Journal of Pharmaceutical Care is an open access journal officially published by the Research Center for Rational Use of Drugs (RCRUD) of the Tehran University of Medical Sciences, and Iranian Society of Clinical Pharmacists which is focused on experimental and clinical pharmaceutical practices to present researches, hot topics, requirements and regulations of the pharmaceutical practice area. Manuscript in Clinical Pharmaceutical Practice, Pharmaceutical Care Regulations, Pharmaceutical Care in hospitals and community pharmacies, Pharmacotherapy, Pharmacoepidemiology, Pharmacogenomics, Pharmacokinetics, Pharmacoeconomics, Clinical pharmacokinetics, Drug Utilization Evaluation review, Medication safety, Drug and Poison Information Services and Health services research are welcome.Content includes Original Articles, Systematic Review or Meta-Analysis, Review Articles, Case Reports and Letters to the Editor.
JPC is an open access, peer-reviewed, and quarterly journal that considers for publication articles in all fields and specialties ofpharmaceutical care in English language. This journal has both online and print versions and no charges are levied for publication.
Journal of Pharmaceutical Care is indexed and abstracted in: Citefactor, Dimensions, Index Copernicus (IC), Google Scholar, Magiran, Directory of Open Access Journal (DOAJ) and Islamic World Science Citation Center (ISC).
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Nonprescription Corticosteroid Use, Per Capita Consumption and Pattern of Distribution of Commonly Used Corticosteroids in Khuzestan Province Pharmacies Throughout 2016
Background: Corticosteroids are widely used in many medical problems; therefore, they are easily available in all types of pharmacies. Because of their dramatic response and different available formulations, the non-prescription use of these drugs is high, even though there are many side effects related to their use. The present study evaluates and compares the data reported by FDA, main health insurance organizations and pharmaceutical companies that distribute the corticosteroids.
Methods: This descriptive correlational, cross-sectional study was designed to assess the prevalence, distribution pattern, per capita prescription and non-prescription consumption of 11 high-consumption corticosteroids in private and public pharmacies of Khuzestan province throughout 2016.
Results: The results indicated that the highest distribution of corticosteroids is related to private pharmacies. Among the cities of Khuzestan, the highest rate of non-prescription use of corticosteroids was in Haftkel city, and the lowest was in Andika city. Among the drugs, prednisolone 5 mg tablets and dexamethasone 5 mg tablets have the highest per capita prescription and non-prescription consumption in Khuzestan province, respectively.
Conclusion: According to the results of this study, the per capita consumption of corticosteroids is high, and the pharmacies seem to dispense these drugs widely. Therefore accurate recording of the distribution and dispense of corticosteroids by FDA on a monthly and annual basis is crucial. It is necessary to increase the supervision of drug companies that provide the supply of corticosteroids.
Assessment of Training of Community Pharmacists towards the Prevention of COVID-19 in a North Central State of Nigeria
Background: Community pharmacists(CPs) are key providers of basic healthcare in communities, and barriers that may hinder enormous results in their role during the COVID-19 pandemic should be addressed. We conducted training on the strategies for strengthening the Infection Prevention and Control (IPC)among CPs.
Methods: Participants were 31 CPs in Ilorin, Kwara State. A quasi-experimental, before-and-after study was carried out. Data were captured using a self-administered questionnaire. The questionnaire had three sections; the frst contained sociodemographic characteristics such as sex, age, and years of practice. The second section contained eight questions used to assess the knowledge of the respondents, each was assigned a score of “1” and the total obtainable score was “8”. The third section identifed the role of CPs in the prevention of COVID-19.
Results: The mean age of the 31 CPs who participated in the training was 49.5 ± 13.7 years, and18 (58.1%) were males. The mean pre-test IPC training score was 4.968±1.329, while the meanpost-test IPC training score was 5.323±1.077, (t=-1.611, p=0.118). All respondents identifed that CPs had roles in the prevention of COVID-19. Among them, 27 (87.1%) identifed community health awareness campaigns as their main role in the prevention of COVID-19. Regarding years of practice, 6 (35.3%) respondents with less than 20 years had COVID-19 IPC knowledge gain compared to 10 (71.4%) others with more than 20 and above years of practice (P=0.04).
Conclusion: The training achieved its short-term objective. There is a need to for supervisory visits on the CPs at their place of practice to ensure knowledge acquired is put to the best use.
Background: Tyrosine Kinase Inhibitors (TKIs) are drugs of choice for Chronic Myeloid Leukemia (CML) treatment. CML healthcare costs greatly exceed of other haematological malignancies treatment mostly due to TKIs. There are several generic and brand preparations of imatinib and nilotinib, the only available TKIs, in Iran with different prices and varied insurance coverage. We have studied TKIs utilization and also investigate the effect of different insurance coverage on TKIs utilization in Iran.
Methods: This was drug utilization study about Imatinib and Nilotinib over 14 years. It was conductedin two phases; data extraction from pharmaceutical wholesale data (2003-2017) for utilization trend assessment and registered data of prescriptions from Sizdah-Aban Pharmacy (2011-2014) for utilization trend and insurance coverage assessment such as; prescriptions frequency, number of TKIs, insurance companies and their cost coverage in each prescription.
Results: Imatinib consumption increased signifcantly from 2003 to 2013. This trend stoppedafterward. Nilotinib consumption had ascending trend. The trend line of years 2014 to 2017was steeper and statistically signifcant (β=0.0014, p-value=0.02). The amount of nilotinib costcoverage by insurance companies increased signifcantly from 2011 to 2014 (p-value=0.04). The coverage of imatinib costs by insurance companies changed slightly during the study period that was not statistically signifcant. Frequency of prescriptions with full cost coverage doubled for nilotinib, while did not change remarkably for imatinib, from 2011 to 2014. Mean (SD) of imatinib and nilotinib counts per prescription was signifcantly higher in prescriptions for which 100% of the cost was covered.
Conclusion: We found increasing trend in nilotinib utilization and observed some effects fromnilotinib cost coverage by insurance on its consumption. This study made a clear picture for policy makers to monitor imatinib and nilotinib use appropriateness and design the proper cost-effective studies to make evidence-based decisions
Atorvastatin-Induced Myalgia in Iranian Patients: A Hospital-Based Study to Determine the Prevalence and Associated Risk Factors
Backgrounds: Statins are associated with several muscle complaints, such as: myositis, myalgia, muscle weakness, muscle spasms and rhabdomyolysis. Age, race, gender, dose of statin, concomitant medications, concomitant disorders and genetics have been reported as the most important risk factor for statin-induced myalgia. The aim of this study was to determine the prevalence and associated risk factors of atorvastatin-induced myalgia in hospitalized patients in Tehran, Iran.
Methods: In this cross sectional study, a questionnaire was developed by expert panel opinions. The questionnaire was included various items regarding demographic data and myalgia evaluation factors. Seven hundred patients were included in the study and necessary data were gathered. Finally, the data were analyzed and a statistical model was designed to predict the myalgia risk factors.
Results: The rate of myalgia was 44.3% among studied patients. By developing a multivariate logistic model, female gender (OR= 0.47, P-value<0.001) was one of the most important factors in myalgia occurrence.
Conclusion: The results of this study suggest that gender, age, atorvastatin dose, duration of atorvastatin usage and presence of myotoxic disease are the main predictors of myalgia in Iranian population. Hence, the findings of this study can be considered to predict the myalgia incidence risk in Iranian population.
Effect of Insecurity on the Provision of Pharmaceutical Care in Akwa Ibom State: The Community Pharmacist’s Perspective
Background :Pharmaceutical care is an important aspect of healthcare provided by pharmacists which is associated with good clinical outcomes and improved quality of life. Robberies and insecurities is a common occurrence in community pharmacies and when left unchecked can have economic, financial consequences and also influence the provision of care. The aim of this study was to assess the perceived effect of insecurity on the provision of pharmaceutical care in community pharmacies in Uyo, Akwa Ibom State.
Methods: This study was a cross sectional survey among community pharmacists in community pharmacies in Uyo, Akwa Ibom State. All community pharmacies in Uyo metropolis were visited and an informed consent was obtained from the pharmacists before the commencement of the study. A semi-structured questionnaire was used in the collection of data in this study. The questionnaire evaluated the perceived effect of the current robberies on pharmaceutical care where the evaluation statements were structured in Likert scale format.
Results: A total of 76 pharmacists consented to participate in the study where 56 (73.7%) were males and 20 females. The mean age of the study participants was 28.25 + 1.543 years and 82.9% of the participants had 1-10 years community pharmacy experience. Majority of the pharmacists agreed that insecurity has hindered history taking (52%), blood pressure checks (84.2%), patient counseling (80.2%) and decreased sales (52.6%).
Conclusion:There is a negative perceived effect of recent insecurities on the provision of pharmaceutical care services and sales. This aspect should be explored in further studies and research.
Clinical advantages of licorice (Glycyrrhiza spp.) have been investigated for several years. It has been traditionally used for a variety of disorders. Different constituents with various characteristics have been isolated from Glycyrrhiza spp. extracts. This review aimed to summarize the current knowledge on the pharmacological efficacy and safety of licorice extract constituents to treat the pathophysiology of acne vulgaris (AV) and the associated postinflammatory hyperpigmentation (PIH). Anti-androgenic, antimicrobial, anti-inflammatory, antioxidant, depigmenting, and skin-turnover-accelerating properties have been identified for licorice extract which could be effective against AV and PIH through multiple pharmacological mechanisms. The active compounds responsible for these pharmacological activities, molecular mechanisms, safety profile, as well as the in vitro, in vivo, animal, and clinical studies are discussed. Licorice extract possesses broad-spectrum activity and could be considered as an effective and safe option in the treatment of AV and its associated PIH. However, evidence-based clinical trials are required to prove its efficacy as well as safety. We hope this paper can provide new insights for further studies, particularly large controlled clinical trials.
Green tea (GT) is among the most common drinks in the world. There are some reports on interactions between GT and some drugs. This paper attempts to provide a comprehensive review of this subject. The data are collected by searching PubMed, Scopus, Web of science, and Embase. The keywords used as search terms are "camellia sinensis", "pharmacodynamics", "pharmacokinetic", "EGCG", and "drug interaction". We have found 24 eligible articles. Finally, the related papers are given in our review. GT is containing polyphenols that interfere with many drugs. The most important of these polyphenol compounds is epigallocatechin-3-gallate (EGCG), which most of the reported interactions are due to the presence of EGCG. Interaction of GT with different drugs occurs in the context of both pharmacodynamics and pharmacokinetics that includes drug absorption, metabolism, and renal excretion. The mechanisms of these interactions consist of increase in the concentration included several medications such as melatonin, midazolam, and amlodipine consuming after GT; these interactions can be toxic. Additionally, it has been reported that serum levels of several drugs such as nadolol, digoxin, amoxicillin, and clozapine are decreased and their efficacy are reduced when they simultaneously administer with GT. The serum concentration of rhodamin 123, quinidine, and doxorubicin have increased when these drugs were co-administered with GT. GT has pharmacodynamics interactions with a few drugs such as a hydrochlorothiazide. As proposed and discussed here, GT has the potential for interactions with numerous other drugs and thus clinicians should be aware of reported and potential interaction of GT with various medications in order to avoid adverse reactions and achieve expected clinical response.