Drug-Drug Interactions among Elderly Patients at Hospital Discharge: A Cross-Sectional Descriptive Study.

Background: The presence of multiple comorbidities makes prescription of multiple drugs essential in the elderly. Thisis attended with an increased risk of potential drug-drug interactions (DDIs). Aim and objectives: To determine the number of DDIs, their severity, and the common DDIs detected in the prescriptions written for elderly patients of a tertiary care teaching hospital and identify any difference in terms of gender. Material and Methods: This was a cross-sectional study. Every prescription was screened for potential DDIs using the Lexicomp® software. The detected DDIs were classified as X, avoid combination; D, consider therapy modification; and C, monitor therapy as per the Lexicomp® criteria. Results: The data from 124 patients discharged from the General Medicine department of a tertiary care hospital were evaluated. Of these, 67.7% (82/124) were females. A total of 39 category X-DDIs, 71 category D-DDIs, and 349 category C-DDIs were seen. There was a significant positive correlation between the umber of drugs prescribed and the number of DDIs detected (p < 0.001). Conclusion: Our study showed that DDIs were common among elderly patients. A large number of DDIs belong to category C, which requires only monitoring of therapy. Careful planning of the treatment regimen at the time of hospital discharge can decrease the number of drugs prescribed and, thereby, the number of potential DDIs can be decreased.

Approaches to learning and academic performance in pharmacology among second-year undergraduate medical students / Abordagens de aprendizagem e desempenho acadêmico em farmacologia entre estudantes de medicina do segundo ano

AIMS: To determine the learning approach of second-year undergraduate medical students and whether a surface or deep approach to learning had any correlation with the pharmacology sessional and university examination marks obtained. METHODS: A cross-sectional study was conducted among second-year medical students in their fifth semester. To determine the students' learning approach, whether superficial or deep, we used the Revised Two Factor Study Process Questionnaire (R-SPQ-2F), which contains 20 items in the form of a five-point Likert scale and is suitable for use in higher education settings. Cronbach's alpha was calculated using the scores obtained from a sample of 20 students to determine the internal consistency. To determine the relationship between the learning approach and examination scores, the average of the individual sessional examination marks and the university examination scores obtained by the students were calculated. RESULTS: Of the 170 students who participated in the study, 87 (51.2%) were females. The Cronbach's alpha value was considered acceptable for both surface and deep approach. While the academic performance was significantly better in females (U=2571.5; p=0.001), no difference was seen in the learning approach based on gender. Fifty (29.4%) students had a higher score for the surface approach. This group had lower examination scores compared with those with equal scores for surface and deep approach or higher scores for the deep approach. A weak negative correlation was seen between the examination marks and surface approach (τb=-0.167; p=0.002). When analyzed based on gender, the correlation was statistically significant only in females (τb=-0.173; p=0.02). CONCLUSIONS: A weak negative correlation was seen between the examination marks and surface approach to learning. Although statistically significant, the actual difference between the groups was of a small magnitude. Hence, whether promoting deep learning approach improves academic performance in terms of marks obtained in the examination needs to be confirmed by further studies.

OBJETIVOS: Investigar a abordagem de aprendizagem de estudantes de medicina do segundo ano de graduação e se uma abordagem superficial ou profunda teve alguma correlação com as notas obtidas na disciplina de farmacologia e nos exames universitários. MÉTODOS: Um estudo transversal foi conduzido entre estudantes do segundo ano de medicina em seu quinto semestre. Para determinar a abordagem de aprendizagem dos alunos, como superficial ou profunda, usamos o questionário Revised Two Factor Study Process Questionnaire (R-SPQ-2F), que contém 20 itens em forma de uma escala Likert de cinco pontos, sendo o seu uso adequado para ambientes de ensino superior. O alfa de Cronbach foi calculado usando as pontuações obtidas de uma amostra de 20 alunos para determinar a consistência interna. Para determinar a relação entre a abordagem de aprendizagem e as pontuações do exame, calculou-se a média das notas dos exames individuais e as pontuações dos exames universitários obtidas pelos alunos. RESULTADOS: Dos 170 alunos que participaram do estudo, 87 (51,2%) eram do gênero feminino. O alpha de Cronbach foi considerado bom tanto para a abordagem superficial quanto profunda. Enquanto o desempenho acadêmico foi significativamente melhor em mulheres (U=2571,5; p=0,001), nenhuma diferença baseada no gênero foi observada na abordagem de aprendizagem. Cinquenta (29,4%) estudantes tiveram uma pontuação mais alta para a abordagem superficial. Esse grupo teve escores de exame mais baixos em comparação com aqueles com escores iguais para abordagem superficial e profunda ou escores mais altos para a abordagem profunda. Uma fraca correlação negativa foi observada entre as notas do exame e a abordagem superficial (τb=-0,167; p=0,002). Quando analisada com base no gênero, encontrou-se uma correlação de magnitude fraca e negativa apenas no gênero feminino (τb=-0,173; p=0,02). CONCLUSÕES: Uma fraca correlação negativa foi observada entre as notas do exame e a abordagem superficial para a aprendizagem. Embora estatisticamente significativa, a diferença real entre os grupos foi de pequena magnitude. Portanto, se a promoção de uma abordagem de aprendizagem profunda melhora o desempenho acadêmico em termos de notas obtidas no exame, isso precisa ser confirmado por outros estudos.

Prescribing generic drugs using a generic name: Are we teaching it right.

The Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, state that “Every physician should, as far as possible, prescribe drugs with generic names and he/she shall ensure that there is a rational prescription and use of drugs.”. Undergraduate medical students are introduced to drug nomenclature early on during their pharmacology course. They are told that generic name or, more appropriately, non-proprietary name (usually international non-proprietary name INN), is to be used while writing prescriptions.

Willingness to participate in a clinical trial and understanding of informed consent information among medical students.

Studies have shown that the decision to participate or not participate in a clinical trial does not necessarily imply that the volunteers have completely understood the clinical trial process. A study carried out among medical and non-medical student volunteers revealed that even though the former group had a better recollection of the key facts, their understanding was still below expectation. In our study, medical students were invited to voluntarily take part in a hypothetical exercise in which they were presented with an informed consent form to indicate their willingness to participate in an anti-malarial drug trial. They were encouraged to clarify their doubts and asked to answer a questionnaire to determine their willingness/unwillingness. They were asked to state their reasons and recall key information given in the informed consent form. Responses were submitted by 155 students and 51% of the respondents consented to participate in the trial. As many as 13.5% did not know the name of the drug under study, 14.8% could not recall the main adverse effects to be expected, and 12.3% did not know that they could opt out of the study, this being significantly more in those who had consented to participate (p0.0. As is evident from our study, even presenting a detailed consent form containing an explanation might leave a considerably large number of potential volunteers with an incomplete understanding of the study. Therefore, it is necessary to make an active effort to ensure that the counselling of the volunteers is based on their ability to comprehend the information provided.