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An education intervention on prescribing patterns of drugs for acid-related disorders in a clinic setting : a case study / Jacqueline Louise MinnieMinnie, Jacqueline Louise January 2007 (has links)
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.
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An education intervention on prescribing patterns of drugs for acid-related disorders in a clinic setting : a case study / Jacqueline Louise MinnieMinnie, Jacqueline Louise January 2007 (has links)
Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2007.
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A retrospective drug utilisation study of antimicrobials in a private primary health care group / Norah Lucky Katende-KyendaKatende-Kyenda, Norah Lucky January 2005 (has links)
The commonest prescribed group of drugs is antimicrobials. Various studies have shown that
they are overused globally. Since Primary health care represents the first tier of the health
care system, evaluation of antimicrobial use in primary health w e settings is a necessity to
ensure rational and cost-effective use of these agents in the treatment of infectious diseases.
It has been reported by Hooton and Levy (2001 : 1088) that 20% to 50% of antimicrobials are
inappropriately used in developing countries. According to Rebana et al. (1998: 175) the
increasing overuse of antimicrobials has resulted in an enormous escalation in the total costs
of drugs contributing to 15% to 30 % of the total health budget. Hooton and Levy
(2001: 1087) reported in a study that inappropriate use and overuse of antimicrobials are risk
factors for the emergence of antibiotic resistant bacteria. There is a high incidence of
infectious diseases in developing countries that are due to the rapid spread of resistant strains
through over-crowding, poor sanitation and unsafe sexual practices (Liu et al., 1999: 540).
The general objective of the study was the analysis and interpretation of the usage and related
costs of antimicrobial prescriptions in a private primary health w e setting in South Africa.
The study is a non-experimental, quantitative, retrospective drug utilisation review of
antimicrobial usage in a private primary health care setting. Data were obtained from the
central database of a private primary health care service provider. Data of nine randomly
selected clinics, situated in different geographical areas of South Africa, were extracted for
the period 1st January to 31st December 2001. The study population was made of the total
patient population of patients using antimicrobials during this one year period.
Antimicrobial usage was analysed according to: number of patients, age and gender
distribution, diagnosis, pharmacological groups.
The total number of patients who visited the nine clinics during the year was 83 655 of which
59.50% were females and 40.22% males. In 0.28% of the cases gender was not indicated.
Patients in age groups 6 (20-40 years) and 7 (40-60 years) accounted for the highest number
of patients (66.31%, n = 54 964). A total of 515 976 medicine items costing R1 716 318.90
were prescribed, of these, 18.69%, (N=96 423) were antimicrobials costing 60.89%, (R1 045
108.00). Of the total number of patients that visited the nine clinics, 65.34% (N=54 663) were
prescribed antimicrobials. The total number of diagnoses (140 723) where antimicrobials
were prescribed accounted for 68.52% (N46 42 1).
The highest number of antimicrobial prescriptions according to pharmacological and age
groups were: penicillins followed by sulphonamides and tetracyclines. The diagnoses with the
highest number of antimicrobial prescriptions were the respiratory tract infections (viral
influenza, acute bronchitis and upper respiratory tract infection) and pelvic inflammatory
disease
The prescribing of antimicrobials in respiratory tract infections could indicate overuse and
inappropriate use of these drugs. Because most of these infections are caused by viruses or
other non-bacterial agents, are self limiting. Therefore, the use of antibiotics courses is neither
necessary nor appropriate in these conditions. The overuse and inappropriate use of such
drugs have an effect on the health of the patients needing cure, and the general budget on
health care service. It is recommended that further studies are conducted on antimicrobial
prescribing and use. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.
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A retrospective drug utilisation study of antimicrobials in a private primary health care group / Norah Lucky Katende-KyendaKatende-Kyenda, Norah Lucky January 2005 (has links)
The commonest prescribed group of drugs is antimicrobials. Various studies have shown that
they are overused globally. Since Primary health care represents the first tier of the health
care system, evaluation of antimicrobial use in primary health w e settings is a necessity to
ensure rational and cost-effective use of these agents in the treatment of infectious diseases.
It has been reported by Hooton and Levy (2001 : 1088) that 20% to 50% of antimicrobials are
inappropriately used in developing countries. According to Rebana et al. (1998: 175) the
increasing overuse of antimicrobials has resulted in an enormous escalation in the total costs
of drugs contributing to 15% to 30 % of the total health budget. Hooton and Levy
(2001: 1087) reported in a study that inappropriate use and overuse of antimicrobials are risk
factors for the emergence of antibiotic resistant bacteria. There is a high incidence of
infectious diseases in developing countries that are due to the rapid spread of resistant strains
through over-crowding, poor sanitation and unsafe sexual practices (Liu et al., 1999: 540).
The general objective of the study was the analysis and interpretation of the usage and related
costs of antimicrobial prescriptions in a private primary health w e setting in South Africa.
The study is a non-experimental, quantitative, retrospective drug utilisation review of
antimicrobial usage in a private primary health care setting. Data were obtained from the
central database of a private primary health care service provider. Data of nine randomly
selected clinics, situated in different geographical areas of South Africa, were extracted for
the period 1st January to 31st December 2001. The study population was made of the total
patient population of patients using antimicrobials during this one year period.
Antimicrobial usage was analysed according to: number of patients, age and gender
distribution, diagnosis, pharmacological groups.
The total number of patients who visited the nine clinics during the year was 83 655 of which
59.50% were females and 40.22% males. In 0.28% of the cases gender was not indicated.
Patients in age groups 6 (20-40 years) and 7 (40-60 years) accounted for the highest number
of patients (66.31%, n = 54 964). A total of 515 976 medicine items costing R1 716 318.90
were prescribed, of these, 18.69%, (N=96 423) were antimicrobials costing 60.89%, (R1 045
108.00). Of the total number of patients that visited the nine clinics, 65.34% (N=54 663) were
prescribed antimicrobials. The total number of diagnoses (140 723) where antimicrobials
were prescribed accounted for 68.52% (N46 42 1).
The highest number of antimicrobial prescriptions according to pharmacological and age
groups were: penicillins followed by sulphonamides and tetracyclines. The diagnoses with the
highest number of antimicrobial prescriptions were the respiratory tract infections (viral
influenza, acute bronchitis and upper respiratory tract infection) and pelvic inflammatory
disease
The prescribing of antimicrobials in respiratory tract infections could indicate overuse and
inappropriate use of these drugs. Because most of these infections are caused by viruses or
other non-bacterial agents, are self limiting. Therefore, the use of antibiotics courses is neither
necessary nor appropriate in these conditions. The overuse and inappropriate use of such
drugs have an effect on the health of the patients needing cure, and the general budget on
health care service. It is recommended that further studies are conducted on antimicrobial
prescribing and use. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.
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An education intervention on prescribing patterns of drugs for acid-related disorders in a clinic setting : a case study / Jacqueline Louise MinnieMinnie, Jacqueline Louise January 2007 (has links)
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.
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Establishing an essential medicine list for the State of KuwaitAlayadhi, Nadyah Y. A. H. January 2017 (has links)
The Health Sector at the state of Kuwait is facing many challenges. One of which is public expectations in health are high, and thus, the Ministry of Health (MOH) in Kuwait has amplified the health expenditure by 86% since 2007. And since the medicine budget represents half of the total MOH budget, it is proposed that the development in health policy might be a suitable tool to control the inflation within the health budget. This thesis examines the opportunities and challenges of introducing an EML in Kuwait and the factors influencing its effectiveness. A mixed-methodology approach has been used to enhance and validate the data, in the form of interviews, comparative studies and questionnaires. One major limitation to the research was the lack of previous data relating to this work, and the information should be gathered in person in the form of hard copies, and later, the data was analysed using qualitative and quantitative approaches. It has been attained that, the EML might be a valuable tool if adopted and implemented appropriately, EML adjustment to country health situation is crucial for successful utilisation and fulfilling the concept objectives. Standard Treatment Guidelines are fundamental part of EM selection process, in Kuwait there were lack in the uniformity of the local STG, but fortunately, there is an eagerness to innovate, and the medicine situation might benefit from a type of organisation, overall, if the EML implemented efficiently in Kuwait, it might help in improving the general health and control the inflation in MOH budget.
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Establishing an Essential Medicine List for the State of KuwaitAlayadhi, Nadyah Y.A.H. January 2017 (has links)
The Health Sector at the state of Kuwait is facing many challenges. One of which is public expectations in health are high, and thus, the Ministry of Health (MOH) in Kuwait has amplified the health expenditure by 86% since 2007. And since the medicine budget represents half of the total MOH budget, it is proposed that the development in health policy might be a suitable tool to control the inflation within the health budget. This thesis examines the opportunities and challenges of introducing an EML in Kuwait and the factors influencing its effectiveness. A mixed-methodology approach has been used to enhance and validate the data, in the form of interviews, comparative studies and questionnaires. One major limitation to the research was the lack of previous data relating to this work, and the information should be gathered in person in the form of hard copies, and later, the data was analysed using qualitative and quantitative approaches. It has been attained that, the EML might be a valuable tool if adopted and implemented appropriately, EML adjustment to country health situation is crucial for successful utilisation and fulfilling the concept objectives. Standard Treatment Guidelines are fundamental part of EM selection process, in Kuwait there were lack in the uniformity of the local STG, but fortunately, there is an eagerness to innovate, and the medicine situation might benefit from a type of organisation, overall, if the EML implemented efficiently in Kuwait, it might help in improving the general health and control the inflation in MOH budget.
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