Objective To analyze the costs of emergency medication in the West China Hospital within one month after Lushan earthquake based on actual medication of the victims’ disease spectrum. Methods We collected emergency medication data as evaluation index in the West China Hospital within one month after Lushan earthquake, including daily cost, cumulative percentage of pharmacology category, average cost per day/person, average cost per day/person when DUI=1, difference between average cost per day /person, and average cost per day/person when DUI=1, etc. Then, we input data using Excel software for statistically analyzing the costs of emergency medication within one month after the earthquake. Results During one month after the earthquake, the costs changed consistently with the number of victims, which implied the change of costs was rational. Injuries were classified into 6 categories and 12 kinds according to ICD-10. The costs of medication accounted for 71% of the total costs. Six kinds of illness accounted for 21%. Medication for injuries was classified into 3 categories and 18 kinds; average cost per day was 186.87 yuan and average cost per person was 1 702.70 yuan. Medication for illness was classified into 5 categories and 28 kinds; average cost per day was 38.96 yuan and average cost per person was 185.13 yuan. The mean value of average cost per day/person of injection was 14.52/5.08 times more than that of non-injection. Meanwhile, the mean value of average cost per day/person of imported medication was 7.10/5.28 times more than that of domestic medication. Conclusion The factors that impact the medication costs include: a) disease burden and traumatic conditions of the sick and wound; b) administration pathway (injection vs. non-injection); c) imported or domestic medication; and d) the rationality of taking DUI as evaluation index. When DUIgt;1, injection through the vein and imported medication take a larger share which increase the costs of medication. Emergency rescue package should mainly prepare for the injury. In order to ensure the timely, safe and effective medication, injection should be given priority to. We also should take into consideration crash-resistance/anti-quake package, reasonable dosage, convenience-to-use of drugs as well as the needs of the illness.
Objective To investigate the information of label use of high-alert drugs for children of high risk population, in the Military General Hospital of Beijing PLA. Methods We selected high-alert drugs used in this hospital as objectives. The package inserts of these drugs were investigated and medication parts for children were analyzed. Results 201 drugs regarded as high-alert drugs were included, of which only 78 drugs have accurate detailed description of medication for children, accounting for 38.8% of the total of investigated high-alert drugs. Conclusion Children, as high-risk population, needs more attention concerning the use of high-alert drugs. However, risks in the use of high-alert drugs increased due to the lack of the information of label use of high-alert drugs. To ensure the safety of drug use in children, the information of drug use for children in the package inserts should be urgently supplemented.
Objective To study medication usage in women and children from the distress area related to the Wenchuanearthquake. Methods Information about which medications that 329 patients used in West China Second University Hospital,Sichuan University was collected by the HIS system and classified by using the ICD-10system.The cases and times of medication, the total number of drugs, the drug cost per capita, and the drug cost per day were calculated using Excel. The defined daily dose (DDD) and drug utilization index (DUI) were analyzed. According to the principle of DDD amp; DUI, CDDD amp; CDUI were designed to analyze the drugs used by children. Results A total of 398 drugs in 25 categories were applied to 329 patients. Every case used infusion solutions, the DDDs of vitamins were the highest, the usage and duration of vitamins and antibacterial agents were the longest among the 25 kinds of the drugs. The cost of Amoxicillin Sulbactam injection was the highest. Many kinds of medications were prescribed to these patients,the rate of DUIgt;1 vs DUIlt;1 are 32.3% amp;47.2%. The results of CDUI indicated overuse of drugs was serious in children less 1yr old.The CDUI of precortisyl was the highest:40 to 80. Conclusions The system for distribution of medication to patients to children and women during an emergency is flawed. According to our findings we make new suggestions for changes, which have to be proved by further research.
Objective To investigate the medication usage in 55 children with urinary tract stones due tomelamine contaminated milk powder who were treated in West China Second University Hospital, Sichuan University werecollected. Methods The hospital’s patient records for the 55 melamine poisoning cases leading to urinary tract stones.Using Assess and excel software to analyze the frequency and sum of drug use, as well the average daily costs and per capitacost for patients. Results For the 55 cases of urinary tract stones, a total of 19 categories and 117 kinds of drugs were used. It was been found that Herba Lysimachiae granules were the most used medicine. The most costly was Cefminox, and finally the drug used in the highest quantity was 0.9 percent sodium chloride injection, the drug cost distribution is unevenness.Conclusions The rationality valuation for children medication lacks of international vulgate index, methodology and needs more basic research. It is worth to study the burden of children with basic disease.
Objective To study the medication usage in children with crush syndrome in Wenchuan Earthquake. Methods The information of the medications of 7 children with crush syndrome in West China Second University Hospital, Sichuan University was collected by medical history. The cases and times of medication, the total number of drugs, the drug cost per capita and the drug cost per day were calculated by Excel. Results A total of 113 drugs in 19 categories were appl ied to 7 children with crush syndrome. Most children used Vitamins and antibacterial agents. The cost of gamma globul in injection was the highest. Conclusions The rational ity valuation for children medication lacks international vulgate index and needs more basic research.
Objective To study the medication usage in patients with severe acute respiratory syndrome (SARS). Methods The information of the medications of 680 patients with SARS in Xiao Tang Shan Hospital was collected by HIS system and classified by using computer model on the basis of disease factor. The usage time and cases, and cost of these medications were calculated. The defined daily dose (DDD) and drug utilization index (DUI) were analyzed. Results A number of 359 drugs in 17 categories were applied to 680 patients with SARS. Most cases used antibacterial agents, the DDDs of immunomodulator and vitamins were the highest, the usage duration of vitamins and infusion fluids were the longest among 17 kinds of the drugs. The cost of methylpredni-solone injection was the highest. The mortality rate, kinds of drugs and frequency of drugs were higher in type C, type D and serious SARS patients than that of type A and common SARS patients. Conclusions Many kinds of medications have been prescribed to SARS patients. The dosages of these medication are very high, especially glucocorticoids, immuneomodulator and nutrient agents. The computer model on the basis of disease factor is probably valid, rapid and easy to standardize.
ObjectiveTo analyze the influence factors of the stable angina pectoris patients' medication compliance based on health belief model. MethodsFrom January to December, 2013, 107 patients with stable angina pectoris were interviewed using the self-design questionnaires, and multiple stepwise linear regression statistical was used to analyze. ResultsThe influence factors of increasing medication compliance were as follows:"myocardial infarction can lead to death", "patients with stable angina pectoris may suffer a sudden myocardial infarction", "over the past year the number of the angina pectoris", "standard treatment is good for prevention of myocardial infarction", "suffering myocardial infarction, even if not dying, there is no more chance to live", "take medicine on time can get family's praise", and "among the people that I know there are patients who die of myocardial infarction". The partial regression coefficients were 0.245, 0.251, 0.248, 0.099, 0.234, 0.162, 0.095, respectively; while "worry about side effects of the drugs", "can't afford the medicine", the partial regression coefficients were -0.164 and -0.114. ConclusionHealth belief model is helpful for general practitioners to evaluate the effect factors of medication compliance on stable angina pectoris.
ObjectiveTo summarize and improve the nursing skills of medication for hemodialysis patients. MethodsWe observed and took nursing measures for adverse medication events in 280 hemodialysis patients treated in our dialysis center from July 2013 to December 2013, and actively prevented all kinds of complications caused by medications. ResultsIn this group of patients, 26 had adverse drug events. Five patients with bleeding after central venous catheter indwelling were cured by changing the dressings. One patient had heparin induced thrombocytopenia, and the complication disappeared after the use of non-heparin hemodialysis. One patient had urokinase allergic reaction, and the complication disappeared by cardio-pulmonary resuscitation. One patient had EPO associated pure red cell aplastic anemia, and the patient did not suffer from it any more by changing the EPO. Two patients with high blood pressure recovered to normal by reducing the use of blood for rHuePO. One had allergic reaction for Iron Dextran Injection and was successfully treated by ICU. Six patients with severe reactive hypoglycemia were corrected quickly by intravenous injection of 50% glucose injection. One patient with adverse reaction to levocarnitine was cured by lowering the frequency of medication to one time per week. Two patients had flu-like symptoms after the use of biological agents were cured by stoppage of the medicine. ConclusionAdverse drug effect should be carefully observed, and patients' education and nursing skills of medical workers should be improved to ensure the medication safety of hemodialysis patients.
ObjectiveTo investigate the use of anti-hypertensive drugs among hypertension patients in examination medical center. MethodThis was a cross-sectional survey. Data of 3 000 cases of medical examination center health records from December 2012 to December 2013 were sampled, and 1 310 patients with hypertension were screened for analysis of medication. ResultsIn the 1 310 hypertension patients, 959 used antihypertensive drugs before, among whom 423 (44.11%) accepted only one anti-hypertensive drug and 536 (55.89%) accepted compound anti-hypertensive drugs or combined medicine. In patients of the previous kind, calcium channel blocker classes of antihypertensive drugs were used the most (n=244, 25.44%). Among the second kind of patients, 359 (37.43%) were treated with a two-compound drug or a combination of two drugs, and most of them used the combination of calcium channel blocker with angiotensin receptor blocker or calcium channel blocker with angiotensin converting enzyme inhibitor. ConclusionsThe current using of anti-hypertensive drug is in accordance with the recommendation of anti-hypertensive treatment guidelines in some way, but there are still some gaps between real clinical practice and guidelines.
Objective To explore the hormone medication compliance in children with chronic kidney disease (CKD) and analyze its influencing factors. Methods Between May and December 2013, 96 children were investigated by questionnaires about medication compliance when they were out of the hospital. Then we analyzed the influencing factors for medication compliance. All the data were analyzed by SPSS 19.0 software. Results Of these 96 children, medication nonadherence accounted for 52% (50). The main guardian, educational level of the father, educational level of the mother, residence, duration of illness, time of hospitalization, and understanding of the treatment plan played significant roles in causing different medication compliance among these children (P＜0.05). Logistic regression analysis showed that duration of illness [OR=2.204, 95%CI (1.253, 3.875), P=0.006], residence [OR=2.615, 95%CI (1.0 23, 6.687), P=0.045] and the mother’s educational level [OR=0.147, 95%CI (0.028, 0.788), P=0.025] were the independent factors for medication compliance. Conclusions According to the survey, hormone medication compliance in children with chronic kidney disease is not satisfying. We should strengthen the health education in children and their parents, and adopt specific interventions to enhance the medication compliance so as to effectively control the disease and delay the progression.