1.Is nationwide special campaign on antibiotic stewardship program effective on ameliorating irrational antibiotic use in China? Study on the antibiotic use of specialized hospitals in China in 2011-2012.
Xiao-xu ZOU ; Zi FANG ; Rui MIN ; Xue BAI ; Yang ZHANG ; Dong XU ; Peng-qian FANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(3):456-463
With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly over prescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
Anti-Bacterial Agents
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China
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Drug Prescriptions
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statistics & numerical data
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Drug Utilization
;
statistics & numerical data
;
trends
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Drug Utilization Review
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methods
;
statistics & numerical data
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Geography
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Hospitals
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classification
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statistics & numerical data
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Humans
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Inpatients
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statistics & numerical data
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Outpatients
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statistics & numerical data
2.Medicine prescription practices of homeopathic undergraduate students in West Bengal, India.
Subhranil SAHA ; Munmun KOLEY ; Jogendra Singh ARYA ; Gurudev CHOUBEY ; Shubhamoy GHOSH ; Subhasish GANGULY ; Aloke GHOSH ; Sangita SAHA ; Malay MUNDLE ; E-mail: DRMALAYMUNDLE@GMAIL.COM.
Journal of Integrative Medicine 2014;12(1):7-12
OBJECTIVETo our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students.
METHODSA cross-sectional study was carried out involving all the students from four government homeopathic schools of West Bengal, India. Ethical requirements were ensured and data were collected using self-administered questionnaires. Chi-square tests and logistic univariate regression analyses were performed to identify associations and differences.
RESULTSA total of 328 forms were completed. Of these, 264 (80.5%) homeopathic undergraduate students admitted of prescribing medicines independently and most (40.5%) said that they did this 2-3 times a year. The most common reasons for this were 'urgency of the problem' (35.2%), 'previous experience with same kind of illness' (31.8%), and 'the problem too trivial to go to a doctor' (25.8%). About 63.4% of the students thought that it was alright to independently diagnose an illness while 51.2% thought that it was alright for them to prescribe medicines to others. Common conditions encountered were fever, indigestion, and injury. Students who prescribed medicines were more likely to belong to Calcutta Homeopathic Medical College and Hospital (odds ratio = 5.8; 95% confidence interval 2.247-14.972). Prescription by students gradually increased with academic years of homeopathic schools. Many students thought it was alright for students to diagnose and treat illnesses.
CONCLUSIONPrescription of medicines by homeopathic undergraduate students is quite rampant and corrective measures are warranted.
Adult ; Cross-Sectional Studies ; Drug Prescriptions ; standards ; statistics & numerical data ; Female ; Homeopathy ; education ; manpower ; standards ; Humans ; India ; Male ; Students ; statistics & numerical data ; Surveys and Questionnaires ; Young Adult
3.Analysis of Bone Mineral Density among the Elderly Participated in the Exercise Programs Weekly for 1 Year.
Journal of the Korean Geriatrics Society 2001;5(2):185-195
BACKGROUND: Although there were many studies about increasing the bone mineral density(BMD) of the elderly by exercise program, the results of weekly exercise participation degree are still to be not prepared. Therefore I examined that the effect of weekly exercise participation degree on BMD level of the elderly. METHODS: Subjects were 93 older adults (male=43, female=50) residing in Seoul-Seniors-To-wei. These people are either participating in exercise program for a year, or not in Song-Do Hospital Exercise Prescription Center. Among the elderly, if one were took part in exercise program 5 days or more weekly, they are classified in Group A(male = 14, female= 14), if one were took part in exercise program 5 days weekly, they are classified in Group B (male = 14, female = 17), if one were took part in exercise program a day weekly. they are classified in Group C(mal =8, female= 13). and if one were not took part in exercise program, they are involved in Group I)(male=7, female=6). All the measured data were represented by mean and standard deviation using SPSS package(ver10.0). The statistical techniques for data analysis of BMD levels of the four groups in male and female groups were to analyze the differences among groups by one way ANOVA. And then I performed the Scheffe post-hoc method forinvestigating exactly the differences among groups. The 5% level of significance was used as the critical level for acceptance of hypotheses for the study. RESULTS: There were no statistical difference (p>0.05) among four male or female groups in BMD levels of head, anus, trunk, ribs, and pelvis parts. But there were statistical differences(p <0.05) among four male or female groups in BMD levels of legs, spine, and total. On the condition of legs, the BMD level of Group A exercised in 5 days or more weekly was 1.58 g/cm2 (F=6.774, p=0.001) in male groups and 1.17 g/cm2 (F =6.616. p=0.001) in female groups. These levels were the highest among four groups. And on the condition of spine, the BMD level of Group A was 1.17 g/cm2(F=7.732, p=0.001) in male groups and 1.16 g/cm2(F=6.243, p=0.002) in female groups. These levels were the highest among four groups. Also on the cutiditiuii of total, the BMD level of Group A was 1.53 g/cm2(F=5.677, p=0.003) in male groups and 1.1 g/cm(F=5.283, p=0.003)in female groups. These levels were the highest among four groups. CONCLUSION: Although the exercise is advantageous to the elderly people, if they are participated in 5 days or more weekly, they will be gained more benefit on BMD level and so on.
Adult
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Aged*
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Anal Canal
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Bone Density*
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Female
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Head
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Humans
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Leg
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Male
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Pelvis
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Prescriptions
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Ribs
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Spine
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Statistics as Topic
4.Study on traditional Chinese medicine prescriptions for cardiovascular diseases over the past 20 years and logistic regression analysis.
Rong TIAN ; Li CHEN ; Yanting YANG ; Ping LI
China Journal of Chinese Materia Medica 2012;37(4):541-544
OBJECTIVETo analyze the relationship between TCM's characteristics and treatment of cardiovascular diseases on the basis of the modem medical research literatures about treatment of cardiovascular diseases and establish a mathematic model in order to give reference for clinical study and clinical prescription for treatment of cardiovascular diseases with TCMs.
METHODArticles on treatment of cardiovascular diseases with TCMs published at home in the past 20 years were collected and screened to summarize the number of TCMs with different function, property, flavor, channel tropism and the number of them with the therapeutically effect on cardiovascular diseases. And a mathematic model was established on the multivariate discriminatory analysis.
RESULTMedicines for activating blood circulation and removing blood stasis (21.21%), those restoring deficiency (17.65%), those attributive to heart channel (21.82%) and those attributive to spleen channel (16. 11%) were relatively active in study for treatment of cardiovascular diseases and showed great difference (P < 0.05). According to findings of the logistic regression screen, TCMs attribute to heart, spleen, gallbladder, pericardium channel and those restoring deficiency were important impact factors with therapeutically effect on cardiovascular diseases (regression coefficient > 0 and P < 0.05). The coincidence was 91.6% between mathematical computing and original classification, indicating the coincidence with relevant theories of the traditional Chinese medical science.
CONCLUSIONA more objective Logistic regression equation with a higher accuracy rate of retrospective inspection is established to detect the effect of TCMs with different characteristics on cardiovascular diseases. It is suggested that more experiments and clinical comparative studies on treatment of cardiovascular diseases with TMCs shall be included in pharmacopeia.
Cardiovascular Diseases ; drug therapy ; Drug Prescriptions ; statistics & numerical data ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Logistic Models ; Multivariate Analysis
5.Evaluation of the importance of herbs in the Chinese herbal compounds based on the theory of rough sets.
Journal of Biomedical Engineering 2013;30(5):1007-1009
The theory of rough sets has been applied to evaluate the importance of each herb in the Chinese herbal compounds in this study. This method could distinguish core herbs through different syndrome types in the same class of prescription by measuring the importance of attributes. Compared to the frequency statistical method, the rough sets method could reveal law of compatibility in categorized formula more deeply. This study gives some guidance to clinical application of herbs and the drug screening in the development of new Chinese traditional medicine.
Decision Trees
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Diagnosis, Differential
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Drug Prescriptions
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statistics & numerical data
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Drug Therapy, Combination
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Drugs, Chinese Herbal
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therapeutic use
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Medicine, Chinese Traditional
6.A Survey on Experience and Illness Management of Rural Women with Osteoarthritis.
Journal of Korean Academy of Fundamental Nursing 2006;13(3):419-427
PURPOSE: This descriptive survey was done to assess how rural women with osteoarthritis perceive their symptoms, what are their treatment preferences, and how they manage their illness. METHOD: Individual interviews were carried out with 205 women with osteoarthritis living in rural areas. Structured questionnaires were used and the interviewers were 7 trained research assistants. Descriptive statistics were used for data analysis with SPSS win 11.5 program. RESULTS: Of the respondents, 68.8% were overweight and 15.1% were obese, 86.9% reported pain in the knees, low back, and shoulders and the average pain score was 66.06. Those knowing the exact diagnosis accounted for 73.7% of the respondents but only 49.7% reported receiving medical treatments, and 40.2% who received treatment adhered to their prescription. Folk medicines were used by 14.1% of the respondents, but 65.2% among them reported that folk medicines were not effective. Exercise 2.03 times per week was reported by 17.1% of the respondents and 48.6% reported preferring to walk. CONCLUSION: Women with osteoarthritis in rural areas need a rehabilitative care program focused on exercise. The community health care system in the rural area should deliver optimal health care for this population. The results of this study can be used as a basis for planning intervention programs for women with osteoarthritis in the rural area.
Community Health Services
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Surveys and Questionnaires
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Delivery of Health Care
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Diagnosis
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Female
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Humans
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Knee
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Osteoarthritis*
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Overweight
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Prescriptions
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Shoulder
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Statistics as Topic
7.Analysis of medication regularity of traditional Chinese medicine prescriptions for gastropyretic excessiveness diabetes based on data mining.
Ye-Ran WANG ; Yang ZHANG ; Qi-Bing QIN ; Ping WANG ; Long TAN
China Journal of Chinese Materia Medica 2020;45(1):196-201
To analyze the medication regularity of traditional Chinese medicine(TCM) prescriptions for gastropyretic excessiveness diabetes recorded in Chinese Medicine Prescriptions Dictionary. A total of 103 eligible prescriptions were input into the system platform, and the Apriori algorithm was used to analyze their medication regularity. The 103 prescriptions for gastropyretic excessiveness diabetes were selected from the system, and 29 herb medicines were found with frequency of usage more than 8. Totally 33 commonly used herbal pairs(support degree≥10), twenty-three 3-herb core combinations(support degree≥8, confidence values≥0.5), and twenty-one 4-herb core combinations(confidence values≥0.5) were discovered after the medication regularity analysis by Apriori algorithm. The herbal medicine combinations with the highest correlation degree were discovered after the association rule analysis on the 103 prescriptions(support degree≥10, confidence values≥0.5). The four properties, five tastes, channel distributions and frequency of dose of the 103 prescriptions were also obtained after the corresponding analysis. According to the analysis and summary of the above data, the combination of Trichosanthis Radix, Anemarrhenae Rhizoma, Coptidis Rhizoma and Ophiopogonis Radix could reflect the medication regularity of TCM prescriptions for gastropyretic excessiveness diabetes to a certain degree, which is of great significance in guiding value in clinic.
Data Mining
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Diabetes Mellitus/drug therapy*
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Drug Prescriptions/statistics & numerical data*
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Drugs, Chinese Herbal/administration & dosage*
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Humans
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Medicine, Chinese Traditional
8.Application of modern imformation technology in study of traditional Chinese medicine presciptions.
Wei LONG ; Pei-xun LIU ; Jing GAO
China Journal of Chinese Materia Medica 2007;32(13):1260-1263
With the imformation technology getting a great progress in recent years, the modem imformation technology is extensively employed in the study of traditional Chinese medicine (TCM) prescriptions. In this article a summary is given, which includes applications of modern imformation technology in the study of TCM presciptions. It focus on the introduction of the databse technology, data-mining technology and chemometrics, and brief virtual screening technology, experimental design, innovation design, study of complexity and bioinformatics technology, all of which deployed in the study of TCM presciptions, so as to enligten researchers on modernized study of TCM prescription and its development in the future.
Databases as Topic
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statistics & numerical data
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Drug Combinations
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Drug Information Services
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statistics & numerical data
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Drugs, Chinese Herbal
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administration & dosage
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chemistry
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Humans
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Medicine, Chinese Traditional
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methods
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Plants, Medicinal
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chemistry
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Prescriptions
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statistics & numerical data
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Quantitative Structure-Activity Relationship
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Software
9.Evaluation of Outpatient Antibiotic Use in Beijing General Hospitals in 2015.
Chuan YANG ; Wen-Qiang CAI ; Zi-Jun ZHOU
Chinese Medical Journal 2017;130(3):288-296
BACKGROUNDMedical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate antibiotic use in China remains common and the situation requires urgent improvement. Here, we analyzed the prescriptions of antibiotics and evaluated the rationality of antibiotic use among outpatients in Beijing general hospitals during 2015.
METHODSWe collected basic medical insurance claim data from January 1, 2015 to December 31, 2015 in 507 general hospitals of Beijing. A descriptive analysis of outpatient antibiotic prescribing was performed. The Anatomical Therapeutic Chemical Classification/defined daily doses system was used to evaluate the rationality of antibiotic use.
RESULTSOver the study, an estimated 721,930, 613,520, and 822,480 antibiotics were dispensed in primary, secondary, and tertiary general hospitals corresponding to 5.09%, 5.06%, and 2.53% of all prescriptions, respectively. Antibiotic combinations represented 2.95%, 7.74%, and 10.18% of the total antibiotic prescriptions, respectively. Expenditure for the top twenty antibiotics in primary, secondary, and tertiary general hospitals was RMB 42.92, 65.89, and 83.26 million Yuan, respectively. Cephalosporins were the most frequently prescribed class of antibiotic in clinical practice. The antibiotics used inappropriately included azithromycin enteric-coated capsules, compound cefaclor tablets and nifuratel nysfungin vaginal soft capsules in primary hospitals, amoxicillin and clavulanate potassium dispersible tablets (7:1) and cefonicid sodium for injection in secondary hospitals, cefminox sodium for injection and amoxicillin sodium and sulbactam sodium for injection in tertiary hospitals.
CONCLUSIONSAntibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy initiatives are required to promote the judicious use of antibiotics.
Adolescent ; Adult ; Age Distribution ; Aged ; Amoxicillin ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Cephalosporins ; therapeutic use ; China ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; Hospitals, General ; Humans ; Middle Aged ; Outpatients ; statistics & numerical data ; Young Adult
10.Drug Utilization Review of Antiulcerative Agents in Korean Elderly Inpatients.
Wonsik LEE ; Seung Mi LEE ; Hye Won KOO ; Byung Joo PARK
Korean Journal of Preventive Medicine 2002;35(1):41-48
OBJECTIVES: To review the drug prescription pattern of antiulcerative agents for elderly inpatients. METHODS: The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1994. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription. Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. RESULTS: The number of patients prescribed antiulcerative agents was 1,059 (64.9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by H2 antagonist (16.0%). Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the total omeprazole prescriptions. CONCLUSIONS: Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulcerative agents.
Aged*
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Busan
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Cimetidine
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Cohort Studies
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Diagnosis
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Diazepam
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Drug Interactions
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Drug Prescriptions
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Drug Utilization Review*
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Drug Utilization*
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Drug-Related Side Effects and Adverse Reactions
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Female
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Hospitals, Community
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Humans
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Inpatients*
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Insurance
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Korea
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Male
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Omeprazole
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Prescriptions
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Statistics as Topic