Validation of patients’ satisfaction regarding medications’ information questionnaire (Psmiq) in Karachi, Pakistan

SUMMARY. The aim of present study was to develop a validated patient satisfaction regarding medications’ information questionnaire (PSMIQ). It was an extra cultural adaptation of previous questionnaires used in other part of the world. The PSMIQ was premeditated by an expert group of 15 physicians and 15 pharmacists from a formerly validated questionnaire. A preliminary draft of PSMIQ comprised of seventeen items, with responses recorded on a five Likert scale. The internal validation of PSMIQ was approved by conducting a cross-sectional and analytical study. Around one thousand and fifty patients participated in present study. The validity of PSMIQ items was determined through factor analysis, and the reliability was evaluated with Cronbach’s alpha coefficient (α). Cronbach alpha value for transformed 13-item questionnaire was found to be 0.738. These items were assigned four sub scales. When compared it was observed that these subscales were significantly correlated with one another (p < 0.01). Patient satisfaction level for items regarding general information and usage instructions was above 70% however their satisfaction regarding potential problems and cost issues was less than 40%. Their satisfaction was positively associated with females for subscale 1 and 4 (p < 0.01). Responders who were stable had better total satisfaction scores compared with unstable ones in response to subscale 1, 2 and 3. In response to item regarding potential problematic issue, hypertension patients were 1.687 times more satisfied than patients suffering from other diseases (OR = 1.687; 95% CI = 1.247-2.283). Patient satisfaction survey used in the present study was found to be reliable and valid. Respondents were more satisfied regarding medications’ general information and usage instructions, however not satisfied with information regarding potential problems and cost issues

Effect of lipid and cellulose based matrix former on the release of highly soluble drug from extruded/spheronized, sintered and compacted pellets

Abstract Background The study was to develop an extended release (ER) encapsulated and compacted pellets of Atenolol using hydrophobic (wax based and polymeric based) and high viscosity grade hydrophilic matrix formers to control the release of this highly water soluble drug by extrusion/spheronization (ES). Atenolol is used for cardiovascular diseases and available as an immediate release (IR) tablet dosage form. The lipids, Carnauba wax (CW), Glyceryl monostearate (GMS) and cellulose based i.e. Hydroxypropyl methylcellulose (HPMC) and Ethyl cellulose (EC) were used in preparing Atenolol ER pellets. Thermal sintering and compaction techniques were also applied to control the burst release of Atenolol. Method For this purpose, thirty-six trial formulations (F1-F36) were designed by Response Surface Methodology (RSM), using Design-Expert 10 software, keeping (HPMC K4M, K15 M & K100 M), (EC 7FP, 10FP & 100FP), waxes (GMS, & CW), their combinations, sintering temperature and duration, as input variables. Dissolution studies were performed in pH, 1.2, 4.5 and 6.8 dissolution media. Drug release kinetics using different models such as zero order, first order, Korsmeyer-Peppas, Hixon Crowell, Baker-Lonsdale and Higuchi kinetics were studied with the help of DDsolver, an excel based add-in program. Results The formulations F35 and F36 showed compliance with Korsmeyer-Peppas Super case II transport model (R2 = 0.975–0.971) in dissolution medium pH 4.5. No drug excipient interaction observed by FTIR. Stereomicroscopy showed that sintered combination pellets, (F35), were highly spherical (AR = 1.061, and sphericity = 0.943). The cross-sectional SEM magnification (at 7000X) of F34 and F35 showed dense cross-linking. The results revealed that the optimized formulations were F35 (sintered pellets) and F36 (compacted pellets) effectively controlling the drug release for 12 h. Conclusion Extended-release encapsulated, and compacted pellets were successfully prepared after the combination of lipids CW (10%) and GMS (20%) with EC (10FP 20% & 100FP 20%). Sintering and compaction, in addition, stabilized the system and controlled the initial burst release of the drug. Extended release (ER) Atenolol is an effective alternative of IR tablets in controlling hypertension and treating other cardiovascular diseases