Effect of the expanded Senior Citizens Act of 2010 (Republic Act of 9994) on drug accessibility among the elderly

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aims to determine the effect of the Expanded Senior Citizens Act of 2010 on drug accessibility among elderly.<br /><strong>METHODS:</strong> Descriptive, cross-sectional design involving 775 senior citizens from Manila,Pampanga, Iloilo, Bacolod, Cagayan De Oro and Iligan.<br /><strong>RESULTS:</strong> Thirty-eight percent (38%) of senior citizens were not aware of the law, but 90% knew about the 20% discount and 54% knew about the 12% VAT exemption. Half (50%) of them ask for 20% discount all the time when they buy their medicines. Only half are given full discount every time they ask for it, and 32% are given to the VAT exemption. As a result, less than half (48%) are able to buy all their medicines.<br /><strong>CONCLUSION:</strong> Privileges are not fully enjoyed by senior citizens either due to lack of awareness or noncompliance of drug outlets to the provisions of the Law.</p>

Prevalence of clinically diagnosed acute otitis media (AOM) in the Philippines: A national survey with a developing country's perspective

BACKGROUND AND AIMS: Acute otitis media (AOM) seems to be a significant public health problem, but national data on its prevalence is lacking. This study aims to determine the prevalence of acute otitis media in the Philippines and characterize this population.METHODS: A cross-sectional survey of children 0-12 years old in community health centers and schools was performed, utilizing a multi-stage cluster sampling design.RESULTS: Thirteen areas were included in the survey with 26 household and school clusters, surveying a total of 2,277 children. There were 218 children with clinically diagnosed acute otitis media, with an overall prevalence rate of 9.6%. Among the children with AOM, 108 (10%) were male while 110 (9.2%) were female. There were 32 (14.6%) cases of AOM in the 0-2 year olds, 56 (9.5%) in the 3-6 year olds, and 117 (8.4%) in the 7-12 year old children.CONCLUSIONS: The overall prevalence of clinically diagnosed acute otitis media in the Philippines is 9.6%, with a variables area-specific prevalence. There is no gender predilection, with the 0-2 age group having the most prevalent cases of AOM in the sample.

Effect of government-mediated access pricing on availability of directly affected drugs in retail drug stores in the Philippines from 2009 to 2011

BACKGROUND: There is a scarcity of studies on the effects of government-mediated access pricing (GMAP) as another price regulation approach on drug availability. OBJECTIVES: This study was done to compare changes in percent availability in drug stores from 2009 to 2011 of innovator drugs, competitor drugs and cheap generic drugs containing drug molecules affected by GMAP policies in the Philippines. METHODS: Data from a random survey of 600 drug stores stratified by location and retail type, undertaken separately in 2009 and 2011 by IMS Health Philippines, were analyzed. Percent availability of the innovator brand, a competitor, and cheapest generic version for 11 selected drug molecules in said drug stores were compared for 2009 and 2011. RESULTS: Of the 11 innovator drugs, 3 had significant reductions in percent availability in drugstores ranging from 9.7% to 39.0%. Among competitor drugs, 3 had reductions ranging from 37.4% to 81.7%. The availability of cheap generic versions of drug molecules in drug stores immensely increased in 2011 except for telmisartan. CONCLUSION: GMAP could have adversely affected availability in drug stores of both innovator and competitor drugs. Cheaper generic drugs have become more available in the Philippines.

Risk of visual loss in advanced glaucoma after trabeculectomy and combined cataract surgery

OBJECTIVE: This study determined the risk of postoperative visual loss and the factors affecting the decrease in visual acuity in patients with advanced glaucoma who underwent trabeculectomy or combined cataract surgery. METHODS: Charts of patients with advanced glaucoma who underwent trabeculectomy or combined cataract surgery were reviewed for the following parameters: visual acuity (VA), intraocular pressure (IOP), and visual-field indices of the Humphrey perimetry. Eyes that lost 2 or more Snellen lines or worsened one category two months after surgery were identified. Central vision was lost (wipeout) when best corrected VA was less than 20/200, characterized as a sudden, permanent, and unexplained visual loss within 2 months post-operatively. Analysis of variance (ANOVA) determined the differences between groups and logistic regression analyzed the factors affecting the decrease in visual acuity postoperatively. RESULTS: Ninety-eight eyes of 92 patients aged 18 years and older were included in the study. The incidence of postoperative visual loss 2 months after surgery was 20 percent (20/98), of which 3 percent (3/98) was considered "wipeout." Factors affecting the decrease in VA postoperatively include the presence of surgical complications (p = 0.04) and increase in postoperative IOP at two months (p = 0.05). CONCLUSION: The incidence of wipeout among patients with advanced glaucoma who underwent trabeculectomy or combined cataract surgery is low and generally occurs in patients with central-splitting fixation. Surgical complications play a major role in causing postoperative decrease in VA.

The prevalence of psychiatric disorders among the chronically-ill medical patients in selected tertiary hospitals in the Philippines

OBJECTIVE: This study was conducted to document the prevalence of psychiatric morbidity among chronically ill medical patients in selected hospitals in the Philippines. METHODS: This is a cross-sectional study of the chronically medically ill patients seen in selected Primary are Evaluation of Mental Disorders (PRIME-MD), 774 patients were screened for mental disorders. The prevalence of each of the psychiatric disorders were calculated using the formula for estimation of a proportion for stratified random sampling. The differences in the sample size from each of the study sites were taken into consideration in the estimation of the sitespecific prevalence of mental disorders. The 95 percent confidence intervals of the prevalence rates were computed. RESULTS: Almost half of the patients (47.8 percent) were diagnosed with at least one of the psychiatric disorders elicited from the PRIME-MD. Thirty two percent had depressive disorder, followed by anxiety disorder, somatoform disorders, alcohol-related disorder and eating disorder. According to hospital site, the overall prevalence rate of psychiatric disorder was noted to be highest at the Davao Medical Center. CONCLUSION: The overall prevalence of psychiatric disorder noted in this study was higher than that described in foreign literature, the most common of which was depression.

A post-marketing surveillance study on the safety and efficacy of valsartan (Diovan) among Filipino patients with mild to moderate essential hypertension

OBJECTIVE: The objective of this study was to determine the safety, tolerability, and efficacy of valsartan (Diovan?) 80 mg tablet in the treatment of mild to moderate, uncomplicated essential hypertension in Filipino patients.METHODS: Patients who were 18-80 years of age, male or female diagnosed with essential hypertension with mean sitting diastolic blood pressure (SDBP)> 90mmHg to 115mmHg were given valsartan? 80mg tablet daily for a minimum of 2 weeks to a maximum of 8 weeks of treatment.RESULTS: A total of 3224 evaluable patients were included in the study. Almost forty percent (39.6%) of patients are newly-diagnosed hypertensives, 25.8% have been hypertensives for 1 to 2 years,17% for 3-5 years, and 17.6% for more than 5 years. The mean systolic blood pressure (SBP) at baseline was 156.9 mmHg ± 15.4 mmHg while the mean diastolic blood pressure (DBP) at baseline was 98.7 mmHg ± 6.4 mmHg. The SBP decreased at visit 2 to a mean of 135.3 mmHg ± 12.6 mmHg which reduction was very highly significant (paired t-test= 9.13, p

Cost-effectiveness analysis of the impacts on infection and morbidity attributable to three chemotherapy schemes against Schistosoma japonicum in hyperendemic areas of the Dongting Lake region, China.

A study was carried out in 8 villages endemic with S. japonicum in Hunan Province, China from 1998 to 2000 to evaluate the cost-effectiveness in preventing schistosome infection and related morbidity under three chemotherapy schemes: (1) 'clue' chemotherapy, consisting of treatment to those with contact with infected water and/or symptoms of infection; (2) 'mass' chemotherapy-treatment to all the villagers except those not able to take praziquantel; and (3) 'screen' chemotherapy-treatment prescribed to the stool egg positive cases after Kato-Katz examination. An itemized cost menu was used to estimate the cost incurred to each scheme, from the perspective of the health care provider. The numbers of cases prevented by chemotherapy schemes were estimated through standardized attributable fractions of the outcomes to absence of chemotherapy before intervention. The cost-effectiveness ratios were calculated using weighted ranks of unit costs of the four outcome measurements: the costs per case with infection, liver and spleen abnormality (as determined by ultrasonography) prevented and 1% reduction in intensity of infection (as estimated by egg per gram feces, EPG) after the two years of intervention. Sensitivity of total cost to changes in the costs of personnel, praziquantel and other key factors were analyzed. It is demonstrated that all the three schemes had a significant impacts on the prevalence and intensity of infection, but the overall effects on liver and spleen morbidity of the residents varied between schemes. Mass chemotherapy achieved the best cost-effectiveness ratio, with unit costs of preventing cases of infection, liver and spleen abnormality and 1% reduction of EPG being RMB yuan 161.2, 99.8, 219.3 and 176.3, respectively. However, clue and screen chemotherapy schemes did not show significant prevention of liver damages in the villagers. The unit costs per case prevented for the outcomes were RMB yuan 140.2, 602.7 and 169.3, respectively for clue chemotherapy, while RMB yuan 190.0, 448.4 and 145.0 respectively for screen chemotherapy. The study concluded that mass chemotherapy should still be the choice of preference in areas where prevalence of infection and frequencies of contact with infested water by residents are high, particularly if the drug cost could be further reduced. Clue chemotherapy could be an alternative to mass chemotherapy, especially when the frequency of water contact is not as high as 80% recorded in our study. Screen chemotherapy is the least favored option in the hyperendemic area of Hunan Province.