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Analyzing Adverse Events Following FluAH1N1 Vaccination in Chiang Mai, Thailand
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Abstracts / Research in Social and Administrative Pharmacy 8 (2012) e1–e66
plans improved cost-related medication adherence. As mail order and online pharmacies become more prevalent, these findings may bring light to how patient behavior is affected by alternative prescription delivery mechanisms.
Patient Actions Taken After Experiencing an Adverse Drug Event in the United States in 2005 and 2007 E.E. Thatcher1, K.B. Farris1, J. Perepelkin2, K. De Jong1, 1 University of Michigan, College of Pharmacy, Ann Arbor, Michigan, United States, 2University of Saskatchewan, College of Pharmacy and Nutrition, Saskatoon, Saskatchewan, Canada Objectives: In the United States in 2009, there were over 1.2 million hospitalizations from adverse drug events. The objective of this study was to identify characteristics and actions taken by those subjects who experienced an adverse drug event in either 2005 or 2007. Methods: The Prescription Drug Study is a nationallyrepresentative, publically available, anonymous survey, including Americans 50 years and older. Subjects were interviewed in both 2005 and 2007 (n¼3536). Variables analyzed from both 2005 and 2007 included: demographics; experience of an adverse drug event (ADE); and actions taken after the event occurred (hospitalization, talked to doctor, emergency room visit, and stopped taking prescription without taking to a doctor).Descriptive statistics, chi-square, and t-tests were performed to determine the differences between those who experienced one ADE in 2005 or 2007, and those who experienced an ADE in both 2005 and 2007. Results: In 2005 and 2007, 16.4% (n¼505) and 15.0% (n¼462) of subjects had an ADE, respectively. Of those subjects, 167 had an ADE in both 2005 and 2007. Those who had ADEs in both 2005 and 2007 were more likely to: be older than their counterparts (t¼2.072, p¼0.039); be taking more prescription medications per month (t¼2.245, p¼0.026); stop taking a prescription without talking to a doctor first (t¼9.079, p!0.000); talk to a doctor about the ADE (t¼15.920, p!0.000); and visit the doctor or emergency room (t¼4.211, p!0.000). Conclusions: Individuals who are older and taking more prescriptions were more likely to experience ADEs perform post-ADE health behaviors. From this study, it is apparent that those who are sicker are more at risk for multiple adverse drug events.
ARV, The Miracle to Live Longer: Figuring out The Meaning of Antiretroviral Drugs for People Living with HIV/AIDS R.S. Handayani, Y. Yuniar, N.K. Aryastami, National Institute of Health Research and Development, Ministry of Health Republic of Indonesia
Objectives: Antiretroviral drugs (ARVs) have been used widely in the epidemic of HIV AIDS to enhance the life expectancy of people living with HIV AIDS (PLHIV). ARV cannot cure HIV AIDS and they have to be consumed a whole life once they have been started. It creates a problem of adherence when people get boring of using them, sometimes ends up with drop out. In this research we tried to figure out the meaning of ARV for PLHIV which have led to how they deal with ARV especially how PLHIV adhere to ARV therapy. Methods: The research was a qualitative research conducted in 2011 in two provinces of Indonesia respectively West Java Province (Bandung and Cimahi district) and Bali Province (Denpasar and Badung district). Data collected by doing in-depth interview with 17 people living with HIV AIDS, consisted of 9 female and 8 male ages 20 to 42 years. The interviews were analyzed by content analysis method. Results: PLHIVs interpret ARV not as common drugs, furthermore ARVs are considered as a miracle and helper to survive, the spirit to live and a hope to live longer. By using ARVs life became calmer, feeling healthy and confidence as they were not ill, and therefore they can go back to their activity normally. Some PLHIV deal with ARV therapy by using some strategies such as considered ARV as vitamins and using alarm to remind them. The experiences of their friends who drop out therapy and had to undergo the second line ARVs or even die, have also encouraged their adherence. Even though for some PLHIV, ARVs such as a burden and make them boring but they tried to survive the therapy as they realize the meaning of ARV for their life. Conclusions: ARVs for PLHIVshave deeper meaning other than just common drugs. They considered ARV as a miracle in their life therefore they tried to survive the therapy.
Analyzing Adverse Events Following FluAH1N1 Vaccination in Chiang Mai, Thailand K. Thiankhanithikun1, K. Chaiyapun2, T.M. Noiwinit3, P. Sribundit4, 1Faculty of Pharmacy, Chiang Mai University, Thailand, 2Sanpatong Hospital, Chiang Mai, Thailand, 3Hangdong Hospital, Chiang Mai, Thailand, 4 Chiang Mai Health Provincial Office, Chiang Mai, Thailand Objectives: Analyzing the coverage and adverse events following 48,850 doses of FluAH1N1 vaccination among the voluntary high-risk group in multi-setting in Chiang Mai Province, in comparison with seasonal Flu2009 vaccination. Methods: The informed consent paper and adverse event booklet were created by Chiang Mai Adverse Drug Reaction Network in collaboration with Health Provincial Office and 24 district networks, as the counseling tools of stimulus FluAH1N1 vaccination. Reports of adverse event were analyzed.
Abstracts / Research in Social and Administrative Pharmacy 8 (2012) e1–e66 Results: There were 47,292 people getting FluAH1N1 vaccination; this covered 96.81% of the target number. The highest number was the healthcare professional group (79.90%), while the lowest was the pregnant women group (6.21%). There were four non-target, high-risk groups (38.09%), including ageO65 years with chronic diseases (1.60%), healthcare volunteer (17.92%), high-risk relatives (4.79%), and clusters (13.81%). The response of adverse event reporting via booklet was 44.16% of total vaccination, which was similar to the Seasonal Flu2009 reporting (48.71%). The incidence of FluAH1N1 adverse event was 1.85%, which was lower than the incidence of Seasonal Flu2009 (4.66%). Most of the adverse events, 98.88%, were non-serious reactions, the same percentage as Seasonal Flu2009 vaccine (99.04%). A majority of pregnant women refused the FluAH1N1 vaccination because of the public news linking the vaccination to fetus dead. Conclusions: Most of adverse events of both FluAH1N1 and Seasonal Flu2009 vaccine in Chiang Mai Province were non-serious and occurred at low percentages. Coverage of FluAH1N1 vaccination did not reach both the target number and target group because of the vigilance of adverse event in pregnant women. Systemic analysis of adverse events and counseling may be the better tools for motivating the coverage and adverse event reporting of Flu AH1N1 vaccination.
Counseling of Patients by Pharmacy Attendants in Karachi, Pakistan: A Pilot Study S.Q. Jamshed1, M.J. Siddiqui1, K. Rajiah2, I. Azhar3, 1 Kulliyyah of Pharmacy, International Islamic University, Kuantan, Malaysia, 2School of Pharmacy and Health Sciences, International Medical University, Kuala Lumpur, Malaysia, 3Department of Pharmacognosy, Faculty of Pharmacy, University of Karachi, Karachi, Pakistan Objectives: To explore the views and opinions of pharmacy attendants towards patient counseling in community pharmacies in Karachi, Pakistan. Methods: In this cross-sectional, descriptive study design, a questionnaire related to their professional qualification, experience with counseling, barriers to counseling and continuing pharmacy education program was self-administered to 100 conveniently selected pharmacy attendants in Karachi, Pakistan. Results: All the respondents were male and had an experience of more than 10 years. Three-fourth of the respondents (n¼75: 75%) stated that they give an average dispensing time of 5-7 minutes to each patient. One half of the respondents (n¼50; 50%) strongly agreed to provide adequate drug information to patients. More than three-fourth of the respondents (n¼78; 78%) admitted to prescribe both OTC and prescription medicines. More than half of the respondents (n¼66;
e57
66%) stated that they are more interested in counseling rather than dispensing only. More than three-quarter of the attendants (n¼78; 78%) strongly disagreed to have continuing pharmacy education sessions. Slightly less than one-fourth of the respondents n¼20; 20%) considered CPE sessions as knowledge improvement tools. A very large majority (n¼85; 85%) disagreed to have pharmacist in community pharmacies. Conclusions: Community pharmacy attendants expressed strong interest in patient counseling. Interestingly, they denied the need of professionally qualified community pharmacist in the community pharmacy.
Heavy Metal Contents in Registered Dietary Supplements in Malaysia: A Pilot Study from the Drug Safety Perspective M.J. Siddiqui1, Z. Ismail2, N.S. Khari2, N.N. Mohamad2, S.Q. Jamshed1, 1Faculty of Pharmacy, International Islamic University, Kuantan, Pahang, Malaysia, 2 Pharmaceutical Chemistry, School of Pharmacy, Universiti Sains Malaysia, Penang, Malaysia Objectives: In Malaysia dietary supplements are rampantly consumed for general health and well-being and therefore, available in community pharmacies, health food stores, night markets, grocery stores and even obtained via internet. However, gap in the level of Malaysian consumer’s awareness regarding the toxicity of dietary supplements is a major issue, which needs to be addressed by the analysis of their constituents. This study was aimed to evaluate and analyze the heavy metal contents such as lead (Pb), cadmium (Cd), arsenic (As) and mercury (Hg) in registered dietary supplements available in community pharmacies in Malaysia Methods: This study was focused on Eurycoma longifolia (Tongkat Ali), glucosamine, Allium sativum (garlic) and Zingiber officinale (ginger) products. A total of twenty registered single ingredient dosage form dietary supplements from different brands were purchased from community pharmacies located in Penang. The samples were then evaluated and subjected to analysis by atomic absorption spectrometry. Results: The study showed that variable amounts of lead have been quantified as 0.29 -0.47 ppm (Tongkat Ali), 0.19 – 0.27 ppm (glucosamine), 0.01 – 0.38 ppm (garlic) and 0.26 – 0.74 ppm (ginger) products. While for cadmium detection, the amounts indicated 0.02 – 0.24 ppm (Tongkat Ali), 0.03 – 0.22 ppm (glucosamine), 0.06 ppm (ginger) and was absent in garlic No traces of arsenic and mercury were found in all four product samples. The regression linear coefficients (r2) for Pb, Cd, As and Hg standards were 0.9990, 0.9958, 0.9960 and 0.9989, respectively. Conclusions: The amount of Pb, Cd, As and Hg in all the products were found within the limits as per the requirement stated by National Pharmaceutical Control
Abstracts / Research in Social and Administrative Pharmacy 8 (2012) e1–e66
plans improved cost-related medication adherence. As mail order and online pharmacies become more prevalent, these findings may bring light to how patient behavior is affected by alternative prescription delivery mechanisms.
Patient Actions Taken After Experiencing an Adverse Drug Event in the United States in 2005 and 2007 E.E. Thatcher1, K.B. Farris1, J. Perepelkin2, K. De Jong1, 1 University of Michigan, College of Pharmacy, Ann Arbor, Michigan, United States, 2University of Saskatchewan, College of Pharmacy and Nutrition, Saskatoon, Saskatchewan, Canada Objectives: In the United States in 2009, there were over 1.2 million hospitalizations from adverse drug events. The objective of this study was to identify characteristics and actions taken by those subjects who experienced an adverse drug event in either 2005 or 2007. Methods: The Prescription Drug Study is a nationallyrepresentative, publically available, anonymous survey, including Americans 50 years and older. Subjects were interviewed in both 2005 and 2007 (n¼3536). Variables analyzed from both 2005 and 2007 included: demographics; experience of an adverse drug event (ADE); and actions taken after the event occurred (hospitalization, talked to doctor, emergency room visit, and stopped taking prescription without taking to a doctor).Descriptive statistics, chi-square, and t-tests were performed to determine the differences between those who experienced one ADE in 2005 or 2007, and those who experienced an ADE in both 2005 and 2007. Results: In 2005 and 2007, 16.4% (n¼505) and 15.0% (n¼462) of subjects had an ADE, respectively. Of those subjects, 167 had an ADE in both 2005 and 2007. Those who had ADEs in both 2005 and 2007 were more likely to: be older than their counterparts (t¼2.072, p¼0.039); be taking more prescription medications per month (t¼2.245, p¼0.026); stop taking a prescription without talking to a doctor first (t¼9.079, p!0.000); talk to a doctor about the ADE (t¼15.920, p!0.000); and visit the doctor or emergency room (t¼4.211, p!0.000). Conclusions: Individuals who are older and taking more prescriptions were more likely to experience ADEs perform post-ADE health behaviors. From this study, it is apparent that those who are sicker are more at risk for multiple adverse drug events.
ARV, The Miracle to Live Longer: Figuring out The Meaning of Antiretroviral Drugs for People Living with HIV/AIDS R.S. Handayani, Y. Yuniar, N.K. Aryastami, National Institute of Health Research and Development, Ministry of Health Republic of Indonesia
Objectives: Antiretroviral drugs (ARVs) have been used widely in the epidemic of HIV AIDS to enhance the life expectancy of people living with HIV AIDS (PLHIV). ARV cannot cure HIV AIDS and they have to be consumed a whole life once they have been started. It creates a problem of adherence when people get boring of using them, sometimes ends up with drop out. In this research we tried to figure out the meaning of ARV for PLHIV which have led to how they deal with ARV especially how PLHIV adhere to ARV therapy. Methods: The research was a qualitative research conducted in 2011 in two provinces of Indonesia respectively West Java Province (Bandung and Cimahi district) and Bali Province (Denpasar and Badung district). Data collected by doing in-depth interview with 17 people living with HIV AIDS, consisted of 9 female and 8 male ages 20 to 42 years. The interviews were analyzed by content analysis method. Results: PLHIVs interpret ARV not as common drugs, furthermore ARVs are considered as a miracle and helper to survive, the spirit to live and a hope to live longer. By using ARVs life became calmer, feeling healthy and confidence as they were not ill, and therefore they can go back to their activity normally. Some PLHIV deal with ARV therapy by using some strategies such as considered ARV as vitamins and using alarm to remind them. The experiences of their friends who drop out therapy and had to undergo the second line ARVs or even die, have also encouraged their adherence. Even though for some PLHIV, ARVs such as a burden and make them boring but they tried to survive the therapy as they realize the meaning of ARV for their life. Conclusions: ARVs for PLHIVshave deeper meaning other than just common drugs. They considered ARV as a miracle in their life therefore they tried to survive the therapy.
Analyzing Adverse Events Following FluAH1N1 Vaccination in Chiang Mai, Thailand K. Thiankhanithikun1, K. Chaiyapun2, T.M. Noiwinit3, P. Sribundit4, 1Faculty of Pharmacy, Chiang Mai University, Thailand, 2Sanpatong Hospital, Chiang Mai, Thailand, 3Hangdong Hospital, Chiang Mai, Thailand, 4 Chiang Mai Health Provincial Office, Chiang Mai, Thailand Objectives: Analyzing the coverage and adverse events following 48,850 doses of FluAH1N1 vaccination among the voluntary high-risk group in multi-setting in Chiang Mai Province, in comparison with seasonal Flu2009 vaccination. Methods: The informed consent paper and adverse event booklet were created by Chiang Mai Adverse Drug Reaction Network in collaboration with Health Provincial Office and 24 district networks, as the counseling tools of stimulus FluAH1N1 vaccination. Reports of adverse event were analyzed.
Abstracts / Research in Social and Administrative Pharmacy 8 (2012) e1–e66 Results: There were 47,292 people getting FluAH1N1 vaccination; this covered 96.81% of the target number. The highest number was the healthcare professional group (79.90%), while the lowest was the pregnant women group (6.21%). There were four non-target, high-risk groups (38.09%), including ageO65 years with chronic diseases (1.60%), healthcare volunteer (17.92%), high-risk relatives (4.79%), and clusters (13.81%). The response of adverse event reporting via booklet was 44.16% of total vaccination, which was similar to the Seasonal Flu2009 reporting (48.71%). The incidence of FluAH1N1 adverse event was 1.85%, which was lower than the incidence of Seasonal Flu2009 (4.66%). Most of the adverse events, 98.88%, were non-serious reactions, the same percentage as Seasonal Flu2009 vaccine (99.04%). A majority of pregnant women refused the FluAH1N1 vaccination because of the public news linking the vaccination to fetus dead. Conclusions: Most of adverse events of both FluAH1N1 and Seasonal Flu2009 vaccine in Chiang Mai Province were non-serious and occurred at low percentages. Coverage of FluAH1N1 vaccination did not reach both the target number and target group because of the vigilance of adverse event in pregnant women. Systemic analysis of adverse events and counseling may be the better tools for motivating the coverage and adverse event reporting of Flu AH1N1 vaccination.
Counseling of Patients by Pharmacy Attendants in Karachi, Pakistan: A Pilot Study S.Q. Jamshed1, M.J. Siddiqui1, K. Rajiah2, I. Azhar3, 1 Kulliyyah of Pharmacy, International Islamic University, Kuantan, Malaysia, 2School of Pharmacy and Health Sciences, International Medical University, Kuala Lumpur, Malaysia, 3Department of Pharmacognosy, Faculty of Pharmacy, University of Karachi, Karachi, Pakistan Objectives: To explore the views and opinions of pharmacy attendants towards patient counseling in community pharmacies in Karachi, Pakistan. Methods: In this cross-sectional, descriptive study design, a questionnaire related to their professional qualification, experience with counseling, barriers to counseling and continuing pharmacy education program was self-administered to 100 conveniently selected pharmacy attendants in Karachi, Pakistan. Results: All the respondents were male and had an experience of more than 10 years. Three-fourth of the respondents (n¼75: 75%) stated that they give an average dispensing time of 5-7 minutes to each patient. One half of the respondents (n¼50; 50%) strongly agreed to provide adequate drug information to patients. More than three-fourth of the respondents (n¼78; 78%) admitted to prescribe both OTC and prescription medicines. More than half of the respondents (n¼66;
e57
66%) stated that they are more interested in counseling rather than dispensing only. More than three-quarter of the attendants (n¼78; 78%) strongly disagreed to have continuing pharmacy education sessions. Slightly less than one-fourth of the respondents n¼20; 20%) considered CPE sessions as knowledge improvement tools. A very large majority (n¼85; 85%) disagreed to have pharmacist in community pharmacies. Conclusions: Community pharmacy attendants expressed strong interest in patient counseling. Interestingly, they denied the need of professionally qualified community pharmacist in the community pharmacy.
Heavy Metal Contents in Registered Dietary Supplements in Malaysia: A Pilot Study from the Drug Safety Perspective M.J. Siddiqui1, Z. Ismail2, N.S. Khari2, N.N. Mohamad2, S.Q. Jamshed1, 1Faculty of Pharmacy, International Islamic University, Kuantan, Pahang, Malaysia, 2 Pharmaceutical Chemistry, School of Pharmacy, Universiti Sains Malaysia, Penang, Malaysia Objectives: In Malaysia dietary supplements are rampantly consumed for general health and well-being and therefore, available in community pharmacies, health food stores, night markets, grocery stores and even obtained via internet. However, gap in the level of Malaysian consumer’s awareness regarding the toxicity of dietary supplements is a major issue, which needs to be addressed by the analysis of their constituents. This study was aimed to evaluate and analyze the heavy metal contents such as lead (Pb), cadmium (Cd), arsenic (As) and mercury (Hg) in registered dietary supplements available in community pharmacies in Malaysia Methods: This study was focused on Eurycoma longifolia (Tongkat Ali), glucosamine, Allium sativum (garlic) and Zingiber officinale (ginger) products. A total of twenty registered single ingredient dosage form dietary supplements from different brands were purchased from community pharmacies located in Penang. The samples were then evaluated and subjected to analysis by atomic absorption spectrometry. Results: The study showed that variable amounts of lead have been quantified as 0.29 -0.47 ppm (Tongkat Ali), 0.19 – 0.27 ppm (glucosamine), 0.01 – 0.38 ppm (garlic) and 0.26 – 0.74 ppm (ginger) products. While for cadmium detection, the amounts indicated 0.02 – 0.24 ppm (Tongkat Ali), 0.03 – 0.22 ppm (glucosamine), 0.06 ppm (ginger) and was absent in garlic No traces of arsenic and mercury were found in all four product samples. The regression linear coefficients (r2) for Pb, Cd, As and Hg standards were 0.9990, 0.9958, 0.9960 and 0.9989, respectively. Conclusions: The amount of Pb, Cd, As and Hg in all the products were found within the limits as per the requirement stated by National Pharmaceutical Control