Evaluation of Drug Procurement with the E-Phurchasing System on the Availability of Drugs at the Pharmacy Installation of the Central Aceh Regency Health Office 2021

The purpose of the study was to evaluate drug procurement with the E-Purchasing system on the availability of drugs at the Pharmacy Installation of the Health Office of Central Aceh Regency. The research design used qualitative research methods through in-depth interviews accompanied by direct observation (observation). Informants of the Head of the Health Office, the Head of the Pharmacy Installation of the Health Office, the Planning and Finance Subdivision of the Health Office, the drug management officer at the Health Office and the health center drug management officer were 2 people. Data analysis is presented in the form of a text (content analysis). The results of the research on the availability of drugs at the Pharmacy Installation of the Aceh Tengan District Health Office have not been maximized, the process of ordering drugs by E-purchasing and Non-E-purchasing is in accordance with PMK No. 63 of 2014, but the fulfillment time is not in accordance with the 2014 Pharmaceutical Service Standards. The budget provided for the drug procurement process by e-purchasing is not sufficient. The conclusion of this study is that the availability of drugs in the Pharmacy Installation of the District Health Office of Central Aceh Regency has not been maximized. This drug vacancy is caused by the number of drugs that are not all realized, the time of drug delivery by the distributor.

Drug Discovery for Mycobacterium tuberculosis Using Structure-Based Computer-Aided Drug Design Approach

Developing new, more effective antibiotics against resistant Mycobacterium tuberculosis that inhibit its essential proteins is an appealing strategy for combating the global tuberculosis (TB) epidemic. Finding a compound that can target a particular cavity in a protein and interrupt its enzymatic activity is the crucial objective of drug design and discovery. Such a compound is then subjected to different tests, including clinical trials, to study its effectiveness against the pathogen in the host. In recent times, new techniques, which involve computational and analytical methods, enhanced the chances of drug development, as opposed to traditional drug design methods, which are laborious and time-consuming. The computational techniques in drug design have been improved with a new generation of software used to develop and optimize active compounds that can be used in future chemotherapeutic development to combat global tuberculosis resistance. This review provides an overview of the evolution of tuberculosis resistance, existing drug management, and the design of new anti-tuberculosis drugs developed based on the contributions of computational techniques. Also, we show an appraisal of available software and databases on computational drug design with an insight into the application of this software and databases in the development of anti-tubercular drugs. The review features a perspective involving machine learning, artificial intelligence, quantum computing, and CRISPR combination with available computational techniques as a prospective pathway to design new anti-tubercular drugs to combat resistant tuberculosis.

Kidney Disease Management in the Hospital Setting: A Focus on Inappropriate Drug Prescriptions in Older Patients

Aging with multimorbidity and polytherapy are the most significant factors that could led to inappropriate prescribing of contraindicated medications in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the prescriptions of contraindicated drugs in older adults in CKD and to identify their associated factors in a hospital context. An observational retrospective study was carried out considering all patients ≥65 years with at least one serum creatinine value recorded into the REPOSI register into 2010–2016 period. The estimated glomerular filtration rate (eGFR) was applied to identify CKD. A descriptive analysis was performed to compare demographic and clinical characteristics; logistic regression models were used to estimate factors of inappropriate and percentage changes of drug use during hospitalization. A total of 4,713 hospitalized patients were recorded, of which 49.8% had an eGFR <60 ml/min/1.73 m2; the 21.9% were in treatment with at least one inappropriate drug at the time of hospital admission with a decrease of 3.0% at discharge (p = 0.010). The probability of using at least one contraindicated drug was significantly higher in patients treated with more several drugs (OR 1.21, 95% CI 1.16–1.25, p <0.001) and with CKD end-stages (G4: 16.90, 11.38–25.12, p < 0.001; G5: 19.38, 11.51–32.64, p < 0.001). Low-dose acetylsalicylic acid was the contraindicated drug mainly used at the time of admission, reducing 1.2% at discharge. An overall increase in therapeutic appropriateness in hospitalized older patients with CKD was observed, despite a small percentage of therapeutic inappropriateness at discharge that underlines the need for a closer collaboration with the pharmacologist to improve the drug management.

Evaluasi ketersediaan obat di beberapa puskesmas wilayah kabupaten X tahun 2019

Drug management in public health centers (Puskesmas) needs to be solve properly to ensure continuing availability and affordability medical services that efficient, effective and rational. The aims of this study are to describe and evaluate drug management in four Puskesmas on Kabupaten X, especially in planning, demanding, receiving, distribution, and storage. This study is a descriptive-evaluative study, with quantitative and qualitative methods, using retrospective data in 2019. The results show that suitability of the types of drugs available with the district drug formulary : 93.46-98.57%; accuracy of drug demand 114-416%; receiving accuracy 76-128%; dead stock 1.3-31.57%; prescriptioning generic drugs 94.72-100%; and the value of damaged drugs 0-17,37%. Results of this study can be concluded that the drug management in four Puskesmas still not optimal because not in accordance with the standard.

Household Drug Management Practices of Residents in a Second-Tier City in China: Opportunities for Reducing Drug Waste and Environmental Pollution

The total amount of drug waste is expanding significantly as populations age and societies become wealthier. Drug waste is becoming a problem for health and the environment. Thus, how to reduce and effectively dispose of drug waste is increasingly becoming an issue for society. This study focuses on household drug management, which involves five sub-practices: selection, purchasing, using, storing, and disposing of drugs. A questionnaire survey was conducted in a second-tier Chinese city that reveals both problems and opportunities in these five sub-practices. The results show that consumers are aware of significant issues with regard to the safe and effective use of drugs as well as with regard to proper ways of disposing of and recycling drugs. Moreover, our analysis reveals promising opportunities for addressing these issues by developing novel services based on the idea of connecting the five involved sub-practices of household drug management. Connecting and adjusting practices in this manner can be seen as an important factor in reducing drug waste and pharmaceutical pollutants.