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Objective To evaluate and intervene polypharmacy in multimorbid elderly patients in order to explore the application effects and reliability of Beers criteria and medication appropriateness index(MAI)and improve the safety,rationality and feasibility of drug use through the whole process of pharmaceutical directions. Methods This study included 191 patients with multimorbidity.Based on the Beers criteria and MAI,enrolled elderly patients with multimorbidity were evaluated and intervened.Moreover,based on the efficacy,safety and suitability,clinical pharmacists and geriatricians made new medication strategy,and undertook a follow up study every month after discharge.After six months,all patients were evaluated again.All data were recorded before and 6-months after intervention. Results After versus before intervention,the potentially inappropriate polypharmacy was decreased[21 cases(10.99%)vs.98 cases(51.31%),χ2 = 65.154,P< 0.05]in multimorbid elderly patients.Moreover,the MAI score was significantly decreased after the intervention(6.35 ± 5.25 to 0.75 ± 1.81,Z= - 10.549,P< 0.05). Conclusions Through the whole process of pharmaceutical directions of clinical pharmacists,the Beers Criteria- and MAI-based assessment and intervention could improve the safety,rationality and efficiency of drug therapy in multimorbid elderly patients.
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OBJECTIVE:To provide reference for rational use of adjuvant drugs in the clinic.METHODS:By retrospective method,the utilization of top 10 adjuvant in the list of consumption sum and DDDs in our hospital during 2013-2015 were analyzed statistically in respects of consumption sum,DDDs,DDC,B/A,etc.RESULTS:During 2013-2015,the consumption sum of adjuvant drugs in our hospital increased from 32 959 000 yuan to 42 436 500 yuan,and its proportion in total consumption sum increased from 31.28％ to 35.22％.The top 10 adjuvant dosage forms in the list of consumption sum were injection,and varieties included activating blood circulation to dissipate blood stasis,nerve nutrition,immunoregulation drugs.The consumption sum fluctuated but was on the increase in general.Top 10 adjuvant drug types in the list of DDDs were mainly drugs for enhancing tissue metabolism,vitamins,nerve nutrition,activating blood circulation to dissipate blood stasis.In terms of DDC,main dosage form was injection;B/A of these drugs was poor and drug price was in high level.CONCLUSIONS:It is suggested to standardize the utilization of adjuvant drugs,so as to promote the effective,economical and rational use of drugs.
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Objective To explore the effect of polypharmacy assessment and intervention on elderly inpatients mainly in both economy and safety. Methods One hundred and forty elderly inpatients were selected. Fifty patients took less than 5 drugs, 75 patients took 5- 9 drugs, and 15 patients took more than 10 drugs. According to medication appropriateness index (MAI) and Beers criteria, the polypharmacy of elderly inpatients was assessed and intervened. The results were compared before and after intervention. Results The discrepancy rate of Beers criteria, incidence of potential risk, total scores of prescription MAI and average daily drug cost after intervention were significantly lower than that before intervention: 7.14% (10/140) vs. 16.43% (23/140), 22.14% (31/140) vs. 90.71%(127/140), 0(0,0)scores vs. 6.00(2.25,10.00)scores and (30.60 ± 19.71) yuan vs. (35.34 ± 26.84) yuan, and there were statistical differences (P<0.01 or <0.05). Conclusions Irregular medication exists widely in elderly patients, and the polypharmacy assessment and intervention can lighten the financial burden of elderly patients and improve the safety of drug therapy.
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Objective To observe the effect of the compound Qinbudan recipe in treating multi-drug resistant pulmonary tuberculosis (MDR-PTB) of deficiency of both qi and yin. Methods A randomized controlled trial was carried out in 72 MDR-PTB cases, and the patients were divided into treatment group and control group, 36 cases in each group. The treatment group was treated with the compound Qinbudan recipe while the control group was treated with Feitai capsules. After treatment for 3 months, the therapeutic effect, scores of traditional Chinese medical syndromes, and adverse reactions were compared in the two groups. Results ( 1) After treatment for 3 months, the total effective rate of the treatment group was 82.86%, and that of the control group was 25.81%, the difference being significant (P 0.05) . ( 4) Blood routine examination and hepatorenal function showed no disorders during the treatment. Gastrointestinal disturbance was not found either. Conclusion The compound Qinbudan recipe is effective in treating multi-drug resistant pulmonary tuberculosis of deficiency of both qi and yin, and has better effect on relieving shortness of breath, night sweating, spontaneous perspiration and cough with phlegm than Feitai capsules .
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OBJECTIVE@#To explore the method and effect of the midfacial degloving approach and modified hemifacial degloving approach associated with nasal endoscopic surgery in the treatment of the nasal diseases.@*METHOD@#Thirty patients with nasal diseases were treated with nasal endoscopic surgery by midfacial degloving approach and modified hemifacial degloving approach. Four cases underwent midfacial degloving approach with standard method, three cases were underwent by hemifacial degloving approach and our modified hemifacial degloving approach associated with nasal endoscopic surgery were performed in twenty-three cases. We used Caldwell-Luc's approaches which located mainly in affected-side, and modified bilateral intercartilaginous incision, which at first peeled off integrality healthy-side cutis and mucosa of nasal septum as well as periosteum of basis nasi. With preserving the integrality of the healthy-side nasal cavity parenchyma, the pyriform aperture incisions extending to the healthy-side vestibule wasn't been cut. With the incisions of septal cartilage of nasal and disease- side cutis and mucosa of nasal septum as well as the pyriform aperture incisions extending to the affected-side vestibule, the lesion were cleared away completely by modified midfacial degloving approach associated with nasal endoscopic surgery.@*RESULT@#All cases cuts achieved primary healing. One of four cases with midfacial degloving approach suffered from straightness of nasal vestibule. One of three cases with hemifacial degloving approach was led to perforation of nasal septum. In 23 cases operated hy modified hemifacial degloving approach, no straightness of nasal vestibule and no perforation of nasal septum was happened.@*CONCLUSION@#The midfacial degloving approach and modified hemifacial degloving associated with endoscopic surgery can achieve the advantages of a widely exposed field for operation, no facial scar, making tumour resection easier, and also no nasal- stuffed in healthy nasal cavity as well as no straightness of nasal vestibule after modified approach.