ABSTRACT
OBJECTIVE To analyze the effect of pharmaceutical practice of pediatric pharmacists providing internet medication consultation services. METHODS A total of 8 356 children’s medication cases through the “Our Pharmacists” online medication consultation platform （hereinafter referred to as “Our Pharmacists”） were collected from July 2020 to June 2022. The general information， disease type and irrational drug use were analyzed statistically. RESULTS Among 8 356 cases， 4 234 were male and 4 122 were female； the age of children was mainly from 12 months to 3 years old； the consulting diseases were mainly respiratory diseases （46.56%）， followed by digestive system diseases （18.41%） and skin system diseases （12.71%）. Among respiratory diseases， the proportion of irrational drug use was 92.30%， mainly including the use of antibiotics without indication （83.59%）， inappropriate selection of Chinese patent medicines （61.14%） and compound cold medicines （49.77%）， etc. Among digestive system diseases， the proportion of irrational drug use was 71.15%， mainly including not using oral rehydration salts （48.85%）， inappropriate use of probiotics （31.19%）， the use of antibiotics without indication （26.89%）， etc. A total of 4 273 evaluations of pharmacist services were received from child guardians， with a five-star rating of 99.88%. CONCLUSIONS Pharmacists provide pediatric medication consultation services through “Our Pharmacists”， providing individualized evidence-based medication suggestions， increasing the safety of drug use and satisfaction with pharmaceutical care， and ensuring the safety of children medication.
ABSTRACT
OBJECTIVE：To establish c harge-by-dose model for pediatric drugs in our hospital ，so as to provide reference for reducing patients ’expenditure，saving medical insurance funds and reducing drug proportion. METHODS ：Since June 2019，a total of 12 kinds of drugs with heavy usage ，high price and large savings in our hospital were selected to establish pediatric charge-by-dose list. The drugs included in the list were split into 1/2 or 1/5 small-sized drug for charge-by-dose model. The process，quality control standards and surplus （loss）drug record of charge-by-dose model were formulated to coordinate the use of pediatric drugs between pharmacies and pediatric departments. The quantity and amount of drugs which were split ，and the drug proportion in pediatric departments were compared between charge-by-dose model and charge-by-unit model （theoretical value of dosage conversion in the same period ）during Jun.-Dec. 2019. RESULTS ：From Jun. to Dec. 2019，the quantities of split drugs each month with charge-by-dose model and charge-by-unit model were （3 346.43±734.73）and（6 821.71±1 468.81）；the amounts of split drugs each month with two models were （53 576.03±10 958.78）yuan and （112 642.75±21 308.77）yuan， respectively，with statistical significance （P＜0.05）. The drug proportion in four pediatric internal medicines departments and one neonatal medicine department had decreased to varying degrees. CONCLUSIONS ：Pediatric drug charge by dose can reduce the use and amount of drugs ，save medical insurance expenditures ，decrease the drug proportion of department.
ABSTRACT
OBJECTIVE： Te analyze the problems of clinical use in pediatric drug in China， and to put forward related countermeasures and suggestions. METHODS： Using “children” and “pediatrics” as retrieval words， registered drug information were retrieved from the website of China Food and Drug Administration； the data of pediatric drug use prescription was retrieved from hospital prescription system of 9 hospitals； all drug information were retrieved from national drug data management system； off-label drug use investigation and the literatures of pediatric drug use in medical institutions （5 representative third grade general medical institutions） were retrieved from CNKI and Wanfang database. General information and problems of pediatric drug use in China were investigated. RESULTS： A total of 170 009 items of registered drug information were retrieved， including 2 784 drug information items labeled with ”children” or ”pediatrics”， accounting for 1.64％；320 000 drug prescriptions from hospital prescription system of 9 hospitals covered 22 treatment areas involving 1 186 drugs and 51 dosage forms. Only 10％ suitable for children. The retrieval results of database showed that the incidence of children off-label drug use in outpatients prescriptions of 5 hospitals was in high level， mainly manifesting as without the information of pediatric drug use， hyper-indication drug use， hyper-dosage drug use. There were many problems in clinical pediatric drug use in China， such as less variety for children， single dosage form and specification， widespread off-label drug use， lack of scientific reference for drug use， difficulty in developing pediatric drug clinical trials， etc. CONCLUSIONS： Although the policies to protect children’s clinical drug use have been introduced in China， the problems facing children’s clinical drug use in China are still very serious. While further implementing relevant policies， it is necessary to establish a linkage management system led by government departments， with the full participation and mutual cooperation of society， enterprises， medical institutions and patients so as to guaratee the safety of pediatric drug use in clinic.
ABSTRACT
Population pharmacokinetics is an emerging discipline developed from the combination of classical pharmacokinetic compartment model and statistics principles, which has been received more and more attention in recent years. Population pharmacokinetics plays important roles in all stages of new drug research. In the early preclinical phase, population pharmacokinetic analysis can help to achieve the preliminary prediction of parameters from animal to human, optimize clinical trial designs, and shorten the time required for new drugs from laboratory to clinical trials. In clinical trials and applications stage, population pharmacokinetic research can help researchers investigate the related covariates that affecting pharmacokinetic behavior of patients comprehensively, and find potential drug-drug interactions in clinical. In addition, population pharmacokinetics has a unique advantage in pediatric drug development due to its strong analysis ability of sparse data. This paper provides a summary on the history and methods of population pharmacokinetics, and the application in new drug discovery and development.
ABSTRACT
OBJECTIVE:To provide reference for promoting the development of related legislation work on ensuring pediatric drug use in China. METHODS:The legislation process of pediatric drug use in US,the effects of current Best Pharmaceuticals for Children Act and Pediatric Research Equity Act on pediatric drug use in US were intrduced and analyzed,suggestions on guarantee-ing the accessibility and safety on pediatric drug use in China were put forward. RESULTS & CONCLUSIONS:The policy6-month period of pediatric exclusive protectionin Best Pharmaceuticals for Children Act has motivated the enthusiasm of phar-maceutical companies developing pediatric studies,while it affects the marketing of generic drugs. Pediatric Research Equity Act has achieved remarkable effect in terms of ensuring the safety of pediatric drug use by forcing pharmaceutical companies to carry out pediatrics assessments,while there is no enough force for the marketed drugs that has not been widely used for children. En-couragement and enforcement are useful methods for promoting development of pediatric drug use. It is suggested to take measures like modifingone drug two formsin Prescription Management Regulations,accelerating approvals of related pediatric drugs on the premise that safety is guaranteed,implementing tax preference for related pharmaceutical companies that produced pediatric drugs,promoting the entry of drug reimbursement list and empowering CFDA to force pharmaceutical companies to implement pedi-atric studies to promote the accessibility and safety of pediatric drugs.
ABSTRACT
OBJECTIVE:To evaluate evidence situation and implementation of global national drug policies on rational pediatric drug use,and to provide decision-making reference for setting up national drug policies for rational pediatric drug use which adapt to the situation of China.METHODS:By retrieving domestic and foreign related database,scanning drug management websites of WHO,the European Union as well as many countries and regions.A pre-designed data extraction form was used to collect information of the policies of rational pediatric drug use.The information was summarized and analyzed.RESULTS:A total of 45 literatures were included,involving WHO and the European Union,the United States,Canada,Britain,Ireland,Holland,Germany,Spain,France,Australia,New Zealand,China,India,Korea,Japan,South Africa and many other countries and regions.The main points of concern for the national policies of rational pediatric drug use in all countries included promoting the development of clinical trials of children's drugs,formulating and promoting essential medicine list for children,formulating and promoting standard treatment guideline of national pediatric formulary,etc.,and promoting pediatric drug monitoring after the listing.The United States,the European Union and Japan had enacted national laws and regulations on pediatric drug clinical trials;WHO,South Africa and India had developed pediatric essential medicine list;WHO,Britain and China had established pediatric formulary.CONCLUSIONS:It is suggested that the relevant departments should refer to the experiences of the United States and the European Union and other countries and regions to establish national drug policies which adapt to pediatric disease burden and drug use in China
ABSTRACT
OBJECTIVE:To provide reference for rational use and standard management of antibiotics. METHODS:The relevant information for antibiotics used in the inpatients of our hospital involved in antibiotics special rectification during 2011 to 2014 were extracted from hospital information system,and the relevant data of antibiotics use were analyzed statistically. The changes of several indicators in the inpatients of our hospital were investigated,including the utilization rate and amount of antibiotics,DDDs and the uti-lization rate of typeⅠincision antibiotics for prophylactic use. RESULTS:The ratio of consumption sum of antibiotics in total con-sumption sum were decreasing from 2011 to 2014. The utilization rate of antibiotics and of typeⅠincision antibiotics for prophylactic use were decreased significantly,decreasing from 77.30% and 47.57% in 2011 to 57.24% and 5.89% in 2014. The consumption sum of cefepime occupied the first 3 places in 3 years. DDDs of cefotaxime and cefoperazone/sulbactam occupied the first 2 places in 4 years. CONCLUSIONS:The development of“antibiotics special rectification activities”have achieved remarkable results in our hospi-tal,the various index of antibiotics in the inpatients have been obviously improved,and clinical application of antibiotics become more reasonable,which lay a good foundation for continuous improvement of clinical application and management of antibiotics.