Quality prescribing in general practice

To implement continuous improvement of prescribing in general practice with a model closely linking the work of general practitioner and a clinical pharmacist aiming to improve the safety and efficiency of treatment with medicine. Emphasise is on polypharmacy (multiple medications) which is increasing across countries and although appropriate especially in patients with multiple comorbidities it can cause serious problems to patients and is a major challenge for the health care systems. Problems include adverse drug reactions and harmful drug interactions with reduced quality of life, increased overall morbidity, mortality and increased costs to health care systems

Knowledge, attitudes and practices of health care professionals towards adverse drug reaction reporting in public sector primary health care facilities in a South African district

Purpose: Adverse drug reactions (ADRs) have an appreciable impact on patients’ health. Little is known however about ADR reporting in ambulatory care environments especially in low- and middle-income countries. Consequently, our aim was to determine knowledge, attitudes and practices (KAP) among health care professionals (HCPs) towards ADR reporting in primary health care (PHC) facilities in South Africa. The findings will be used to direct future activities. Methods: Descriptive, cross-sectional design using quantitative methodology among 8 public sector community health care centres and 40 PHC clinics in the Tshwane Health District, Gauteng Province. A self-administered questionnaire was distributed to 218 HCPs, including all key groups. Results: A total of 200 responses were received (91.7%). Although an appropriate attitude towards ADR reporting existed, the actual frequency of ADR reporting was low (16.0%). Of the respondents, 60.5% did not know how to report, where to report or when to report an ADR and 51.5% said the level of their clinical knowledge made it difficult to decide whether or not an ADR had occurred. Over 97.5% stated they should be reporting ADRs with 89% feeling that ADR reporting is a professional obligation and over 70% that ADR reporting should be compulsory. When results were combined, the overall mean score in terms of positive or preferred practices for ADR reporting was 24.6% with pharmacists having the highest scores. Conclusion: Under-reporting of ADRs with gaps in KAP was evident. There is a serious and urgent need for education and training of HCPs on ADR reporting in South Africa

Forecasting pharmaceutical expenditure in Europe : adjusting for the impact of rebates and discounts

European healthcare systems are under constant pressure to contain healthcare expenditure. Understanding future drug expenditure is an important consideration for payers when formulating policies. QuintileIMS publishes European forecasts that are underpinned by its audited volume data and publicly available list prices. With increasing price pressures, list to net price divergence is growing, although some of this information is commercially sensitive and thus not publicly available. The objective of this study was to further develop an established forecast to account for this divergence and explore its impact

PP262—Can authorities take full advantage of the availability of generic atypical antipsychotic drugs? implications for the future

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Utilisation of the ESMO-MCBS in practice of HTA

It is highly appreciated that the European Society of Medical Oncology has developed a system to assess new oncologic compounds according to their value to patients. Consequently, offering decision-support to those who either want to use the new cancer therapies in clinical practice but cannot keep up-to-date with all therapy options or, alternatively, to those who have to decide whether or not to fund new oncology medicines or exclude from reimbursement due to their low value. This is particularly important with ever-rising prices for new oncology medicines which have increased up to ten fold in recent years

Genetic consequences of selection cutting on sugar maple (Acer saccharum Marshall)

Selection cutting is a treatment that emulates tree-by-tree replacement for forests with uneven-age structures. It creates small openings in large areas and often generates a more homogenous forest structure (fewer large leaving trees and defective trees) that differs from old-growth forest. In this study, we evaluated whether this type of harvesting has an impact on genetic diversity of sugar maple (Acer saccharum Marshall). Genetic diversity among seedlings, saplings, and mature trees was compared between selection cut and old-growth forest stands in Québec, Canada. We found higher observed heterozygosity and a lower inbreeding coefficient in mature trees than in younger regeneration cohorts of both forest types. We detected a recent bottleneck in all stands undergoing selection cutting. Other genetic indices of diversity (allelic richness, observed and expected heterozygosity, and rare alleles) were similar between forest types. We concluded that the effect of selection cutting on the genetic diversity of sugar maple was recent and no evidence of genetic erosion was detectable in Québec stands after one harvest. However, the cumulative effect of recurring applications of selection cutting in bottlenecked stands could lead to fixation of deleterious alleles, and this highlights the need for adopting better forest management practices

Identification of Lithocholic Acid as a Molecular Glass Host for Room-Temperature Phosphorescent Materials

Lithocholic acid was identified as a molecular glass host material for room temperature phosphorescent (RTP) chromophores. Differential scanning calorimetry (DSC) was performed on a series of structurally similar, biologically sourced molecules, including lithocholic acid, β-estradiol, cholesterol, and β-sitosterol, in an effort to identify new amorphous molecular glasses independent of plasticizing additives. DSC analysis revealed lithocholic acid and β-estradiol form stable molecular glasses post thermal processing unlike neat cholesterol and β-sitosterol. The ability of lithocholic acid and β-estradiol to stabilize high wt. % loadings of d10-pyrene and a mixture of d10-pyrene and an iridium chromophore, bis(2,4-difluorophenylpyridinato)-tetrakis(1-pyrazolyl)borate iridium(III) (FIr6), was also investigated. All β-estradiol formulations show β-estradiol cold crystallization. Optical microscopy and wide angle X-ray scattering measurements suggest spherulite β-estradiol crystals form during this process. Finally, time-resolved luminescence and phosphorescence quantum yield experiments show that the d10-pyrene RTP lifetime is longer and the d10-pyrene phosphorescence quantum yield is higher in lithocholic acid molecular glasses than in β-estradiol molecular glasses. The discrepancy in lifetime and quantum yield values is explained by quantitatively smaller rates of non-radiative decay from the triplet state of d10-pyrene in lithocholic acid

Effect of Ion Concentration on the Electro-Optic Response in Polymer-Stabilized Cholesteric Liquid Crystals

We have previously reported that the application of a DC field can adjust the position and/or bandwidth of the selective reflection notch in polymer-stabilized cholesteric liquid crystals (PSCLCs). The proposed mechanism of these electro-optic (EO) response is ion-facilitated electromechanical deformation of the polymer stabilizing network. Accordingly, the concentration of ions trapped within the polymer network should considerably influence the EO response of PSCLC. Our prior studies have indicated that photoinitiators can increase ion density in PSCLC by an order of magnitude. Here, we isolate the contribution of ionic impurities associated with liquid crystal monomers (LCMs) by utilizing initiator-less polymerization. PSCLCs prepared with LCM with low ion concentration show bandwidth broadening of the reflection band whereas PSCLCs prepared with LCM with high ion concentration exhibit a red shifting tuning of the reflection band. The extent of the tuning or bandwidth broadening of the CLC reflection band depends on the concentration of LCMs and the chirality of the LCM.</div