ANALISIS PENYEBAB OBAT KADALUARSA DI INSTALASI FARMASI RUMAH SAKIT IBU DAN ANAK ERIA BUNDA PEKANBARU TAHUN 2020

Pelayanan kefarmasian merupakan pelayanan penunjang serta pusat pendapatan utama bagi rumah sakit. Instalasi farmasi merupakan salah satu unit pelaksanaan fungsional yang menyelenggarakan seluruh kegiatan pelayanan kefarmasian. Di instalasi farmasi Rumah Sakit Ibu dan Anak Eria Bunda Pekanbaru berpotensi menghasilkan obat kadaluarsa yang dapat menimbulkan kerugian bagi rumah sakit. Tujuan dari penelitian ini adalah untuk mengetahui penyebab obat kadaluarsa di instalasi farmasi Rumah Sakit Ibu dan Anak Eria Bunda Pekanbaru. Penelitian ini merupakan penelitian kualitatif deskriptif. Subjek penelitian ini terdiri dari Kepala Instalasi Farmasi, Penanggung Jawab Farmasi Rawat Inap, Koordinator Perbekalan Farmasi dan Alkes, Staf Farmasi Rawat Jalan, dan Staf Gudang Farmasi. Dengan metode pengumpulan data menggunakan observasi dan wawancara. Dari hasil penelitian dapat disimpulkan bahwa penyebab obat kadaluarsa di instalasi farmasi Rumah Sakit Ibu dan Anak Eria Bunda Pekanbaru disebabkan oleh perencanaan obat yang terlalu berlebih dari konsumsi pemakaian rata-rata rumah sakit, pengadaan obat yang tidak memperkirakan berapa banyak obat yang mau dipesan, serta penyimpanan obat dikarenakan human error dimana kesalahan pada saat penyimpanan yang tidak FIFO dan FEFO. Saran bagi instlasi farmasi Rumah Sakit Ibu dan Anak Eria Bunda Pekanbaru yaitu dengan mengadakan pelatihan dan sosialisasi terhadap perencanaan dan pengadaan obat, serta meningkatkan pengawasan dalam melakukan penyimpanan obat. Pharmaceutical services are support services as well as the main revenue center for hospitals. The pharmacy installation is one of the functional implementation units that organize all pharmaceutical service activities. The pharmacy installation at the Eria Bunda Mother and Child Hospital in Pekanbaru has the potential to produce expired drugs that can cause harm to the hospital. The purpose of this study was to determine the causes of drug expiration in the pharmacy installation of Eria Bunda Mother and Child Hospital Pekanbaru. This research is descriptive qualitative research. The subjects of this study consisted of the Head of the Pharmacy Installation, the Person in Charge of Inpatient Pharmacy, the Coordinator of Pharmacy and Medical Devices, the Outpatient Pharmacy Staff, and the Pharmacy Warehouse Staff. With the data collection method using observation and interviews. From the results of the study, it can be concluded that the cause of expired drugs in the pharmacy installation of Eria Bunda Mother and Child Hospital Pekanbaru is caused by excessive drug planning than the average hospital consumption, drug procurement that does not predict how many drugs to order, and storage. medicine due to human error where the error during storage is not FIFO and FEFO. Suggestions for the pharmacy installation of Eria Bunda Mother and Child Hospital Pekanbaru, namely by holding training and socialization of drug planning and procurement, as well as increasing supervision in carrying out drug storage.

Overview of antidepressants on the pharmaceutical market of Ukraine and dynamics of their consumption during 2015-2019

Among persistent health and disability disorders in Ukraine, the third place among men and the second among women are neuropsychiatric disorders, in the pharmacotherapy of which antidepressants are widely used. The aim of the work was to study the range and outpatient and hospital consumption of antidepressants in Ukraine. The analysis of the range and volume of antidepressant consumption was conducted in the outpatient market during 2015–2019 and in the hospital market during 2016–2019, according to the analytical company «Proxima Research»/«Morion». Consumption was calculated according to the ATC/DDD methodology. DDD/1 000 inhabitants per day (DID, DDD per 1 000 inhabitants per day) was used as a unit of measurement. The results of the study showed that in the pharmaceutical market of Ukraine during 2015–2019, 94–101 tons of antidepressants were used on an outpatient basis, including 29–36 tons of domestic production and 65 tons of foreign manufacturers. In 2016–2019, the hospital used a smaller number of antidepressants TH – 78–79 TH, including 27–29 TH of domestic production and 52–49 TH – imported. The number of trade names of antidepressants in outpatient consumption is 16–22% higher than the number of trade names in hospital consumption, which may be due to lower government procurement of drugs in this group. It was found that outpatient consumption of antidepressants in the period 2015–2019 increased 2.22 times – from 1.08 DID in 2015 to 2.40 DID in 2019. Consumption in hospitals was much lower and ranged from 0.20 DID in 2016. Up to 0.19 DID in 2019 (With a peak of 0.24 DID in 2017). The increase in the use of outpatient antidepressants was gradual, without abrupt changes. Most INN antidepressants, with the exception of N06AX20 Various drugs and the herb St. John's wort N06AX25, have been included in modern medical and technological documents: the State State form of drugs (8–11 issues) and the List of domestic and foreign drugs that can be purchased by health facilities, which are fully or partially funded from the state and local budgets (2015–2017), which indicates their proven clinical efficacy and safety.

Evolution of Antimicrobial Consumption During the First Wave of COVID-19 Pandemic

Background: The first wave of COVID-19 pandemic may have significantly impacted antimicrobial consumption in hospitals. The objective of this study was to assess the evolution of antimicrobial consumption during this period. Methods: A retrospective quasi-experimental before–after study was conducted in a Spanish tertiary care hospital. The study compared two periods: pre-pandemic, from January 2018 to February 2020, and during the COVID-19 pandemic from March to June 2020. Antimicrobial consumption was analyzed monthly as defined daily doses (DDD)/100 bed-days and overall hospital and ICU consumption were evaluated. Results: An increase in the hospital consumption was noticed. Although only ceftaroline achieved statistical significance (p = 0.014), a rise was observed in most of the studied antimicrobials. A clear temporal pattern was detected. While an increase in ceftriaxone and azithromycin was observed during March, an increment in the consumption of daptomycin, carbapenems, linezolid, ceftaroline, novel cephalosporin/β-lactamase inhibitors or triazoles during April–May was noticed. In the ICU, these findings were more evident, namely ceftriaxone (p = 0.029), carbapenems (p = 0.002), daptomycin (p = 0.002), azithromycin (p = 0.030), and linezolid (p = 0.011) but followed a similar temporal pattern. Conclusion: An increase in the antimicrobial consumption during the first wave of COVID-19 pandemic was noticed, especially in the ICU. Availability of updated protocols and antimicrobial stewardship programs are essential to optimize these outcomes.

PP265 Application Of A Case-Mix Method For Medical Consumables Management In Anhui Province, China Using Healthcare Big Data

IntroductionThe case-mix method involves combining cases with similar complexities and medical services. The process of treating one episode of the disease and receiving treatment is the research unit, thus achieving different medical units. The feasibility of the calculation method is verified by calculating the public hospital consumption ratio, medical income, health materials expenditure indicators, and the differences between the various types of surgical combinations. A decision-making basis can then be provided for the creation of government indicator standards.MethodsMedical records and data on the expenditure of medical consumables for the first and fourth quarters of 2017 were collected from seven third-class provincial hospitals. The medical consumption ratio for different diseases and surgical methods was calculated for the case-mix groups using a weighting method. Data were analyzed by descriptive statistics and the independent samples t-test.ResultsThere were significant differences in the proportions of combined use for different types of diseases. The same combination also had significant differences between different hospitals. In the fourth quarter of 2017, the operating group's consumption ratio was significantly lower than in the first quarter (p = 0.000).ConclusionsIt is reasonable to calculate the proportion of consumption by combined weighted analysis, which is also fairer for hospitals with better technical levels. This calculation method can be used by governments to manage the use and cost of medical consumables in hospitals.

Trends of Adult Antimicrobial Hospital Consumption in Catalonia (Spain) from 2008 to 2018

Background: Antimicrobial resistance is a disturbing problem in the health system. A relationship between the use of certain antimicrobials and a resistance increase has been proposed. Since this phenomenon is not usually attributed to specific uses of antimicrobials but preferably to its evolution over the years, the analysis of the antimicrobial consumption over time can justify the epidemiological situation of a given region in terms of resistance and possible increases and decreases for specific microorganisms. The objective of this study was to analyze the evolution of the use of antimicrobials in Catalonia during 2008–2018 through the VINCat program (Infection Control and Antimicrobial Stewardship Catalonian Program). Methods: The number of hospitals participating in the VINCat increased from 46 in 2008 to 63 in 2018 (ie, 68.8% and 85.7% of all adult acute-care hospital beds in Catalonia, respectively). Hospitalization days recorded at the participating hospitals increased from 2,991,053 in 2008 to 3,714,938 in 2018. The Anatomical Therapeutic Chemical Classification (ATC) defined daily dose (DDD) index was used for monitoring antimicrobial consumption. Simple linear regressions were performed, the linear relationship was checked by ANOVA tests, and the Pearson correlation (Pc) coefficients were obtained. Values of P ≤ .05 were considered statistically significant. Results: From 2008 to 2018, there was a statistically significant increase of global antibacterial consumption (65.50 vs 71.73 DDD per 100 bed days; P = .001) and antimycotic consumption (3.09 vs 3.45 DDD per 100 bed days, P = .012) due to an increase of consumption in the surgical units. At the same time, there was a decrease in the consumption of antimycotics in the medical units (4.35 vs 3.90 DDD per 100 bed days; P =.029). Cephalosporins and carbapenem consumption increased both globally (10.88 vs 13.86 DDD per 100 bed days; P < .001) and in medical and surgical units (3.26 vs 5.38 DDD per 100 bed days; P < .001). This increase was mainly associated with ceftriaxone (3.45 vs 5.46 DDD per 100 bed days; P < .001) and meropenem (1.12 vs 3.08 DDD per 100 bed days; P < .001). There was a global decrease in the consumption of penicillins (26.10 vs 24.24 DDD per 100 bed days; P = .012) and quinolones (11.63 vs 9.61 DDD per 100 bed days; P = .004). This trend was observed also in ICUs and medical units but not in surgical units, for which only quinolones showed a significant decrease. Decreases in the use of amoxicillin/clavulanate acid (17.80 vs 14.24 DDD per 100 bed days; P < .001) and ciprofloxacin (5.68 vs 4.01 DDD per 100 bed days; P < .001) were observed. Conclusions: The increase in the use of antimicrobials in Catalonia is concerning. This increase is attributable to the use of these drugs in surgical units. Antibiotic stewardship measures should be aimed primarily at these units. The increasing use of carbapenems should be analyzed.Funding: NoneDisclosures: Juan Pablo Horcajada reports consulting fees from MSD, Pfizer, and Menarini as well as speaker honoraria from MSD, Pfizer, and Zambon.

Impact of population ageing on hospital consumption and medical demography in metropolitan France: The example of obstetricians

The challenges of medical demography have become a major issue today in France, mainly because of the conjunction of two phenomena. Namely, a massive retirement of the “baby boom” generation and a delay in the medical training induced by the “numerus clausus” that had not anticipated that phenomenon. Unfortunately, the repercussion of the population ageing on hospital consumption and consequently on medical demography is very poorly integrated into the calculation and implementation of the medical professions’ numerus clausus in 2010. Thus we suggest a model that not only identifies the effective demand for care on operational geographical scale, namely, the health territory, but that also makes a projection of healthcare consumption based on the age of population of each “health territory” in a T+1 future. To illustrate this model, we take as example the obstetricians’ activity in France.