ABSTRACT
Background and Objectives: Patient needs specific guidelines from their pharmacist in support of better compliance of their medicine used. Counseling of the patient and patient representative is important for improving the therapeutic out comes. Counseling patients can improve their understanding regarding medication, disease and life style modifications which in turn improves compliance. Material and Methods: Patients and/or patient party were counseled as per the Omnibus Budget Reconciliation Act-1990 guidelines. The data was collected as per OBRA-90 during the period of eighteen month and was analyzed using statistical software SPSS version 17. Results: Three hundred and fifty patients were counseled during the study period. Majority of the counseled patients were females [75.9%]. Mean counseling time taken by the pharmacist was 7.43 minute. Minimum time taken to counsel the patient was 6-10 minutes in 58.41% of the counseled, followed by less than 5 minutes in 19.68% and 11-15 minutes in 8.89%. About 10.47% were counseled for more than 15 minutes by the pharmacist. Greater numbers of the patients referred to the Medicine Counseling Center (MCC) were from Obstetrics and Gynecology departments and most of them were directed by doctors [50.47%]. Conclusion: This study highlights that role of doctor is important to encourage patient to attend counseling services. Counseling is the integral part that not only help patient to understand the use of their medicine but also to improve their therapeutic out comes. The effect of counseling on compliance should be studied in future.
ABSTRACT
OBJECTIVES: To study the prevalence of adverse drug reactions (ADRs) in five different hospitals of Kathmandu Valley. MATERIALS AND METHODS: An analytical cross sectional study was designed from May 2007 to September 2007 in which prevalence of ADR was calculated. A total of 37 cases of ADRs were taken from 4287 patients and 10% of the remaining population without ADRs i.e. 425 out of 4250 patients was selected randomly. ADRs were analyzed as per the structured questionnaires designed by Canadian adverse drug reaction monitoring program. Data thus obtained were analyzed by using SPSS and Excel 2003 software and relevant statistical tools were applied. RESULTS: Prevalence of ADR in this study was 0.86% and male to female ratio was 0.85. 54.1% were female and 45.9% were male (P = 0.65). The highest percentage of ADRs were seen in adult patients, however the difference was statistically not significant. Maximum numbers of ADRs were reported from skin, 35.13% followed by GIT, 29.72% and then from CNS, 18.91%. Anti-infectives were associated with maximum number of ADRs followed by IV urograffin. Rashes, 35.13% were the most common type of ADRs reported followed by vomiting, 13.51% and then dizziness which was 10.81%. Regarding the outcomes attributed to ADRs, one patient died due to ADR caused by dapsone and 15 cases got hospitalized due to ADRs. The incidence of ADRs in different age groups was not significant. Similarly, there was no significant association between ADRs and sex. No significant difference was seen in case of age group less than one year as compared to two or more years of age (P = 0.78). For causality of ADRs, according to Naranjo algorhythm scale, 35% of reactions were assessed to be probable, 32% as possible and 19% were definite. Similarly, for severity assessment, 54% reports were mild, 35% were moderate and 10.81% were severe. CONCLUSION: Prevalence of ADR in this study was 0.8% which is similar to other studies in other countries. All the ADRs were not toxic reactions and they were unpredictable.