ABSTRACT
Background:Tobacco harm reduction when advocated by care providers as continuum of care towards the goal of tobacco cessation might result in long-term abstinence than it is currently seen. This study aimed to qualitatively explore the healthcare professionals approach and self-reported practices related to tobacco harm reduction and smoking cessation. Methods: A purposive sample (N=36) of multi-specialty healthcare professionals providing tobacco related cessation services at six private medical teaching institutes were engaged in semi-structured qualitative interviews between July 2020 and October 2020 in Chennai. Results: The results indicated that majority of the healthcare professional抯 lack conceptual understanding about tobacco harm reduction. Harm reduction was practised and nicotine replacement therapy was prescribed by psychiatrists in this study. Majority of the healthcare professionals were found to have misconceptions that promoting harm reducing practices instead of cessation might result in continued addiction to nicotine products among the clientele. Conclusions: The findings reveal that tobacco harm reduction remains an under-utilized clinical practise in Indian setting due to knowledge and awareness gaps among multi-specialty healthcare professionals. Improved sensitization through continuous medical education updates is needed to inform effective clinician-affirmative tobacco harm reduction practices.
ABSTRACT
BACKGROUND: A number of molecularly targeted agents in oncology are tested in clinical studies in combination with conventional chemotherapy and/or radiotherapy. There is the possibility that the pharmacokinetics and dynamics of these targeted agents may be different when administered alone as against when administered in combination with other agents. AIM: The aim of this study is to understand the effects of addition of combination agents on the pharmacokinetics of a new, investigational, cyclin dependent kinase inhibitor anti‑cancer drug (Compound A) using population pharmacokinetic (pop‑PK) analysis. MATERIALS AND METHODS: Integrated pop‑PK analysis of data obtained from multiple phase I/II studies of Compound A, given alone or in combination with other agents. RESULTS: A two compartmental model was found suitable to explain the pharmacokinetics of Compound A. No statistically significant influence of patient covariates or combination agents on the pharmacokinetic parameters of the central compartment was detected up to a significance level of 0.01. Model evaluation showed that the parameter estimates are stable and that the variability in the data was well reproduced by the model. CONCLUSIONS: This study represents the first time that a pop‑PK analysis was performed in India for a targeted anti‑cancer agent being developed in India. Such an analysis is useful to not only understand the influence of patient covariates and combination agents on the pharmacokinetics of a new investigational agent, but would also be valuable in the simulation of later phase clinical trials for the agent under development.