Strategies of drugs cost containment in hospital: A systematic literature review.

BACKGROUND: In recent years, the world's health system faces with increasing trend of costs. In this regard, Hospital is one of the environments that consumes a large share of the total expenditure of the health system. Medications are one of the most expensive components in hospitals, which require appropriate measurements to control and reduce costs. The present systematic review was conducted to identify strategies and actions for cost containment in hospital. METHOD: Using the PRISMA protocol, a systematic review of the texts was performed to identify strategies and actions for reducing drug cost. In this systematic review, the selected keywords were searched in the following databases: web of sciences, Scopus, PubMed, Google Scholar, and Embase. The inclusion criteria included English-language articles, hospital-level studies, and those studies performed on reducing and controlling hospital costs. The exclusion criteria also included the followings: primary health care studies, non-English language studies, health system studies, and studies solely focussed on the cost-effectiveness of a particular drug. The quality of these articles was investigated using the checklist adapted and modified in the present study. RESULTS: A total of 4696 articles were identified from the reviewed databases and 26 articles were identified from some other sources. After removing duplicate studies and reviewing the title, summary, and full text of articles using reference check and supplemental search, 21 articles were finally included. A number of strategies or managerial actions were extracted from the final articles. According to the qualitative results, qualitative meta-synthesis was used and after eliminating duplicate solutions, the data were classified into five groups: procurement, storage, distribution, prescription, and use. CONCLUSION: According to the increasing cost of medicines, some hospital managers now attempt to reduce hospital costs using drug chain management. Drug cost reduction strategies can be applied for any component of drug chain management such as procurement, storage, distribution, prescription, and use. Also, proper implementation of these strategies and rationalisation of drug use will result in more efficiency of the hospital.

Do highly cited clinicians get more citations when being present at social networking sites?

BACKGROUND AND AIMS: The advent of social networking sites has facilitated the dissemination of scientific research. This article aims to investigate the presence of Iranian highly cited clinicians in social networking sites. MATERIALS AND METHODS: This is a scientometrics study. Essential Science Indicator (ESI) was searched for Iranian highly cited papers in clinical medicine during November-December 2015. Then, the authors of the papers were checked and a list of authors was obtained. In the second phase, the authors' names were searched in the selected social networking sites (ResearchGate [RG], Academia, Mendeley, LinkedIn). The total citations and h-index in Scopus were also gathered. RESULTS: Fifty-five highly cited papers were retrieved. A total of 107 authors participated in writing these papers. RG was the most popular (64.5%) and LinkedIn and Academia were in 2nd and 3rd places. None of the authors of highly cited papers were subscribed to Mendeley. A positive direct relationship was observed between visibility at social networking sites with citation and h-index rate. A significant relationship was observed between the RG score, citations, reads indicators in RG, and citation numbers and there was a significant relationship between the number of document indicator in Academia and the citation numbers. CONCLUSION: It seems putting the papers in social networking sites can influence the citation rate. We recommend all scientists to be present at social networking sites to have better chance of visibility and also citation.

A study of West Nile virus infection in Iranian blood donors.

BACKGROUND: West Nile virus is a mosquito transmitted virus that can cause disease in humans and horses. A majority of people infected with WNV will have no symptoms or may only experience mild symptoms, such as headaches. About 20% of infected humans develop a flu-like illness characterized by fever; while in the elderly and immunocompromised West Nile virus can cause a more serious neurologic disease and may be fatal. West Nile virus infection is endemic in the Middle East. West Nile virus can also be transmitted by transfusion through infected blood components.The objective of this study is to find the West Nile virus-RNA incidence and anti-West Nile virus prevalence amongst Iranian blood donors in order to determine whether this emerging infection is a possible risk for the blood supply in Iran. METHODS: Serum samples from 500 blood donors who donated blood at the Tehran Blood Transfusion Center were collected between May and October 2005. Serum samples were examined for IgM and IgG antibodies to West Nile virus using the ELISA method. The samples were tested for the presence of West Nile virus RNA by the real-time RT-polymerase chain reaction assay. All data were analyzed statistically using the Chi-Square test. RESULTS: All 500 donors were negative for West Nile virus-specific IgM antibody at the time of donation. No WNV RNA-positive samples were detected. The percentage of seropositivity of IgG antibodies to WNV was 5% at donation. CONCLUSION: No evidence of WNV-specific IgM antibody and WNV RNA in blood donor samples was found. In order to increase the safety of blood donation, it is essential to continue surveillance of this emerging infection in order to protect the blood supply in the future.

Prevalence and trends of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among blood donors in Iran, 2004 through 2007.

BACKGROUND: Evaluation and monitoring the prevalence of transfusion-transmissible viral infections in blood donors is a valuable index of donor selection and blood safety. This study analyzed the trends of blood-borne infections among Iranian blood donations during 4 years. STUDY DESIGN AND METHODS: Viral screening results of 6,499,851 allogeneic donations from 2004 through 2007 were analyzed. All donations were screened for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis. The prevalence of HBV, HCV, and HIV infections per 100,000 donations and 95% confidence interval was calculated. The p value was estimated by chi-square test. RESULTS: The prevalences of HBV, HCV, and HIV decreased during the 4-year study from 2004 through 2007. The overall prevalence was 0.56% for HBV, 0.004% for HIV, and 0.13% for HCV. There was a significant and impressive decrease in hepatitis B surface antigen prevalence from 0.73% in 2004 to 0.41% in 2007. The prevalence of HIV appeared to have decreased from 0.005% in 2004 to 0.004% in 2007 although the decrease was not significant. HCV prevalence showed a slight decline in blood donations from 0.14% in 2005 to 0.12% in 2007. CONCLUSION: The trends of transfusion-transmitted infection prevalence in Iranian blood donations suggest that most of the safety measures employed in recent years in Iran have been effective.

The prevalence of SEN virus infection in blood donors in Iran.

BACKGROUND: SEN virus is a blood-borne, single-stranded, nonenveloped DNA virus. Two of its strains (D and H), appear to be associated with non-A-to-E hepatitis more frequently than the others, although it is not clear whether this observation has any significance. The prevalence of SEN virus in otherwise healthy individuals, including blood donors, differs markedly by geographic region. In this study, an investigation to evaluate the prevalence of SEN virus strains among blood donors in Tehran was carried out. METHODS: Sera of 260 blood donors who were negative for hepatitis B surface antigen (HBsAg) and third-generation hepatitis C virus antibody (anti-HCV) were tested for SEN virus-D and -H DNA. DNA was extracted from plasma of 260 blood donors and amplified by semi- nested polymerase chain reaction. RESULTS: SEN virus-D viremia was detected in four (1.5%) of the 260 blood donors (95% confidence interval (CI), 0.0 - 3%). SEN virus-H viremia was detected in 47 (18.08%) of the 260 blood donors (95% CI, 13.4 - 22.8%). Both SEN virus-D and SEN virus-H viremia were detected in nine (3.4%) of the 260 blood donors (95% CI, 1.2 - 5.7%). SEN virus-D or SEN virus-H viremia was identified in 60 (23.08%) of the 260 blood donors (95% CI, 18.08 - 28.08%). CONCLUSION: Out of the 260 blood donors, 60 (23%) were infected by SEN virus-D/H. The prevalence of SEN virus-H is more than SEN virus-D. Our results also showed that the high prevalence of SEN virus in healthy blood donors with no history of blood transfusion may attribute to the transmission modes other than parenteral transmission.

Frequencies of HLA-DRB1 in Iranian normal population and in patients with acute lymphoblastic leukemia.

BACKGROUND: Recognition of HLA alleles is useful in transplantation and in anthropological and disease studies. Acute lymphoblastic leukemia (ALL) is the most common blood cancer. It is now generally agreed that both genetic and environmental factors play an interactive role in the development of ALL disease. It is unknown whether there exists a restriction to certain MHC genotypes in leukemia like ALL. METHODS: Genetic construct of HLA DRB1 was studied in Iranian normal populations and in patients with acute lymphoblastic leukemia using PCR-SSP method. RESULTS: It was shown that the most common allele in DRB1 locus in normal population was DRB1*11 (20%), whereas DRB1*09 was the least frequent allele (0.9%). Additionally, this study presented the results of HLA-DRB1 typing in 106 ALL patients and compared them with normal individuals. Comparison of the results between the normal population and the patient group revealed that there was allelic association between the DRB1*13 and the disease. Results showed that the difference between the frequencies of DRB1*13 in patients and normal individuals was significant (p=0.04), but there was a moderate difference among the frequencies of DRB1*04, *07, and *09 in childhood (0-15 years) ALL. The frequencies of DRB1*13, *04, and *07 in patients were 2.5, 16, 4.5% and, in normal individuals, were 11.4, 10, and 8.3%, respectively. CONCLUSIONS: It should be concluded that DRB1*13, which showed a decrease in patients, should be protective against acute lymphoblastic leukemia (ALL), whereas DRB1*04, which was moderately increased in patients, could be considered a susceptible allele for childhood ALL.