Assessment of effectiveness expenditures of pharmacy information system in medication-related services in hospitals of Iran

Background: On average, 40% of the gross income of each country is devoted to the health care with medication expenditures accounting for 19% of the total expenses. Less than ¼ of the medication expenditures is allocated to the inpatients department. The measures taken regarding the management of expenditures when selecting and implementing the strategies for managing medication expenditures have made the pharmacists to take the quality issues as well as the safety of the patients into account. Methods: The present research intends to explore the expenditures of effectiveness of Pharmacy Information System (PIS) for the medication services as far as effectiveness of delivered services is concerned in some selected hospitals in the city of Isfahan, Iran. The present research of applied and descriptive-analytical nature was conducted in the hospitals in the City of Isfahan, Iran. Instruments used for collecting data included self designed checklist conforming to the guidelines of the American Society of Health-System Pharmacists (ASHP) the validity of which was assessed based on the viewpoints of the expert professors. The data gathered by interview and observation methods. Then, they were analyzed using non-parametric tests of Mann-Whitney and the Wilcoxon tests and SPSS software (11.5 version). Results: The highest rate of the expenditures of the effectiveness of the pharmacy information system belonged to the teaching hospitals with a mean score of 48.5%, while the lowest rate was found to be for private hospitals with a mean score of 28.1%. Based on the findings of the Wilcoxon test, no statistically significant difference was observed among the hospitals in terms of effectiveness-related expenditures. Conclusions: Given the results of the study, it can be noted that a successful plan for managing the medication-related expenditures must be information-based

Applying an Ethical Framework to Herbal Medicine

Herbal medicines make a vital contribution to healthcare globally, but from production through to practice, there are ethical challenges that require attention. Ethical challenges are often analysed through application of an ethical framework because this can facilitate a consistent and structured approach. In healthcare, the most commonly used framework over recent decades has been that of the four principles: beneficence, nonmaleficence, autonomy, and justice. However, for various reasons that are explained, this approach to ethical analysis is not the most fitting for the global phenomenon of herbal medicine. In this paper, a relatively new moral framework that is based upon the globally accepted values of care, respect, honesty, and fairness is explored in relation to herbal medicine for the first time. Through application of this framework, the ethical challenges and actions needed to address them become clear, thus resulting in practical recommendations for enhancing ethical standards in herbal medicine

Biological Activities of Essential Oils: From Plant Chemoecology to Traditional Healing Systems

Essential oils are complex mixtures of hydrocarbons and their oxygenated derivatives arising from two different isoprenoid pathways. Essential oils are produced by glandular trichomes and other secretory structures, specialized secretory tissues mainly diffused onto the surface of plant organs, particularly flowers and leaves, thus exerting a pivotal ecological role in plant. In addition, essential oils have been used, since ancient times, in many different traditional healing systems all over the world, because of their biological activities. Many preclinical studies have documented antimicrobial, antioxidant, anti-inflammatory and anticancer activities of essential oils in a number of cell and animal models, also elucidating their mechanism of action and pharmacological targets, though the paucity of in human studies limits the potential of essential oils as effective and safe phytotherapeutic agents. More well-designed clinical trials are needed in order to ascertain the real efficacy and safety of these plant products

An evaluation of adherence to society of pharmacists' standards care in pharmacy information systems in Iran

Introduction: Pharmacy information system (PIS) is a complex computerized system used for collecting, storing, and managing the medication therapy data in the course of patients' care. The purpose of this study was to evaluate the level of adherence to the standards established by the societies of pharmacists in the PISs employed in the hospitals in Isfahan, Iran. Methods: The present study was an applied, descriptive-analytical study conducted on the PISs of 19 teaching, private and social insurance hospitals in Isfahan in 2011. Study population consisted of the PISs available in the hospitals under study. Study sample was the same as the study population. The data collection instrument was a self-developed checklist based on the guidelines of the American Society of Health-System Pharmacists and Pharmaceutical Society of Australia, whose validity was assessed and confirmed by expert professors' views. Having been collected by observation and interview methods, data were analyzed by SPSS 18 software using Mann-Whitney statistical test. Results: The findings of the study revealed that the highest rank in adherence to the standards of societies of pharmacists was obtained by social services hospitals (32.75%), while the private hospitals obtained the lowest rank (23.32%). Conclusions: Based on the findings, in the PISs in the hospitals under study, some standards of the society of pharmacists were ignored. Hence, prior to designing and implementing PIS, a needs analysis is required to increase its users' motivation to identify the system potentialities and to allow the system development in compliance with the world technology advancement

Biodiversity, life forms and chorotypes of threatend medicinal plants in Tehran watershed, Iran

This research was carried out to identify and introduce the threatened medicinal plants, life form, and chorotypes of them in Tehran watershed. Initially after distributed species identification on the watershed based on the fieldwork, each of the species was compared with the red list and finalized. Results showed that in Tehran watershed there are 51 threatend medicinal plants belonging to 21 families and 43 genera. The families with the high number of red species include, Rosaceae (8 species) and Lamiaceae (7 species), and the main genera was Ferula (3 species). 43 species isd Endemic in Iran, 3 species are in Data Deficient (DD), 20 species in Vulnerable (VU) and 26 in Low Risk (LR) status. Two species Ferula persica Willd. and Dracocephalum kotschyi Boiss. are in Endangered (EN) status Because of low distribution and overuse of those. The dominant life forms of the identified species using Raunkiaer's method were: Hemicryptophytes (He) with 41.18% (21 species) and Phanerophytes (Ph) with 39.22% (20 species). From the choryotype perspective, the most of the identified species belongs to Irano-Turanean, and then Europe-Siberian- Irano-Turanean regions

A survey on the users' satisfaction with the hospital information systems (HISs) based on DeLone and McLean's model in the medical-teaching hospitals in Isfahan city

Background and purpose: The user's satisfaction with information system in fact denotes the extent the user is satisfied with the system's achievement in fulfilling his/her information requirements. This study tries to explore the users' satisfaction with hospital information systems (HISs) based on DeLone and McLean's model focusing on the medical-teaching hospitals of Isfahan city. Methodology: This study which was applied and descriptive-analytical in nature was carried out in the medical-teaching hospitals of Isfahan city in 2009. Research population consisted of the system users from which a sample was selected using random sampling method. The size of the sample was 228. Data collection instrument was a self-developed questionnaire produced based on the satisfaction criterion in the DeLone and McLean's model. Its content validity was assessed based on the opinions given by the computer sciences professionals with its estimated Cronbach's alpha found to be 92.2. The data were analyzed using SPSS software. Findings: As the findings of the study showed, the differences among the mean scores obtained for the satisfaction with different kinds of HISs in use in the hospitals were statistically significant (p value≤0.05). Generally, Kowsar System (old version) and Pouya Samaneh Diva system gained the highest and lowest mean scores for the criterion in question, respectively. The overall mean score for the satisfaction was 54.6 for different types of systems and 55.6 among the hospitals. Conclusion: Given the findings of the study, it can be argued that based on the used model, the level of users' satisfaction with the systems in question was relatively good. However, to achieve the total optimum condition, when designing the system, the factors affecting the enhancement of the users' satisfaction and the type of hospital activity and specialty must be given special consideration. © AVICENA 2014

Antiviral activity of monoterpenes thymol, carvacrol and p-cymene against herpes simplex virus in vitro

Introduction: In recent years, with increased prevalence of viral infections and having no specific treatment  and also the continuous appearance of resistant viral strains, finding of novel antiviral agents is necessary.  Methods and Results: In this study, monoterpenes of thymol, carvacrol and p-cymene were screened for their inhibitory effect against herpes simplex virus type 1 (HSV-1) in vitro on Vero cell line CCL-81-ATCC using a plaque reduction assay. The antiviral activity of three monoterpenes (thymol, carvacrol and p-cymene) were evaluated by cytotoxicity assay, direct plaque test. In addition, the modes of antiviral action of these compounds were investigated during the viral infection cycle. Results showed that the inhibitory concentrations (IC50) were determined at 0.002%, 0.037% and >0.1%, for thymol, carvacrol, p-cymene, respectively. A manifestly dose-dependent virucidal activity against HSV-1 could be exhibited for compounds tested. In order to determine the mode of the inhibitory effect, compounds were added at different stages during the viral infection cycle. At maximum non-cytotoxic concentrations of the compounds, plaque formation was significantly reduced by more than 80% when HSV-1 was pre incubated with p-cymene. However, no inhibitory effect could be observed when the compounds were added to the cells prior to infection with HSV-1 or after the adsorption period. Conclusions: These results indicate that compounds affected HSV-1 mostly before adsorption and might interact with the viral envelope. Thymol exhibited a high selectivity index and seems to be a promising candidate for topical therapeutic application as antiviral agent for treatment of herpetic infections

An Examination of Family Physicians Plan Implementation in Rural Areas from Perspectives of Managers, Personnel and Clients in Context of Health System: Strengths and Weaknesses

Background: Family physician plan (FPP) and referral system (RS) is one of the major plans in Iran’s health system with the aim of increasing the accountability in the health market, enhancing the public’s access to the health services, lowering the unnecessary costs and equitable distribution of health across the society. Aim: Taking these into consideration, this study assessed the strengths and weaknesses of the Family Physician Plan in the Iranian villages based on the perspectives of the family physicians, managers, employees and clients in the health system in 2014. Subjects and Methods: A descriptive-applied and cross-sectional design was used for this study. Its statistical population consisted of two groups: the first group included all the family physicians and the managers, employees practicing in the health system of Borujen town (n=62 subjects) who, using 2-round consensus Delphi technique, were asked what are 4 main strengths and 4 weaknesses of the Family Physician Plan implemented during the past few years. This was done using an open questionnaire. The second group included village households and clients. The size of the second group was 400 heads of the households. Similarly, using SERVQUAL questionnaire, their ideas regarding 4 strengths and 4 weaknesses observed for the Family Physician Plan were asked. Subsequently, their given responses were compared and similar ideas were merged into one and for prioritization, the second questionnaire was prepared. But, it was just given to the employees. The responses to the questionnaire were ranked according to Likert scale. Finally, the collected data were put into SPSS software 13 to be analyzed. Results: As the results indicated, among the strengths reported in the implementation of the Family Physician Plan by the respondents the following ones had the highest frequency: the timely follow-up care of the patients with mental disorders, blood pressure (hypertension) and diabetes (55.4%), permanent caring for the patients from the start of the disease stage to the treatment or death stage (54.3%), elderly care (45.7%), equal enjoyment of the right to health expenditure per capita by all the society members and implementing the principle of justice in the health-care and the presence of physician in all villages (44.6%). On the contrary, the following weaknesses had the highest frequency: lack of provision of transportation needs for the Family Physician Plan’s employees (53.2%), insufficient funding (48.4%), the high workload for the physician (46.8%).Conclusion: To enhance the public’s accessibility to the health services and enable their just utilization from such services, the Family Physician Plan must be assessed by the respective health care organization. In this way, it will be possible to identify its shortcomings paving the path to more effective measures towards promoting the quality of the medical-related activities.Keywords: Family Physician, Health system, Assessment, Employee

An evaluation of role of the informational components in decision-making process of health systems’ managers based on World Health Organization’s standards

Background:Objective of current study was to enhance the effectiveness of the organization its goals, health system managers must possess sufficient knowledge about health information systems which are regarded as the basis of decision-making at different managerial levels. The present research tried to explore the extent of meeting the information management components and evaluate its role in decision-making of health systems' managers.Methods:Descriptive-analytical in nature, this study intended to examine the urban and rural health centers as well as health system. Data were collected through a self-designed checklist produced based on the World Health Organization’s standards which include the information presentation (6 components), information interpretation (5 components) and using information in decision-making process (1 component) for urban and rural health centers. The checklist designed for health system included needs-analysis and information collection, presentation, processing and interpretation components. The gathered data were then put into SPSS version of 13 and analyzed using independent t-test.Results:The findings of the study revealed that compared to urban centers, the rural health centers had a higher level in meeting the components in 3 main areas i.e. information presentation, information interpretation and information use in decision-making process (P <0.05). As far as sub-measures were concerned, the rural health centers gained a higher mean score for data presentation in the health system and other interpretation-related components (P <0.05). The level of meeting data presentation components revealed that the mean score for using data for decision-making purposes was high while the mean score for data processing was found to be low.  Conclusion: Proper processing and appropriate use of data in the decision-making by the managers and public policy-makers are the missing requirements which must be taken into account.

Phytochemical compositions and biological activities of essential oil from Eremurus persicus (Joub. & Spach) Boiss.

Introduction: The genus Eremurus is native to Eastern Europe and temperate Asia. Particularly, Eremurus persicus (Joub. &amp; Spach) Boiss. is highly valued in traditional foods and medicine. Scientific knowledge about E. persicus chemical composition and bioactivity is required. &nbsp;Methods and Results: The present study is aimed to determine the volatile composition of E. persicus essential oil (EO) by means of gas chromatography coupled to flame ionization/mass spectrometry detector. Moreover, the antioxidant, antimicrobial, anticancer, and acetylcholinesterase inhibitory activities of the EO were tested. Interestingly, the anti-dermatophyte potency was close to that of the drug griseofulvin, with minimum fungicidal concentration ranging between 0.7 and 4.5% depending on the fungi strain. The EO was also effective against hepatocellular carcinoma (Hep-G2) and breast adenocarcinoma (MCF-7) human cancer cell lines in a concentration (200-1500 ng/mL)-dependent manner, with a decrease of the cell viability up to 65% and 52%, respectively. The E. persicus EO was rich in terpenes and oxygenated terpene derivatives. Individually, limonene (16.25%), geranylgeraniol (15.23%), n-nonanal (9.48%), geranyl acetone (9.12%), benzene acetaldehyde (8.51%), linalool (7.93%), α-pinene (6.89%), and 1,8-cineol (5.22%) were the most abundant volatile compounds and could be chosen as analytical markers of this essential oil. Conclusions: In conclusion, our results suggested that this EO possesses a wide range of bioactive properties that could be useful in nutraceutical, functional foods and cosmeceutical formulations