Importancia del cuadro básico de medicamentos en la prescripción médica / Importance of the list of essential medicines in medical prescription

Resumen La implementación en instituciones de salud de un cuadro básico permite adquirir y administrar una larga lista de medicamentos que presenta a los médicos las alternativas de tratamiento, así como la descripción académica colegiada de indicaciones, dosis, efectos secundarios, interacciones y análisis de costo-beneficio, con lo que se facilita la prescripción médica y la administración de insumos para la salud. El Comité de Ética y Transparencia en la Relación Médico-Industria emite diversas recomendaciones para la optimización de los beneficios generados por los cuadros básico de medicamentos.

Abstract The implementation of an essential medicines list in health institutions allows acquiring and administering a long list of drugs that offers treatment alternatives to physicians, as well as a collegiate academic description of indications, doses, side effects, interactions and cost-benefit analyses, thus facilitating medical prescription and administration of health products. The Committee of Ethics and Transparency in the Physician-Industry Relationship issues several recommendations for optimizing the benefits generated by essential medicines lists.

Comparison of the Effects and Medication Cost of Tenofovir Disoproxil and Entecavir in the Treatment of Hepatitis B / 中国药房

OBJECTIVE: To compare the effects and medication cost of tenofovir disoproxil and entecavir in the treatment of hepatitis B. METHODS: A total of 300 patients with HBV infection selected from our hospital during Sept. 2015-Sept. 2016 were randomly divided into tenofovir disoproxil group and entecavir group, with 150 cases in each group. Tenofovir disoproxil group was given Tenofovir disoproxil fumarate tablet 300 mg orally, qd. Entecavir group was given Entecavir tablet 0. 5 mg orally, qd, for consecutive 48 weeks. HBV-DNA level, negative conversion rate of HBV-DNA, ALT level and ALT normalization rate were compared between 2 groups before treatment, after 24, 48 weeks of treatment. The medication cost-effectiveness ratio and ADR were compared between 2 groups after 48 weeks of treatment. RESULTS: There were no statistical significances in the level of HBV-DNA between 2 groups before treatment, the level of ALT and ALT normalization rate before treatment, after 24, 48 weeks of treatment (P>0. 05). Compared with entecavir group, the level of HBV-DNA in tenofovir disoproxil group after 24, 48 weeks of treatment was decreased significantly (P<0. 05); the negative rate of HBV-DNA in tenofovir group was slightly higher after 24 weeks of treatment, without statistical significance (P>0. 05); the negative rate of HBV-DNA was slightly increased after 48 weeks of treatment (P<0. 05). Negative conversion rate of HBV-DNA and medication cost-effectiveness ratio of ALT normalization in tenofovir disoproxil group were better than entecavir group (P<0. 05). The incidence of ADR in tenofovir dipivoxil group was lower than entecavir group (P<0. 05). CONCLUSIONS: Tenofovir dipivoxil can effectively treat HBV, and its effects and medication cost are both better than entecavir.

A comparison of medication adherence between subsidized and self-paying patients in Malaysia

@#Background: Limited efforts have been made to evaluate medication adherence among subsidized and self-paying patients. Objective: To investigate medication adherence among patients with and without medication subsidies and to identify factors that may influence patients’ adherence to medication. Setting: Government healthcare institutions in Kuala Lumpur, Selangor, and Negeri Sembilan and private healthcare institutions in Selangor and Negeri Sembilan, Malaysia. Methods: This cross-sectional study sampled patients with and without medication subsidies (self-paying patients). Only one of the patient’s medications was re-packed into Medication Event Monitoring Systems (MEMS) bottles, which were returned after four weeks. Adherence was defined as the dose regimen being executed as prescribed on 80% or more of the days. The factors that may influence patients’ adherence were modelled using binary logistic regression. Main outcome measure: Percentage of medication adherence. Results: A total of 97 patients, 50 subsidized and 47 self-paying, were included in the study. Medication adherence was observed in 50% of the subsidized patients and 63.8% of the self-paying patients (χ²=1.887, df=1, p=0.219). None of the evaluated variables had a significant influence on patients’ medication adherence, with the exception of attending drug counselling. Patients who attended drug counselling were found to be 3.3 times more likely to adhere to medication than those who did not (adjusted odds ratio of 3.29, 95% CI was 1.42 to7.62, p = 0.006). Conclusion: There is no significant difference in terms of medication adherence between subsidized and self-paying patients. Future studies may wish to consider evaluating modifiable risk factors in the examination of non-adherence among subsidized and self-paying patients in Malaysia.