Panjasaram Naidoo, University of KwaZulu-Natal, Discipline of Pharmaceutical Science, South Africa.
Adverse drug reactions affect adults and children in varying magnitudes, resulting in mortality and morbidity. Reporting of ADR as part of pharmacovigilance activity, is vital to ensure positive health outcomes. This study aimed to assess the current knowledge, practice and perceived barriers towards adverse drug reaction (ADR) reporting amongst doctors and pharmacists in teaching hospitals situated in the eThekwini Metro of KwaZulu Natal, South Africa. Descriptive quantitative cross sectional study was conducted amongst doctors and pharmacists in 5 teaching hospitals in KwaZulu Natal, using a pre-tested questionnaire. Data was captured and analyzed using SPSS version 22 with p values <0.05 considered statistically significant. Response rate was 76.5% [98] . Whilst 100% of respondents were familiar with the term pharmacovigilance (PV), knowledge scores were low with 85.71% selecting the incorrect definition. No training was received by 68.36% of respondents on ADR reporting. Even though 59 (60.2%) respondents indicated that their patient experienced an ADR, only 46.94% actually reported the ADR, with only 4 respondents satisfied with the feedback received from authorities after reporting an ADR. Barriers were cited that prevented respondents from reporting ADRs. Respondents were also not happy with the South African PV system. Over 70% of respondents indicated that they would participate in a PV training programme. Whilst the majority of pharmacists and doctors were familiar with the concept of PV, less than 50% reported an ADR. Many barriers were cited that contributed to respondents not effectively practising PV with the majority willing to participate in PV training to better their knowledge.
Bernard Cheung graduated from the University of Cambridge. In 2007-2009, he held the chair in Clinical Pharmacology and Therapeutics in Birmingham. He is now the Sun Chieh Yeh Heart Foundation Professor in Cardiovascular Therapeutics at the University of Hong Kong, and heads the Division of Clinical Pharmacology and Therapeutics. He is an Honorary Consultant Physician of Queen Mary Hospital and the Medical Director of the Phase 1 Clinical Trials Centre. He is an Honorary Professor at the Hong Kong University Shenzhen Hospital and a Visiting Professor of Shenzhen University. He is the Editor-in-Chief of Postgraduate Medical Journal. He has 270 publications, 7500 citations and an h-index of 43.
In Hong Kong 70% of inpatient care is in public hospitals and most acute emergencies are treated in public hospitals. Therefore the most serious adverse drug reactions present to public hospitals. The Clinial Data Analyais and Reporting System (CDARS) has been capturing prescribing and dispensing data, as well as clinic and hospital attendance data, in Hong Kong for over ten years. This authentic source of information can link clinical events, at least the serious ones, with dispensing data. There are three recent examples of how we used these data. Firstly, contaminiated batches of generic valsartan were recalled in 2018 and we monitored the daily admissions due to stroke in the whole of Hong Kong. Fortunately, there was not the slightest signal of an abrupt rise in stroke. Secondly, we studied drug-related hypokalaemia (low plasma potassium) in the population. Of around 25000 hospitalisations due to hypokalaemia over a 10-year period, around 5000 were due to diuretics, one third of which were due to indapamide used for the treatment of hypertension. Lastly, we studied the incidence and risk factors for vancomycin-induced acute kidney injury. 1450 cases were identified over a five-year period. We identified trough vancomycin level, baseline renal function, organ dysfunction and concomitant drugs as risk factors These studies demonstrate the power of using computerised population medical data to investigate uncommon adverse effects of drugs. These big data can be used to complement the spontaneous reports from clinicians
Lectins, by combination of our established enzyme-linked lectin sorbent assay(ELLSA) and inhibition study, have been used as powerful tools in many glycoconjugate recognition researches. In this short review, four highlights are shared: There are (i) The recognition profiles of Gal/GalNAc specific lectins was updated and upgraded; (ii) Based on the cross specificities of applied lectins, a new classification system was introduced; (iii) Applications of lectins used to detect and to identify N-glycan and/or Tn glycotope in glycoconjugates were intergraded; (iv) The polyvalency of the glycotopes in glycans plays a critical role in glycan-lectin recognitions was established. This is an unexplored area of glycobiology and one of the most promised direction towards the coming age of glycoscience transformation.
Danyah has completed her PGY1 at the age of 28 years at King Abdulaziz Medical City, Jeddah. She is an intyernal medicine clinical pharmacist at King Fahad Armed Forces Hospital, Jeddah.
Kidney-transplant recipients have complex medication regimens due to chronic comorbidities, in addition to immunosuppressive medications leading to serious medication-related problems (MRPs). 1 Pharmacists play crucial role in identifying and assessing MRPs, providing education, monitoring and suggesting alternative medications. Studies reported that clinical-pharmacists joining renal-transplant clinics have potential impact on patients’ outcomes. 2,3 There is a paucity of data on prevalence of MRPs in kidney-transplant patients at King-Abdulaziz medical city, Jeddah. Therefore, the study aims to determine the prevalence and types of MRPs in kidney-transplant recipients at the outpatient clinics. Secondary objectives include identifying the pharmacological classes of medications contributed to the MRPs, the categories of MRPs and the predictors of MRPs. Methods: Retrospective cross-sectional, electronic health records review. Data were collected from June 2016 until June 2017. Inclusion criteria: patients above 18 years, receiving maintenance immunosuppressants and at least 3 months post-transplant. MRPs include: Drug-drug interactions, ADR, improper dosing, medications without clear indication, indication with no medication and Duplication. A sample of 80 patients was estimated to detect prevalence of 31%of one MRP at least per patient with 95%confidence interval, 5%precision, an alpha of 0.05. Results and conclusion: Screened patients were129. The mean age was 50±15.75, 66.3% were males. Most common comorbidities were hypertension(62%) and diabetes(42.5%). The prevalence of MRPs was 28.97% in 1393 medication orders reviewed. The most frequent MRP types were drug-drug interactions(46.1%) and duplications(16.7%), Most common medications involved were Immunosuppressive and cardiac-medications. Most significant predictors for developing >3MRPs were: number of medications and duration post kidney-transplant.
Abdeen Mustafa Omer, Occupational Health Administration, Ministry of Health, Khartoum, SudaÂ
The strategy of price liberalisation and privatisation had been implemented in Sudan over the last decade, and has had a positive result on government deficit. The investment law approved recently has good statements and rules on the above strategy in particular to pharmacy regulations. Under the pressure of the new privatisation policy, the government introduced radical changes in the pharmacy regulations. To improve the effectiveness of the public pharmacy, resources should be switched towards areas of need, reducing inequalities and promoting better health conditions. Medicines are financed either through cost sharing or full private. The role of the private services is significant. A review of reform of financing medicines in Sudan is given in this study. Also, it highlights the current drug supply system in the public sector, which is currently responsibility of the Central Medical Supplies Public Corporation (CMS). In Sudan, the researchers did not identify any rigorous evaluations or quantitative studies about the impact of drug regulations on the quality of medicines and how to protect public health against counterfeit or low quality medicines, although it is practically possible. However, the regulations must be continually evaluated to ensure the public health is protected against by marketing high quality medicines rather than commercial interests, and the drug companies are held accountable for their conduct.