فهرست مطالب

Research in Pharmacy Practice - Volume:10 Issue: 1, Jan-Mar 2021

Journal of Research in Pharmacy Practice
Volume:10 Issue: 1, Jan-Mar 2021

  • تاریخ انتشار: 1400/03/31
  • تعداد عناوین: 9
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  • Debjyoti Talukdar, Satish Jankie, Shyam Sundar Pancholi, Arindam Chatterjee, Parveen Kumar, Madan Mohan Gupta Pages 1-9

    This study highlights the importance of community pharmacists’ strategic role in hindering the progression of the SARS-CoV-2 virus in the community setting and innovative measures to protect themselves. This article focuses on the features, control, and prevention of COVID-19 and social awareness measures of the pandemic. The means employed by the community pharmacist to safeguard his health while providing pharmaceutical services during COVID-19 is compiled and presented to benefit health‑care professionals around the world. As per the US Center for Disease Control and Prevention, community pharmacists play a crucial role in providing essential drugs to patients without knowing their current COVID-19 status. They also work in conditions that make them susceptible to COVID-19 exposure. Despite the availability of guidelines, community pharmacists need to be trained in personal protective equipment for efficient protection and prevention of spread. Community pharmacists are essential frontline warriors against transmission of the SARS-CoV-2 virus in the community and act as frontline workers to educate the public on COVID-19. They are at high risk and need to observe necessary precautions to mitigate the spread of the virus.

    Keywords: Community pharmacist, COVID‑19, SARS‑CoV‑2
  • Gianluca Cuomo, Alessandro Raimondi, Marianna Rivasi, Giovanni Guaraldi, Vanni Borghi, Cristina Mussini Pages 10-16
    Objective

    Adherence to lipid-lowering drugs could be challenging in our patients as it is in the general population, which is described as low as 25%. Our aim was to evaluate adherence to statins and to investigate clinical event impact on it.

    Methods

    This retrospective study on HIV+ patients attending to Clinic of Modena (Italy) was conducted in order to evaluate characteristics, clinical events, and adherence on lipid-lowering drugs. All drugs for comorbidities are distributed by the hospital pharmacy and recorded in an electronical database. Adherence was also evaluated in patients who were supplied with antilipemics in external pharmacies through phone calls. Patients were considered adherent if the percentage of correct time of drug refill was >80%.

    Findings

    Totally 1123 patients were evaluated. Lipid‑lowering drugs (statins, fenofibrate, and omega‑3 oil) were prescribed in 242 patients (21.5%). Prescription occurred mainly in those who were older, males, and Italians. Two hundred of them (82.6%) used statins alone, 23 (9.5%) only fenofibrate or omega‑3 oil, and 19 (7.8%) a combination of both drugs. The median adherence was 90% while patients with adherence >80% resulted 153 (63.2%). Forty-six (19%) had a clinical history of cardiovascular events; 59% of them, placed in secondary prophylaxis, and 76%, already in treatment, continued to adhere. No differences in terms of adherence according to the type of drug distribution (hospital pharmacy or outside pharmacies) were found.

    Conclusion

    Linking the supply of these drugs to that of antiretrovirals led to a good level of adherence higher than that described in the general population. The majority of the patients who experienced a cardiovascular event remain adherent to the prescribed therapy

    Keywords: Adherence, antilipemics, HIV, medication, Statins
  • Mainul Haque, Abdullahi Rabiu Abubakar, Olayinka O. Ogunleye Ibrahim Haruna Sani, Israel Sefah, Amanj Kurdi, Salequl Islam, Brian Godman Pages 17-22
    Objective

    Measures are ongoing to prevent the spread of COVID-19 and treat it with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding treatments such as hydroxychloroquine with misinformation fuelling prices hikes and suicides. Shortages have also appreciably increased costs of PPE, potentially catastrophic among lower- and middle-income countries such as Nigeria with high copayment levels. Consequently, a need to investigate changes in availability, utilization, and prices of relevant medicines and PPE during the pandemic in Nigeria.

    Methods

    Exploratory study among community pharmacists with a survey tool comprising four sections including questions on changes in consumption, prices, and shortages of medicines and PPE from the beginning of March 2020 to the end of June 2020. In addition, suggestions from community pharmacists and co-authors on ways to reduce misinformation.

    Findings

    30 out of 34 pharmacists participated giving a response rate of 88.2%. Significant increases were seen (3‑fold or more increase) in the consumption of hydroxychloroquine (100%), vitamins/immune boosters (96.7%) and antibiotics (46.7%) as well as PPE (100%). Considerable price increases (50% increase or greater) also seen for antimalarials (96.7%), antibiotics (93.3%), vitamins/immune boosters (66.7%), and PPE (100%). Shortages are also seen for hydroxychloroquine and vitamins/immune boosters but most severe for PPE (80% of pharmacies).

    Conclusion

    Encouraging to see increases in the utilization of vitamins/immune boosters and PPE. However, a considerable increase in the utilization and prices of antimicrobials is a concern that needs addressing including misinformation. Community pharmacists have a key role in providing evidence-based advice and helping moderate prices.

    Keywords: Community pharmacists, COVID‑19, medicines, Nigeria, price rises
  • Periklis Charalampous, Aliki Peletidi Pages 23-29
    Objective

    The age-standardized prevalence of cardiovascular diseases (CVDs) among the Cypriot population in 2017 was estimated to be 5552 per 100,000. Therefore, the CVD prevention in Cyprus is of paramount importance. Pharmacists are one of the most accessible health-care professionals (HCPs) and the first port of call for the public. In Cyprus, there are 55.59 pharmacies per 100,000 inhabitants. Therefore, the role of Cypriot pharmacists (CPs) in primary CVD prevention is essential. This study aimed to explore both the existing and potential future roles of CPs in CVD prevention.

    Methods

    A descriptive qualitative study employing structured interviews (SIs) was conducted. Initially, the CPs were identified through a list provided by the Cypriot Pharmaceutical Services. The researcher(s) then contacted CPs by telephone. Face-to-face interviews were scheduled based on the CP’s availability. In total, 21 SIs were transcribed verbatim, coded, and analyzed thematically. SIs continued until data saturation was achieved.

    Findings

    The findings are reported under the themes of pharmacists’ knowledge and role, resources/tools available and training, communication and relations, and barriers. CPs expressed the need for training, and they are ready to have a more proactive role within the primary health care. The main barrier identified was the lack of responsiveness of the public and the lack of CP’s time.

    Conclusion

    CPs have the potential to actively participate in CVD prevention in Cyprus. CPs want to start offering primary CVD health services, with the smoking cessation being the first intervention.

    Keywords: Cardiovascular disease prevention, Cypriot pharmacists, healthpromotion, pharmacy‑led preventive services
  • Kwame Opare Asamoah, George Asumeng Koffuor, Alhassan Abdul Mumin, Baba Mohammed Sulemana, Majeed Saeed, Lawrence Quaye Pages 30-37
    Objective

    Neonates are more susceptible to infections, as well as medication toxicities. This study, therefore, sought to describe the clinical characteristics, medication prescription pattern, and treatment outcomes for neonates admitted to the neonatal intensive care unit (NICU) of a tertiary health-care facility in Ghana.

    Methods

    A retrospective cross-sectional study was conducted to ascertain clinical records, conditions for admission, spectrum of medications prescribed, and treatment outcomes from neonatal patient folders.

    Findings

    Of 667 folders reviewed (51.4% males and 48.6% female), 61.8% were preterm (mean gestational age: 34.2 ± 3.6 weeks), 64.6% had low birth weight (LBW) (mean birth weight: 2.1 ± 0.9 kg), 90.6% were delivered through spontaneous vaginal delivery, and 57.4% delivered at the tertiary health-care facility. Of the 667 neonates, 70%, 27.1%, and 2.9% were queried with one, two, or three medical conditions, respectively. Respiratory distress, preterm, and pyrexia were common single queried conditions (88.5%). LBW, hypothermia, and single queried medical conditions were associated (P ≤ 0.0001) with preterm male neonates. The mean duration of stay of preterm neonates was 3.5 ± 3.2 days (term babies: 1–2 days [P = 0.0085]). Of 1,565 medications prescribed to the 667 neonates, 67.5% were antibacterial, with gentamicin (53.0%) being the most prescribed. 98.4% of neonates were prescribed at least one medication (i.e., 67.5% were prescribed antibacterial medications, 14.6% supplements, 11.0% bronchodilators, and 7.0% antiseizure); mean medication combination 2.6 ± 0.8 per neonate. Majority (75.4%) of the cases reviewed had treatment success.

    Conclusion

    Respiratory distress and preterm deliveries are predominant presenting conditions, with antibacterial medication, mainly gentamicin and ampicillin, on prescription. Treatment success is significantly high at the NICU.

    Keywords: Gentamicin, neonatal intensive care unit, neonates, preterm delivery, respiratory distress
  • Mohammadreza Tabatabaei, Gholamali Dorvashy, Rasoul Soltani, Shiva Samsamshariat, Rokhsareh Meamar, Ali Mohammad Sabzghabaee Pages 38-42
    Objective

    Opioid abuse is widespread throughout the world. Aspiration pneumonia is a serious problem following opioid overdose and poisoning. This study aimed to evaluate the safety and effectiveness of antimicrobial management of opioid-overdose induced aspiration pneumonia in a referral poisoning management university hospital in Iran.

    Methods

    In an observational cross-sectional study (September–March 2019), opioid poisoned patients diagnosed with aspiration pneumonia within a maximum of 48 h of their overdose were evaluated regarding several variables, including the level of consciousness on admission, drug regimen used for the treatment of aspiration pneumonia, and its appropriateness, and the correctness of the used antibiotics dose and the therapeutic outcome.

    Findings

    During the study, 53 eligible patients were identified and included in the study. The most frequently abused opioids were methadone (60.4%) and opium (17%). “Ceftriaxone + Clindamycin” (54.7%) and “Meropenem + Vancomycin” (9.5%) were the most frequently administered regimens. Regarding treatment outcome, most cases (n = 36, 67.9%) were discharged with a stable and satisfying medical status, while 3.8% of the cases (n = 2) died.

    Conclusion

    The use of antibiotics in the treatment of aspiration pneumonia in hospitalized patients with opioid overdose in our referral university hospital is associated with notable antibiotic regimen choice issues. The implementation of strategies for improving the pattern of antibiotic prescribing for these patients is necessary

    Keywords: Antibiotic regimen, aspiration pneumonia, opioid overdose, treatment
  • Hosein Saneian, Saeedeh Ghaedi, Fatemeh Famouri, Majid Khademian, Najmeh Ahmadi, Mohammadreza Memarzadeh, Somayeh Sadeghi, Peiman Nasri Pages 43-49
    Objective

    This study aimed to evaluate the effectiveness, safety, and document the reported adverse effect of a herbal‑based laxative (Goleghand®) for the maintenance treatment of functional constipation in young children.

    Methods

    We conducted a randomized clinical trial from April 2019 to September 2020. Children aged 2–15 years with functional constipation defined according to the Rome IV criteria were eligible for study inclusion. Eligible children were randomly allocated to receive polyethylene glycol (PEG) or Goleghand®. The number and consistency of stools per day, painful defecation, abdominal pain, and fecal incontinence were reported weekly by parents. The statistical analyses were performed by determining means and standard deviations, t-test, Chi-square test, ANOVA repeated measures, and Fisher’s exact test, with significance, accepted at the 5% level.

    Findings

    Sixty patients have been enrolled in the study. Parental satisfaction scores did not change significantly in either group or over the follow‑up period. Our results showed that the effect of time (P < 0.001) and also the effect of group type (P = 0.01) on the number of fecal defecations was significant. The mean number of defecations increased first and then decreased significantly over time, but this decrease was more significant in the PEG group than in the Goleghand® group (P = 0.001). Furthermore, the effect of time on the fecal consistency score was significant (P = 0.047). The mean score of fecal consistency in both groups decreased over time.

    Conclusion

    Goleghand® was similar in efficacy to PEG for 8 weeks of pediatric functional constipation treatment in this randomized clinical trial. Goleghand® can be considered as a new herbal laxative drug for pediatric functional constipation.

    Keywords: Child, Constipation, Herbal‑based Laxative, Polyethylene glycol
  • Alice C. Ceacareanu, Shanria D. Jolly, George K. Nimako, Zachary A. P. Wintrob Pages 50-56
    Objective

    Type 2 diabetes mellitus (T2DM) affects 10% of Americans and is associated with an increased incidence of cancer. Statins are first‑line cholesterol-lowering medications in the treatment of hyperlipidemia. Several studies have demonstrated a relationship between statin use and reduced cancer incidence. We examined the cancer benefits of statin subtypes, with specific attention to disease‑free survival (DFS) and overall survival (OS).

    Methods

    This retrospective review included adults with T2DM diagnosed with solid tumors at Roswell Park Cancer Institute in Buffalo, NY, USA (2003–2010). Individuals with gestational diabetes, incomplete records, or diagnosed with rare solid tumors were excluded. Follow-up began at the date of diagnosis and ended with the first confirmed recurrence, death, or loss of contact. Demographics were assessed by Chi-square, Kaplan–Meier survival analyses, and Cox proportional hazards regression.

    Findings

    Overall, 1102 patients met inclusion criteria, 52.1% of the study participants were female, and 578 participants (52.5%) died during the follow-up period which ranged from 0 to 156 months. Hydrophilic statin use was associated with improved DFS at 5-year follow-up (41.0% vs. 36.9%, P = 0.0077) compared to lipophilic statin use. Multivariate regression revealed that hydrophilic statins were associated with improved DFS (hazard ratio [HR]: 0.706, 95% confidence interval [CI]: 0.526–0.947) and OS (HR: 0.685, 95% CI: 0.503–0.934). Pravastatin was associated with improved OS (HR: 0.674, 95% CI: 0.471–0.964).

    Conclusion

    In patients with T2DM and cancer, hydrophilic statins, and pravastatin in particular, are associated with improved DFS as well as OS. Further research examining the cancer‑specific effects of hydrophilic and lipophilic statins is needed to better understand their beneficial effects.

    Keywords: Cancer mortality, cancer recurrence, diabetes mellitus, hydrophilicstatins, lipophilic statins, pravastatin
  • Shiva Samsam Shariat, Shafeajafar Zoofaghari, Farzad Gheshlaghi Page 57