Study on the present situation of narcotic drugs equipment and management in 251 primary healthcare institutions from Qiandongnan prefecture / 中国药房

OBJECTIVE To investigate the present equipment and management situation of narcotic drugs in primary healthcare institutions from Qiandongnan prefecture of Guizhou province. METHODS The questionnaire survey was conducted among pharmacy department heads and medical staff from primary healthcare institutions in Qiandongnan prefecture of Guizhou province. Descriptive statistical analysis was conducted on the survey results. RESULTS Of 251 healthcare institutions in this survey， 29 healthcare institutions were equipped with narcotic drugs， accounting for 11.55%. The reasons for the narcotic drugs unequipped were mainly as follows: insufficient attention， no storage conditions for narcotic drugs， complex program of narcotic drug management， small amount usage and so on. Among the 29 primary healthcare institutions equipped with narcotic drugs， all of them did not monitor patient usage， accounting for 100%； 29 healthcare institutions did not implement a return visit or follow-up every 3 months， accounting for 100%. CONCLUSIONS The health administration departments should strengthen the administration of narcotic drugs in primary healthcare institutions. At the same time， training on standardized management and clinical rational application of narcotic drugs for medical staff in primary healthcare institutions should be enhanced by the health administrative department.

Expert consensus on quality control management of key links for narcotic drugs and class Ⅰ psychotropic substances in medical institutions of Yunnan province / 中国药房

Narcotic drugs and class Ⅰ psychotropic substances have always been special management drugs in medical institutions. Although relevant policies and regulations have been introduced at the national level ，there are problems of poor policy understanding and inconsistent implementation in medical institutions in the process of policy implementation. In order to standardize the management of narcotic drugs and class Ⅰ psychotropic substances in medical institutions of Yunnan province ， based on the preliminary research and Delphi expert consultation ，this editing group finally formed the Expert Consensus on Key Links Quality Control Management of Narcotic Drugs and Class I Psychotropic Substances in Medical Institutions of Yunnan Province by focusing on the key aspects of quality control of key links for narcotic drugs and class Ⅰ psychotropic substances in medical institutions ，aiming to provide reference for the clinical use and management of narcotic drugs and class Ⅰ psychotropic substances in medical institutions of Yunnan province.

Comparison between ropivacaine and lidocaine in prostatic peripheral nerve block anesthesia / 中华泌尿外科杂志

The present study retrospectively analyzed the clinical data of 137 patients who underwent prostate in North Jiangsu People's Hospital from June 2020 to May 2021. All patients underwent peripheral prostatic nerve block anesthesia (PPNB). The observation group received 1% ropivacaine 32 ml local, and the control group received the same dose of lidocaine. There was no significant difference in general data before puncture between the two groups ( P>0.05). All 137 cases were performed by the same surgeon. The number of puncture needles in the observation group and the control group was (20.2±2.8) and (20.2±2.9), respectively, and the difference was not statistically significant ( P>0.05). The visual analogue scores (VAS-1) of pain during puncture in the observation group and the control group were (2.62±0.74) and (2.48±0.79) points, respectively. The visual numeric score (VNS-1) was (3.03±0.88) points and (3.15±0.80) points, respectively, and there was no significant difference ( P>0.05). 30 min after puncture, VAS-2 was (0.48±0.53) points and (0.30±0.47) points, VNS-2 was (3.31±0.48) points and (3.55±0.71) points, respectively.The differences were statistically significant ( P<0.05). There was no significant difference in overall complication rate between the two groups ( P=0.661).

O julgamento de adolescentes varejistas do tráfico de drogas no Brasil: uma análise de processos judiciais / Legal sentences of adolescents for small-scale drug trafficking in Brazil: an analysis of judicial decisions / Sentencias judiciales contra adolescentes del microtráfico de drogas en Brasil: un análisis de las decisiones judiciales

Resumo (analítico) O objetivo do artigo é analisar os processos judiciais relativos ao ato infracional de tráfico de drogas, em Petrolina-PE (2011-2014), com base na revisão analítica das instituições e leis historicamente voltadas para a menoridade, segundo a Theory of Sentencing. Apreciou-se o conteúdo social das variáveis legais e extralegais, analisando o efeito cumulativo dos determinantes das sentenças. As decisões judiciais mais encontradas foram extinção processual e absolvição. Medidas socioeducativas de advertência, liberdade e semiliberdade são mais recorrentes que a internação. No entanto, há disparidades das sentenças em casos análogos e imputação de penas análogas em casos díspares. Conclui-se que o sistema penal é produtor e reprodutor de desigualdades sociais e a punição é percebida e utilizada como técnica de controle e transformação de adolescentes pobres apreendidos com pequenas quantidades de drogas.

Abstract (analytical) The purpose of this article is to analyze the legal sentences for drug trafficking offense in Petrolina, a city in the state of Pernambuco, in the period 2011-2014 based on the analytical review of institutions and laws that have historically targeted minorities and the Theory of Sentencing. The social content of legal and extralegal variables was analyzed, analyzing the cumulative effect of determinants for the sentences. The most frequent judicial decisions were procedural extinction and acquittal. Socioeducational measures of warnings, dropping of all charges and suspended sentences are more common than imprisonment. However, there are disparities in sentences for similar cases and the handing down of analogous sentences in disparate cases. It is concluded that the penal system is a producer and reproducer of social inequalities and punishment is perceived and used as a technique for the control and transformation of poor adolescents who are caught with small amounts of drugs.

Resumen (analítico) El objetivo del artículo es analizar los procesos judiciales de tráfico de drogas, en Petrolina-PE (2011-2014) de adolescentes, basado en la revisión analítica de las instituciones y leyes históricamente orientadas hacia las minorías y la Theory of Sentencing. Se apreció el contenido social de las variables legales y extralegales, analizando el efecto acumulativo de los determinantes de las sentencias. Las decisiones judiciales más encontradas fueron la extinción procesal y la absolución. Las medidas socioeducativas de advertencia, libertad y semilibertad son más recurrentes que la internación. Sin embargo, hay disparidades de sentencias en casos análogos e imputación de penalización análogas en casos dispares. Se concluye que el sistema penal es productor de desigualdades sociales y el castigo es percibido y utilizado como técnica de control y transformación de adolescentes pobres incautados con pequeñas cantidades de drogas.

Analysis on the use of narcotic drugs for inpatients / 药学实践杂志

Objective To investigate and analyze the inpatient use of narcotic drugs, provide reference for clinical norms and rational use of narcotic drugs. Methods The narcotic prescription number, usage and cost were analyzed statistically. The inpatient narcotic use was analyzed by screening the dose form, indication, and dosage. Results The injections topped the list of narcotic prescriptions from year 2016 to 2019 with 15 820 (61.4%), 15 813 (61.5%), 16 682 (64.7%) and 17 293 (71.5%) prescriptions respectively. The oral and topical narcotic drugs were less prescribed. Although pethidine hydrochloride injection prescriptions decreased year by year, it still topped in the narcotic use with 8 009 (31.1%), 7 707 (30.0%), 7 151 (27.7%) and 6 844 (28.3%) prescriptions each year. Pethidine hydrochloride injection was mostly used for patients with cancer and chronic pancreatitis. Conclusion Doctors preferred to use injectable narcotics for patients with moderate to severe pain. Improper use of narcotic drugs was noticed, such as unsuitable choice of dose form, inappropriate use of pethidine hydrochloride injection, etc. Pharmacists should keep vigilant in prescription review and medication intervention for narcotic drugs to improve the standardization and rational use of narcotics.

Abuse or dependence of narcotic drugs and psychotropic drugs inhospital patients / 预防医学

Objective @#To understand the current situation and characteristics of narcotic drugs and psychotropic drugs abuse or dependence among hospital patients and to provide reference for strengthening the management of narcotic drugs and psychotropic drugs.@*Methods @#We collected clinical data from hospitals in Shandong and Guizhou provinces in 2016 and selected patients with history of narcotic drugs and psychotropic drugs. We investigated them through telephone or face-to-face interview,then described the characteristics of demographic information and abuse or dependence of narcotic drugs and psychotropic drugs in diagnosed drug abusers.@*Results @#A total of 280 patients with drug abuse or dependence were recruited,of which 223 cases from nine hospitals in Shandong and 57 cases from five hospitals in Guizhou. There were 170 male patients,accounting for 60.71%; 193 patients aged 45 years and above,accounting for 68.93%; 223 married patients,accounting for 80.51%; 166 patients with a education level of junior high school and below,accounting for 61.25%; 125 patients engaged in agriculture,accounting for 48.64%. Benzodiazepine was the main drugs abused or dependenced by hospital patients,accounting for 73.57%（206 cases）. There were also 83 cases of polydrug abuse,accounting for 29.64%. Among the patients with drug abuse or dependence,45.71% had no special feelings,41.07% had symptoms or felt uncomfortable after withdrawal; 64.64% was for improving their sleep quality. @*Conclusion @#Most patients with abuse or dependence of narcotic drugs and psychotropic drugs are middle- or senior-aged and have polydrug abuse. Benzodiazepine are the main abused drugs. The common reason for narcotic and psychotropic drug abuse or dependence is to have a good sleep.

Analysis of the Quality of Pharmaceutical Care for Cancer Pain Therapy in 64 Hospitals from Beijing / 中国药房

OBJECTIVE： To investigate pharmaceutical care of cancer pain therapy in medical institutions from Beijing area， and to provide reference for improving the quality of pharmaceutical care for cancer pain in medical institutions and formulating cancer pain therapy decision by public health administration departments at different levels. METHODS： Inspection results of standardized diagnosis and treatment for cancer pain were analyzed retrospectively in Beijing Pain Therapy Quality Control and Improvement Center during Feb.-Mar. 2018. Scoring results of pharmaceutical care （20 points） and its 5 sub-items （personnel participation， drug supply， drug management， outpatient prescription comment and inpatient prescription comment， 4 points each item） were analyzed statistically and classified according to hospital level and pharmaceutical care inspection results. RESULTS： A total of 64 hospitals in Beijing participated in the inspection， including 27 tertiary A hospitals （42.19％）， 21 tertiary B hospitals （32.81％）， 16 secondary hospitals or first-level hospitals （25.00％）. Pharmaceutical care in all hospitals met the inspection requirements with qualified rate of 100％. 52 hospitals performed excellently （81.25％）， and 12 hospitals were qualified for pharmaceutical care （18.75％）. Among 5 sub-items of personnel participation， drug supply， drug management， outpatient prescription comment and inpatient prescription comment， the average score of drug supply item was the highest （3.83±0.05）； the lowest was the personnel participation item （2.93±0.13）. The results of pharmaceutical care inspection in tertiary A hospitals （17.80±0.28） and tertiary B hospitals （17.78±0.30） were significantly better than those in secondary hospitals or first-level hospitals（16.16±0.50）（P＜0.01 or P＜0.05）； there was statistical significance only in the score of outpatient prescription comment among 5 sub-items（P＝0.026）. Total scores of the hospitals with excellent pharmaceutical care were significantly higher than those of the hospitals with qualified pharmaceutical care in terms of personnel participation， outpatient prescription comment and inpatient prescription comment （P＜0.01 or P＜0.05）. There was significant difference in the inspection results of pharmaceutical care among the excellent group， the qualified group and the unqualified group classified by the results of personnel participation item （P＜0.01 or P＜0.05）. CONCLUSIONS： The quality of pharmaceutical care for cancer pain therapy in medical institutions from Beijing area has reached the qualified level， but the participation of clinical pharmacists in cancer pain therapy and outpatient prescription comment still need improvement in further. The training of clinical pharmacists and information construction of narcotic drug management should be strengthened so as to improve the overall quality of pharmaceutical care for cancer pain.

Establishment and Practice of Information Management Platform for Cancer Pain and Chronic Pain Patients in Outpatient Department / 中国药房

OBJECTIVE: To complete standardized management and follow-up for the cancer pain and chronic pain patients in outpatient department. METHODS: Information management platform was designed and established for cancer pain and chronic pain patients in outpatient department, including information entry, information inquiry, prompt for drug dispensing in advance, file unified management and regular scanning and removing excess medical records. The procedure of prescribing narcotic drugs for first visiting, subsequent visiting and follow-up patients was introduced. File management and prescription rationality before and after the establishment of information platform were compared. The adoption of pharmacist' s recommendation after the establishment of information platform were counted. RESULTS: Compared with before the establishment of information platform, the ratio of problematic profiles decreased from 42. 96％ to 7. 06％ (P＜0. 05); the ratio of irrational prescription decreased from 4. 39％ to 1. 19％ (P＜0. 05). Pharmacists provided a total of 1 542 recommendations for the patients with poor pain control and ADR. The adoption rate of the pharmaceutical recommendations was 63. 62％. CONCLUSIONS: The cancer pain and chronic pain information management platform can manage the outpatients' profile effectively and improve the rationality of the prescription. Meanwhile, the pharmacists have played an important role in the pain treatment for outpatients.

Comments on the Prescriptions of Analgesic Drugs for the Patients with Cancer Pain Using PCNE Classifi-cation System / 中国药师

Objective: To analyze the prescriptions of analgesic drugs for the patients with cancer pain, and promote the rational use of narcotic and analgesic prescriptions. Methods: Using the PCNE classification system, the list of all drug-related problems (DRPs) from 115 patients admitted to the standardized treatment of cancer pain from January to December 2017 was analyzed. Re-sults: In our hospital from January to December 2017, there were 52 cases of prescribed DRPs for narcotic and analgesic drugs in the standardized treatment of cancer pain with the incidence of 45. 22% . DRPs mainly focused on treatment safety with the incidence of 72. 31% . The drug choice caused the highest incidence of DRPs accounting for 63. 24% , followed by dose selection accounting for 20. 59% . Conclusion: There are still unreasonable prescriptions of narcotic analgesia in our hospital. According to the PCNE classifi-cation system, it is necessary to strengthen the communication with clinicians, carry out education for the patients with cancer pain, and further educate pharmacy staff on the knowledge of analgesic drugs. Through the above measures, the regulation of prescription medication for narcotic analgesics can be intensified.

E-salud educación virtual en la prevención del consumo de sustancias psicoactivas / E- health: prevention of the consumption of psychoactive substances using virtual education

La utilización de herramientas virtuales para la salud ha sido estudiada desde diversos enfoques. Esta revisión narrativa se propone identificar el conocimiento generado con respecto a la educación virtual en la prevención del consumo de sustancias psicoactivas, para lograr este objetivo se analizó la producción científica que hay al respecto, seleccionando textos que trabajarán específicamente las herramientas virtuales en el tema de las adicciones, debido a que el uso de drogas evidencia un aumento en los ámbitos internacional, nacional y local en su mayoría en población juvenil (que es también el público que hace mayor uso de las Tecnologías de la Información y la Comunicación), en tanto que las iniciativas educativas virtuales para este fin se han centrado más en las herramientas (Internet y teléfonos móviles) que en el público, en la metodología y en los contenidos; los principales hallazgos apuntan a destacar que la prevención del consumo de sustancias psicoactivas puede lograrse mediante la educación virtual, pues las acciones formativas y las estrategias innovadoras redundarían en la adopción de hábitos saludables, puede concluirse que falta evidencia científica que lo sustente debido a que se requiere de evaluaciones de impacto de los programas y la inclusión de padres y educadores.

The use of virtual tools for health has been studied from many ways. This narrative research has as aim to know the scientific knowledge about virtual education in prevention of consumption of psychoactive substances (SPA), to achieve this objective, the scientific production was analyzed, selecting texts that specifically talk about the virtual tools in the subject of addictions, because use of drugs is increasing in international, national and local ambit mostly in the youth population (which is the public that makes greater use of ICT), while the virtual educational initiatives for this purpose have focused more on tools (Internet, ICT and mobile phones) than in people, methodologys and contents, in conclusion is not enough scientific evidence in virtual educational strategies for the SPA consumption prevention, that have been implemented, evaluated and planned for parents and educators.

Dynamic Analysis of the Utilization of Opioid Analgesics in Cancer Pain Inpatients of Our Hospital / 中国药房

OBJECTIVE:To provide reference for rational use of cancer pain narcotic drugs in our hospital. METHODS:The amount of narcotic drugs in our hospital was analyzed statistically during second quarter of 2012 to second quarter of 2015. RE-SULTS:12 specifications and 4 dosage forms of narcotic drugs were involved in our hospital during second quarter of 2012 to sec-ond quarter of 2015. Total amount of narcotic drugs was in an increasing tendency. Oxycodone hydrochloride sustained-release tablet was the largest quantity of narcotic drug used and grew fastest. The amount of surgical drugs kept stable,while total amount of oral preparation increased significantly,in particular,a significant increase in Morphine tablets. CONCLUSIONS:The application of narcotic drugs in our hospital is basically reasonable. The preferred oral principle has been implemented,and treatment of cancer pain is more standardized.

Analysis of the Utilization of Narcotic Drugs in Our Hospital during 2013-2015 / 中国药房

OBJECTIVE:To evaluate the current situation and trend of narcotic drugs used in our hospital,and to provide refer-ence for scientific management and rational use of narcotic drugs. METHODS:The utilization of narcotic drugs in our hospital dur-ing 2013-2015 was analyzed statistically in terms of consumption sum,DDDs,DDC and B/A,etc. RESULTS:The consumption sum of narcotic drugs in our hospital increased year by year,mainly injection. Both consumption sum and DDDs of Sufentanil ci-trate injection took up the first place during 2013-2015,Morphine hydrochloride sustained-release tablets and Fentanyl citrate injec-tion took up 2nd and 3rd place in the list of DDDs. Top 3 drugs in the list of DDC were Oxycodone hydrochloride prolonged-re-lease tablets(40 mg),Remifentanil hydrochloride for infection(2 mg)and Sufentanil citrate injection. B/A of Sufentanil citrate in-jection,Morphine hydrochloride tablets and Oxycodone hydrochloride prolonged-release tablets(10 mg)were all close to 1.0, showing good synchronization of economic and social benefits. CONCLUSIONS:The consumption sum of narcotic drugs in our hospital has increased year by year. The utilization and management of narcotic drugs is basically in line with related standard and treatment criteria,but the management of narcotic drugs still need to be strengthened in the future.

Analysis of the Utilization of Narcotic Drugs in Our Hospital during 2013-2015 / 中国药房

OBJECTIVE:To evaluate the current situation and trend of narcotic drugs used in our hospital,and to provide refer-ence for scientific management and rational use of narcotic drugs. METHODS:The utilization of narcotic drugs in our hospital dur-ing 2013-2015 was analyzed statistically in terms of consumption sum,DDDs,DDC and B/A,etc. RESULTS:The consumption sum of narcotic drugs in our hospital increased year by year,mainly injection. Both consumption sum and DDDs of Sufentanil ci-trate injection took up the first place during 2013-2015,Morphine hydrochloride sustained-release tablets and Fentanyl citrate injec-tion took up 2nd and 3rd place in the list of DDDs. Top 3 drugs in the list of DDC were Oxycodone hydrochloride prolonged-re-lease tablets(40 mg),Remifentanil hydrochloride for infection(2 mg)and Sufentanil citrate injection. B/A of Sufentanil citrate in-jection,Morphine hydrochloride tablets and Oxycodone hydrochloride prolonged-release tablets(10 mg)were all close to 1.0, showing good synchronization of economic and social benefits. CONCLUSIONS:The consumption sum of narcotic drugs in our hospital has increased year by year. The utilization and management of narcotic drugs is basically in line with related standard and treatment criteria,but the management of narcotic drugs still need to be strengthened in the future.

Analysis of the Utilization of Narcotic Drugs for Cancer Pain Patients in Outpatient and Emergency De-partment of Our Hospital during 2014-2016 / 中国药房

OBJECTIVE:To provide reference for the rational utilization of narcotic drugs in cancer pain patients. METH-ODS:In retrospective survey,2275 prescriptions of narcotic drugs for cancer pain patients in outpatient and emergency depart-ment of our hospital during 2014-2016 were analyzed statistically in respects of general information,drug amount,consumption sum and DDDs,etc. RESULTS:The proportion of male patients and female patients with cancer pain in our hospital were 65.63%and 34.37% within 3 years,mainly aged 21-90. The consumption amount and sum of narcotic drugs in our hospital increased year by year. Dosage forms were mainly tablet. The consumption amount,sum and DDDs of Morphine hydrochloride sustained-release tablets took up the first places among narcotic drugs. And those of Pethidine hydrochloride injection were the lowest. CONCLU-SIONS:The utilization of narcotic drugs is rational in outpatient and emergency department of our hospital on the whole. Morphine preparations are the predominant analgesic drugs for patients with cancer pain.

Applied analysis of the use of narcotics in surgical pharmacy of our hospital from 2014 to 2016 / 中国生化药物杂志

Objective To analyze the current situation and tendency of the application of narcotics in surgical pharmacy in our hospital from 2014 to 2016,and to evaluate them. Methods The usage and sales of narcotics data and the operation volume were collected by His system of our hospital and statistically analyzed. Results The drug usage and sales of narcotics and operation volume were increased year by year. DDDs of sufentanil was ranked in second in 2014 and 2015 ,and rose to first in 2016.DDDs of fentanyl(0.5mg) was ranked in first in 2014 and 2015,and declined to third in 2016.DDDs of remifentanil third in 2014 and 2015 rose to second in 2016. Remifentanil and sufentanil were ranked in top two in DDC. Conclusion The usage of narcotics in surgical pharmacy of our hospital is reasonable.

Establishment of standardized treatment demonstration ward for cancer pain and its influence on the management of narcotic drugs / 中国生化药物杂志

Objective To explore the effect of setting up standardized treatment demonstration ward for cancer pain on the management of narcotic drugs. Methods The study group (from 2015 to 2016 to create the standardized treatment of cancer pain ward) and control group (from 2013 to 2014 to create a standardized pain treatment demonstration unit ) all kinds of narcotic drugs dosage and medication frequency (DDDs), a monthly 30 prescriptions from tumor anesthesia, analysis of prescription writing quality qualified the rate and the rate of unreasonable use. Results The study group of patients with cancer pain drug usage and DDDs, oxycodone dosage rises fast, DDDs way ahead, dosage of morphine increased gradually, morphine dosage gradually decreased, transdermal fentanyl DDDs decreased, pethidine dosage remains low. The research group for the passing rate of prescription writing quality 99.3％, the control group of prescription writing quality qualified rate is 81.1％, the research group of narcotic drug use rate was only 4％, reasonable utilization rate is as high as 96％ is not reasonable, unreasonable use of narcotic drugs control group was as high as 18.5％, reasonable utilization rate is only 81.5％ (P<0.05). Conclusion The creation of standardized pain treatment demonstration unit narcotic drugs more reasonable structure, can improve the quality of narcotic drugs prescription writing qualified rate, reduce the rate of unreasonable use, reasonable use of pain medicine has positive significance to ensure patient safety and efficacy of.

Analysis of the Utilization of Narcotic Drugs for Inpatients in Our Hospital from 2012 to 2014 / 中国药房

OBJECTIVE:To provide reference for the rational use of narcotic drugs. METHODS:The utilization of narcotic drugs for inpatients in our hospital during 2012-2014 were collected from HIS,and analyzed statistically in respects of consumption amount,consumption sum,DDDs,B/A,DDC and consumption amount of the different departments,and so on. RESULTS:The quantity and consumption amount of Morphine sulfate sustained-release tablets,Oxycodone hydrochloride sustained-release tablets and Codeine phosphate tablet ranked the first 3 places during 2012-2014. Morphine sulfate sustained-release tablets,Oxycodone hy-drochloride sustained-release tablets and Fentanyl transdermal patch(8.4 mg)steadily occupied the first 3 places in the list of con-sumption sum. In the list of DDDs,Fentanyl transdermal patch and Morphine sulfate sustained-release tablets took up the first 3 places;Morphine hydrochloride injection,Bucinnazine hydrochloride injection and Meperidine hydrochloride injection occupied the last 3 places. B/A value of Morphine sulfate sustained-release tablets and Fentanyl transdermal patch(8.4 mg) in 2012,Oxycodo-ne hydrochloride sustained-release tablets in 2014,Fentanyl transdermal patch(2.5 mg)in 2013 and 2014 were all equal to 1 and synchronized well. Others were all biased. DDC of narcotic drugs kept stable in 3 years,and DDC of Oxycodone hydrochloride sus-tained-release tablets took up the first place,followed by Fentanyl transdermal patch (8.4 mg). Narcotic drugs were consumed in 19 departments,but mainly in the department of oncology and general surgery. In the department of oncology,the consumption amount and sum of oral formulation were both significantly higher than other dosage forms,accounting for more than 88% and 52% respectively. CONCLUSIONS:The variety and dosage form of narcotic drugs could meet the clinical needs and its application is basically reasonable. Besides,the utilization of narcotic drugs in the department of oncology consistent with the basic principles of WHO three steps cancer analgesia treatments.

A Retrospective Study between Pre- and Post-Introduction of Narcotic Drugs of Palliative Care for Cancer Patients at the Long-term Care Unit

Objective: The aim of this study was to investigate the palliative care for cancer patients provided by a long-term care unit. Methods: We retrospectively investigated the medical records of 194 patients who hospitalized in our long-term care unit between April 2010 and December 2014. The patients shared with a group of two, narcotic drugs non-use period (previous group; until March 2012) and narcotics use period (later group; in April 2012 or later), and it was compared with a background, hospitalization period, result on discharge, narcotic drug administration, symptom relief. And it was surveyed hospitalization dynamics of our palliative care unit for comparison. Result: Cancer patients were 16 (22%) in previous group of 74 patients and were 79 (66%) in later group of 120. The proportion of cancer patients in later group increased to three times (p<0.001). In later group, the average hospital stay was shortened to half (144 days, p<0.01) and the mortality discharge rates increased (78%, p<0.05). Narcotic drugs were administered to more than half (57%) of cancer patients in later group, and pain relief was significantly better. In the period of later group, number of hospitalized patients in palliative care unit was also increased. Conclusion: It was suggested that the long-term unit can perform palliative care for cancer patients in cooperation with the palliative care unit.

A Study on the Policy Implication on the Management of Narcotics Distribution for Medical Use

OBJECTIVES: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. METHOD: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. RESULTS: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. CONCLUSION: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.

Analysis of the Utilization of Narcotics Drugs in Our Hospital during 2012 to 2013 / 中国药房

OBJECTIVE:To provide reference for rational use of narcotics drugs in the clinic. METHODS:A total of 5 841 prescriptions of narcotic drugs in our hospital from Jan. 2012 to Dec. 2013 were selected as subjects. The utilization of drugs was an-alyzed statistically using DDDs,DDC and DUI as index. The situation of pharmacists prescriptions dispensing was analyzed with missing rate of unqualified prescriptions as an indicator. RESULTS:7 narcotics drugs DUI≤1.00 in 2012. 9 narcotics drugs DUIs≤1.00 in 2013. The highest missing rate of unqualified prescriptions was 9.33% in the inpatient pharmacy in 2013. The amount and DDDs of Morphine hydrochloride injection,Morphine sulfate sustained-release tablet and Oxycodone sustained-release tablet all in-creased in 2013,compared to in 2012;DUI of all morphine preparation were >1.00. DUI of Codeine phosphate tablet and Bucin-nazine tablet were decreased from 1.64 and 1.11 in 2012 to 1.02 and 0.74 in 2013,tending to be reasonable. The amount and DDDs of Sulfentanyl injection,Remifentanil injection and Fentanyl patch all in 2013,compared to in 2012. CONCLUSIONS:The utilization of narcotics drugs in our hospital basically tend to be rational,but still many deficiencies exist. We should strengthen in-tervention and management on the the utilization of narcotic drugs further.