An observational cross-sectional study to assess knowledge, attitude and practice of resident doctors and nursing professionals regarding pharmacovigilance in a tertiary care teaching hospital in Central India

Background: Adequate knowledge, positive attitude and motivated practice of pharmacovigilance are the building pillars of ADR reporting. This study was conducted to evaluate the knowledge and attitude towards pharmacovigilance and adverse drug reaction reporting among the resident doctors and nursing staff in AIIMS Bhopal, Madhya Pradesh, India.Methods: This cross-sectional questionnaire based study was carried out in a tertiary care centre. The survey was carried out using a pre-validated questionnaire that included 20 questions to evaluate the participant’s knowledge, attitude and practice.Results: Answers to knowledge based questions were given correctly by around 82.6% (95% CI 0.7576 to 0.8794) of resident doctors and 74% (95% CI 0.6033 to 0.8424) nursing professionals. The difference of basic knowledge about pharmacovigilance between resident doctors and nursing professionals was insignificant (p-value is 0.7967). The most common reason for underreporting was unawareness, which was opted by 69% (95% CI 0.6153-0.7617) of resident doctors, while among the 58% (95% CI 0.4422-0.7064) nursing staff, the major factor was non-feasible ADR monitoring system in hospital. The suggestion of conducting training and awareness programme to promote ADR reporting given by resident doctors and nursing staff were 85% (95% CI 0.7872-0.0957) and 80% (95 % CI 0.6677-0.8895) respectively.Conclusions: The participants were well aware of pharmacovigilance and adverse drug reaction reporting. They had expressed the positive attitude towards pharmacovigilance and ADR reporting. But the routine practice of reporting ADRs is lacking. Hence there is need for increasing awareness and building positive attitude and practices among the health care professionals

Prescription audit to evaluate the pattern and errors in a tertiary care hospital

Background: Medication errors are widespread public health issue. Prescription errors commonly results in medication error. Prescription error can be largely avoidable this study was performed with aim to point out the common mistake in the prescription which may endanger patients.Methods: Our study was cross-sectional and observational, performed in Index Medical College. 320 prescriptions were reviewed. Analysis was done for presence or absence of essential components of prescription like prescriber information’s, patients information’s, details of drug like its dosage form, strength, frequency, total duration of treatment, warnings or instruction for use. The observed data was expressed in number and percentage.Results: Patient information was complete 315 (98.44%) in prescriptions. Prescriber’s information were present in 284 (88.75%). Legibility was seen in 240 (75%). Use of generic drug, capital letters for drug name, warning are seen in 9 (2.81%), 39 (12.19%), 3 (0.94%) respectively. Completeness in terms of the name of drug, dose, strength, route, frequency, duration and dosage forms of prescribed drugs was seen in 252 (78.75%) prescriptions.Conclusions: Properly framed and written prescription can largely prevent medication error. Regular prescription audit must be carried out so that common mistake can be identified and corrective measure with the help of training session, workshop can be taken

An observational cross-sectional study to determine the effect of telmisartan on reducing microalbuminuria in diabetic hypertensive patients in tertiary care teaching hospital, Central India

Background: There are many groups of drugs to decrease microalbuminuria like angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), calcium channel blockers and direct vasodilators. Among these, ACEI and ARBs are commonly used for this purpose. If side effects occur, ACEI are replaced with ARBs. Many ARBs have been studied for their effect on reducing microalbuminuria, but data on telmisartan with its additional unique properties are scarce in Indian population.Methods: This cross sectional observational study was carried out in a tertiary care centre. We first measured base line urine albumin levels in included patients, 3 months after treatment with telmisartan using ‘hemocue urine albumin analyser’. We collected and compared both baseline and after treatment data of microalbuminuria and analysed in descriptive statistics.Results: A total of 110 patients participated in this study; out of which 10 patients were excluded from the study because they were not available for follow up. As compared to baseline, urine albumin level decreased by 30.42% after 12 weeks treatment with telmisartan (P <0.001).Conclusions: Microalbuminuria is one of the leading cause of end stage renal disease and coronary heart diseases in diabetic hypertensive patients. Drugs like ACE inhibitors, Angiotensin receptor blockers, Calcium channel blockers and direct vasodilators are used to prevent these complications. In this present study, we concluded that telmisartan decreases urine albumin excretion around 30.42% from baseline after 12 weeks of treatment