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ObjectiveBy analyzing the current situation of drug selection and evaluation in medical institutions in the world，we aim to understand the development of relevant selection methods and tools，provide reference basis for drug selection in traditional Chinese medicine （TCM） medical institutions，and promote the optimization of drug catalogs in TCM medical institutions. MethodBased on the method of scoping review，the eight databases were systematically searched，the included documents were screened，extracted and analyzed，and the research results were graphically displayed. ResultA total of 23 articles were included in this study，including 13 in Chinese and 10 in English，involving 23 methods or tools related to drug selection. Of the 14 methods or tools from Chinese medical institutions，the earliest one was published in 2012，and five were published in 2022. The published methods or tools involved different levels of hospitals，different drug varieties，different evaluation angles，etc.，such as the drug selection methods of one county hospital and one township hospital， methods and tools for different types of drugs such as antibacterial drugs，ibuprofen preparations，proton pump inhibitors and hypoglycemic drugs used in pediatric intensive care units， Chinese patent medicine selection tools， tools for evaluation from the perspective of pharmacoeconomics， and universal tools for selecting domestic medical institutions. The nine drug selection tools of foreign medical institutions were from the European，American，Asian and African countries. It was first published in 1955. The contents included the formulation standards that medical institutions should follow for drug prescription sets，the management formulation and update of hospital prescription sets，and drug evaluation tools. ConclusionOn the whole，the drug selection methods and institutional methods of foreign medical institutions developed earlier than those in China. In recent years，Chinese medical institutions have paid high attention to drug selection and released various types of drug selection tools. However，the standardization should be further improved in the future.
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OBJECTIVE To establish an evaluation syste m of clinical effec tiveness of Drug Selection Guideline for Medical Institutions，and to provide reference for drug selection in medical institution. METHODS Retrieved from relevant Chinese government websites ，PubMed，Embase，CBM and CNKI ，etc.，from the inception to Sept. 14th 2021，related contents of clinical effectiveness related to three secondary indicators ，such as “recommended level and strength of guideline ”“clinical pathway ”and “evidence and level of efficacy ”were extracted respectively ；evaluation system was construction for the clinical effectiveness. RESULTS A total of 5，4 and 17 policy documents or literatures were included according to “recommended level and strength of guideline”“clinical pathway ”and“evidence and level of efficacy ”，respectively.“The recommended level and strength of drug guideline”could reflect the clinical effectiveness of drugs ，and the evaluation content referred to the recommended level and strength of the selected drugs in the guidelines for corresponding indications. “Clinical pathway ”was the embodiment of drug effectiveness, and the evaluation content referred to the clinical path of whether the selected drugs were included in the corresponding indications. The evaluation contents of “evidence and level of efficacy ”were different between chemical medicine/ biological agent and Chinese patent medicine ；evidence and quality level of efficacy research for chemical medicine/biological agent referred to GRADE system ，while those for Chinese patent medicine referred to classic works or clinical experience inheritance. Therefore，the evaluation contents of this index system were the evidence and quality level of the efficacy research related to selected drugs. CONCLUSIONS The evaluation system of clinical effectiveness of drugs constructed from the perspective of drug selection in medical institutions can lay the foundation of evaluation system for the construction of Drug Selection Guideline for Medical Institutions ，and also provide reference for drug selection in medical institutions.
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In order to promote the standardization of drug selection in medical institutions ，enhance the level of pharmaceutical affairs management of medical institutions and promote the safe ，effective，economical and appropriate use of drugs in the treatment of diseases ，the Drug Selection Guideline for Medical Institutions （hereinafter refer to as the Guideline ）is formulated. The development of the Guideline for medical institutions is following the latest definition of Institution of Medicine （IOM）， National Academy of Sciences and based on the methodology of WHO handbook for guideline development. During the construction of the Guideline ，the research points of the Guideline are constructed on the basis of Delphi method ；a drug selection and evaluation system with 10 primary indicators and 30 secondary indicators as the core is also designed. The evaluation indexes can be divided into research indexes and policy indexes according to their attributes and main sources of evidence. The GRADE method is used to evaluate the quality of the evidence system for research indexes ，while the policy indexes are graded according to the Legislation Law of the People ’s Republic of China . On this basis ，the evaluation methods of those indexes are constructed by using evidence-based medicine method ，the recommendation is formed through expert consensus method ，and finally a standard guideline for drug selection in medical institutions is formed.
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OBJECTIVE：To provid e reference for hospital decision-maker to select and use repaglinide and naglinide reasonably. METHODS ：Through reviewing literautre ，guideline and instruction ，full score system was estalished for comunni- cation between pharmacists and physicians ；from the aspects of clinical necessity ，effectiveness，safety，economy，medical insu- rance attribute ，essential medicine attribute ，original research attribute ，drug packaging attribute ，drug market and enterprise attributes，the Mini health technology assessment （Mini HTA ）was carried out for repaglinide and nateglinide ，and scored on the basis of weight value. RESULTS ：Repaglinide and naglinide ’s final score were 77 and 74，respectively. For type 2 diabetes，both of them could reduce postprandial blood glucose ，and had less side effect and good safety. They were both included in the medical insurance list. Both of them were original varieties ，easy to store and had a long period of validity. Although they were expensive in the treatment of type 2 diabetes，their manufacturers had a good reputation and were widely used in the world ，which was a good choice for patients with type 2 diabetes. But they were different to certain extent ；repaglinide could be used in patients with poor renal function [eGFR ＜30 mL/min] without dose adjustment ；nateglinide should be adjusted according to eGFR for renal excretion. Repaglinide was essential medicine but nateglinide wasn ’t；repaglinide didn ’t need shading storage but nateglinide did. In addition ， a variety of liver drug enzyme inducers or inhibitors may interact with the two drugs ，and special groups should be used with. CONCLUSIONS ：Mini HTA provide reference for the selection and rational use of repaglinide and nateglinide ；patients with type 2 diabetes can select suitable drug according to their own conditions and needs. When combined with other drugs ，blood glucose should be closely monitored to prevent the occurrence of hypoglycemia.
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Hypertension is a common chronic cardiovascular disease,which is a serious threat to patient's health.The choice of antihypertensive drugs are multiple,different doctors hold the different views.The research surveyed our hospital's clinicians in order to understand the selection of drugs in hypertension prevention and treatment.According to the research,we intended to regulate the clinical drug use,improving the rational use of drugs,and benefit patients.
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Hypertension is a common chronic cardiovascular disease,which is a serious threat to patient's health.The choice of antihypertensive drugs are multiple,different doctors hold the different views.The research surveyed our hospital's clinicians in order to understand the selection of drugs in hypertension prevention and treatment.According to the research,we intended to regulate the clinical drug use,improving the rational use of drugs,and benefit patients.
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BACKGROUND AND PURPOSE: Individualized drug testing for tumors using a strategy analogous to antibiotic tests for infectious diseases would be highly desirable for personalized and individualized cancer care. METHODS: Primary cultures containing tumor and nontumor stromal cells were utilized in a novel strategy to test drug responses with respect to both efficacy and specificity. The strategy tested in this pilot study was implemented using four primary cultures derived from plexiform neurofibromas. Responses to two cytotoxic drugs (nilotinib and imatinib) were measured by following dose-dependent changes in the proportions of tumor and nontumor cells, determined by staining them with cell-type-specific antibodies. The viability of the cultured cells and the cytotoxic effect of the drugs were also measured using proliferation and cytotoxicity assays. RESULTS: The total number of cells decreased after the drug treatment, in accordance with the observed reduction in proliferation and increased cytotoxic effect upon incubation with the two anticancer drugs. The proportions of Schwann cells and fibroblasts changed dose-dependently, although the patterns of change varied between the tumor samples (from different sources) and between the two drugs. The highly variable in vitro drug responses probably reflect the large variations in the responses of tumors to therapies between individual patients in vivo. CONCLUSIONS: These preliminary results suggest that the concept of assessing in vitro drug responses using primary cultures is feasible, but demands the extensive further development of an application for preclinical drug selection and drug discovery.
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Humans , Antibodies , Cells, Cultured , Communicable Diseases , Drug Discovery , Fibroblasts , Precision Medicine , Neurofibroma, Plexiform , Pilot Projects , Schwann Cells , Sensitivity and Specificity , Stromal CellsABSTRACT
The main aim of this study was to develop an objective Drug Evaluation Scoring System (DESS) by determining criteria for differentiation among 5 PPI drugs available in the market i.e. esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole. Secondly, was to assign weightage according to its importance of the criteria. Thirdly, was to determine the scores and rank the PPI drugs. In developing DESS, 200 points was assigned for the clinical documentation criterion, 300 points for the clinical efficacy criterion, 200 points for the safety criterion and 300 points for the cost criterion. The higher the assigned score, the higher importance the criterion is. The criteria were designed in the format of questionnaire to enable participants to allocate scores according to their perception on the importance of the criteria. Self-administered questionnaires were distributed to 165 specialists and medical officers. Study findings from the scoring system found that all PPI drugs have very negligible difference in clinical efficacy and clinical safety. Omeprazole was found to be the most cost economical PPI in the government hospitals. The DESS was able to compare and rank PPI drugs based on the scoring system and also assist in the selection of PPI drugs into the drug formulary.
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Objective: To analyze the situation of secondary hypertension caused by different etiology and its treatment status so as to improve its treatment. Methods: Totally 580 patients with secondary hypertension selected with strict criteria were divided into 4 groups in accordance with the etiology. The data were dealt with SPSS 13.0. We analyzed the sex, age, systolic pressure, diastolic pressure and positive incidence of family history of all the secondary hypertension patients in each group, and compared their usage of every unilateral preparation. Results: The average age of renal parenchymal disease was more advanced than that of adrenal disease and other diseases. The administration of diuretics and angiotensin-converting enzyme inhibitor (ACEI) in renal parenchymal disease group, αβ receptor blocking agents and calcium antagonists in kidney-artery disease group, α antagonists in adrenal disease and compound antihypertensive agents in other diseases groups all affected advantage of the ratio. Conclusion: Diuretics and ACEI are suitable for hypertension caused by renal parenchymal disease. αβ receptor blocking agents and calcium antagonists are suitable for that caused by kidney artery disease, but α receptor blocking agents are suitable for that caused by adrenal disease.
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Objective To analyze the situation of secondary hypertension caused by different etiology and its treatment status so as to improve its treatment. Methods Totally 580 patients with secondary hypertension selected with strict criteria were divided into 4 groups in accordance with the etiology. The data were dealt with SPSS 13.0. We analyzed the sex, age, systolic pressure, diastolic pressure and positive incidence of family history of all the secondary hypertension patients in each group, and compared their usage of every unilateral preparation. Results The average age of renal parenchymal disease was more advanced than that of adrenal disease and other diseases. The administration of diuretics and angiotensin-converting enzyme inhibitor (ACEI) in renal parenchymal disease group, αβ receptor blocking agents and calcium antagonists in kidney-artery disease group, a antagonists in adrenal disease and compound antihyportensive agents in other diseases groups all affected advantage of the ratio. Conclusion Diuretics and ACEI are suitable for hypertension caused by renal parenchymal disease, αβ receptor blocking agents and calcium antagonists are suitable for that caused by kidney artery disease, but a receptor blocking agents are suitable for that caused by adrenal disease.