Establishment of Hospital Intravenous Drug Use Management Model Based on Index System Construction / 中国药师

Objective: To construct the management model for intravenous drug use based on index system in a hospital.Methods: A three-level organizational framework was established, the KPI assessment method was used to set control index and observational index respectively for outpatients and inpatients.The completion of the clinical department indicators were monitored and analyzed with the help of the hospital information systems, and regulated by pharmacy and management tools.Results: After the application of the hospital intravenous drug use management model, the qualification rate of intravenous medication orders was improved in December 2015 (89%) when compared with that in December 2014 (68%), and the difference was statistically significant(P＜0.05).The indices of intravenous drug use of inpatients and outpatients in 2015 were significantly improved when compared with those in 2014.Conclusion: The hospital intravenous drug use management model based on index system construction can effectively reduce unnecessary intravenous medication and promote the rationality of intravenous medication.

Demographic characteristics and intravenous drug use among hepatitis C patients in the Kota Setar district, Kedah, Malaysia / 한국역학회지

OBJECTIVES: This study explored the demographic characteristics of hepatitis C patients in the Kota Setar (KS) district, Kedah, Malaysia, the prevalence of intravenous drug use (IVDU) as a risk factor among these patients, and the associations between IVDU and demographic characteristics. METHODS: Retrospective data pertaining to 713 patients from January 2009 to December 2013 were retrieved from hospital and disease notification records for analysis. The risk factors for hepatitis C virus (HCV) infection were grouped into IVDU and non-IVDU risk factors for analysis using multiple logistic regression. RESULTS: Of the hepatitis C patients included in this study, the most common age group was 31 to 40 years (30.2%), and male patients (91.2%) made up the overwhelming majority. Ethnic Malays constituted approximately 80.4% of the patients, and IVDU was the main risk factor (77.8%) for HCV infection. Multiple logistic regression showed that male patients were 59 times more likely to have IVDU as a risk factor for HCV infection. Single patients were 2.5 times more likely to have IVDU as a risk factor. Patients aged > or =71 years were much less likely than patients aged < or =30 years to have IVDU as a risk factor for HCV infection. CONCLUSIONS: IVDU was found to be an important risk factor for HCV infection among patients in the KS district. The factors associated with IVDU included age, sex, and marital status. Appropriate preventive measures should be developed to target the groups in which IVDU is most likely to be a risk factor for HCV infection.

Needle-sharing behavior among intravenous heroin users:prevalence and risk factors / 中华行为医学与脑科学杂志

Objective To investigate the prevalence and risk factors of needle-sharing behavior among intravenous drug users (IDUs).Methods Data regarding socio-demographics,drug abuse characteristics and HIV related health literacy of 474 heroin IDUs were collected.Antisocial personality disorder of IDUs was diagnosed through Mini international neuropsychiatric interview.Results The prevalence of needle sharing among IDUs was 53.8％.Needle-sharing behavior of IDUs was significantly associated with male gender,marital status of being single and separated/divorced,local dwelling,an early age of first drug abuse and antisocial personality disorder (OR =1.11 ～ 6.69,P＜0.05).Conclusion Heroin IDUs have high prevalence of needle sharing.A comprehensive social,behavior and psychology based intervention is needed to effectively prevent HIV infection in IDUs.

A Case of Re-replacement of the Mitral Valve in an Intravenous Drug User / 日本心臓血管外科学会雑誌

In Japan, infective endocarditis (IE) or prosthetic valve endocarditis (PVE) due to intravenous drug use (IDU) is rare. We report the case of a patient with PVE due to IDU who required mitral valve replacement (MVR) and tricuspid valvoplasty (TVP). A 21-year-old woman with an IDU history had earlier acquired IE, and had undergone MVR using a bioprosthetic valve and TVP in November, 2010. She was transferred to our institute because of fever and general fatigue in February, 2012. Echocardiography revealed vegetation on the mitral bioprosthetic valve, and antibiotic administration was started. Although the infectious condition improved, the vegetation became more mobile. A second MVR, using a bioprosthetic valve, and TVP were performed 18 days after admission. The patient's postoperative course was uneventful, and she was discharged on postoperative day 32. At one and a half years after the second surgery, the patient is currently followed-up regularly at our department, and PVE recurrence has not been observed.