenings, managing chronic diseases, assisting patients with medication management, administering immunizations, and working with hospitals and health systems to improve patient care and reduce the number of patients who are readmitted to the hospital following their hospital stay.

  • Framework for Patient Safety

    Medication errors are common in general practice and in hospitals. Both errors in the act of writing (prescription/dispensing/administration errors) and prescribing faults due to erroneous medical decisions can result in harm to patients. Any step in the prescribing process can generate errors. Slips, lapses, or mistakes are sources of errors, as in unintended omissions in the transcription of drugs. Faults in dose selection, omitted transcription, and poor handwriting are common. Inadequate knowledge or competence and incomplete information about clinical characteristics and previous treatment of individual patients can result in prescribing faults, including the use of potentially inappropriate medications. An unsafe working environment, complex or undefined procedures, and inadequate communication among health-care personnel, particularly between doctors and nurses, have been identified as important underlying factors that contribute to prescription errors and prescribing faults. Active interventions aimed at reducing prescription errors and prescribing faults are strongly recommended. These should be focused on the education and training of prescribers and the use of on-line aids. The complexity of the prescribing procedure should be reduced by introducing automated systems or uniform prescribing charts, in order to avoid transcription and omission errors. Feedback control systems and immediate review of prescriptions, which can be performed with the assistance of a hospital pharmacist, are also helpful. Audits should be performed periodically.

  • ARTS AND SCIENCE OF PRESCRIBING

    Prescribing patient is a mammoth task. It is recommended that healthcare professionals who prescribe medications exercise critical thinking skills to ensure the safe and effective use of therapeutic agents. It should be endowed with communication skills, diagnostic skills, knowledge of medicines, an understanding of the principles of clinical methodology, consecutive risk and uncertainty. In fact, clinicians prescribe in varied situations, often in the absence of patient, and rational prescribing decisions must be based on knowledge interpreted in the light of many other factors. Purpose of the study: Discussion and projection of drug prescribing among patients of both acute and chronic care. The pharmacists have a vital role to play which is thoroughly discussed. Findings: Prescribing is not just a piece giving patient a piece of paper and advising him to follow instructions. Many factors and necessary considerations are lying beneath. Materials and Methods: Research conducted a comprehensive year-round literature search, which included books, technical newsletters, newspapers, journals, and many other sources. Medicine and technical experts, pharma company executives and representatives were interviewed. Projections were based on estimates such as drug end users, providers or prescribers, general theories of rational use, implication and types of different prescribing methods. Research limitations: Very few articles found in matters regarding along with a very less interest paid by general people to talk about medicine use, prescription, pharmacists in counseling therapy, ADRs and their management. It was very difficult to bring out facts of irrational prescribing or different prescribing policy by the providers cause prescription holding patients rarely co-operates in this. Practical Implication: A good prescribing is the soul of patient compliance and safety along with well-being after a period of illness. Along with students, researchers and professionals of different background and disciplines, e.g. Pharmacists, doctors, nurses, hospital authorities, public representatives, policy makers and regulatory…