Suchergebnisse

Introduction and objectives: Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with anti-inflammatory, analgetic and antipyretic properties and are used in the treatment of acute mild to moderate pain, chronic pain and inflammatory conditions and fever. The aim of the study was to analyze the consumption of NSAIDs, purpose of use, length of therapy, adverse effects and patient's perception about efficacy and safety of the drugs. All patients, who had a NSAID prescribed, were included in the study. Method: The research was done in the Military Medical Academy, Belgrade, Serbia from June to December 2008. A questionnaire filled with the assistance of a pharmacist, contained questions about co morbidities, use and adverse effects of NSAIDs. All patients with at least one NSAID prespription (diclofenac, ibuprofen, flurbiprofen, naproxen, piroxicam, tenoxicam, meloxicam) were included in the study. The responses were statistically processed using the /-test. Results: 160 patients were included in the study. The majority of the patients (59.4%) used one NSAID in tablet form (48.8%). The most frequent used were diclofenac and ibuprofen. 51.9% suffered from rheumatic diseases for more than 5 years. Every other patient used both NSAIDs and gastroprotective drugs, most often ranitidine (58.1%). Conclusion: The results show that rheumatic diseases are often present in older patients and that treatment with NSAIDs lasts longer than five years. Mild gastric problems have been recorded as adverse effects of NSAIDs, most often nausea and pain in the stomach. This is probably due to the frequent use of diclofenac and ibuprofen, drugs with low or moderate risk for gastric toxicity as well as the concomitant use of H2-antagonists and proton pump inhibitors.

Introduction and objectives: Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with anti-inflammatory, analgetic and antipyretic properties and are used in the treatment of acute mild to moderate pain, chronic pain and inflammatory conditions and fever. The aim of the study was to analyze the consumption of NSAIDs, purpose of use, length of therapy, adverse effects and patient's perception about efficacy and safety of the drugs. All patients, who had a NSAID prescribed, were included in the study. Method: The research was done in the Military Medical Academy, Belgrade, Serbia from June to December 2008. A questionnaire filled with the assistance of a pharmacist, contained questions about co morbidities, use and adverse effects of NSAIDs. All patients with at least one NSAID prespription (diclofenac, ibuprofen, flurbiprofen, naproxen, piroxicam, tenoxicam, meloxicam) were included in the study. The responses were statistically processed using the /-test. Results: 160 patients were included in the study. The majority of the patients (59.4%) used one NSAID in tablet form (48.8%). The most frequent used were diclofenac and ibuprofen. 51.9% suffered from rheumatic diseases for more than 5 years. Every other patient used both NSAIDs and gastroprotective drugs, most often ranitidine (58.1%). Conclusion: The results show that rheumatic diseases are often present in older patients and that treatment with NSAIDs lasts longer than five years. Mild gastric problems have been recorded as adverse effects of NSAIDs, most often nausea and pain in the stomach. This is probably due to the frequent use of diclofenac and ibuprofen, drugs with low or moderate risk for gastric toxicity as well as the concomitant use of H2-antagonists and proton pump inhibitors. ; Uvod i cilj rada: Nesteroidni antiinflamatorni lekovi (NSAIL) ispoljavaju antiinflamatorno, analgetičko i antipiretičko dejstvo i primenjuju se kod akutnih bolova blagog do umerenog intenziteta, hroničnih bolnih i zapaljenskih stanja, te povišene telesne temperature. Cilj ove studije bio je da se analizira vanbolnička potrošnja NSAIL, način primene, dužina terapije i neželjene reakcije, kao i iskustva pacijenata u vezi sa efikasnošću i bezbednošću lekova. U studiju su uključeni svi pacijenti kojima je propisan NSAIL. Metode: Istraživanje je sprovedeno u Vojnomedicinskoj akademiji u Beogradu, u periodu od juna do decembra 2008. godine. Pacijenti su, uz pomoć farmaceuta, popunjavali upitnik koji se sastojao od pitanja vezanih za pridružena oboljenja, upotrebu i neželjene efekte NSAIL. U studiju su uključeni svi pacijenti kojima je na recept bio propisan neki od NSAIL (diklofenak, ibuprofen, flurbiprofen, naproksen, piroksikam, tenoksikam, meloksikam). Odgovori su statistički obrađeni primenom x2-testa. Rezultati: U studiji je učestvovalo 160 pacijenata. Većina pacijenata (59,4%) je koristila jedan NSAIL, 48,8% ispitanika je primenjivalo lek u obliku tablete. Diklofenak i ibuprofen su najčešće korišćeni lekovi. U ispitivanoj grupi pacijenata, 51,9% pacijenata je bolovalo od reumatične bolesti duže od 5 godina. Svaki drugi pacijent je istovremeno primenjivao NSAIL i gastroprotektivni lek, najčešće ranitidin (58,1%). Zaključak: Rezultati pokazuju da se NSAIL često primenjuju duže od pet godina, u lečenju reumatičnih bolesti koje su zastupljene kod starijih pacijenata. Najčešći neželjeni efekti NSAIL su blagi gastrointestinalni problemi, nauzeja i bol u stomaku. Ovo se objašnjava time što se najviše koriste diklofenak i ibuprofen, lekovi koji imaju slab ili umeren rizik za ispoljavanje gastričnih neželjenih efekata, ali i zbog istovremene primene NSAIL i H2-blokatora/inhibitora protonske pumpe.

Introduction: While medicine shortages are complex, their mitigation is more of a challenge. Prospective risk assessment as a means to mitigate possible shortages, has yet to be applied equally across healthcare settings. The aims of this study have been to: 1) gain insight into risk-prevention against possible medicine shortages among healthcare experts; 2) review existing strategies for minimizing patient-health risks through applied risk assessment; and 3) learn from experiences related to application in practice. Methodology: A semi-structured questionnaire focusing on medicine shortages was distributed electronically to members of the European Cooperation in Science and Technology (COST) Action 15105 (28 member countries) and to hospital pharmacists of the European Association of Hospital Pharmacists (EAHP) (including associated healthcare professionals). Their answers were subjected to both qualitative and quantitative analysis (Microsoft Office Excel 2010 and IBM SPSS Statistics®) with descriptive statistics based on the distribution of responses. Their proportional difference was tested by the chi-square test and Fisher's exact test for independence. Differences in the observed ordinal variables were tested by the Mann-Whitney or Kruskal-Wallis test. The qualitative data were tabulated and recombined with the quantitative data to observe, uncover and interpret meanings and patterns. Results: The participants (61.7%) are aware of the use of risk assessment procedures as a coping strategy for medicine shortages, and named the particular risk assessment procedure they are familiar with failure mode and effect analysis (FMEA) (26.4%), root cause analysis (RCA) (23.5%), the healthcare FMEA (HFMEA) (14.7%), and the hazard analysis and critical control point (HACCP) (14.7%). Only 29.4% report risk assessment as integrated into mitigation strategy protocols. Risk assessment is typically conducted within multidisciplinary teams (35.3%). Whereas 14.7% participants were aware of legislation stipulating risk assessment implementation in shortages, 88.2% claimed not to have reported their findings to their respective official institutions. 85.3% consider risk assessment a useful mitigation strategy. Conclusion: The study indicates a lack of systematically organized tools used to prospectively analyze clinical as well as operationalized risk stemming from medicine shortages in healthcare. There is also a lack of legal instruments and sufficient data confirming the necessity and usefulness of risk assessment in mitigating medicine shortages in Europe. © Copyright © 2020 Miljković, Godman, Kovačević, Polidori, Tzimis, Hoppe-Tichy, Saar, Antofie, Horvath, De Rijdt, Vida, Kkolou, Preece, Tubić, Peppard, Martinez, Yubero, Haddad, Rajinac, Zelić, Jenzer, Tartar, Gitler, Jeske, Davidescu, Beraud, Kuruc-Poje, Haag, Fischer, Sviestina, Ljubojević, Markestad, Vujić-Aleksić, Nežić, Crkvenčić, Linnolahti, Ašanin, Duborija-Kovačević, Bochenek, Huys and Miljković.

INTRODUCTION: While medicine shortages are complex, their mitigation is more of a challenge. Prospective risk assessment as a means to mitigate possible shortages, has yet to be applied equally across healthcare settings. The aims of this study have been to: 1) gain insight into risk-prevention against possible medicine shortages among healthcare experts; 2) review existing strategies for minimizing patient-health risks through applied risk assessment; and 3) learn from experiences related to application in practice. METHODOLOGY: A semi-structured questionnaire focusing on medicine shortages was distributed electronically to members of the European Cooperation in Science and Technology (COST) Action 15105 (28 member countries) and to hospital pharmacists of the European Association of Hospital Pharmacists (EAHP) (including associated healthcare professionals). Their answers were subjected to both qualitative and quantitative analysis (Microsoft Office Excel 2010 and IBM SPSS Statistics(®)) with descriptive statistics based on the distribution of responses. Their proportional difference was tested by the chi-square test and Fisher's exact test for independence. Differences in the observed ordinal variables were tested by the Mann-Whitney or Kruskal-Wallis test. The qualitative data were tabulated and recombined with the quantitative data to observe, uncover and interpret meanings and patterns. RESULTS: The participants (61.7%) are aware of the use of risk assessment procedures as a coping strategy for medicine shortages, and named the particular risk assessment procedure they are familiar with failure mode and effect analysis (FMEA) (26.4%), root cause analysis (RCA) (23.5%), the healthcare FMEA (HFMEA) (14.7%), and the hazard analysis and critical control point (HACCP) (14.7%). Only 29.4% report risk assessment as integrated into mitigation strategy protocols. Risk assessment is typically conducted within multidisciplinary teams (35.3%). Whereas 14.7% participants were aware of legislation stipulating risk ...