Current Disposal Practices of Unused and Expired Medicines Among General Public in Delhi and National Capital Region, India.

BACKGROUND: Stocking unused or expired medicines or donating these to others can lead to accidental or inappropriate ingestion, increasing the risk of adverse drug reaction(s) and even lead to antibiotic resistance. Further improper disposal of expired or unused medicines is associated with environmental pollution, health hazards and damage to ecosystem. Ecopharmacovigilance is an important area in this context. OBJECTIVE: To explore the awareness and disposal practices of unused/expired in the general public. MATERIALS AND METHODS: The current study is an observational, cross-sectional, questionnaire-based study conducted in 956 medicine consumers in New Delhi and National Capital Region, India. The knowledge, attitude, and practice of consumers regarding the disposal of unused medicines were evaluated. RESULTS: The majority (89.9%) of consumers opined that expiry of medicine(s) meant for completion of shelf life, production of toxic chemical and loss of or decreasing of beneficial effects of medicines. Majority (87%) of the consumers stored medicines at home. Almost all (92.6%) of the consumers threw away the expired medicines after storing for few days. Consumers discarded the expired medicines mainly in household trash (73%). The majority (93%) of consumers were in favour of a government program to collect unused or expired medicines from their home. CONCLUSION: The knowledge and practices of consumers towards disposal of unused and expired medicines needs to be improved. Health care professionals, government and policy makers should offer training to educate and guide the general public on safe and proper disposal practices of expired or unused medicines.

Predictive value of symptoms for quality of life in first-episode schizophrenia.

BACKGROUND: Management of the disease symptomatology impacts the long-term functioning and quality of life (QOL) in psychotic patients. AIM: The aim of this research was to study the association between psychiatric symptoms (positive, negative and general psychopathology symptoms) and QOL in first-episode schizophrenia patients. METHODS: Fifty-five first-episode drug-naïve schizophrenia outpatients were recruited from a tertiary care hospital in New Delhi, India. WHOQOL-Bref (World Health Organization Quality of Life) Scale was used to assess multi-dimensional domains of QOL (physical, psychological, social and environmental health). The patients were evaluated clinically using PANSS and followed up for 6 months. Multivariate analyses were carried out to outline the symptoms which are predictive of QOL in these patients. RESULTS: Physical well-being as assessed with WHOQOL-Bref is significantly impacted by the positive, negative and general psychopathology symptoms of the disease. General psychopathology symptoms demonstrated a strong relationship with different facets of QOL. These symptoms are predictive of physical (P=0.025) and psychological health (P=0.026), social relationships (P=0.009) and environmental QOL (P=0.022). CONCLUSIONS: The general psychopathology symptoms significantly impact QOL in a diverse manner. Negative symptoms have a greater influence than positive symptoms on subjective QOL. CLINICAL IMPLICATIONS: The antipsychotics focus on primary positive and negative disease symptoms. There is a need to develop a holistic approach (target non-psychotic symptoms intensively) in the disease management to prevent further long-term impairment of QOL.

Adverse drug reactions: trends in a tertiary care hospital.

BACKGROUND: Pharmacovigilance (PV) System is an integral part of drug therapy which helps in detection, monitoring and designing strategies to minimize the occurrence of adverse drug reaction (ADRs). Present study was planned to study the patterns of ADRs in a tertiary care government hospital. METHODS: The present study was carried out for a period of one year. Suspected adverse drug reaction reports due to medications submitted to the Department of Pharmacology under the Pharmacovigilance Programme of India were included. The reports were analyzed for their type, severity, organ system involvement, and the causality assessment was performed using Naranjo Probability Scale. RESULTS: A total of 520 ADRs were received. The highest percentage (66.2%) of ADRs was seen in adult patients. Female patients experienced more (57.5%) ADRs. 95% of ADRs occurred in patients receiving 5 or more drugs. Medicine department reported the maximum number (38.46%) of ADRs. Antimicrobial agents (AMA) (35.7%) were the commonest group of drugs causing ADRs. Amongst the organ systems affected, skin constituted a major component (40.4%). Causality assessment revealed that 55% of the ADRs were possible. Majority of the ADRs were non-serious and only 7 cases were serious and required hospitalization. CONCLUSION: The results suggest that healthcare professionals (HCP) at this institution are cognizant of PV. However a closer liaison between the HCPs and the hospital PV centre, periodic reinforcement of the HCPs regarding the need for PV can further improve spontaneous reporting. The data will also help in designing strategies for framing policies towards safer use of drugs in future.