Inappropriate prescribing of antimalarial therapy for the treatment of undifferentiated febrile illness among the elderly.
Background: Inappropriate prescribing results in serious health outcomes in the elderly, increasing morbidity and mortality and wasting resources. In developing countries, physicians sometimes ignore parasitological diagnoses and presumptively treat fever as malaria, leading to overtreatment and dru...
| Publicado en: | Journal of Pharmacy Practice & Research Vol. 48; no. 6; pp. 530 - 537 |
|---|---|
| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2018
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=133581484&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 133581484 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1445937X 6CKV jtl: Journal of Pharmacy Practice & Research issn: 1445937X maglogo: N pubinfo: dt: Dec2018 vid: 48 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 133581484 133581484 133581484 10.1002/jppr.1452 133581484 ppf: 530 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Inappropriate prescribing of antimalarial therapy for the treatment of undifferentiated febrile illness among the elderly. aug: au: Menon, Vineetha Bharathan Ramesh, Madhan Pereira, Pratibha Chilkunda Raviprakash, Venkatesh Undela, Krishna affil: Department of Pharmacy Practice, JSS College of Pharmacy, JSS University, Mysore India sug: subj: Inappropriate Prescribing Economics Antimalarials Therapeutic Use Fever of Unknown Origin Drug Therapy Prescribing Patterns Human Incidence Aged Aged, 80 and Over Prospective Studies Tertiary Health Care Academic Medical Centers Fever of Unknown Origin Diagnosis Root Cause Analysis Antimalarials Administration and Dosage Injections Overdose Female Bedridden Persons Leukocytes Hospitalization of Older Persons Guideline Adherence Multidisciplinary Care Team Inappropriate Prescribing Prevention and Control Antimalarials Adverse Effects Quality of Life Aged: 65+ years Aged, 80 & over Female ab: Background: Inappropriate prescribing results in serious health outcomes in the elderly, increasing morbidity and mortality and wasting resources. In developing countries, physicians sometimes ignore parasitological diagnoses and presumptively treat fever as malaria, leading to overtreatment and drug resistance. Aim: The aim of this study was to determine the incidence, pattern, predictors and cost implications of inappropriate prescribing of antimalarials among elderly in‐patients. Methods: A prospective interventional study was performed over 18 months at the Department of Internal Medicine, in a tertiary care teaching hospital. Fever case management of all patients was studied to identify inappropriate antimalarial prescriptions without a confirmed diagnosis. Root cause analysis was performed to characterise inappropriate prescribing, along with economic implications. Results: During the study period, 403 fever cases were reported, of which 36% (n = 145) received a malaria test. Although 94% (n = 137) tests returned negative results, 32% (n = 44) of these patients were prescribed antimalarial drugs without a confirmed diagnosis, primarily monotherapy with injectable artesunate (61%) for an average of 4 days, resulting in 41% overdoses and 38% underdoses. The estimated direct cost associated with inappropriate prescribing was US$1291.67. Female bedridden patients who presented with fever associated with chills and rigors and hospitalised for longer were more likely to be irrationally prescribed antimalarials. Except for total leucocyte counts, all the other laboratory examinations were within normal limits for the study cohort (p < 0.05). Conclusion: Strict treatment guidelines for antibiotic use and a multidisciplinary team approach are required to prevent inappropriate prescribing and possible adverse effects without affecting health‐related quality of life. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|