Browsing by Author "Bajracharya, O"
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Publication Academic detailing(Kathmandu University, 2010) Shankar, PR; Jha, N; Piryani, RM; Bajracharya, O; Shrestha, R; Thapa, HSAbstract There are a number of sources available to prescribers to stay up to date about medicines. Prescribers in rural areas in developing countries however, may not able to access some of them. Interventions to improve prescribing can be educational, managerial, and regulatory or use a mix of strategies. Detailing by the pharmaceutical industry is widespread. Academic detailing (AD) has been classically seen as a form of continuing medical education in which a trained health professional such as a physician or pharmacist visits physicians in their offices to provide evidence-based information. Face-to-face sessions, preferably on an individual basis, clear educational and behavioural objectives, establishing credibility with respect to objectivity, stimulating physician interaction, use of concise graphic educational materials, highlighting key messages, and when possible, providing positive reinforcement of improved practices in follow-up visits can increase success of AD initiatives. AD is common in developed countries and certain examples have been cited in this review. In developing countries the authors have come across reports of AD in Pakistan, Sudan, Argentina and Uruguay, Bihar state in India, Zambia, Cuba, Indonesia and Mexico. AD had a consistent, small but potentially significant impact on prescribing practices. AD has much less resources at its command compared to the efforts by the industry. Steps have to be taken to formally start AD in Nepal and there may be specific hindering factors similar to those in other developing nations. Key words: Academic detailing, pharmaceutical industry, evidence-based informationPublication Prevalence of adverse drug reactions with commonly prescribed drugs in different hospitals of Kathmandu valley(Kathmandu University, 2007) Jha, N; Bajracharya, O; Namgyal, TAbstract Objectives: To study the prevalence of adverse drug reactions (ADRs) in five different hospitals of Kathmandu Valley. Materials and Methods: An analytical cross sectional study was designed from May 2007 to September 2007 in which prevalence of ADR was calculated. A total of 37 cases of ADRs were taken from 4287 patients and 10% of the remaining population without ADRs i.e. 425 out of 4250 patients was selected randomly. ADRs were analyzed as per the structured questionnaires designed by Canadian adverse drug reaction monitoring program. Data thus obtained were analyzed by using SPSS and Excel 2003 software and relevant statistical tools were applied. Results: Prevalence of ADR in this study was 0.86% and male to female ratio was 0.85. 54.1% were female and 45.9% were male (P = 0.65). The highest percentage of ADRs were seen in adult patients, however the difference was statistically not significant. Maximum numbers of ADRs were reported from skin, 35.13% followed by GIT, 29.72% and then from CNS, 18.91%. Anti-infectives were associated with maximum number of ADRs followed by IV urograffin. Rashes, 35.13% were the most common type of ADRs reported followed by vomiting, 13.51% and then dizziness which was 10.81%. Regarding the outcomes attributed to ADRs, one patient died due to ADR caused by dapsone and 15 cases got hospitalized due to ADRs. The incidence of ADRs in different age groups was not significant. Similarly, there was no significant association between ADRs and sex. No significant difference was seen in case of age group less than one year as compared to two or more years of age (P = 0.78). For causality of ADRs, according to Naranjo algorhythm scale, 35% of reactions were assessed to be probable, 32% as possible and 19% were definite. Similarly, for severity assessment, 54% reports were mild, 35% were moderate and 10.81% were severe. Conclusion: Prevalence of ADR in this study was 0.8% which is similar to other studies in other countries. All the ADRs were not toxic reactions and they were unpredictable. Key words: Prevalence, ADRs, Drugs