Naturalistic Evaluation of Pharmacotherapy Consultations Provided to Hospital Clinicians: A Developing Country’s Perspective

Abstract

Background: Critical appraisal of published literature for hospital clinicians has never been taken as an initiative in developing countries. Objective: This study was aimed at evaluating the nature of pharmacotherapy consultations from the drug information center (DIC) of the Postgraduate Institute of Medical Education and Research, Chandigarh, India. Methods: The DIC received pharmacotherapy consultation requests from January 2016 to December 2017. Various aspects such as clinical queries, patient-related factors, and disease-related information in these requests were recorded and analyzed. Descriptive statistics and χ2 test were used for the analysis of the data and feedback evaluation, respectively. Results: During the study, a total of 179 consultation requests were documented. On 19 (10.61%) encounters, pharmacotherapy consultations occurred for emergency patient care. Of the 179 queries, 31 (17.3%) were answered immediately while 148 (82.68%) were answered within an average time of 1.6 hours. The most common type of query was the pharmacotherapy of disease, followed by dose calculation and dose modification. Communications with DIC staff took place for timely critical appraisal of the medical literature, followed by a judicious selection of higher antimicrobials and other drugs. The time taken for answering a query was found to be a statistically significant determinant of user satisfaction ( P < .05). Conclusion: The evidence level–specific drug information service was established and catered to hospital clinicians through critical evaluation of offline and online resources. DIC services have the potential to revolutionize the pharmacy and pharmacology curriculum in developing countries.

Randomized controlled trial of cefazolin monotherapy versus cefazolin plus azithromycin single dose prophylaxis for cesarean deliveries: A developing country's perspective

“…The prolonged rupture of membranes and increasing number of vaginal examinations are well-recognized risk factors in the development of infectious morbidity associated with cesarean section. [8] However, in the present study, analysis of all women who developed SSI showed that nearly one-third of women had ruptured membranes for more than 12 h when compared to only 1.6% of those who did not develop SSI. Other risk factor for developing SSI in addition to these include chorioamnionitis, premature rupture of membranes, prolonged labor (particularly prolonged second stage), large incision length, subcutaneous tissue thickness more than three cm, subcutaneous hematoma, lack of antibiotic prophylaxis, emergency delivery, excessive blood loss, preeclampsia, and diabetes mellitus.…”

“…[10] A judicious selection of antimicrobials is the need of the hour, especially in developing countries such as India. [8] The present study is the first randomized controlled trial from a developing country evaluating the maternal and neonatal outcomes in women undergoing either planned or emergency cesarean section and receiving the single versus combination of antimicrobial agents as prophylaxis regimen.…”

“…The background incidence of hospital-acquired infections, especially in the tertiary-care government hospitals of India remain high due to more number of patients with increased complications and/or co-morbidities. [78] The study aimed at evaluating the prophylaxis efficacy of azithromycin as an add on in routine cefazolin for cesarean deliveries.…”

Assessment of the Impact of Clinical Pharmacology Consultations Provided to Hospital Clinicians From the Drug Information Center—An Outcome Research in a Developing Country

“…Although the initial setup of landline and mobile phone is still helping us in providing DIC service in major way, the social media platforms such as WhatsApp, Facebook, and e-mails have further strengthened the communication between the hospital doctor and the DIC staff. 12 The gearing Internet services in developing countries can explain opting for and the utilization of these communication channels in DIC service. At present, there is no other DIC that utilizes these social media platforms for DIC communication.…”

Pharmacotherapy Patient Counselling: Another feather in the cap for Clinical Pharmacology discipline in a resource-limited setting

“…3 Thus, there is a call for the novel clinical pharmacology service via which one can bridge this gap and help the local population with relevant counseling related to the treatment plan and tailor it towards patient-specific concerns. 4 Authors hypothesized that difficult counseling scenarios such as drugs to be avoided in mastocytosis patients, myasthenia gravis, long QT syndrome, porphyria patients, could be the arena to explore for pharmacology and clinical pharmacology departments in developing countries. With this background idea, the DIC started patient counseling sessions for the five diseases (Figure 1).…”