Family support-based intervention using a mobile application provided by pharmacists for older adults with diabetes to improve glycaemic control: a randomised controlled trial

International Journal of Clinical Pharmacy - Background Family support is crucial in the care of older patients with diabetes. However, more information is needed to evaluate the potential benefits...     

Practice and attitudes regarding the management of childhood diarrhoea among pharmacies in Thailand

Objectives To compare practice behaviour and attitudes of pharmacy personnel in the management of childhood diarrhoea between type I (requiring a pharmacist to be on duty) and type II (pharmacist not required) pharmacies, between those surveyed in 2008 and in 2001, and between new‐generation (graduation ≤10 years) and old‐generation (graduation >10 years) pharmacists. Methods The setting was 115 pharmacies in a city in the south of Thailand. The study was separated into two phases: a simulated client method to evaluate history taking, drug dispensing and advice giving among pharmacy personnel and a questionnaire to measure attitudes and factors affecting diarrhoea treatment. Key findings In the simulated client method study, questions asked and advice given by the providers (the pharmacists or non‐pharmacists responding to the simulated clients), especially in type II pharmacies, were insufficient. Only 5.2% of pharmacies correctly dispensed for a child with viral diarrhoea, using oral rehydration salts (ORS) alone. Appropriate ORS dispensing of providers was not affected by shop type, survey time or peer generation. However, 52.2% of providers inappropriately dispensed antibiotics for such illness. In the questionnaire study, 108 completed surveys were obtained (a response rate of 93.9%). The providers working in 2008 more strongly agreed that ORS was effective, safe, used by health professionals and requested by patients, relative to those in 2001 (P < 0.05). No potential factor influencing the actual ORS dispensing was identified. Nevertheless, antibiotic dispensing was affected by beliefs in producing recovery and high profit. Conclusions Practice and attitudes of pharmacy personnel were inappropriate in the management of childhood diarrhoea. Revision of the pharmacy curriculum did not result in improvement of practice as seen by the similarity of practice patterns among the 2001 and 2008 samples. Improvement of knowledge and practice behaviour among providers in pharmacies is needed.     

慢性病患者生命质量测定量表体系共性模块的分析:结构方程的应用

目的 对慢性病患者生命质量测定量表体系共性模块(QLICD-GM)的结构进行分析.方法 根据理论构想及因子分析结果提出量表结构的理论模型,用结构方程模型对其进行验证与评价.结果 整个结构模型的近似误差均方根RMSEA为0.0606,RMSEA 90% CI=(0.0569;0.0643),非范拟合指数NNFI为0.941,相对拟合指数CFI为0.947,标准化残差均方根SRMR=0.0693,以上指数显示模型拟合较好.结论 结构方程模型分析结果与因子分析及理论构想吻合,说明QLICD-GM可以分为躯体功能、心理功能和社会功能三个领域10个小方面,结构效度较好.     

Assessment of multimedia-supported intervention in Muslim diabetic patients treated with insulin

This study aimed to evaluate the effect on diabetic care of an educational DVD in Jawi, the primary spoken language of Muslims in the study area, and pharmacist intervention among Muslim patients with diabetes treated with insulin. Type 2 diabetes Muslim patients on insulin treatment and poor glycemic control (N?=?143) in one hospital in southern Thailand were recruited to participate in a 6-month-period pre- and post-intervention study. For the intervention, the pharmacist provided the patients with education using a DVD and then asked them to show how to use insulin injection. Afterward, the pharmacist would correct the techniques for patients individually. At 6 months after intervention, significant reductions in glycated hemoglobin (HbA_1c) (8.31?±?1.40 to 7.19?±?1.15 %, P?<?0.001), fasting blood glucose (FBG) (195.06?±?86.14 to 115.81?±?11.48 mg/dL, P?<?0.001), systolic blood pressure (130.62 to 126.57 mmHg, P?=?0.004), triglycerides (183.36?±?90.48 to 182.31?±?90.68 mg/dL, P?<?0.001), and total cholesterol (199.57?±?68.77 to 194.97?±?64.77 mg/dL, P?=?0.006) were detected in patients who received the intervention. Increased low-density lipoprotein cholesterol (LDL-C) level (P?=?0.028) but no significant change in high-density lipoprotein cholesterol (HDL-C) were found (P?=?0.900). Moreover, medication adherence, diabetes knowledge, and skill in using insulin injection improved at the end of the study (P?<?0.001). In conclusion, the combination of language-specific educational DVD and pharmacist intervention appears to improve the short-term outcomes of diabetes care in Muslim patients on correctional insulin therapy.     

Stability of quinine dihydrochloride in commonly used intravenous solutions

The stability of quinine dihydrochloride (Q) at a concentration of 12 mg/ml, in three common intravenous (i.v.) solutions, was studied. Admixtures of Q were prepared in the following vehicles, in glass containers: 5% dextrose in water, 5% dextrose in normal saline solution and normal saline solution. The solutions were kept under fluorescent light at room temperature. Concentrations of Q were monitored for 24 h using a stability–indicating high–pressure liquid chromatographic (HPLC) method. More than 90% of the initial concentration of Q remained in all solutions under the study conditions, and all samples remained clear and colourless over the entire 24–h period. Admixtures containing Q at a concentration of 1.2 mg/ml in the three solutions were stable (<10% decomposition) for at least 24 h and did not require protection from light. However, the use of the admixtures as soon as possible after preparation is still recommended because some decrease in concentration was observed on storage.     

Use of 0.75 mg Levonorgestrel for postcoital contraception in Thailand

OBJECTIVE: This study identified the pattern of Levonorgestrel (LNG) use and self-reported side-effects among Thai women in Songkla. METHOD: The eligible subjects were 100 Thai women who had used 0.75 mg LNG at least once in the past 12 months. The participants completed a questionnaire at the survey sites, which were seven pharmacies and five shopping malls. RESULTS: Eight percent of LNG users had never used any contraceptive methods other than day count and withdrawal. Thirty-nine percent took more than four tablets of LNG per month, which was the limit instructed in the label. Only 3% used LNG for emergency situations such as having unprotected intercourse or burst condom. At least 22% of subjects took LNG according to instructions which were last revised 2 years earlier. The study also revealed poor knowledge among the users on side-effects and limit of drug use. Compared to the previous studies, this study found a higher incidence of side-effects. Forty-four percent of subjects experienced cycle disturbances and 32% nausea, respectively. CONCLUSION: The Thai FDA should seriously consider requiring manufacturers to revise labels of LNG to be consistent with those recommended by WHO.