Evaluation of drug promotional brochures in a tertiary teaching hospital of Kannur, India

Background: Pharmaceutical industries worldwide are heavily involved in aggressive drug promotions. WHO has framed guidelines for ethical drug promotion in 1988. The transparency of pharmaceutical advertisements is important because decision of the physician is likely to be influenced by the claims made by the pharmaceutical companies in the promotional drug brochures and pharmaceutical industries treat their marketing material as “educational material” for doctors. Authors did this study to analyze the information given on drug promotional brochures by the drug companies using ethical criteria of drug promotion by WHO 1988 and to verify the authenticity of the claims given by the pharmaceutical companies in drug promotional brochures.Methods: Cross sectional study extending from 1/8/2012 to 31/7/2013. 612 drug promotional brochures satisfied our inclusion criteria. Drug brochures were analyzed with WHO ethical criteria 1988 and further categorizing the data into type of claims, number and source of references. Validity of journal articles were checked by using a validity measure developed by Cardarelli.Results: Total 612 brochures satisfied inclusion criteria. INN was mentioned in 93.8% of collected brochures. Brand name was mentioned in 100% brochures. Content of active ingredients was mentioned in 92% of brochures. Name of the other ingredients known to cause problem 28.4% of brochures. Dosage form or regimen was mentioned in 23.2% of brochures. Approved therapeutic use mentioned in 65.7% brochures. Side effects and major adverse drug reactions were mentioned in 31.4% brochures. Precautions and contraindications and warnings were mentioned in 30.4% drug promotional brochures. Drug interactions were mentioned in 26.5% brochures. Name and address was mentioned by 69.1% brochures. There were 1144 claims and 739 references. Efficacy claims were 84.88% of the total claims. Main source of reference was from journal articles (74.1%) and among them 49.65% were randomized control trials. Only 47.94 % of the journal references were valid.Conclusions: Brochures were lacking in vital information which included contraindication, warning, precaution, name of the other ingredients known to cause problem hence companies were found violating WHO ethical criteria. Claims were not well supported with references. Less than half of the given journal references were only valid. This study highlights the need of healthcare professionals to remain cautious about promotional material presented by pharmaceutical representatives

Quality of life of alcohol dependent patients attending a deaddiction centre in Kannur district

Background: Quality of life (QOL) is individuals' perceptions of their position in life. QOL of alcohol dependent patients is an area that has received relatively less attention compared to other alcohol related problems.Methods: A deaddiction centre based cross sectional study was done on 370 individuals using a predesigned questionnaire during the period of 2012-2013. The data was analyzed using SPSS version 17. Spearman’s rank correlation test was used to find association between the study variables.Results: The mean age of the study subjects was 38.08±8.46 years. The mean duration of drinking was 12.62±7.47 years. The overall score of the QOL and the perceived health in alcohol dependent patients was 3.19±0.89 and 3.01±0.98 respectively. The mean of the transformed scores of physical, psychological, social and environmental domains are 69.12±12.82, 57.84±12.81, 58.52±17.05, 68.62±10.23 respectively. Statistical analysis of age with physical, environmental and social domains showed a significant negative correlation; literacy status with QOL, perceived health, physical, psychological, social and environmental domains showed a significant positive correlation; socio economic status with QOL and psychological domain showed a significant positive correlation; duration of drinking with QOL, perceived health, physical and psychological domain showed a significant negative correlation.Conclusions: Harm from alcohol use is a major public health problem. Reducing the level of social and health harms from alcohol requires preparation and planning

Hepatitis B surface antibody levels among health-care personnel vaccinated against hepatitis B in a teaching hospital in South India

Background: Hepatitis B virus infection is a global health priority, and health-care personnel (HCP) have 10 times higher prevalence than the general population. Seromonitoring identifies those with low titers and vaccine nonresponders with increased risk. Objective: The objective of the study was to assess hepatitis B surface antibody (anti-HBs) titers and associated factors among HCP vaccinated against hepatitis B in a teaching hospital in Kerala. Methods: A cross-sectional study was done among 454 vaccinated HCP, and anti-HBs antibody titers were assessed by enzyme-linked immunosorbent assay method. Results: Participants included 162 (35.7%) doctors, 132 (29.3%) nursing and laboratory personnel, and 160 (35.3%) supporting staff. The mean age was 38.06 ± 11.33 years, and 72% were female. Majority (92.5%, 420) were seroprotected and 78.9% (358) with high (>100 mIU) titers. Moderate (10–100 mIU) and low (10 years since vaccination, and age >40 years were independent predictors for poor seroprotection, while increasing doses and boosters were positively associated. Conclusions: Majority of vaccinated HCP were seroprotected. Incomplete schedules, older age, and prolonged time since vaccination can lead to decline in titers, and periodical seromonitoring should guide hepatitis B revaccination strategies