Development of a Biobank from a Legacy Collection in Universitas Gadjah Mada, Indonesia: Proposed Approach for Centralized Biobank Development in Low-Resource Institutions.

Introduction: The establishment of a biobank requires specific expertise along with relatively expensive infrastructure and appropriate technology. This causes certain challenges in biobank implementation for research in low-middle-income countries. Biobank development with established specimens and data collection (legacy collection) was an approach used in the Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada. This approach aimed to identify the resources available at present, while providing nontechnical information for further development of a centralized biobank. Materials and Methods: Retrospective modeling was done in 2015 by recruiting existing specimen collections and their associated data. The steps were as follows: (1) informing research stakeholders through discussion with experts and stakeholders; (2) identifying specimen collections to be used; (3) determining the system, infrastructure, and consumables needed; (4) determining inclusion criteria; (5) building an in-house database system; (6) organizing data and physical specimen collections; and (7) validating data and physical sample arrangement. All technical procedures were built into standard operating procedures. Results: The model included specimens from one -80°C freezer. The associated data included demographic, clinical diagnosis, and physical sample information. Samples came from six studies, collected between 2001 and 2014. A web-based database was built based on the MySQL programming system. Information on biospecimens from a total of 4196 subjects collected in 11,358 vials was entered into the database, following physical rearrangement of vials in the -80°C freezer with one-dimensional barcodes taped to vials, boxes, and racks. A validation test was done for data concordance between the database and physical arrangement in the -80°C freezer, showing no discrepancies. Conclusion: This report demonstrated current technical and nontechnical insights to further develop a centralized biobank for health research at an academic institution in Indonesia.

Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy.

OBJECTIVE: To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe. METHODS: This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents. RESULTS: FINDINGS FROM THIS CHART REVIEW INCLUDE: 28.8% of the prescribed medications were not effective for the documented condition, 26.3% of the prescribed doses were incorrect, and 44.5% of the drugs prescribed were not the least expensive alternative. DISCUSSION: This preliminary study suggests a need for a focused intervention with family medicine residents regarding inappropriate polypharmacy issues with older patients.