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Background: The provision of comprehensive individual health care services in outpatient units is intricately linked to drug management practices and the quality of available pharmacy services, ensuring optimal medication supply and use. Objective: This study aimed to assess the practices of drug management and the quality of outpatient pharmacy services at Haji Padjonga Daeng Ngalle (HPDN) Regional General Public Hospital in Takalar Regency, Indonesia. Method: The evaluation of drug management involves conducting in-depth interviews in the outpatient unit, focusing on planning, budgeting, procurement, storage, and distribution, compared with government regulatory standards. The quality of pharmacy services was assessed using the Solvin technique with 100 respondents, evaluating five dimensions: physical evidence, reliability, responsiveness, assurance, and empathy, using the servqual questionnaire with a Likert scale (ranging from very dissatisfied = 1, dissatisfied = 2, somewhat satisfied = 3, satisfied = 4, to very satisfied = 5). Results: Research findings indicated the level of compliance of drug management with regulations as follows: planning (66.67%), budgeting (60%), procurement (100%), storage (100%), and distribution (100%). The quality of pharmacy services demonstrated high questionnaire validity (r = 0.714), and the average dimension was a score of 4, indicating satisfactory satisfaction levels. Conclusion: This study reflects HPDN hospital's compliance with regulations while identifying specific areas for improvement to enhance the quality of pharmacy services. [ABSTRACT FROM AUTHOR]

Chronic heart failure (CHF) is a common complication and cause of death in dialysis patients. Although several clinical guidelines and expert consensus on heart failure (HF) in the general population have been issued in China and abroad, due to abnormal renal function or even no residual renal function (RRF) in dialysis patients, the high number of chronic complications, as well as the specificity, variability, and limitations of hemodialysis (HD) and peritoneal dialysis (PD) treatments, there are significant differences between dialysis patients and the general population in terms of the treatment and management of HF. The current studies are not relevant to all dialysis-combined HF populations, and there is an urgent need for high-quality studies on managing HF in dialysis patients to guide and standardize treatment. After reviewing the existing guidelines and literature, we focused on the staging and diagnosis of HF, management of risk factors, pharmacotherapy, and dialysis treatment in patients on dialysis. Based on evidence-based medicine and clinical trial data, this report reflects new perspectives and future trends in the diagnosis and treatment of HF in dialysis patients, which will further enhance the clinicians' understanding of HF in dialysis patients. [ABSTRACT FROM AUTHOR]

Introduction: In alignment with China's national directive for improved drug management in anesthesiology, the Affiliated Hospital of Qingdao University initiated a quality improvement project, aiming to tackle the prevailing challenges of inefficiencies in drug administration, escalating drug costs, and the notable communication gap between pharmacists and anesthesiologists. Methods: We employed a Plan-Do-Study-Act methodology to establish a pharmacy team and execute a multidimensional pharmaceutical intervention. The interventions included the formulation of standard procedures, guidelines and regulations, assistance from an information system (including automatic dispensing cabinets and prospective prescription review system), communication feedback (via WeChat groups), and education for anesthesiology staff. The intervention spanned from April to September 2023, focusing on optimizing medication management, achieving cost savings, and enhancing the satisfaction of anesthesia team members, with an additional observation from October to December 2023. Results: Following the interventions, improvements were observed in drug management practices. These enhancements included increased compliance with accounting procedures, more rigorous registration of controlled substances, and more effective disposal of liquid residues. There was no adverse events related to high-alert medications or look-alike drug usage errors. The introduction of automatic dispensing cabinets and a prospective prescription review system markedly improved work efficiency. The utilization of a WeChat group facilitated effective communication about unreasonable prescriptions and drug-related issues. Among the 29,061 patients who underwent surgery both before and after the interventions, significant reductions were observed both in the drug proportion and the per capita drug costs (P = 0.03, P = 0.014, respectively). The per capita drug cost decreased by 20.82%, from ¥723.43 to ¥572.78, consistently remaining below ¥600 throughout the 9-month observation period. The per capita cost of monitoring drugs including dezocine, butorphanol, haemocoagulase agkistrodon, penehyclidine, and ulinastatin experienced a significant reduction (P < 0.05). Additionally, in the satisfaction questionnaires returned, a remarkable 94.44% of anesthesiology staff expressed high satisfaction with the comprehensive pharmaceutical interventions. Conclusion: The quality improvement project has yielded remarkable positive outcomes, serving as a model worthy of reference and replication in similar healthcare settings. [ABSTRACT FROM AUTHOR]

The study presents an assessment of surgical and drug management of periodontal complications during pregnancy, with a focus on the impact of these interventions on pregnant women’s oral health and fetal development. Management dedicated to periodontal complications during pregnancy can help improve the oral health of pregnant women and reduce the risk of associated obstetric complications. These findings support the need to integrate periodontal treatment into prenatal care to improve both maternal and fetal health. Women with pre-existing periodontal disease may experience a worsening of their condition during pregnancy, with potential repercussions on overall health. Understanding the hormonal effects and risks associated with periodontal complications during pregnancy is essential to implement appropriate management strategies and ensure proper oral care during this delicate period. Preventive management and prompt treatment can significantly contribute to maintaining periodontal health and reducing risks to the mother and fetus. Vitamin complexes, especially vitamin C, are essential for the functioning of the immune system and contribute to the synthesis of collagen, a protein important for tissue health, including gums. Adequate levels of vitamin C can help heal gum tissues and reduce inflammation.

Background: Drug management information systems can serve as tools for decision-making. The effectiveness of such a system can be assessed through evaluation. One of the evaluation methods used is the PIECES method. Objectives: This research aims to evaluate and develop a drug management information system using the PIECES method. Methods: The research conducted was a qualitative descriptive study with inductive analysis. Sampling for this research was conducted purposive sampling. System development in this study utilized the prototype method, with interviews conducted for Management Information System (MIS) evaluation using the PIECES Framework. The design of the MIS system was created using Data Flow Diagrams and Entity Relationship Diagrams. The designed MIS system development was evaluated using the same method. Data processing in qualitative research consists of valid, clear, and accountable word descriptions, sentences, or narratives provided by the researchers, followed by data validation using triangulation techniques and Nvivo 12 Plus software. Results: Evaluation results using the PIECES Framework indicate that the implemented MIS system benefits and aids staff performance in daily drug dispensing. However, there are still manual tasks and lacking features such as distribution, drug expiration warnings, and minimum stock on the dashboard. The proposed design for MIS system development includes several features such as stock in, stock out, and distribution, complemented with drug expiration warnings, minimum stock alerts on the dashboard, and reports for each feature. Conclusion: Implementing the proposed MIS system design can assist and streamline work processes by providing comprehensive information, thus serving as a decision-making tool.

OBJECTIVE: To explore the application effects of Health Failure Mode and Effect Analysis (HFMEA) in the outpatient drug management process. METHODS: Using HFMEA as the theoretical framework, the hazard analysis and decision tree analysis were conducted on drug management process in the outpatient pharmacy of the hospital, the failure mode that need to be corrected immediately was identified, and corresponding improvement plans were formulated. From Jul. To Dec. 2021 was taken as before intervention and from Jul. To Dec. 2022 was taken as after intervention (after the HFMEA team implemented the improvement plans), the improvements of risk-prioritized number (RPN) and drug management items ( drug turnover days, drug receive time, inventory time, number of validity-verification adverse events, number of drug acceptance inspection errors) were compared before and after intervention to analyze the improvement effects. RESULTS: After 6 months of intervention, the RPN had decreased from 234 before intervention to 96, with a decreasing amplitude of 59%, the drug turnover days, drug receive time and inventory time were significantly shortened, the numbers of validity-verification adverse events and drug acceptance inspection errors were significantly reduced, with statistically significant differences (P<0. 05). CONCLUSIONS: The application of HFMEA to effectively screen out the failure mode in drug management process and to establish informationized drug management system can significantly improve the drug management levels, reduce medication errors, ensure safe and effective medication in patients. [ABSTRACT FROM AUTHOR]

This article provides information on the surgical and medical management of periodontal complications during pregnancy. It emphasizes the importance of integrating periodontal treatment into prenatal care to improve the health of both the mother and fetus. The article discusses the impact of hormonal changes during pregnancy on gum inflammation and the development of periodontal disease. It also highlights the importance of maintaining good oral hygiene and seeking regular dental care during pregnancy. The document includes a list of scientific articles and studies that cover various aspects of oral health and pregnancy outcomes, providing valuable information for researchers and healthcare professionals. [Extracted from the article]

In the current COVID-19 era, one of the critical factors influencing the quality of hospital services is drug management, with planning and procurement being particularly pivotal to avoid drug shortages. This study aimed to examine the selection, procurement, and lead time aspects of drug management at the pharmacy installation hospital in Jakarta during the COVID-19 pandemic. Conducted as a descriptive study with retrospective data, total sampling was utilized to collect data, incorporating 1,413 drugs. The data, collected on observation sheets, underwent univariate analysis using Microsoft Excel. Results indicated that out of the seven measurable indicators, two met the standards: the percentage of allocated funds for drug procurement at 70.5%, and the frequency of errors in orders occurring five times. However, five indicators fell below the standards: the suitability of drug items with the National Formulary at 14.15%, the suitability of drug items with the Hospital Formulary at 68.15% (with an 80% benchmark), the frequency of each item's procurement in a year at a low category of 43.45%, the percentage of conformity between planning and reality at 99.61%, and the achievement of lead time for ordering drugs at 5.08 days. In conclusion, the selection, procurement, and lead time aspects of drug management at the "X" Hospital Pharmacy Installation did not fully meet the established standards. Therefore, it is recommended that healthcare management implements and adheres to robust drug management system regulations, particularly during pandemic situations, to ensure optimal hospital services.

The development of“Internet + Healthcare”in recent years has led to the development of the healthcare industry while breaking through the regional restrictions of traditional medical treatment to provide convenience for patients. Aiming to regulate online diagnosis and treatment，the current regulation stipulated that online diagnosis and treatment cannot be applied to“primary diagnosis”patients，while the violations of relevant regulations and breach of medical service contract require bearing civil liability and administrative responsibility. However，there are some problems with online consultation in practice，such as the ambiguous boundary between medical consultation and diagnosis and treatment services，the lack of specific standards for primary diagnosis review，and the weak practical ability of current norms. In addition，illegal primary diagnosis on the internet also disrupts drug administration. Based on the issues above，this essay puts forward the following corresponding suggestions and measures. It is necessary to strictly distinguish between medical consultation and diagnosis or treatment activities，refine the current regulations for the primary diagnosis，and improve drug management systems related to internet diagnosis and treatment， improving the current legal system to regulate online diagnosis and treatment activities strictly. [ABSTRACT FROM AUTHOR]

Unintentional medication discrepancies at admission are differences between the best possible medication history and the prescribed treatment at admission, and are associated with adverse outcomes, particularly in older people. This study aimed to identify the clinical profiles of geriatric inpatients with unintentional medication discrepancies at hospital admission. A classification tree Chi-square Automatic Interaction Detector (CHAID) analysis was conducted to assess those patients' profiles and characteristics that were associated with a higher risk of unintentional medication discrepancies. One-hundred and thirty consecutive older patients admitted to acute care (87 ± 5 years old; 61.8% women) were assessed. The CHAID analysis retrieved 5 clinical profiles of older inpatients with a risk of up to 94.4% for unintentional medication discrepancies. These profiles were determined based on combinations of three characteristics: use of eye drops, frequent falls (≥ 1/year), and admission due to urgent hospitalization. These easily measurable clinical characteristics may be helpful as a supportive measure to improve pharmacological care. [ABSTRACT FROM AUTHOR]

BACKGROUND: Oral oncolytic drug approvals have increased in recent years along with the incidence of hematologic malignancies, leading to expanded roles for oncology pharmacy specialists in the management of oral oncolytics. OBJECTIVE: To describe the clinical role of oncology pharmacy specialist--driven interventions in patients receiving oral oncolytics prescribed in a hematology clinic at a community cancer center. METHODS: This was a retrospective chart review of patients with confirmed hematologic malignancy who initiated treatment with or who were already receiving oral oncolytics between January 1, 2021, and June 30, 2021, in the outpatient hematology clinics at Miami Cancer Institute Baptist Health South Florida. Patients who were enrolled in a clinical trial were excluded from the study. The primary study outcome was to describe the type and frequency of pharmacy specialist interventions in the management and safety of oral oncolytics. The secondary outcome was to identify the trends between the number and type of interventions and the baseline patient characteristics and drug class. Descriptive statistics were used in the data analysis. RESULTS: A total of 701 oncology pharmacy specialist--driven interventions relating to oral oncolytic management were performed. The pharmacy specialists' interventions most frequently included medication access (16.4%), drug initiation/proposal (10.8%), supportive care (9.8%), patient education (9.1%), and medication therapy management (6.6%). The medications that most frequently required intervention were lenalidomide, pomalidomide, and venetoclax, which align with the most frequent disease states at the institution's practice, multiple myeloma and acute myeloid leukemia. CONCLUSION: This review demonstrates the clinical role of oncology pharmacy specialists in the management of oral oncolytic therapy in the outpatient hematology setting, specifically as it relates to medication access, drug initiation/proposal, supportive care management, patient education, and medication therapy management. [ABSTRACT FROM AUTHOR]

Background: The existence of the COVID-19 pandemic has caused a shift in medicine use in patients. Objective: This study aims to determine patterns and differences in medicine use at Airlangga University Hospital before (2018 and 2019) and after (2020–2022) the COVID-19 pandemic based on ABC, VEN and ABC-VEN matrix analysis. Methods: This study is a retrospective cross-sectional study. Data on all patients’ medicine use items between January 1st, 2018 – December 31st, 2022 which obtained from the hospital information system will be analyzed according to category based on the principles of ABC analysis, VEN, and the ABC-VEN combination and a statistical t-test analysis in SPSS to find out differences in medicine use at the Universitas Airlangga Hospital in the pre-pandemic era of COVID-19 versus the era of the COVID-19 pandemic. Results: Based on the results of the study, a total of 6893 drug items were obtained. There was a significant shift in the pattern of non-essential medicines use prescribed to patients after the COVID-19 pandemic (p < 0,05). Conclusion: There was a shift in the pattern of use of prescribed non-essential medicines after the COVID-19 pandemic compared to before the pandemic occurred. [ABSTRACT FROM AUTHOR]

Drug management is part of pharmaceutical service activities, which includes interrelated stages: selection, planning, requesting, receiving, storage, distribution, controlling, recording, reporting, monitoring and evaluation, which play an essential role in ensuring the availability of drugs at PHCs. The systematic review aims to identify indicators of drug management at PHCs in Indonesia and analyze factors that influenced it. This systematic review used the PRISMA methods. Google Scholar is an electronic database to identify related studies. This study is limited publications from 2013 to 2023. The quality of the articles was assessed using JBI Critical Appraisal. The electronics database search earned 570 articles, while only nine articles met the criteria for analysis. Several indicators are different from the standards used due to several factors. Based on the result, factors influencing drug management at PHCs include human resources, financing, information management, facilities, and technology. For most of them, human resources are a determining factor that significantly influences the quality of pharmaceutical services at PHC’s in Indonesia. The implementation of pharmaceutical services at the PHCs must be carried out by at least one pharmacist, the person in charge, who can be assisted by pharmaceutical technical staff as needed. Resources humans influence indicators of planning accuracy; suitability of requests; storage; distribution; control; recording, reporting, and archiving. This study's results are to make improvement strategies, including interventions to improve the quality of pharmaceutical services that impact community satisfaction and stakeholders.

L'admission d'un patient âgé à l'hôpital constitue un point critique à la continuité de son traitement médicamenteux. La conciliation médicamenteuse représente un moyen efficace d'identifier et de corriger des erreurs liées à un recueil imparfait de l'historique médicamenteux du patient. La pratique de la conciliation médicamenteuse est sécurisante pour le patient notamment du fait de la détection des erreurs médicamenteuses à impact clinique significatif. La mise en œuvre de cette dernière doit être conforme aux recommandations de la Haute Autorité de Santé (HAS) et son déploiement est aujourd'hui intégré dans le contrat d'amélioration de la qualité et de l'efficience des soins (CAQES). Toutefois, bien que la conciliation médicamenteuse permette d'intercepter les erreurs médicamenteuses, des questions restent posées concernant son impact sur la durée d'hospitalisation, le taux de réadmission et/ou de décès dans les suites de la sortie du patient. Compte tenu des ressources humaines limitées pour réaliser cette activité chronophage, une priorisation des malades doit être examinée. Des études portant sur le devenir des patients et sur les enjeux médico-économiques sont nécessaires afin de pérenniser cette activité. Admission to hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. The practice of medication reconciliation is securing for the patient because of the medication errors detected with significant clinical impact. Its implementation must comply with the recommendations of the French National Authority for Health (HAS) and its deployment is now integrated into the contract for improving the quality and efficiency of care (CAQES). However, although it allows to intercept medication errors, its impact on the length of hospitalization, the rate of readmission and/or death following discharge seems limited. Given the limited human resources to carry out this time-consuming activity, patient prioritization should be considered. Studies on the fate of patients and on the medico-economic issues are also necessary in order to make this activity sustainable. [ABSTRACT FROM AUTHOR]

Introduction In 2010, the presidents of the National Societies of Anaesthesiology signed the Helsinki Declaration on patient safety in anaesthesia, one of the main recommendations of which is the correct labeling of syringes. Aim The aim of the study was to analyze the methods of labeling syringes by anaesthesiological nurses working in the operating room to prepare drugs used during anaesthesia. Material and methods The survey questionnaire was developed by the researchers based on available recommendations and guidelines. The study involved nurses/ward nurses or nurses coordinating the area of anaesthesia. Participation in the study was voluntary and anonymous. The collection of completed questionnaires lasted 3 months. All statistical calculations were performed using the IBM SPSS 23 statistical package and Excel 2013 spreadsheet. The significance level of p<0.05 was assumed in all calculations. Results The respondents came from 349 hospitals from all over Poland, which corresponded to the number of anesthesiology departments. The project involved: 34 nurses from a clinical hospital, 141 nurses from a provincial hospital and 174 nurses from a city hospital. Statistical analysis did not show any significant statistical differences between drug labelling procedures in different hospitals. Statistics confirmed that the use of waterproof markers was a significantly more common way of labelling syringes in city and provincial hospitals than in clinical hospitals, and handwritten descriptions on syringe packages were more common in provincial hospitals than in clinical hospitals (χ² (8)=17.96; p=0.021). Conclusions The existing systems for labelling drugs used in anaesthesia in Poland are not safe. Physicians and anaesthesiology nurses moving between hospitals must be aware of the variety of syringe labels, as well as possible errors and mistakes resulting from this. [ABSTRACT FROM AUTHOR]

The elderly are at the highest risk for drug-related problems caused by age-related physiological changes, multiple chronic illnesses, polypharmacy, and poor drug management. This study aims to analyze the ability of elderly regarding drug management. This study used an observational research method with an elderly population in the East Surabaya area. The research instrument used was MedMaIDETM (Medication Management Instrument for Deficiencies in the Elderly), which can be used to measure ability in medication management in the elderly community who are undergoing selfmedication with at least one medication. Sampling was carried out using a non-random sampling method with a purposive sampling technique. The number of respondents obtained in this study were 100 elderly who live in the East Surabaya area. The inclusion criteria for research respondents were: (1) willing to be a respondent; (2) domiciled in the East Surabaya area; (3) aged = 60 years; (4) able to communicate in Indonesian; and (5) consuming at least one medicine. The variable studied was drug management skills in the elderly which includes knowledge of the medications aspect, knowledge on how to take the medication aspect, and knowledge on how to obtain the medication. The average MedMAIDE scores of respondents in the three domains with a total average value of 1.18 and a standard deviation of 0.10, meanings each elderly at least had one deficiency out of 13 maximun score of deficiencies. There were 70 respondents out of 100 respondents who had limitations in drug management with one deficiency score as the smallest score and the largest total deficiency score being 7. Meanwhile, 30 other respondents had a no deficiency. The most difficult tasks were identified the problems after taking the medication, fill a glass with water, sip enough water to swallow medication and identify if a refill exists on a prescription. The ability of elderly people in the East Surabaya area to manage their medicines was good. The elderly were able to recognize the drugs used, use the drugs correctly, and comply with drug administration. [ABSTRACT FROM AUTHOR]

Therapeutic drug monitoring and Model-informed precision dosing allow dose individualization to increase drug effectivity and reduce toxicity. To evaluate the available evidence on the clinical efficacy of individualized antimicrobial dosing optimization. Data sources : PubMed, Embase, Web of Science, and Cochrane Library databases from database inception to 11 November 2022. Published peer-reviewed randomized controlled trials. Human subjects aged ≥18 years receiving an antibiotic or antifungal drug. Patients receiving individualized antimicrobial dose adjustment. Cochrane risk-of-bias tool for randomized trials. The primary outcome was the risk of mortality. Secondary outcomes included target attainment, treatment failure, clinical and microbiological cure, length of stay, treatment duration, and adverse events. Effect sizes were pooled using a random-effects model. Statistical heterogeneity was assessed by inconsistency testing (I2). Ten randomized controlled trials were included in the meta-analysis (1241 participants; n = 624 in the individualized antimicrobial dosing group and n = 617 in the control group). Individualized antimicrobial dose optimization was associated with a numerical decrease in mortality (risk ratio [RR] = 0.86; 95% CI, 0.71–1.05), without reaching statistical significance. Moreover, it was associated with significantly higher target attainment rates (RR = 1.41; 95% CI, 1.13–1.76) and a significant decrease in treatment failure (RR = 0.70; 95% CI, 0.54–0.92). Individualized antimicrobial dose optimization was associated with improvement, but not significant in clinical cure (RR = 1.33; 95% CI, 0.94–1.33) and microbiological outcome (RR = 1.25; CI, 1.00–1.57), as well as with a significant decrease in the risk of nephrotoxicity (RR = 0.55; 95% CI, 0.31–0.97). This meta-analysis demonstrated that target attainment, treatment failure, and nephrotoxicity were significantly improved in patients who underwent individualized antimicrobial dose optimization. It showed an improvement in mortality, clinical cure or microbiological outcome, although not significant. [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of the study was to show the effects of drug management, home arrangements, and exercise combined program on falling and quality of life in older adults. The multidisiplinary study was conducted with 41 participants aged 65-74 years registered with three Family Health Centers. A combined program which consist of drug management, home arrangements, and exercise program was applied them individually for six months. Data were collected by self-report using a Sociodemographic Form, Domestic Environmental Risk Factors of Falling Form, Fall Risk Assessment Scale, SF-36 Quality of Life Scale, and Follow-up Form. The mean age of the participants was 69.1 ± 3.1 years, and were (F/M:37/4). After three and six months the domestic environmental risk factors of falling, fall numbers, risk and SF-36 quality of life subscales decreased significantly compared to baseline assessment (p<.05). The multidisciplinary program reduced the number of falls, the risk of falling and improved quality of life. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Application of artificial intelligence/machine learning (AI/ML) for automation of diabetes management can enhance equitable access to care and ensure delivery of minimum standards of care. Objective of the current study was to create a clinical decision support system using machine learning approach for diabetes drug management in people living with Type 2 diabetes. Methodology: Study was conducted at an Endocrinology clinic and data collected from the electronic clinic management system. 15485 diabetes prescriptions of 4974 patients were accessed. A data subset of 1671 diabetes prescriptions of 940 patients with information on diabetes drugs, demographics (age, gender, body mass index), biochemical parameters (HbA1c, fasting blood glucose, creatinine) and patient clinical parameters (diabetes duration, compliance to diet/exercise/medications, hypoglycemia, contraindication to any drug, summary of patient self monitoring of blood glucose data, diabetes complications) was used in analysis. An input of patient variables were used to predict all diabetes drug classes to be prescribed. Random forest algorithms were used to create decision trees for all diabetes drugs. Results and Conclusion: Accuracy for predicting use of each individual drug class varied from 85% to 99.4%. Multi-drug accuracy, indicating that all drug predictions in a prescription are correct, stands at 72%. Multi drug class accuracy in clinical application may be higher than this result, as in a lot of clinical scenarios, two or more diabetes drugs may be used interchangeably. This report presents a first positive step in developing a robust clinical decision support system to transform access and quality of diabetes care.

Primary health centers is a facility that organizes health efforts at the first level to achieve health degrees, but in its implementation is still constrained in realizing standard pharmaceutical services. The purpose of the research is to find out the quality of drug management in Tegal City primary Health Center. This study is a non-experimental descriptive study. The study was conducted throughout the primary health center in Tegal City. Data collection is prospective and retrospective by tracing documents to obtain secondary data and direct observations, interviews of pharmaceutical personnel, heads of primary health centers, and heads of the pharmaceutical section to obtain primary data. The next drug management indicator is done descriptive data analysis by calculating the value of the indicator with the formula then compared to the standard and inter primary health care. Indicators of drug management used 28 and those that meet standard 10. Indicator results include conformity of items with disease patterns 76.39%, planning accuracy 321.10%, the accuracy of the number of requests 169.84%, the storage of narcotics 72.92%, the storage of drugs without contamination 98.97%, the storage of high alert drugs 68.15%, the storage of LASA drugs 87.5%, ITOR 1.87 times /year, the availability of drugs 36.08 months, drug items less than 14.01%, safe drug items 37.94%, excess stock items 41.76%, non-prescribed drugs 4.59% and drug value ED 3.85%. These results show that drug management indicators in Tegal City primary health centers have not been efficient and need improvements ranging from the planning stage to control. Indicators that still need improvement include ITOR and all indicators of drug availability. Things that need to be done to improve indicators that have not been efficient include increasing the number and quality of pharmaceutical human resources in primary health centers, increasing supervision of drug use and control, building communication, and a good organizing culture in primary health centers.

OBJECTIVE: To explore whether anesthesiologists' efficiency can be increased via the use of intelligent equipment, thereby improving the quality of surgical anesthesia. SUBJECTS AND METHODS: This paper first introduces the intelligent management system and work flow of drugs and consumables in the department of anesthesiology in our hospital, and then compares the time before and after the use of intelligent equipment, the time for anesthesiologists and nurses to manage drugs and consumables, the misdistribution rate of drugs distributed by anesthetic nurses, and the inventory time and accuracy of narcotic drugs. RESULTS: For the intelligent management with intelligent drug cabinets and logistics robots as the terminal, compared with traditional management, the anesthesiologist saves an average of 24±1 (min) per day in acquisition of drugs and consumables, and the total error rate in drugs and consumables distribution by anesthesia nurses is reduced from 4% to 1%, the inventory time of anesthetic drugs is 12±5 (min) earlier than before, and inventory accuracy has been increased from 94.6% to 98.6%. The anesthesia nurses save an average of 53.1±10 (min) per day from taking medicines to operating anesthesia billing than before. CONCLUSIONS: The intelligent management of drugs and consumables in the Anesthesiology Department improves management efficiency, ensures medication safety for surgical patients, increases anesthesia management time for anesthesiologists, and improves the quality of surgical anesthesia. [ABSTRACT FROM AUTHOR]

Nurses’ knowledge regarding patient safety affects nurses’ behaviors in managing drugs related to patient safety. A preliminary study at Sultan Agung Islamic Hospital Semarang showed that nurses’ knowledge regarding patient safety was still low, especially about drug management, including storing, ordering/prescribing and recording, administering, and monitoring drugs. This study aimed to determine the correlation between nurses’ knowledge regarding patient safety and nurses’ behaviors in drug management among nurses in the inpatient units of Sultan Agung Islamic Hospital, Semarang. This research was an observational study with a cross-sectional design. The population was 178 nurses in the inpatient units of the specified hospital with a total sample of 123 respondents. The data were collected using a questionnaire and analyzed using Spearman’s rank correlation test. The results showed a correlation between nurses’ knowledge regarding patient safety and nurses’ behaviors in storing drugs (p=0.001

This paper summarized the concept and characteristics of "Internet +", analyzed the application and difficulties of "Internet +" in drug management for chronic diseases, summarized the influencing factors of drug compliance of patients with chronic diseases, and put forward suggestions and prospects for the development of Internet + in drug management for chronic diseases. (本文综述了“互联网+”的概念、特点, 分析“互联网+”在慢性病药物管理中的应用情况和难点, 概述慢性病患者服药依从性的影响因素, 并对“互联网+”在慢性病药物管理中的发展提出建议和展望。)

Background: People with visual impairments are often faced with challenges in the process of medicines management and use. Mobile device‐based applications can be a potential solution in reducing these challenges. Objectives: This study aimed to analyse the requirements for developing a mobile device‐based medicines management application for people who are blind and visually impaired. Methods: A questionnaire was designed to examine the requirements for developing a medicines management application for people who were blind and visually impaired. The questionnaire was sent to 2081 people who are blind or visually impaired, and their instructors. Among them, 146 people (125 with visual impairments and 21 instructors) completed the questionnaire. SPSS 23 software was used for statistical analysis. Results: Ninety percent of people with visual impairments and 75% of instructors were willing to assist in application design. Out of 44 data elements, 35 were considered important for designing and creating mobile device‐based medicines management applications. 'Providing education information about drugs in the form of audio files' (4.71 ± 0.56), 'Ability to update software' (4.71 ± 0.56) and 'Ability to search for physician's addresses' (4.71 ± 0.46) were rated highest, in terms of required 'Application capabilities', by the study cohort based on average Likert scale scores (1 = very low, 2 = low, 3 = moderate, 4 = high, 5 = very high). Conclusion: This study provides a set of data elements that people who are blind and visually impaired, and their instructors, have identified as being important to the development and design of mobile device‐based medicines management applications. Developers can use the identified data elements to help in the design and implementation of their medicines management applications or electronic systems. Applications and electronic systems that incorporate features for people who are blind and visually impaired, have the potential to improve quality of life by enabling independent medicines management and medicines adherence, whilst potentially decreasing medication errors, rate of diseases, frequency of hospitalisations and medicines related deaths. [ABSTRACT FROM AUTHOR]

Background and Objectives: Application of artificial intelligence/machine learning (AI/ML) for automation of diabetes management can enhance equitable access to care and ensure delivery of minimum standards of care. Objective of the current study was to create a clinical decision support system using machine learning approach for diabetes drug management in people living with Type 2 diabetes. Methodology: Study was conducted at an Endocrinology clinic and data collected from the electronic clinic management system. 15485 diabetes prescriptions of 4974 patients were accessed. A data subset of 1671 diabetes prescriptions of 940 patients with information on diabetes drugs, demographics (age, gender, body mass index), biochemical parameters (HbA1c, fasting blood glucose, creatinine) and patient clinical parameters (diabetes duration, compliance to diet/exercise/medications, hypoglycemia, contraindication to any drug, summary of patient self monitoring of blood glucose data, diabetes complications) was used in analysis. An input of patient variables were used to predict all diabetes drug classes to be prescribed. Random forest algorithms were used to create decision trees for all diabetes drugs. Results and Conclusion: Accuracy for predicting use of each individual drug class varied from 85% to 99.4%. Multi-drug accuracy, indicating that all drug predictions in a prescription are correct, stands at 72%. Multi drug class accuracy in clinical application may be higher than this result, as in a lot of clinical scenarios, two or more diabetes drugs may be used interchangeably. This report presents a first positive step in developing a robust clinical decision support system to transform access and quality of diabetes care. [ABSTRACT FROM AUTHOR]

Abstract Objective After the large-scale earthquake in 2011, the disaster medical assistance team (DMAT) was made responsible for medical activities during the hyperacute phase of a disaster or accident in Japan. The medicines to be administered at the disaster sites, packaged in medical bags, may be affected by the temperatures there. This study aimed at establishing a method to handle drug bags in high-temperature situations by determining the temperature changes in medical bags subject to high temperatures and examining the effect of opening the bag and using heat-insulating material (HIM) and coolants. Results Closed and semi-opened bags limited the temperature increase in the central part of the bag at both 35 and 40 °C to a greater extent than opened bags. When coolant and HIM were used in closed and semi-opened bags, the internal temperatures were significantly lower than in the opened state at 40 °C. In high-temperature disaster sites, medical bags should be maintained in a semi-opened or closed state using a HIM and coolant.

The impact of Corona Virus Disease-19 or COVID-19 pandemic was seen almost all aspects, especially in health facilities. Puskesmas as known as Public Health Center is a primary health service facility that usually became the first choice for seeking treatment so that Puskesmas can be said to be the backbone in facing and fighting the COVID-19 outbreak. This study aimed to determine the impact of the Covid-19 pandemic on drug management and the level of drug availability at Puuwatu Public Health Center, Kendari City. This study was descriptive-evaluative research with quantitative and qualitative methods and retrospective data collection in 2019 (before the pandemic) and 2020 (during the pandemic). Based on the results of the study, the percentage of the suitability of items with National Formulary increased by 1.3% during the pandemic, the percentage of the empty stock increased by 9.8%, the percentage value of damaged and expired items increased by 1.73%, the percentage of less stock decreased by 6, 43%, the percentage of safe stock and excess stock items decreased by 2.36% and 1.06%, respectively. The percentage value of suitability of the physical number of items did not change both in 2019 and in 2020 at the Puuwatu Health Center, Kendari City

The coronavirus disease that emerged in 2019 (COVID-19) has affected health, societies and economies. Policies that have been imposed by different countries to slow the spread of the disease, including national lockdowns, curfews, border closures and enforcement of social distancing measures have disturbed the drug supply chain and resulted in drug shortages. Uncertainty concerning the pandemic has also led to the panic buying of drugs and the stockpiling of drugs in households, which has amplified the problem. In this cross-sectional study, a self-developed questionnaire was distributed online in order to a) assess the practice of household drug stockpiling prior to the national lockdown in Jordan, b) investigate the factors affecting it and c) measure peoples' knowledge about the consequences of this behaviour. Results from this study show that drug purchasing was reported by 44.3% of the participants and was most common among participants from non-medical backgrounds (336, 75.7%) or those who have chronic diseases (261, 58.8%) and taking chronic supplements (282, 63.5%) regardless of their age, gender, living area or the possession of health insurance. Analgesics and antipyretics were the most frequently purchased drugs (225, 70.5%) and anticipation of their need was the most common reason for purchasing drugs (231, 52.0%). Buyers were also less aware, when compared to non-buyers, that panic buying and drug stockpiling may lead to drug shortages (204, 45.9% vs 325, 58.1%) and that this behaviour can pose a health hazard, especially to children (221, 47.5% vs 342, 61.2%). Our study shows that panic buying of drugs and household drug stockpiling were common in Jordan during the COVID-19 pandemic and this was related to participants' medical knowledge and educational backgrounds. Therefore, educating the general population regarding rational drug use is urgently needed. This is also a compelling case for the development of national guidelines for drug management that target the general population and healthcare personnel, especially pharmacists, to avoid drug shortages during crises. [ABSTRACT FROM AUTHOR]

The coronavirus disease that emerged in 2019 (COVID-19) has affected health, societies and economies. Policies that have been imposed by different countries to slow the spread of the disease, including national lockdowns, curfews, border closures and enforcement of social distancing measures have disturbed the drug supply chain and resulted in drug shortages. Uncertainty concerning the pandemic has also led to the panic buying of drugs and the stockpiling of drugs in households, which has amplified the problem. In this cross-sectional study, a self-developed questionnaire was distributed online in order to a) assess the practice of household drug stockpiling prior to the national lockdown in Jordan, b) investigate the factors affecting it and c) measure peoples’ knowledge about the consequences of this behaviour. Results from this study show that drug purchasing was reported by 44.3% of the participants and was most common among participants from non-medical backgrounds (336, 75.7%) or those who have chronic diseases (261, 58.8%) and taking chronic supplements (282, 63.5%) regardless of their age, gender, living area or the possession of health insurance. Analgesics and antipyretics were the most frequently purchased drugs (225, 70.5%) and anticipation of their need was the most common reason for purchasing drugs (231, 52.0%). Buyers were also less aware, when compared to non-buyers, that panic buying and drug stockpiling may lead to drug shortages (204, 45.9% vs 325, 58.1%) and that this behaviour can pose a health hazard, especially to children (221, 47.5% vs 342, 61.2%). Our study shows that panic buying of drugs and household drug stockpiling were common in Jordan during the COVID-19 pandemic and this was related to participants’ medical knowledge and educational backgrounds. Therefore, educating the general population regarding rational drug use is urgently needed. This is also a compelling case for the development of national guidelines for drug management that target the general population and healthcare personnel, especially pharmacists, to avoid drug shortages during crises.

The scope of drug management in Primary Health Center (PHC) includes planning/selection, procurement, storage, distribution, control of use, and documentation and reporting. During the COVID-19 pandemic, there were many changes in regulation and management in Primary Health Center. Such a situation certainly has an impact on the drug management of Primary Health Center. The purpose of this study is to evaluate drug management in Salaman 1 Primary Health Center in Magelang District, Central Java Province, during the COVID-19 pandemic in 2020. This research is an evaluative study using a descriptive design with a qualitative approach. The data was obtained by three methods, i.e., direct observation, interview, and secondary data. Direct observation was applied to observe the medicines' storage space. Interviews were conducted with five informants selected purposively according to the research's purpose. The assessments of secondary data were performed from the available and relevant data documentations. Data were analyzed by triangulation approach of the three types of data produced, namely observation data, interview data, and secondary data assessment. The results show several problems regarding drug management in Salaman 1 PHC during the COVID-19 pandemic. The drug selection is not precisely suitable for the needs, while drug procurement cannot always be arranged according to the planning. Furthermore, drug distribution is relatively impeded. Control of use found the number of expired and almost expired drugs increases. Drug storage and documentation are the two steps in the drug management cycle conducted appropriately in Salaman 1 PHC during the COVID-19 pandemic. This evaluative study concludes that the COVID-19 pandemic affected the drug management cycle in Salaman 1 PHC in Magelang District in 2020. Therefore, coordination among stakeholders must be improved to anticipate unforeseen circumstances, especially during the pandemic situation. The impacts of new policy implementations must be anticipated by testing, monitoring, and evaluating.

OBJECTIVE: To investigate drug application in Beijing Children's Hospital Affiliated to Capital Medical University (hereinafter referred to as "our hospital"), so as to provide references for delicacy drug management. METHODS: Activity based classification (ABC) analysis, vital-essential-nonessential (VEN) analysis and ABC-VEN matrix analysis methods were adopted to analyze the varieties and consumption sum of drugs used by outpatient and inpatient in our hospital from Sept. 2018 to Aug. 2019, inventory turnover analysis and dosage analysis were conducted at the same time. RESULTS: Totally 698 kinds of drugs were used in the outpatient and inpatient in our hospital from Sept. 2018 to Aug. 2019, with the consumption sum of 669 322 100 yuan. Based on ABC analysis, the constitute ratio of varieties of drugs in categories A, B and C were respectively 15. 90% (111 kinds), 20. 20% (141 kinds) and 63. 90% (446 kinds), the constitute ratio of consumption sum were respectively 79. 85% (534 441 300 yuan), 15. 10% (101 081 400 yuan) and 5. 05% (33 799 400 yuan). Based on VEN analysis, the constitute ratio of varieties of drugs in categories V, E and N were respectively 35. 10% (245 kinds), 54. 44% (380 kinds) and 10. 46% (73 kinds), the constitute ratio of consumption sum were respectively 29. 30% (196 112 200 yuan), 63. 82% (427 185 900 yuan) and 6. 88% (46 024 000 yuan). Combined with ABC-VEN matrix analysis, the highest constituent ratio of varieties was 31. 52% (220 kinds) for drugs in CE category, the highest constituent ratio of consumption sum was 51. 76% (346 472 000 yuan) for drugs in AE category, the lowest constituent ratio of varieties was 0. 86% (6 kinds) for drugs in AN category, and the lowest constituent ratio of consumption sum was 0. 66% (4 411 800 yuan) for drugs in CN category. CONCLUSIONS: The upper and lower limits of inventory of partial CV-category and CE-category drugs should be appropriately adjusted to ensure the supply for clinical necessary and reduce the occurrence of drug shortage; there are some key drugs under national control among AE-category and AN-category drugs, reducing their use can not only reduce drug costs, but also help promoting clinical rational medication. Combining ABC analysis with VEN analysis to analyze the drug application in hospitals over a period of time is a scientific method applied to practical work, which can provide data support for the detailed management of drug inventory and clinical rational medication. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the possible factors that influencing the allergic reactions after intravenous infusion of cytotoxic drugs in summer, and to provide the protocol reference for retrospective investigation to avoid more cases of allergic reactions induced by intravenous infusion of cytotoxic drugs. METHODS: Combined with the investigation of cytotoxic drugs that induced multiple allergic reactions in the oncology department of a Grade Ⅲ, level A hospital in Beijing from Jun. to Jul. 2019, the possible causes of infusion reactions were investigated according to the storage and use of the same batch of drugs and the drugs involved in the medical order. RESULTS: Through the investigation of supply, storage and configuration of the drug, the allergic reactions ruled out the possibility of infusion reactions. However, after comprehensive analysis, it is found that,( 1) the finished infusion solution was exposed to the outdoor summer environment when transported to the department, which could damage the stability of the quality of the infusion solution; (2) in the peak of summer, the immune function of patients might be abnormaldue to the higher temperature and humidity environment. Therefore, the higher temperature and humidity environment was the main cause of allergic reactions after drug infusion. CONCLUSIONS: In summer, the incidence of allergic reactions to antineoplastic drugs will increase. Therefore, temperature-sensitive cytotoxic drugs should be dispensed on the spot, and the humidity and temperature of the ward should be controlled to enhance patient monitoring and care. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the effect of combined drug management and an exercise program on symptoms and the happiness levels of elderly women people living at home. This interventional study included a total of 35 women, aged 65 to 74 years, who were registered at the Family Healthcare Centre. A 14-week program was combined with exercise and drug management. Pre-test and post-test evaluations results were recorded. The Edmonton Symptom Assessment Scale (ESAS), Oxford Happiness Questionnaire-Short Form (OHQ-SF) and a sociodemographic form and Follow-Up form were used for data collection. The mean ESAS points of the symptoms of pain, tiredness, sadness, and insomnia showed a significant decrease after intervention and the sense of well-being improved (p <.001). A statistically significant increase was determined in the happiness levels of the participants after intervention. The combined program of drug management and exercise was found to be effective in raising happiness levels and reducing symptoms in elderly women. [ABSTRACT FROM AUTHOR]

Drug management is a significant activity in determining the availability of effective and efficient drugs. In repentance management, there is a cycle of activities ranging from planning, procurement, storage, distribution, elimination, and drug control. The purpose of drug management is to create a stock of drugs in the right amount and time with minimal costs but still quality. This research is descriptive qualitative research to determine the management system of drug logistics management in Dr. Wahidin Sudirohusodo Makassar hospital's pharmaceutical installations. The data used is primary data in interviews and secondary data in direct observation and document review. The informants in this study include the main person in charge of the pharmaceutical installation, several coordinators in the pharmaceutical installation, and some in the pharmaceutical depot. The total informant is nine people. This study indicates that the management of drug logistics at RSUP Dr. Wahidin Sudirohusodo Makassar is still less effective. This can be seen from several input variables, processes, and outputs that have not been maximized, such as inadequate human resources, inadequate facilities, and infrastructure. This budget is only for procurement and still damaged or expired drugs. It is expected that Dr. Wahidin Sudirohusodo Makassar to pay more attention to the management system of drug logistics management, both input, and process. [ABSTRACT FROM AUTHOR]

Background: The newly emerged coronavirus pandemic (COVID-19) has collapsed the entire global health care system. Due to these settings, a lot of strategic changes are adopted by healthcare facilities to ensure continuity in patient-centered services.Objective: This study aims to evaluate the effectiveness of structural and operational changes made in ambulatory care pharmacy services during the COVID-19 pandemic.Methods: A retrospective comparative study was conducted to evaluate the impact and effectiveness of patient-centered interventions and consequent access to medication management care within Johns Hopkins Aramco Health Care ambulatory care pharmacy services during the COVID-19 pandemic by comparing patient-centered key performance indicators before and during COVID-19 pandemic for a total of 4 months.Results: As a result of the structural and operational changes made in patient-centered ambulatory care pharmacy services during the COVID-19 pandemic, a 48% prescriptions requests and 90% prescriptions fills are increased through online health portal application. A three-fold increase in the pharmacy call center utilization resulted in around 10% abandoned calls. In the number of physical visits to ambulatory care pharmacies, a 37% reduction was also noted. The decrease in staff schedule efficiency and an increase in average prescription waiting time were also noticed. The prescription collection through remote area pick up locations, and medication home delivery services were successful during COVID-19 pandemic as supported by statistical data.Conclusion: The access to ambulatory care pharmacy services during COVID-19 pandemic has been successfully maintained via medication home delivery, remote area pickup locations, pharmacy call-center consultations and refill requests, online health portal application services, and other measures, while reducing the number of physical visits to the JHAH hospital/clinic to ensure compliance with infection control and prevention measures. [ABSTRACT FROM AUTHOR]

Chronic heart failure (CHF) is a common complication and cause of death in dialysis patients. Although several clinical guidelines and expert consensus on heart failure (HF) in the general population have been issued in China and abroad, due to abnormal renal function or even no residual renal function (RRF) in dialysis patients, the high number of chronic complications, as well as the specificity, variability, and limitations of hemodialysis (HD) and peritoneal dialysis (PD) treatments, there are significant differences between dialysis patients and the general population in terms of the treatment and management of HF. The current studies are not relevant to all dialysis-combined HF populations, and there is an urgent need for high-quality studies on managing HF in dialysis patients to guide and standardize treatment. After reviewing the existing guidelines and literature, we focused on the staging and diagnosis of HF, management of risk factors, pharmacotherapy, and dialysis treatment in patients on dialysis. Based on evidence-based medicine and clinical trial data, this report reflects new perspectives and future trends in the diagnosis and treatment of HF in dialysis patients, which will further enhance the clinicians' understanding of HF in dialysis patients., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 The Author(s). Published by IMR Press.)

Introduction: Iran is one of the seven countries in the world with natural disaster distress. Moreover, due to its geopolitical situation and strategic importance, it has always been invaded by neighbors or the developed countries. Medical healthcare of the injured people and distributing medicine in the beginning hours of the disasters and crises have great roles in decreasing pain, fetal injuries and increase in the healing and the survival of the injured. In the present study, to evaluate the defects in drug distribution and necessary health care applications during disasters, the corresponding research in Iran and selected countries have been presented to discuss damages resulted by mismanagements during crises. Methods: The PubMed, Google Scholar and Iranian databases were searched about crisis management with “management”, “medicine”, ‘drug”, “crisis” and “disaster” as keywords individually and in combination. Results: The efforts during disasters, the shortcomings and defects were evaluated. The related data in some countries were also reviewed and the viewpoints for drug management in disasters and crises in Iran were presented. Conclusion: Regarding the damages caused by drug deficiency and the importance of well-organized drug management, it will be possible to save peoples life by efficient drug management and well-planned distribution of medications during natural and man-made disasters.

The review of the literature presents mo­dern data on antioxidant and anti-inflammatory acti­vity of polyphenols, as well as their representatives curcumin and resveratrol in diseases of the respiratory system.

The review of the literature presents modern data on antioxidant activity and immunomodulatory action of vitamin A in diseases of the respiratory system.

The review of the literature presents mo­dern data on antioxidant vitamins — ascorbic acid and toco­pherol. Their antioxidant activity and immunomodulatory action in diseases of the respiratory system is shown.

The review of the literature presents modern data on the group of antioxidant drugs — thiol-containing compounds. Their effect on the oxidation-reduction state in diseases of the respiratory system is shown.

The review of the literature presents modern data on the activators of the transcription factor NFE2L2 and mimetics of antioxidant enzymes. Their effect on the oxidation-reduction state in diseases of the respiratory system is shown.