Analysis of drug promotional literature and its abidance to WHO guidelines

Background: Drug promotional literature (DPL) is used by the pharmaceutical companies for promotion of their drug. It is the commonest source for providing information about the drug to the physician. According to WHO promotional literature should be reliable, truthful, informative, balanced and up to date.Methods: Study was conducted in Department of Pharmacology, Muzaffarnagar Medical College. 200 drug promotional literatures like advertisements published in medical journal, package insert of medicinal products and brochures were collected and analysed according to WHO criteria.Results: Total 200 promotional literatures were analysed. 100 promotional literatures were from the medical journal, 50 were package inserts of medicinal products and 50 were medicinal brochures. On assessing DPL using WHO criteria, all DPL mentioned brand names and dosage form (100%). Most of them published the generic name (98.5%), therapeutic uses (78%), side- effects (75%), dosage regimen (70%), contraindication (62.5%), warnings (55%), drug interaction (54%), precaution (50%), reference to scientific literature (45%), name of manufacture and distributor (99%), address of manufacturer and distributor (50%). Out of 200 DPL only 151 DPL contain references to scientific literature, 88 DPL references were retrievable and 63 were non retrievable.Conclusions: Our study shows although pharmaceutical companies are trying to adhere to the WHO criteria it is not fulfilled. As DPL are an important source of seeking information by the medical practitioner who rely on them to impart treatment to the patient, strict steps to regulate fulfilment of the WHO criteria should be taken by the government and authorities.

Analysis of drug promotional literatures in a tertiary care hospital: a cross sectional study

Background: Large numbers of new drugs are introduced into the market every day and pharmaceutical companies are in the business of development and selling of new drug. There are different modes of drug promotion which include visual aids, leave behind leaflets and audio visuals. Drug Promotional Literatures (DPL’s) claim to provide vital and accurate information regarding the drug. To ensure rational use of drugs a set of standards laid by the WHO for ethical drug promotion.Methods: A cross sectional observational study was performed in Department of Pharmacology at a tertiary care teaching hospital of Navi Mumbai. A total of 100 drug promotional literatures were randomly collected from different outpatient departments and were evaluated by using WHO guidelines.Results: None of drug promotional literature fulfilled all WHO criteria. Generic name, Brand name, active ingredients were mentioned in all. The problem causing ingredient was not mentioned in any of the cases. Safety information was not complete, adverse drug reactions were mentioned in only 45% of the cases, contraindications and drug interactions were mentioned in 39% of the cases. Manufacturer details including name and address of manufacturer was mentioned in 67% of the DPL’s. References were mentioned in 80% of the literature out of which 84% were from journal articles.Conclusions: None of the DPL’s satisfied all the WHO criteria. Incomplete information may lead to irrational prescription of drugs. Therefore, more strict regulations need to be implemented and physicians must critically evaluate DPL’s before considering the same for prescribing.

Analysis of Hot Spots in the Field of Pharmacy ——Taking China Pharmacy as Example / 中国药房

OBJECTIVE： To explore current hot spots in drug research and application，and provide reference of the draft use standard for pharmacy journal editor. METHODS： Taking China Pharmacy （short for our magazine） as example，all literatures published by our magazine and included by CNKI were searched during inception （Jan. 1990） and Mar. 19th， 2019； top 150 literatures [top 100 non-review literatures （NRA） and top 50 review literatures （RA）] were collected according to comprehensive score of downloaded number and citied number as indicators， and then analyzed in respects of publication year，column of NRA，first author’s work unit， subject words； one literatures which the cited number was largest was analyzed separately. RESULTS： Totally 150 literatures were published between 1993 and 2016， while the literature amount reached the maximum value in 2010 （18 articles）. Among NRA， the most were in the columns of “pharmacy administration” （44 articles， 44.00％）， “TCM and ethnic medicine” （18 articles， 18.00％）， “pharmacists and pharmaceutical care” （14 articles， 14.00％）. Among 150 first authors，73 （48.67％） were from college， 62 （41.33％） were from hospital. Subject words of NRA were “status and development” （20 times）， “active ingredient” （14 times）， “international experience” （9 times）， while those of RA were “pharmacological action” （25 times）， “Chinese herbal medicine” （15 times）， “active ingredient” （12 times）. The Principles and Utilization of Sequential Analysis of DDD System of Drug in Hospitals was cited for 1 426 times， which was much higher than the second one （261 times）. CONCLUSIONS： This study can show the good literatures origin and study direction，provide reference to the hot spots for readers. At the same time， high-frequency cited literatures also suggests that researchers can conduct in-depth analysis of controversial and unclear contents in academic circles.

Decipherment of herb medicine Nanwuweizi and Wuweizi in Chinese ancient literature / 中国中药杂志

Nanwuweizi( Schisandrae Sphenantherae Fructus) and Wuweizi( Schisandrae Chinensis Fructus) have long-term history of use as common traditional Chinese medicines since the Eastern Han Dynasty( AD.25-220 year).However their information are always confused in ancient literature because they were both used as " Wuweizi". Nanwuweizi and Wuweizi are faced with problems such as confused distribution of producing areas,unclear source plants and efficacy characteristics,which limit modern resource development and application. Based on ancient literatures of materia medica,this study conducted a systematic review from several aspects,i.e. the name,distribution of producing areas,source plants,efficacy characteristics and processing of the two medicines in ancient time. This study clarified five main aspects,as following,ancient production areas and corresponding modern distribution areas; source plants used for medicinal purposes in ancient time; application period and application scope; efficacy characteristics in clinical application;processing method. This study provides a reference for evaluating the quality and for their clinical application and reasonable development of Nanwuweizi and Wuweizi.

An observational study of various drug promotional advertising brochures: with an emphasis on World Health Organization ethical criteria for medicinal drug promotion

Background: Drug promotional literature (DPLs) is an integral approach of pharmaceutical marketing strategy, which can almost influence a physician to prescribe definite variety of medicine from a particular company. The objective was to evaluate the accuracy, consistency, and validity of the information in accordance with the World Health Organization (WHO) ethical criteria for medicinal drug promotion.Methods: This was an observational study, in which total 100 DPLs were sorted out to evaluate whether the information is consistent/relevant with that presented by the criteria laid down by the WHO guidelines; such as nature of claims, pictorial content presented, cited references, the indication and significance of various data such as figure, graphs, table and clinical data.Results: From all the 100 promotional literatures sorted out, all showed the INN name and brand name, amount of active ingredient, dosage form and name and address of manufacturers/distributers was shown in all; adjuvants known to cause problem were not shown. Moreover, approved therapeutic uses were clearly mentioned in 35, 48 were having pictures presented, scientific graphs and clinical data were shown in 19.Conclusions: The results reveal that, majority of DPLs satisfied only half of the WHO criteria for rational drug promotion and none of them fulfilled all the specified criteria. Incomplete or exaggerated information in DPLs may mislead and result in irrational prescription. Therefore, physicians should critically evaluate DPLs regarding updated scientific evidence required for quality patient care.

Critical appraisal of Drug Promotional Literatures (DPLs) as per World Health Organization (WHO) guidelines

Background: The study was aimed to critically analyse Drug Promotional Literatures (DPLs) using WHO guidelines. This would help to create awareness about DPLs amongst healthcare providers thus encouraging the improvement of healthcare system.Methods: This cross sectional observational study was carried out at Department of Pharmacology, Medical College Baroda. DPLs were collected & critically analysed for consistency, accuracy, validity of the provided information as per WHO guidelines.Results: Out of total 616 DPLs collected, 371 satisfied the inclusion criteria. None of the DPL was fulfilling all criteria according to WHO guidelines. Most of DPLs were having information regarding; generic name / INN (98.39%), brand name (100%), amount of active ingredient per dosage (94.07%), approved therapeutic uses (84.91%), dosage form (91.37%) and name & address of manufacturers (91.91%). Of all the DPLs, information provided for safety parameters like; name of active ingredient known to cause problem (11.59%), dosage regimen (32.88%), side effects & drug reaction (14.56%), major drug interactions (14.02%) and precautions, contraindications and warning (14.29%) seemed to be grossly neglected. Total of 431 claims were evaluated, of which the most common type of claim was efficacy (55.45%). Relevant references to claims were present in (48.74%) DPLs. Total 203 references were evaluated from 371 DPLs, of which maximum reference were from journal article (74.38%).Conclusions: From this study, it was concluded that pharmaceutical companies didn’t follow the WHO guidelines for ethical drug promotion, thus failing to fulfil the rational promotion of drugs. Given the present findings physicians should be cautious about drawing conclusions regarding medicine based on DPLs provided by pharmaceutical companies.

Medicine promotional literature as a source of updated information in Bangladesh: Do those advertising literature promote continued medical education or deceptive advertising?

Background: Drug promotional literature (DPLs) is an integral part of pharmaceutical marketing strategy. This marketing approach influences, a physician to prescribe definite variety of medicine from a particular company. Many physicians bank on exclusively in DPLs. This research was intended to appraise the DPLs available in Bangladesh for accuracy, consistency, and validity of the information in accordance with the WHO rules and regulations. Materials and Methods: This was a cross-sectional study was conducted in Uttara Adhunik Medical College, Dhaka, Bangladesh after collecting DPLs from the different outpatient department. The data was analyzed Microsoft Excel 2016. Results: None of the national and multinational DPLs fulfilled all the WHO criteria. Among the national and multinational DPLs, 94.7% and 100% presented with claims respectively. Out of 284 national and multinational DPLs references citation were presented in 82.04% and 100% respectively. Among the DPLs of national and multinational companies' relevant, irrelevant, and partially relevant pictures were presented in 48.79%, 24.65%, 26.76% and 31.58%, 26.32%, and 42.11%, respectively. Conclusion: DPLs of Bangladesh did not comply with the WHO guidelines while promoting their products. Evidence provided in those DPLs were mostly biased and persuasive since it is focusing mainly on the positive aspect of drug therapy. Accordingly, studied DPLs were principally aiming to maximizes industries' financial benefit rather than fulfill the educational aspects. The Government of Bangladesh should develop very stringent policy and practices regarding DPLs based on science and the WHO guideline as the literature very often act as a primary source of information among medical doctors.

Progress in Clinical Application of Anti-hyperthyroidism Drugs / 中国药师

Taking hyperthyroidism, anti-hyperthyroidism drugs and anti-hyperthyroidism combination as the keywords, 121 litera-tures on hyperthyroidism treatment were reviewed on CNKI and VIP database, and among them, 37 ones were selected as the represent-ative references. The clinical application was reviewed and summarized. Thiourea drugs are the first choice in the clinical treatment of hyperthyroidism;however, they show obvious side effects. Therefore, the drug combination use, especially the combination of Chinese and western medicines was proposed, which could rapidly improve the symptoms and the quality of life, reduce the dosage of western medicines and adverse reactions, and consolidate the curative effect and prevent the recurrence.

The Small Discoveries of Discussion on Differentiation of Internal and External Injury / 浙江中医药大学学报

Objective]To further demonstrate Li Dongyuan, in order to treatBianjing big epidemic diseasein 1232 so as to write this book,and the relevance of , Yin fire theory, Bianjing big epidemic disease and plague. We reread the book which contained symptoms, syndromes and editing order to further demonstrate. [Methods] Under the premise of affirming early stage researching background,to comb the three volumes of , containing the symptoms and the pathogenesis of the syndrome(Yin fire) and treatments rule of prescriptions, horizontal comparing types and symptoms of the plague, longitudinal contacting before and after the onset of epidemic disease with the logic of writingwhich contained symptoms and prescriptions. [Results] We suppose Li Dongyuan was to treatBianjing big epidemic diseasein 1232 so as to writeand theBianjing epidemic diseasewas the plague, combing analysis symptoms, syndromes and editing order of, it is not difficult to find that Li Dongyuan made the thoughts which had the consistency of treating the plague. The first and second volumes ofcontainingYin firesyndrome are similar with the beginning of the plague, and Li Dongyuan created Bu zhong yi qi decoction, Qing shu yi qi decoction by adding and subtracting for curing plague, the third volume contained the treatment to improper diet after the epidemic(e.g., dyspepsia, the wet). There also exists hesitations upon the dosages and forms of prescriptions are inconsistent with the epidemic disease, and the time when Li Dongyuan finished this book etc. [Conclusion] Since the 1960s, scholars analyzed and interpretated Yin Fire in a variety of pathogenesis according to , stomach from internal injuries as a starting point, but it still does not have an intuitive understanding,such thinking and contact unavoidably has less rigorous, but from the perspective of historical background and modern disease interpretation of the classic of traditional Chinese medicine, it is a good way to research of TCM literature mystery,but also from a broader perspective to understand these issues.

An analytical survey of promotional drug literatures at C. U. Shah Medical College and Hospital, Surendranagar.

Background: The research and marketing of a new drug requires a lot of money by the pharmaceutical companies. Promotion through advertising brochures and leafl ets is widely used to infl uence the physicians. Most of the times, this information is the only source of new drug information for the physicians. Hence, this study to analyze the appropriateness, accuracy, and validity of promotional drug literatures was undertaken. Methods: Promotional materials were collected from outpatient departments of C. U. Shah Medical College and Hospital, Surendranagr. They were evaluated according to the “WHO criteria, 1988,” and the references cited to support the claims were checked for their validity and authenticity. The images and the pictorial content were evaluated to fi nd out any biased nature of gender representation. Results: Evaluation of the total 486 brochures showed that none of them fulfi lled all the nine criteria. Of the 308 claims, only 208 (42.79%) gave references to support the claims. Only 27 (39.13%) of the research articles among the 125 journal article cited were of high methodological quality. Among the 218 human fi gures, 144 were patients, and 103 were doctors. Female patients (62.5%) were depicted more than male patients (37.5%). Conclusion: The present study showed that pharmaceutical companies do not strictly follow the WHO guidelines and majority of the research were sponsored by companies. Hence, more stringent regulations need to be implemented for the proper promotion and dissemination of information about the new drugs.

Evaluation of Adherence of Drug Promotional Literatures (DPLs) to World Health Organization Guidelines.

There is limited mechanism to monitor the drug promotional campaign by pharmaceutical industries despite the fact that there is enough evidence of irrational pharmacotherapy increasingly encountered even in the developed countries. Unethical pharmaceutical promotional practice is a common cause of irrational pharmacotherapy which is a most common problem worldwide. Main objective of this study was to evaluate the medicinal promotional literatures provided by the pharmaceutical companies for accuracy, consistency and validity of the information presented in it, using World Health Organization (WHO) criteria for ethical medicinal drug promotion. Two hundred & fifty (n=250) literatures were collected randomly from selected doctors chambers in Barisal, Bangladesh. One hundred & thirty (130) of those literatures were excluded for being either duplicates, reminder literatures, promoting medical devices or cosmetics. The remaining (120) literatures were then screened to match their macro-informational contents against same advised in world health organization ethical criteria for medicinal drug promotion. The name of active constituent(s), content of active ingredient(s) per dosage form & brand name, were mentioned in 100% (n = 120) of promotional literatures, whereas dosage form were mentioned in 91.66% (n = 110), therapeutic indications were mentioned in 99.1% (n = 119) of literatures but informations on side effects mentioned in only 55.33% (n = 70), contraindications in 63.33 % (n = 76), precautions in 51.67% (n = 62) & references in 70 % (n = 84) of drug promotional literatures (DPLs). None of them mention anything about adjuvant. None of the promotional literatures fulfilled all the WHO criteria. Screened literatures were found to display poorly reliable and unbalanced medication information. Healthcare providers shall, accordingly, seek independent medicinal information sources, and not solely depend on commercial sources of medicinal information. Official regulators shall strictly define and mandate medication information contents in printed pharmaceutical promotional materials. Healthcare providers should, also, master the skills of appraising such promotional printed materials if rational medication use is to be achieved. Pharmaceutical industries did not follow the WHO guidelines while promoting their products, thus aiming to satisfying their commercial motive rather than fulfilling the educational aspect of promotion.

Scientific assessment on the outcome of clinical application with peripheral nerve graft materials / 中华显微外科杂志

Objective To discuss how to assess scientifically on the outcome of clinical application with peripheral nerve graft materials. Methods All Pubmed database from 1990 to 2010 were retrieved,and searched the English literatures about the application with peripheral nerve graft materials. The literatures consisted of original clinical research and review excluding animal experiments, repetitive research and irrelevant literatures. The clinical trials data of U.S. was also our target. The information about the safety and effectiveness of peripheral nerve graft materials and related statistical problems were discussed. Results Totally 1578 literatures were identified. Following reading titles and abstracts, we excluded some irrelevant articles. Finally 31 literatures and 2 issue of clinical research from clinical trial data of U.S. were included. After analysis on the literatures, we gained the following results: a remarkable degree of homogeneity among patients can be formed by setting the inclusion and exclusion criteria. For the assessment of proper digital nerve repair, Macknnon- Dellon evaluation is commonly applied, but for the composite nerve, BMRC evaluation is the main method and electromyography can be used as a secondary choice. The safety of peripheral nerve graft materials cannot be evaluated throughout one's life according to the current level of science and technology. It should be evaluated by long-term clinical observation. Randomized clinical trials with random grouping was a gold standard for clinical trials with a good balance and strong comparability. However, non-randomized controlled trials also have an important value. Conclusion It is impossible to make all affected factors homogeneity in a limited timespace conditions of clinical trial. However, we can try our best to keep factors homogeneity to maximum degree by setting the inclusion and exclusion criteria. The scientific assessment of outcome of peripheral nerve repair can be carried out with reasonable and internationally recognized nerve function evaluation methods, strict follow-up time and statistics programme meeting the clinical requirement.

Metrological analysis of literatures from 1987 to 2008 on breast reconstruction in China / 中华内分泌外科杂志

Objective Metrological literature analysis of breast reconstruction from 1987 to 2008 in China,in order to illuminate the process of breast reconstruction's development and to predicts the mian tendency of breast reconstruction in the future.Methods Papers about breast reconstruction from 1987 to 2008 on Chinese Medical Current Content (CMCC) and Chinese Bio-medical Literature Database (CBMdisc) were Metrologically analyzed according to journal,institute,surgeon method,optimal time,content and so on.Results In all 247 collected,the first place in order of first jourual,institute,author,area,surgeon methods,optimal time were as follow:Chinese Journal of Aesthetic and Plastic Surgery (15 papers),China Chinese Academy of Medical Sciences and Peking Union Medical College (46 papers),Qi Fazhi (9 papers),Beijin(56 papers),latissimus dorsi perforator flap breast reconstruction,and transverse rectus abdom in is myocutaneous flap breast reconstruction,immediate reconstruction.Conclusions This paper which outlines some features of papers published in China on breast reconstruction in rencent 21 years provides a credible resource for further study.The immediate latissimus dorsi perforator flap breast reconstruction would be the main trend of it's further development.

Acquisition and Screening of TCM Literatures in Non-TCM Periodicals / 国际中医中药杂志

In order to screen and get TCM literatures from non-TCM periodicals,knowledge on types of literature is the first thing one has to be familiar with.Secondarily,one should pay attention to get literatures from multiple subjects and different angles.At last,invisible key words and relative information should also be noted.

O processo como alegoria de ser Judeu: Franz Kafka e um de seus destinos / The Trial and its outcomes: Kafka and his vicissitudes

A literatura de Kafka, produzida no alvorecer do século XX, é mais um processo em andamento na Europa fin-de-siècle. É a escrita de um jovem que busca, para além de seu trabalho burocrático, um sentido para estar ali. Sua produção literária é a tentativa de dar conta desse mundo que não permite uma apropriação, que ora o incorpora, ora o exclui, por sua condição judaica. Condição muitas vezes secundária para ele e os de sua geração, mas que não deixa de marcá-los significativamente. Marcas involuntárias, que não os abandonam e retornam conforme as produzem. Marcas que caracterizam e permitem a construção de uma obra e de uma vida. Aqui tenta-se ler os vestígios dessa tradição abandonada, mas que não se deixa apagar. Que retorna, que impulsiona a produção, não como uma Musa, mas sim como angústia e necessidade de produzir.

Kafka's literature is one of the many intellectual projects underway in the European fin-de-siècle. It is the work of a young man in search of a meaning for being there, despite his bureaucratic work at a government agency. His literature is an attempt to get a hold of a society that sometimes accepts him and sometimes rejects him, for his Jewish background. A background usually not considered by him and his fellows, but always present in many different ways. It is this background that gives way to his literary production and, thus, his own life. This paper is an attempt to read the Jewish background that is behind Kafka's work, a background always present, which works in favor of his production, not as a Muse, but as anguish and the necessity to write.

Major causes of diabetes in ancient literatures / 中华中医药杂志

In this article,the author analyzes the major causes of diabetes at large.They can be divided into deficiency of yin,weakness of five zang organs,improper diet,intemperance in sexual life,metal stimulation,emotional stress,attack by six climate exopathogens,disoperation by toxin and pathogen,over-taken powder,transformation into dryness and damage to fluids and so on.This article offers some valuable clinical bases for the study of this kind of disease.

Comparison of Pharmaceutical Literatures from Commonly Used Chinese Periodical Databases and Automatic Processing of the Retrieved Literatures / 中国药房

OBJECTIVE:To provide references for pharmaceutical workers in retrieving literatures by means of Chinese bi_omedical database(CBM),China journal full-text database(CNK) and Chinese science & technology journal database(VIP).METHDOS:With the commonly research topics of hospital pharmacy as research scope,literatures retrieved by database sampling underwent a preliminary contrast analysis and a computer-assisted automatic meta-analysis after programming.RESU_TLS:None the 3 databases indexed all the tested pharmaceutical periodicals(totaled 79 kinds).There were differences among the un-indexed periodicals, except a few are the same in kinds.The retrieved literatures of docuterm had a high proportion of repetition;however,the computer had merged the same literatures retrieved in different databases.CONCLUSIONS:The literatures indexed in the 3 databases have their own characteristics,thus literature recall ratio can only be improved by combining multiple databases.The automatic meta-analysis of the retrieval literatures can be performed by means of computer program,the repeated work can be reduced thereafter.

Systemamtic Evaluation of Clopidogrel Combined with Atorvastatin in the Treatment of Ischemic Cardiovascular Disesase / 中国药房

OBJECTIVE:To investigate the effects of clopidogrel plus atorvastatin on ischemic cardiovascular diseases and to explore the clinical significance of drug interactions.METHODS:Literatures were retreived from EMBase,PubMed,Cochrane Library and CNKI with clopidogrel,atorvastatin,clinical trial as

Pharmacoeconomics Applied to Clinical Practice on the Basis of EBM from the Perspective of a Pharmacist / 薬剤疫学

Little pharmacoeconomic data is available in Japan. Numerous studies of economic evaluation of medications have been published in major English language journals to date. In order to effectively utilize the economic evaluation, information previously reported in many types of medical journals, we must evaluate and appraise them according to medical trends in Japan. It is necessary to have skills to critically appraise the validity of published literature and to strictly validate their quality. As a result, it will become possible to make many types of pharmacoeconomic data applicable to each clinical practice by using a criterion on pharmacoeconomic research from the perspective of a pharmacist.

Textual Research on Bian Que's Writings / 中医杂志

The authors advocate that Bian Que lived iil the end of Spring - Autumn Period. Although personal writing first appeared in the Warring States; there were medical officials in all the States, the achievements of whom were examined by their the authority based on their own original records. Moreover. Chang Sangjun. Bian Que's tutor, "left all his secret books on recipes to Bian Que". Hence, the likelihood of appearance of medical monographs in Bian Que's age is very high. His discussions on morbid pulse and normal pulse were also inherited and developed.