In recent decades a growing number of individuals in preschool, middle childhood and adolescence have been diagnosed with ADHD. Accompanying increasing rates of diagnoses is an increase in the use of stimulant medication in preschool populations, a practice not approved by the Food and Drug Administration. This paper reviews the current literature pertaining the social and developmental consequences of ADHD, its effect on the child and family, treatment strategies with and without the use of stimulants, and cultural and diagnostic trends which may be contributing to the rising number of diagnoses. A review of the literature suggests that there is a dire need for further empirical research into the use of stimulant medications in preschoolers, and a number of cultural factors unique to the United States have contributed to increasing rates of ADHD diagnosis.

The South African national drug policy (NDP) was implemented in 1994 to ensure the availability and accessibility of essential drugs to all citizens. The NDP also hoped to ensure the safety, efficacy and quality of drugs as well as to promote the concepts of individual responsibility for health, preventative care and informed decision making. However, drug utilisation studies performed after the implementation of the national drug policy showed that South Africa's pharmaceutical sector was characterised by indiscriminate and irrational drug use, high drug prices and polypharmacy. A retrospective study that was done in 2001 in the clinics supplied by Evander Hospital showed that only 11.9% of prescriptions for acid-related disorders complied with the standard treatment guidelines (STG). It became evident that there was need for an intervention. The general objective of this study was to determine the effect of an education intervention, implemented in 2003, on the prescribing patterns of drugs for acid-related disorders in the Govan Mbeki municipal clinics serviced by Evander Hospital. An empirical pre-intervention and post-intervention study using primary data obtained from patient files at the clinics was done. A quantitative survey of the use of the drugs included in the study (magnesium trisilicate, aluminium hydroxide/magnesium trisilicate combination tablets, cimetidine or omeprazole) was conducted. To determine a baseline, all prescriptions where the drugs selected for this study were prescribed from 1 July 2001 to 31 December 2001 were collected. For the period I January 2002 to 31 December 2002 retrospective data was collected in the form of all prescriptions where the relevant drugs were prescribed. Additional retrospective data was collected for the period January 2002 to 30 June 2003 to determine the outcome of treatment given. The phi coefficient was calculated, and although statistical correlation could not be proven, important tendencies could be detected in the data. Only 8% of the prescriptions adhered to the STG before the presentation of the face to face education intervention. In the first six months following the intervention, STG compliance increased to 15.2%. In the following six-month period, the STG compliance decreased to 14.1 %. The assumption was made that patients were cured if they did not return with the same complaint. Based on this assumption the conclusion was drawn that, before the intervention, 50.2% of the patients were cured. In the first six months after the intervention had taken place the percentage patients who did not return increased from 50.2% to 60.6%. In the second six months after the intervention the percentage of patients who did not return increased to 70.7%. It may be concluded that compliance with the STG improved as a result of the face to face education intervention. Moreover, it was found that cost efficiency improved in parallel and the cure rate seemed to be positively affected by the intervention. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2007.

Thesis (Ph.D. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2010.

Asthma is the most common chronic disease among children worldwide. The prescribing patterns of the medication used to treat asthma in South Africa, as well as the prevalence of paediatric asthma are of interest and need to be investigated. A drug utilisation review was performed to determine the prevalence of asthma, and in particular paediatric asthma in a section of the private health care sector of South Africa. The prescribing patterns of asthma medication were investigated according to different demographic factors, such as gender, geographical area and prescriber type. Data from a medical claims database were extracted and processed to reveal the different prescribing patterns from 1 January 2005 to 31 December 2008. Medication from the MIMS® pharmacological groups 10.2 and 10.4 were used as a basis for asthma medication. Patients had to use at least one medicine item from one of these groups to be included in the study. The prevalence of asthma in the general population showed an increase from 2005 to 2008. The prevalence of asthma as a part of the total database according to the number of patients increased from 23.01% in 2005 (n=347342) to 24.72% in 2008 (n=240854), although the number of patients on the total database decreased from 2005 to 2008. When investigating the number of prescriptions that were dispensed during 2008, asthma prescriptions comprised 7.16% (n=484983) of all prescriptions and the number of asthma medicine items that were dispensed made up 3.72% (n=611139) of the total number of medicine items dispensed in 2008. Paediatric asthma was divided into two age groups for the purpose of this study namely, 0 - 4 years of age and older than 4 years, but younger or equal to 11 years of age ( >4 - 11 years), according to a previous study done by the National Heart Lung and Blood Institute (NHLBI). The results from the data confirmed that the prevalence of asthma was higher in the younger age group. The number of patients using asthma medication in the 0 - 4 years age group comprised 44.40% (n=11306) of the total number of patients in this age group on the database in 2008, compared to 32.84% (n=28347) in the >4 - 11 years age group. Asthma was more common among male patients, whether they were included in the paediatric groups or not. The geographical distribution of paediatric asthma seemed to be connected to the provinces without coastlines and different mining facilities. The combination of asthma medication with antibiotics and systemic corticosteroids were investigated and it was concluded that antibiotics that were used for respiratory tract infections were prescribed the most frequently to asthma patients. The refill–adherence rates of patients with asthma were not satisfactory when considering that asthma is a chronic disease. The average adherence rate for all the asthma products that were brought into account when calculating the refill–adherence rate was 60.95%. A rate above 90% indicates optimal patient adherence. In conclusion this study determined that asthma has a significant prevalence among children in South Africa. The prescribing patterns for the different medication used in the treatment of asthma were investigated and recommendations for further research in this field of study were made. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Acquired Immunodeficiency Syndrome (AIDS) is characterized by the progressive destruction of a person’s immune system and is the latest and most serious stage of Human Immunodeficiency Virus (HIV) infection. Botswana currently has the highest estimated prevalence of HIV infection in the world. Botswana has a relatively young population structure, with about 60% of the approximately 1,8 million people aged less than 45 years. HIV prevalence for pregnant women aged 15–45 years in Botswana did, however, decrease marginally from 36,2% in 2001 to 35,4% in 2002. It is estimated that about 258 000 Botswana are now living with HIV and AIDS, and high morbidity and mortality rates due to HIV/AIDS have seen Botswana slip down the United Nations Development Plan (UNDP) Human Development Index rankings from 71 in 1996, to 122 in 1999/2000. In 2002 Botswana initiated public antiretroviral therapy (ART) at four sites initially to provide treatment to HIV/AIDS patients before expanding the programme to the rest of the country. The specific objective of the study was to investigate the prescribing patterns of ARV drugs at Sekgoma Memorial Hospital ARV therapy clinic (SMH–IDCC) in the central district of Botswana for a two–year period from 2005 to 2006. Data from 1717 patients were obtained from the SMH–IDCC electronic database regarding ARV drugs prescribed during the study period, CD4–Tcell count (cells/?L) at the commencement of therapy and after six months from the commencement of therapy and side effects necessitating change of therapy for the study period 2005 until 2006. The study showed that there were eight antiretroviral therapy (ART) regimens prescribed: zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV), zidovudine plus lamivudine plus nevirapine (AZT/3TC/NVP), Combivir® plus efavirenz (CBV/EFV), Combivir® plus nelfinavir (CBV/NFV), Combivir® plus nevirapine (CBV/NVP), stavudine plus lamivudine plus efavirenz (D4T/3TC/EFV), stavudine plus lamivudine plus nelfinavir (D4T/3TC/NFV), and stavudine plus lamivudine plus nevirapine (D4T/3TC/NVP). The most prescribed ART regimen for adult patients was Combivir® plus efavirenz (CBV/EFV) (51,37%). This was broken down as 17,20% of females and 34,17% of males. The second most prescribed ART regimen was Combivir® plus nevirapine (CBV/NVP)(36% of the total study population (N=1717). This represented 34,17% of females and 1,98% of males. The most prescribed ART regimen in children was zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV) (3,73% of the total population), broken down as 1,05% of females and 2,68% of males. The second most prescribed regimen in this group was zidovudine plus lamivudine plus nevirapine (ZDV/3TC/NVP) (3,50% of total population). The findings from this study indicated that all eight the ART regimens prescribed at the study site were in accordance with the Botswana national ART guidelines. There were thirteen different types of side effects necessitating change of therapy, including pregnancy, treatment failure and poor adherence. The average CD4–Tcell count change (155.63 cells/?L, ± 204.08 cells/?L) for the study population was more than 100% after six months from commencement of therapy, indicating success of therapy in terms of CD4–Tcell count. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Thesis (Ph.D. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2010.

Asthma is the most common chronic disease among children worldwide. The prescribing patterns of the medication used to treat asthma in South Africa, as well as the prevalence of paediatric asthma are of interest and need to be investigated. A drug utilisation review was performed to determine the prevalence of asthma, and in particular paediatric asthma in a section of the private health care sector of South Africa. The prescribing patterns of asthma medication were investigated according to different demographic factors, such as gender, geographical area and prescriber type. Data from a medical claims database were extracted and processed to reveal the different prescribing patterns from 1 January 2005 to 31 December 2008. Medication from the MIMS® pharmacological groups 10.2 and 10.4 were used as a basis for asthma medication. Patients had to use at least one medicine item from one of these groups to be included in the study. The prevalence of asthma in the general population showed an increase from 2005 to 2008. The prevalence of asthma as a part of the total database according to the number of patients increased from 23.01% in 2005 (n=347342) to 24.72% in 2008 (n=240854), although the number of patients on the total database decreased from 2005 to 2008. When investigating the number of prescriptions that were dispensed during 2008, asthma prescriptions comprised 7.16% (n=484983) of all prescriptions and the number of asthma medicine items that were dispensed made up 3.72% (n=611139) of the total number of medicine items dispensed in 2008. Paediatric asthma was divided into two age groups for the purpose of this study namely, 0 - 4 years of age and older than 4 years, but younger or equal to 11 years of age ( >4 - 11 years), according to a previous study done by the National Heart Lung and Blood Institute (NHLBI). The results from the data confirmed that the prevalence of asthma was higher in the younger age group. The number of patients using asthma medication in the 0 - 4 years age group comprised 44.40% (n=11306) of the total number of patients in this age group on the database in 2008, compared to 32.84% (n=28347) in the >4 - 11 years age group. Asthma was more common among male patients, whether they were included in the paediatric groups or not. The geographical distribution of paediatric asthma seemed to be connected to the provinces without coastlines and different mining facilities. The combination of asthma medication with antibiotics and systemic corticosteroids were investigated and it was concluded that antibiotics that were used for respiratory tract infections were prescribed the most frequently to asthma patients. The refill–adherence rates of patients with asthma were not satisfactory when considering that asthma is a chronic disease. The average adherence rate for all the asthma products that were brought into account when calculating the refill–adherence rate was 60.95%. A rate above 90% indicates optimal patient adherence. In conclusion this study determined that asthma has a significant prevalence among children in South Africa. The prescribing patterns for the different medication used in the treatment of asthma were investigated and recommendations for further research in this field of study were made. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Acquired Immunodeficiency Syndrome (AIDS) is characterized by the progressive destruction of a person’s immune system and is the latest and most serious stage of Human Immunodeficiency Virus (HIV) infection. Botswana currently has the highest estimated prevalence of HIV infection in the world. Botswana has a relatively young population structure, with about 60% of the approximately 1,8 million people aged less than 45 years. HIV prevalence for pregnant women aged 15–45 years in Botswana did, however, decrease marginally from 36,2% in 2001 to 35,4% in 2002. It is estimated that about 258 000 Botswana are now living with HIV and AIDS, and high morbidity and mortality rates due to HIV/AIDS have seen Botswana slip down the United Nations Development Plan (UNDP) Human Development Index rankings from 71 in 1996, to 122 in 1999/2000. In 2002 Botswana initiated public antiretroviral therapy (ART) at four sites initially to provide treatment to HIV/AIDS patients before expanding the programme to the rest of the country. The specific objective of the study was to investigate the prescribing patterns of ARV drugs at Sekgoma Memorial Hospital ARV therapy clinic (SMH–IDCC) in the central district of Botswana for a two–year period from 2005 to 2006. Data from 1717 patients were obtained from the SMH–IDCC electronic database regarding ARV drugs prescribed during the study period, CD4–Tcell count (cells/?L) at the commencement of therapy and after six months from the commencement of therapy and side effects necessitating change of therapy for the study period 2005 until 2006. The study showed that there were eight antiretroviral therapy (ART) regimens prescribed: zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV), zidovudine plus lamivudine plus nevirapine (AZT/3TC/NVP), Combivir® plus efavirenz (CBV/EFV), Combivir® plus nelfinavir (CBV/NFV), Combivir® plus nevirapine (CBV/NVP), stavudine plus lamivudine plus efavirenz (D4T/3TC/EFV), stavudine plus lamivudine plus nelfinavir (D4T/3TC/NFV), and stavudine plus lamivudine plus nevirapine (D4T/3TC/NVP). The most prescribed ART regimen for adult patients was Combivir® plus efavirenz (CBV/EFV) (51,37%). This was broken down as 17,20% of females and 34,17% of males. The second most prescribed ART regimen was Combivir® plus nevirapine (CBV/NVP)(36% of the total study population (N=1717). This represented 34,17% of females and 1,98% of males. The most prescribed ART regimen in children was zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV) (3,73% of the total population), broken down as 1,05% of females and 2,68% of males. The second most prescribed regimen in this group was zidovudine plus lamivudine plus nevirapine (ZDV/3TC/NVP) (3,50% of total population). The findings from this study indicated that all eight the ART regimens prescribed at the study site were in accordance with the Botswana national ART guidelines. There were thirteen different types of side effects necessitating change of therapy, including pregnancy, treatment failure and poor adherence. The average CD4–Tcell count change (155.63 cells/?L, ± 204.08 cells/?L) for the study population was more than 100% after six months from commencement of therapy, indicating success of therapy in terms of CD4–Tcell count. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

<p>This study aimed to identify barriers to the availability of essential drugs at health facilities, to identify implementable solutions to those barriers, to develop a monitoring system for tracking implementation of solutions and for tracking drug supply.</p>

Introduction During the last decades, proportion of geriatric patients in the world population increases. This phenonemon is caused particularly by advances in medical science, social care and working conditions. However, the problem still lies in a very frequent polypharmacotherapy and polymorbidity in older patients. With the aim to reduce the frequent adverse drug events in seniors, the explicite criteria of PIMs (potentially inappropriate medications) have been created. The aim of this work was to determine the registration rates of PIMs in several Eastern and Central European countries using all until now published 22 explicit criteria of potentially inappropriate medications in older patients that are available in published scientific literature. Methods A set of 345 PIMs gained from all explicit criteria published in peer- reviewed or impact factor journals by 2015 year and summarized in diploma thesis of S . Grešákové, MSc (defended in June 2016) was used in this work. Every drug has been included in the list only once, disregarding the other conditions of inappropriateness (e.g. drug-disease interactions, dosing schedules, etc.). The exception were PIMs available in non-sustained and sustained-release forms, because each of this drug form can be identified under a specific ATC code....