Effect of Rifabutin Combined with Multi-drugs in the Treatment of Multi-drug Resistant Tuberculosis with Long-term Therapy / 中国药师

Objective:To evaluate the effect and safety of rifabutin combined with multi-drugs in the treatment of multi-drug resist-ant tuberculosis with long-term therapy. Methods:Totally 86 cases of patients with multi-drug resistant tuberculosis were divided into the control group and the treatment group with 43 ones in each according to a random number table method. The two groups were trea-ted with levofloxacin, pasiniazid, ethambutol, protionamide and amikacin etc. The control group was treated with rifapentine, and the treatment group was treated with rifabutin additionally. After 18-month treatment, the negative conversion ratio of sputum smear and sputum mycobacterium tuberculosis culture, lesion absorption rate and cavity closure rate of X-ray chest radiograph and adverse reac-tions in the two groups were compared. Results:The negative conversion ratio of sputum smear and sputum mycobacterium tuberculosis culture in the treatment group was 41. 86% and 32. 56%, respectively, which were similar with those in the control group ( P >0. 05). There were no significant differences in lesion absorption rate and cavity closure rate of X-ray chest radiograph and adverse re-actions between the two groups (P>0. 05). Conclusion:Rifapentine or rifabutin combined with multi-drugs in the treatment of multi-drug resistant tuberculosis can improve the negative conversion rate of sputum mycobacterium and lesion absorption and cavity closure with high safety.

Exploring Medicine Information Needs of Hypertensive Patients Using Short Message Service.

Aims: To explore the pattern of unmet medicine information needs of hypertensive patients on long term therapy and their attitude to use of SMS (mobile phone short message service) for medicine information exchange with hospital pharmacists. Sample: 117 hypertensive patients on long term therapy who had been accessing care for at least one year. Study Design: An exploratory medicine information exchange programme followed by a cross-sectional survey. Place and Duration of Study: Outpatient Clinic of Department of Cardiology at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between October, 2010and May, 2011. Methods: Patients were prompted with SMS twice weekly for 5-8 months for use of their medication with advice to send their medicine information needs to the hospital pharmacist. Received messages were subjected to content analysis to identify their themes. A semi-structured questionnaire was used to explore patient attitude to the use of SMS. The 17-item questionnaire was designed on a 5-point Likert scale for responses with weights of 0-4. Data obtained were analysed using both descriptive and inferential statistics. These include frequencies and mean of weighted averages (MWA); tests of relationships, associations and of differences in means. Results: A total of 63 SMS texts were received from the respondents and 44% of the messages expressed medicine information needs. Majority of the enquiries were related to indications and adverse effects. The patients’ attitude to the use of SMS for medicine information exchange with pharmacists was generally positive (MWA=3.13) with no significant demographic effects. Some (46%) of the patients called for institutionalisation of the medicine information exchange programme. Conclusion: The unmet medicine information needs of chronic hypertensive patients in the study were related mainly to indications and side effects of prescribed and nonprescribed medications and the patients clamoured for use of SMS in redressing the anomaly.

Antihypertension medication adherence and associated factors at Dessie Hospital, North East Ethiopia, Ethiopia.

Hypertension is an overwhelming global challenge. Despite the development of many effective anti hypertensive drugs, target to reduce morbidity and mortality due to high blood pressures are reached in only a minor of patients in clinical practice. Poor adherence is one of the biggest obstacles in therapeutic control of blood pressures. There are complaints from patients and physicians that the poor result of actual antihypertensive drug therapies. Many people with age indifference are attacked by this “silent killer” or which results in target organ damage as a complication. The aim of this study was to assess the magnitude of adherence and the factors associated with non-adherence to anti-hypertensive medication. Cross sectional exclusively convenient study was conducted by using structured questionnaires consisting of open and closed-ended questions on patients diagnosed for hypertension and have already been on anti hypertensive medications at least for three months at Dessie Referral hospital from 20/01/2012 to 29/01/2012. A total of hundred hypertensive patients were screened from hundred six cases by the exclusive criteria and the overall incidence of anti-hypertensive medication non adherence was 26%. The study identifies reasons why patients don’t adherent with the drug regiments. Among Factors associated with non adherence were health system and health care provider poor interaction with patient and therapy factors like frustration and unwanted effect of the medication in the long run. There was indication of non adherence from the study area. Great emphasis should be placed on intervention strategies such as patient counseling and increasing awareness of the physicians, all other prescribers and health care providers at large about the non adherence of anti hypertensive drugs as well as the complication what comes due to this medication non adherence.

Efficacy and Safety of Long-term Aripiprazole Therapy in Patients with Schizophrenia, Schizophreniform Disorder, and Schizoaffective Disorder: A 52-week, Prospective, Open-label Study / 대한정신약물학회지

OBJECTIVE: We investigated the long-term efficacy, safety, and tolerability of aripiprazole in a large number of patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder in Korea. METHODS: This was an open-label, multi-center, single-arm, 52-week study of patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder. Korean patients (N=300) experiencing either a first episode or recurrence participated in this study. The primary efficacy measure was the Positive and Negative Syndrome Scale (PANSS) total score. Secondary efficacy measures included the PANSS positive and negative subscales, and the Clinical Global Impression-Severity of Illness (CGI-S). Safety was evaluated prospectively by recording treatmentemergent adverse events; measuring extrapyramidal symptoms (EPS), vital signs, and body weight; and performing laboratory tests. RESULTS: Overall, 55 (18.33%) of the patients completed the entire 52-week study. Treatment with aripiprazole provided rapid and significant improvement in all of the efficacy measures. Comparing PANSS total scores, PANSS positive subscale scores, and CGI-S scores, first-episode patients showed significant improvement than the patients who had experienced at least one recurrence. There were no significant differences in the mean change of EPS during the study, except for akathisia at week 8 and a significant decrease in serum prolactin level in patients experiencing first and recurrent episodes. At the end of the study, the mean weight gain was 2.40 kg. CONCLUSION: Aripiprazole is effective and safe for patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder during a long-term, 52-week treatment. The result may be associated with the unique mechanism of aripiprazole. We have extended the findings of previous studies in the United States and other countries and demonstrated a similar effectiveness of aripiprazole for Korean patients.

Effect of Long-Term Aripiprazole Therapy on Social Functioning in Korean Patients with Schizophrenia: A 52-Week, Prospective, Open-Label Study / 대한정신약물학회지

OBJECTIVE: We examined the effect of long-term aripiprazole therapy on social functioning in Korean patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder. METHODS: In this 52-week open-label, multicenter, single-arm study, 300 Korean patients with schizophrenia were treated with aripiprazole 10-30 mg/day after administration of 15 mg/day during the first 2 weeks. The primary efficacy measure was the Korean-Social Functioning Scale (SFS-K), and the secondary efficacy measures were the Emotion Assessment, and the Positive and Negative Syndrome Scale (PANSS) score and the Clinical Global Impression - Severity of Illness (CGI-S) to investigate for correlation between social functioning and clinical symptoms. RESULTS: At week 52, there were significant improvements in all the areas of the SFS-K. There was generally no difference in the change of social functioning between patients in the first episode and patients having previous episodes. Significant improvements were also observed in negative emotion and emotional control. Statistically significant correlation between the SFS-K and the PANSS score was observed at week 52. CONCLUSION: The present study showed that long-term treatment with aripiprazole contributed to significant improvement in social functioning in patients with schizophrenia in the long-term treatment. This improvement of social functioning was modestly associated with clinical improvement of symptoms. The results suggest that long-term aripiprazole therapy could be effective not only in treating clinical symptoms, but also in improving social functioning in patients with schizophrenia-spectrum disorder.

Efficacy and Safety of Levetiracetam as Adjunctive Treatment in a Multicenter Open-Label Single-Arm Trial in Korean Patients with Refractory Partial Epilepsy: Over 1-Year Follow-Up / 대한간질학회지

PURPOSE: This prospective, open-label study evaluated the efficacy and safety of adjunctive levetiracetam (LEV) in Korean adults with uncontrolled partial epilepsy. METHODS: A total of 100 patients whose partial seizures were inadequately controlled on their current antiepileptic drugs were enrolled and received LEV (1000-3000 mg/day). Seizure count and adverse events (AEs) were recorded by patients. Global evaluation scale (GES) and quality of life (QOLIE-31) were also evaluated. Additionally effectiveness over 1-year follow-up was investigated. RESULTS: Ninety-two patients completed the short-term 16-week trial. The median percent reduction in weekly seizure frequency over the treatment period was 43.2%. The > or =50% and > or =75% responder rates were 45.4% and 36.1%, respectively. Seizure freedom was observed in 17 patients throughout the initial 16-week treatment period. On investigator's GES, 81 patients were considered improved, with 41 patients showing marked improvement. Most QOLIE-31 scales improved significantly. At the end of the trial, 79 chose to continue follow-up treatment with LEV. At the follow-up visit (ranging 60 to 81 weeks), 64 patients were still taking LEV; during the last 16 weeks, 65.6% of patients had > or =50% reduction, 50.0% had > or =75% reduction, and 35.9% had a 100% reduction. Seven patients showed continuous seizure freedom from the initiation of LEV treatment. During the entire treatment period, LEV was withdrawn in 36 patients; due to lack of efficacy in 22, AEs in six, both in three, other reasons in five. CONCLUSION: Adjunctive LEV therapy in patients with refractory partial epilepsy was effective and well-tolerated, as evidenced by the high seizure freedom and retention rates in both the short-term trial and the long-term follow-up.