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List of accepted abstracts at

Global Pharmacy and Health Care Services Research Summit (GPHSRS) 2016


1- Assessment of Adherence to Venous Thromboembolism Prophylaxis Guidelines: A Cross-sectional Study of Medical Inpatients at a Tertiary-care Hospital, Riyadh-Saudi Arabia

Hanaa Omar, Israa Hussein, BasmaKentab, EmanAlobary

Prince Sultan Military Medical City, Pharmacy Department, Riyadh, Saudi Arabia


Background: Venous thromboembolism (VTE) is a potentially fatal disorder that is often asymptomatic, undiagnosed and associated with a major risk of morbidity and mortality. Hospitalized patients are particularly at high risk. Despite all evidence supporting the importance of VTE prophylaxis, reports from around the world show that guideline recommendations are not always translated into practice, leading to low rate of appropriate prophylaxis.

Objectives: To assess and evaluate the level of adherence of VTE prophylaxis in hospitalized medical patients by following last ACCP guidelines.

Materials & methods: Hospitalized patients were recruited from four medical wards. Data were gathered from patients’ medical records. The Padua Prediction Score was used to classify patients’ risk for the development of VTE. Then, appropriateness of thromboprophylaxis received was judged as sufficient, insufficient or excessive.

Results: A total of 219 patients were included, 148 (67.6%) of them were under general internal medicine and 71 (32.4%) were under nephrology. The risk of VTE was considered high in 134 (61.2%) patients. Overall, VTE prophylaxis was deemed sufficient in 135 (61.64%), insufficient in 20 (9.13%) and excessive in 64 (29.22%) patients. Application of the guideline was significantly higher in patients admitted under general internal medicine (60.7%) compared to those under nephrology 39.3%, (p-value. 0.00).

Conclusion: The study results reflected suboptimal practices in prescribing VTE prophylaxis to hospitalized patients. Interventions to enhance adherence to the guidelines are needed.

 

 2- Evaluation of melatonin prescribing in a tertiary level heath institution of queensland

Eman Ali Alghamdi1, Sohil Khan2 , David M. Pache3,  Honey Heussler4, Treasure M McGuire5,  1Prince Sultan Military Medical City, Pharmacy Department, Riyadh, Saudi Arabia,

2Griffith University, Pharmacy School, QLD, Australia, 3,4,5 University of Queensland, Pharmacy School, QLD, Australia,


Objectives: There were two key aims of this thesis. The first aim was to identify the current knowledge gaps on the efficacy and safety of melatonin treatment in paediatric populations, and to assess the adverse drug reactions in those patients taking melatonin, by conducting a literature review. The second aim was to evaluate the pattern of melatonin prescriptions, as well as melatonin efficacy and safety in paediatric at the Paediatric Respiratory and Sleep Unit, Mater Children’s Hospital, Raymond Terrace, South Brisbane, Queensland.

Materials and methods: For the first aim, a literature review study was performed, which required searching the databases PubMED, MEDLINE, and the Cochrane Database of Systematic Reviews from 1958 to present day (September 2013). only English-language human (RCTs) for inclusion, which had to be on children from 4 months to 18 years of age.

For the second aim, a chart review study was conducted by retrieving the charts of children who had melatonin dispensed to them by Mater Pharmacy Services between 2005 and 2013.

Results: For the literature review study. No significant adverse effects of melatonin treatment were observed in these studies. However, longer follow-up studies and larger sample populations are needed.

For the chart review study, the effectiveness and tolerability of melatonin was assessed in 113 children. The average effective dose of melatonin in all groups was 3.76 mg, usually administered 30 minutes to 1 hour before bedtime. Some adverse effects were observed, such as drowsiness, hyperactivity, or constipation; however these were not common and mild. Thus, melatonin may be effective, safe, and well tolerated in the treatment of chronic insomnia in children.

Conclusion: The literature review suggested that existing studies show some efficacy of melatonin in treating sleep disturbances with few side effects; this finding was confirmed and supported by the retrospective chart review.

 

3- Uncontrolled Glucose Levels: a Risk Factor in Diabetic Patients Presenting with Acute ST Elevation Myocardial Infarction (STEMI)

AbdulRahman Samy Ismaiel, MD - Carol Davila University of Medicine and Pharmacy, Bucharest, Romania


Introduction: Acute myocardial infarction (MI) is a major cause of morbidity and mortality in diabetic patients. Factors unique to diabetes contribute in a higher incidence of MI due to an increase in atherosclerotic plaque formation and thrombosis. Although diabetic patients have a higher risk for developing ischemic heart disease, the effect of diabetes mellitus (DM) on the prognosis of patients with acute MI after reperfusion therapy remains controversial.

Objectives: The aim of this study was to assess and compare the prognosis, complications, systolic and diastolic functions of controlled vs. uncontrolled diabetics.

Materials and Methods: A retrospective study was performed on 98 patients presenting with acute STEMI. 37 patients (37.8%) were found to have DM Type 2. Diabetic patients had their glucose levels measured and were further divided into 2 groups, controlled diabetics with glucose values of ≤125mg/dl for fasting blood sugar (FBS) or postprandial with ≤140mg/dl and uncontrolled diabetics with ≥140 mg/dl for FBS or postprandial ≥200mg/dl.

Results: Out of the 37 diabetic patients, males were 67.6% while females were 32.4% with a mean age of 59±11. Hypertension was present in uncontrolled and controlled diabetics with 80.8% and 54.5% respectively. 3.8% of the uncontrolled diabetics presented with ventricular tachyarrhythmia. Tricoronary artery involvement was found in 34.6% of the uncontrolled patients and in 18% of the controlled patients. Post MI reperfusion management complications were present in uncontrolled and controlled diabetic patients with 11.5% and 9.1% respectively. Systolic dysfunction was present in uncontrolled and controlled groups in 84.6% vs. 72.7% while diastolic dysfunction was present in 73.1% vs. 27.3% respectively. Mortality rate was 3.8% in diabetic patients with uncontrolled glucose levels.  

Conclusions: Uncontrolled glucose levels in diabetic patients were significantly correlated with higher rates of tachyarrhythmia, tricoronary artery involvement, hypertension, post MI reperfusion management complications, mortality rates, systolic and diastolic dysfunctions.

 

4- Impact of community pharmacy diabetes monitoring and education programme on diabetes management: a randomized controlled study

M. Ali1, F. Schifano1, P. Robinson2, G. Phillips3, L. Doherty3, P. Melnick3, L. Laming4, A. Sinclair4 & S. Dhillon1 , 1School of Pharmacy, University of Hertfordshire (UH)

2Merck Sharp & Dohme Ltd., Hoddesdon, Hertfordshire, 3Manor Pharmacy Group, Hertfordshire, 4Bedfordshire and Hertfordshire Postgraduate Medical School, University of Bedfordshire


Objectives: To evaluate the impact of a pharmacist-led patient education and diabetes monitoring program on HbA1c and other cardiovascular risk factors in the community setting.

Materials and methods: Patients with Type 2 diabetes (n=46) attending two community pharmacies in Hertfordshire, UK were randomised to one of two groups. The 'intervention' group (n=23) received a program of education about diabetes, its treatment and associated cardiovascular risk factors. They were seen for monitoring/counselling by community pharmacist on 6 occasions over a 12 month period. Measures included HbA1c, BMI, BP,  blood glucose and lipid profile. The 'control' group (n=23) underwent these measurements at baseline and at 12 months only, without specific counselling or education over and above usual care.

Results: HbA1c fell from 8.2 (65.55) to 6.6% (48.73mmol/mol) (p<0.001) in the intervention group, compared with a fall from 8.1 (64.54) to 7.5% (58.76mmol/mol) in the control group (p=0.03). BP fell from 146/87 to 126/81mmHg in the intervention group (p=0.01) compared with no significant change in the control group (136/86 to 139/82mmHg). Significant reductions in BMI (30.8 to 27kg/m2, p<0.001) and blood glucose (8.8 to 6.9mmol/l, p<0.001) were also observed in the intervention group as compared to no significant changes in the control group. Lipid profile changes were mixed. In the intervention group, improvements were seen in diabetes-related quality of life (p=0.001), diabetes knowledge (p=0.018), belief about the need for medication (p=0.004) and a reduced concern regarding their medication (p<0.001).

Conclusion: Education and counselling by community pharmacists can result in favourable improvements to cardiovascular risk profile of patients with Type 2 diabetes.

  





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GPHSRS 2016

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