Background: A drug-drug interaction (DDI) is a pharmacologic or clinical response to the administration of a drug that can result in adverse outcomes. DDIs are considered preventable adverse drug reactions because these interactions can be learned, predicted and recognized. Objective: To determine potential drug-drug interactions (pDDI) among medications prescribed to adult patients consulting at a primary care clinic in a government teaching hospital. Methods: This was a 6-month retrospective cross-sectional study of drug prescriptions based on medical records of adult Filipinos who were seen and managed at a primary care clinic in a government teaching hospital. Medical charts were systematically selected based on a sampling frame with inclusion and exclusion criteria. Results: A total of 1,490 medical records of adult Filipino patients were included in the study. There were a total of 261 unique prescriptions based on generic formulations and an overall total of 5,978 drugs for a 6-month period of clinic consultations. An average of 4 medications (SD±1.63) were prescribed for every consultation recorded in the medical chart. From the charts that were reviewed, 23% of all adults were given a prescription of 4 drugs (N=348/1490), 26% had 3 drug prescriptions (N=386/1490) and 18% had two drugs, respectively, per clinic visit. Overall, 714/9054 (7.88%) medication pairs were seen to have potential drug interactions. The top three most common drug pairs with pDDI were amlodipine-simvastatin, losartan/hydrochlorothiazide-metformin and aspirin-furosemide. Five hundred twenty-five drug pairs had pharmacodynamic interactions (525/714) while 94 drug pairs (15%) had pharmacokinetic interactions. Conclusion Potential drug-drug interactions were observed in 8% of medications prescribed to adult Filipinos seen at Family Medicine Clinic in a government hospital. Seventy-four percent (74%) of the drug pairs with pDDIs were pharmacodynamic and 15% were pharmacokinetic interactions.
Ambulatory Care Facilities

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients*

No abstract available.
Ambulatory Care Facilities* ; Stomach Neoplasms*

In the multidisciplinary cancer treatment (MCT), it is necessary that radiologists participate in the patients' care, and they might be directly involved to the new practice methods including outpatient clinics. Face-to-face MCT is the most desirable practice method because satisfaction and compliance of the patients is high. However, it should be restrictively expanded due to practical problems such as lack of manpower. As a practical alternative, there is non-face-to-face MCT, like a tumor board, and it has many advantages to overcome the limitations of face-to-face MCT. Therefore, it is necessary to establish policies to support that both two types of MCT are stimulated so that the patients are able to get the optimized cancer management.
Ambulatory Care Facilities ; Compliance ; Humans

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients*

A retrospective study on all deaths in the district health centers and provincial hospital from 1/1/1995 to 31/12/1999 has shown that the mortality rate/inpatients: 0,47%, this rate in men higher than this in women, mainly: Kinh Nation. Ages of 15 -60 account for high rate; dead rate in infant accounts for 20% in total mortality rate. The average time from admission to death was 30,30 minutes. The rate of dead patient received the concentrated diagnosis is very low; the rate of correct diagnosis between the examination department and emergency department: 50%; use of paraclinical: 0.8 time/patient.10,57% nurse and sister did not implement correctly the medical command of medical doctor
mortality ; Ambulatory Care Facilities ; therapy

Background. Telemedicine provides access to health care services during pandemics. It can be utilized to screen asymptomatic persons, follow up close contacts of confirmed cases, monitor individuals with symptoms, conduct specialty consultations, and offer health services to patients during pandemics. Objective. To describe the telemedicine processes, good practices, and areas for improvement in the University of the Philippines Health Service (UPHS) during the COVID-19 pandemic. Methods. This was a cross-sectional study to document telemedicine processes in UPHS. All teleconsultations of employees and students of Philippine General Hospital (PGH) and UP Manila (UPM) during the two-week study period in October 2020 were included. Quantitative data was collected from different modes of patient entry into the UPHS telemedicine services: email, Online Consultation Request and Appointment (OCRA) System, and phone hotlines. Qualitative information was gathered as narrative descriptions of observations in the clinic’s service delivery areas. A focus group discussion was also conducted to illustrate the different steps of the pathway used for telemedicine. Results. The telemedicine services of UPHS consisted of virtual triage, COVID-19/non-COVID-19 consultation, and telemonitoring. The UPHS virtual triage received patient concerns through OCRA or the hotline numbers. On the other hand, the COVID-19 teleconsultation service provided care to employees and students who contacted the clinic regarding symptoms or exposure via email. The non-COVID-19 service had teleconsultation for patients with other medical concerns. Coordination among staff and presence of a consultant were identified as good practices, while the areas for improvement include the lack of written protocols in issuing fit-to-work clearance for difficult cases and the optional use of OCRA for UPHS consult. Conclusion. Telemedicine services at the UPHS included tele-triaging, teleconsultations, and telemonitoring with use of phone calls, short messaging service (SMS), emails, and OCRA. Timely coordination, on-site duty consultants, and use of technology were identified as good practices. Lack of protocols and inconsistent OCRA use are areas for improvement.
Pandemics ; Telemedicine ; Ambulatory Care Facilities

Multidisciplinary care service has started on August 1, 2014 after Korean health authority's decision of its approval and reimbursement. However, despite its early success, it raises some issues caused by less flexibility of the model, which might limit further expansion and development of the model or even establishment of a new model. It has only two types of 4-expert and 5 or more-expert services. It is also reimbursed only when given in outpatient clinic, and much worse, as of face-to-face service. Then, I will review the issues raised so far and try to suggest possible solutions, for example, sort of multidisciplinary consultation service for in-patient multidisciplinary care service. The issues and solutions will engender a lot of controversy, but to discuss about them might be the first step to further develop the service. In addition, I will briefly touch on expected effects of the service, including improvement of cancer care, such as shortening the time from the first visit to diagnosis and treatment or speed-up of diagnosis process, enhancement of cancer patients' satisfaction and so on, which might be helpful to guide future direction of the multidisciplinary care service. The commencement of multidisciplinary care service is an important milestone in cancer care as well as medical system of Korea. However, it is not the best and perfect one but was just chosen as one of champion models. It has much room for improvement or there is still more work to be done to make it better.
Ambulatory Care Facilities ; Diagnosis ; Korea ; Pliability

No abstract available.
Ambulatory Care Facilities ; Humans ; Outpatients ; Pneumonia

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients* ; Pharynx*