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Analysis of drug related problems identificated by pharmacist during provision dispensation and the influence of pharmacist's intervention on prescribing doctors
Močárková, Zdeňka ; Vlček, Jiří (advisor) ; Rudolf, Kamil (referee)
Analysis of drug related problems identificated by pharmacist during provision dispensation and the influence of pharmacist's intervention on prescribing doctors Author: Mgr. Zdeňka Močárková 1 Consultant: Prof. RNDr. Jiří Vlček, CSc. 2 1 Community pharmacy in Chrastava 2 Department of Clinical and Social Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové Introduction: Drug problems (drug related problems, DRPs) shall mean all the circumstances involving drug therapy that can actually or potentially interfere with the expected outcome of therapeutic intervention. The solution DRPs (risk of pharmacotherapy) includes their detection, risk assessment and selection of the appropriate intervention and belongs to the one of the fundamental activities of a pharmacist. Aim of study: The aim of this work was to analyze DRPs, their use as a tool for discussion with doctors and subsequent evaluation and estimation of the limits of this model of cooperation between doctor and pharmacist. Methods: A prospective observational study was conducted in the village Chrastava (1 public pharmacy). Record DRPs detected pharmacist during provision dispensation was conducted in two equally long periods (2 x 30 working days) by using electronic databases (including data of patient, patient used...
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Generic substitution and generic drugs ? the analysis of experience of patients
Charouzová, Lucie ; Vlček, Jiří (advisor) ; Grodza, Pavel (referee)
The law about Generic substitution was legislatively established in the Czech Republic in January 2008. The following year certain doubts about the quality, safety, and potential adverse effects of generic drugs appeared. The above mentioned facts prompted us to analyze patient's awareness, opinions, and experience with generic drugs. We used a prospective questionnaire method in several selected pharmacies in the Czech Republic. Data were collected in the period from January to May 2009, and then they were analysed by specific statistic methods. MS Excel and statistic software SPSS were used. The total of 501 filled-out questionnaires were collected and evaluated. Average age of patients was 50 and two- thirds of them were women. 75 % of patients agree with generic substitution. Half of the number of the patients was at least once offered generic substitution, and majority of them agreed with it. Generic substitution was requested only by 7 % of patients. Generic substitution was more frequently offered to women, older patients, and patients using more than one kind of drug (p<0.05). The results show that GS is accepted by majority of patients, and pharmacists are generally perceived as guarantors of its safety. Insufficient awareness of GS can be one of the key factors preventing wider use of...
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Rationaly Aspectof Antibioticotherapy in Patients treated with Dialysis.
Vrběcká, Radka ; Vlček, Jiří (advisor) ; Zemková, Marcela (referee)
Ždímalová R.: Analysis of consumption of antibiotics in patients treated with dialysis, Charles University in Prague, Faculty of Pharmacy, Department of social and clinical pharmacy, Hradec Králové 2009, 73 pages. Introduction and objective: This study observes consumption of antibiotics in patients treated with dialysis in The University Hospital of Hradec Králové in years 2006 and 2007. Pilot project investigate, which kind of antibiotics used dialyzed patients (DP) the most of all. Studies further compare information from two sets of DP from Czech Republic (Group I) and Lithuania (Group II) in specific aspects of antibiotic's consumption. Methodology: Retrospective analysis resulting from data evaluation from Nephris database of University Hospital of Hradec Králové by DP (2006&2007). Set of data of the Group II from Clinics of Kaunas Medical University - Lithuania was process by retrospective analysis too. GLMZ mode was used for statistical analysis. Results: Group I: from average number of 125 hospitalized patients were treated by antibiotics 71 (57%) patients. Both men and women have the same representation in the group, patients undergoing dialysis mostly in higher age, what has been discovered by mean age 66 years. From 71 patients treated with antibiotic was prescribed the most of all...
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Contextual analysis of medication adherence in patients after kidney transplantation
Košťálová, Barbora ; Malý, Josef (advisor) ; Reischig, Tomáš (referee) ; Vlček, Jiří (referee)
Charles University, Faculty of Pharmacy in Hradec Králové Training Workplace Department of Social and Clinical Pharmacy Doctoral Degree Program Clinical and Social Pharmacy Candidate Mgr. Barbora Košťálová Supervisor doc. PharmDr. Josef Malý, Ph.D. Advisor Title of Doctoral Thesis Contextual analysis of medication adherence in patients after kidney transplantation Introduction: Strict adherence to immunosuppressive medication (IS) is essential for organ transplant patients to minimize the risk of graft rejection. Growing number of randomized controlled trials (RCTs) shows the effectiveness of interventions to enhance medication adherence in transplantation, however, the real-world implementation is still a major challenge. The objective of the thesis was to analyze medication adherence in the context of selected clinical and behavioral aspects in Czech kidney transplant outpatients and to evaluate the range of information available in RCTs to support real-world implementation of adherence-enhancing interventions. Methods: 1) The cross-sectional study was conducted between April and December 2019 in the Transplant clinic of the University Hospital Hradec Králové. All adult outpatients were approached during their scheduled visit at the clinic. Data was collected via patient-administered...
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Contextual analysis of medication adherence in patients after kidney transplantation
Košťálová, Barbora ; Malý, Josef (advisor) ; Reischig, Tomáš (referee) ; Vlček, Jiří (referee)
Charles University, Faculty of Pharmacy in Hradec Králové Training Workplace Department of Social and Clinical Pharmacy Doctoral Degree Program Clinical and Social Pharmacy Candidate Mgr. Barbora Košťálová Supervisor doc. PharmDr. Josef Malý, Ph.D. Advisor Title of Doctoral Thesis Contextual analysis of medication adherence in patients after kidney transplantation Introduction: Strict adherence to immunosuppressive medication (IS) is essential for organ transplant patients to minimize the risk of graft rejection. Growing number of randomized controlled trials (RCTs) shows the effectiveness of interventions to enhance medication adherence in transplantation, however, the real-world implementation is still a major challenge. The objective of the thesis was to analyze medication adherence in the context of selected clinical and behavioral aspects in Czech kidney transplant outpatients and to evaluate the range of information available in RCTs to support real-world implementation of adherence-enhancing interventions. Methods: 1) The cross-sectional study was conducted between April and December 2019 in the Transplant clinic of the University Hospital Hradec Králové. All adult outpatients were approached during their scheduled visit at the clinic. Data was collected via patient-administered...
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Analysis of drug-drug interactions in patients admitted to hospital (I.)
Kukrálová, Kateřina ; Vlček, Jiří (advisor) ; Doseděl, Martin (referee)
Candidate: Kateřina Kukrálová1 Supervisor: prof. RNDr. Jiří Vlček, CSc.1 Consultant: PharmDr. Zuzana Očovská1 1 Department Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Title of the master thesis: The analysis of drug-drug interactions in patients admitted to hospital (I.) The presence of potential drug-drug interactions (DDIs) is common in daily practice and only a small proportion of potential DDIs results in hospitalization of the patients. Nevertheless, DDIs represent a significant cause of hospital admissions. This study aims to identify DDIs in the medication history of the patients admitted to University Hospital Hradec Králové via the emergency department in August-November 2018. The objectives of this study are a) to determine the prevalence of potential DDIs; b) to categorize identified potential DDIs with respect to their mechanism, severity, risk rating, level of documentation and potential outcomes and c) to determine the prevalence of manifest DDIs. This study has a cross-sectional design. The following data were obtained retrospectively from electronic medical records: demographic data, medication history, past medical history, laboratory and clinical findings, and information about hospital admission. The identification of potential DDI was...
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The analysis of eating habits of diabetics in the USA
Vaňkátová, Helena ; Vlček, Jiří (advisor) ; Matoulková, Petra (referee)
Besides the good drug compliance, appropriate nutrition plays important role in successful management of the metabolic aspects of type 2 diabetes mellitus (DM2), and in the prevention of diabetes-related conditions. The goal of this study was to analyze eating habits among DM2 patients in the United States. The Fat- and Fiber-Related Diet Habits Questionnaire (A.Shattuck, 1998) was used in this study to obtain identical data for comparison. The original version was slightly adjusted according to the local habits. The study took place at the El Rio Community Health Center clinics in Tucson, Arizona, USA; during the time period of three months (September to December 2011). Patients with DM2 patients visiting the clinic were recruited for participation. Once patients were given the questionnaire, answers were put into the database created in an Excel application (Microsoft Office 2010) and analyzed using the frequency analysis. 207 patients filled out the questionnaire. The mean age was 56,8 ± 12,6 years, the mean age when diagnosed with DM2 was 45,3 ± 12,7 years, BMI 33,2 ± 7,8 kg/m2, the mean waist circumference 109,7 ± 19,7 cm and the mean A1C was 8,1± 1,7% (ad DCCT). 10% of participants were treated only by the diet, 49% with peroral antidiabetics (PAD), 14% with insulin, and 28% with combination...
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Prospective Survey of Respiratory Infections in Pre-School Children And Parents' Attitude to Prevention And Sel-Treatment
Garbe Gdovin, Daniela ; Vlček, Jiří (advisor) ; Zimčíková, Eva (referee)
1.2. Abstract in English Title: Prospective survey of respiratory infections in preschool children and parents' attitudes to prevention and self-medication Introduction: Respiratory infections have traditionally been at the forefront of morbidity in the Czech Republic. Respiratory infections occur across the entire spectrum of the population and are often an important part of their lives, especially in pediatric patients. It is a disease that, as a rule, in the absence of complications, is not life-threatening and very often the patient can cope the course alone, without special treatment. Greater spectrum and better availability of virological examinations indicate the dominant etiological participation of viruses in the most common respiratory syndromes. The aim of this research was to find out the incidence of respiratory infections in the pre-school age population and attitudes of parents to prevention and self-treatment. Methods: The pilot survey was carried out in a population of children aged 3 to 6 years attending a collective pre-school facility. Data were collected prospectively in the cold season from October 2018 to April 2019 using two questionnaires for parents of preschool children attending a collective institution: questionnaire A, aimed at collecting data on the child's basic health status...
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Analysis of non-cardiac adverse event of glucocorticoid pulse therapy
Polláková, Lenka ; Vlček, Jiří (advisor) ; Macek, Karel (referee)
5 ABSTRACT Candidate: Lenka Polláková1 Supervisor: prof. RNDr. Jiří Vlček, CSc.1 Consultant: doc. MUDr. Tomáš Soukup, Ph.D.2 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University 2 2nd Department of Internal Gastroenterology, University Hospital in Hradec Králové Title of the master thesis: Analysis of non-cardiac adverse event of glucocorticoid pulse therapy Intravenous glucocorticoid pulse therapy (PT GC) is effective in life threatening flares of rheumatic diseases. However, due to GC's pleiotropic effect, higher doses and additive nongenomic mechanism in pulse regimen, it is not free of complications (1). The aim of theoretical part was to describe from literature research the relevance of PT GC, its non- cardiac adverse events (AE) in rheumatic patients and their influencing factors. The aim of experimental part of the study was to analyze the occurrence of non-cardiac AE in real-life setting, analyze risk factors of potential adverse drug reactions (ADR) and its complications and analyze the risk minimalization management in real-life setting. Patients were administered 1000 mg methylprednisolone in 3 to 5 doses on alternating days. Analysis includes 277 rheumatic patients with 325 pulse therapy courses. Data were collected retrospectively from their...
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The influence of pulse glucocorticoid therapy on ECG
Bosaková, Nikola ; Vlček, Jiří (advisor) ; Rozsívalová, Petra (referee)
Candidate: Nikola Juríková1 Supervisor: prof. RNDr. Jiří Vlček, CSc.1 Consultant: doc. MUDr. Tomáš Soukup, PhD.2 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University 2 2nd Department of Internal Medicine - Gastroenterology, University Hospital in Hradec Králové Title of the master thesis: Effect of pulse glucocorticoid therapy on ECG Glucocorticoid pulse therapy (PT) is used to terminate acute exacerbations of immunologically mediated diseases. The aim of this thesis was to analyze the influence of methylprednisolone (MP) PT on ECG changes, mainly on QT interval, as prolonged QT interval may induce ventricular arrhythmias and to identify other risk factors (RF) for QT prolongation. Data were gained retrospectively from medical records of patients hospitalized at II. Internal Gastroenterology Clinic of University Hospital Hradec Králové. QT was corrected to QTc using Bazzet (QTcB) and Fridericia (QTcF) formula, QTc >450 ms (men) and QTc >460 ms (women) was considered prolonged. QTc changes before and after pulse therapy were determined as ∆QTc. 325 pulses of MP were administered to 277 patients (66,0 % women), ECG was available in 94,2 % (n=306 from 325). After PT there was significant ∆QTcF 14,6 ms (p <0,001) and ∆QTcB 5,6 ms (p <0,001)....
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