Therapeutics » Jerry Fahrni

Model for scheduling complex medication regimens

Nov 192011

The abstract below caught my attention. I can’t read the entire article because I don’t have a subscription to the journal (a pet peeve of mine – just sayin’). Nonetheless I found the abstract quite interesting. I think the conclusion is a bit overly optimistic, but the use of computers to calculate an optimized medication schedule for individual patients is a promising idea. (Comput Methods Programs Biomed. 2011 Dec;104(3):514-9. Epub 2011 Oct 5.)

Abstract
Medication adherence tends to affect the recovery of patients. Patients having poor medication adherence show a worsening of their condition and/or increased complications. Unfortunately, between 20% and 50% of chronic patients are unable to manage their medications. This study proposes a model to improve the patients’ medication compliance by reducing medication frequency.

Published studies have shown that, based on the patients’ lifestyle, simplification of the medication frequency and remodeling of the medication schedule is able to help improve medication adherence. Therefore, this study tried to simplify medication frequency by combining therapies. Moreover, by adjusting according to lifestyle, the study also tries to remodel medication timing in relation to mealtimes to create personal medication schedules.

In this study, we used 19,393,452 outpatient prescriptions from the National Health Insurance Research Database to verify our system (algorithm optimized). At the same time, we examined the differences between the frequency summarized by general public and experts’ advice medication behavior. Compared with the experts’ advice method, this system has reduced the medication frequency in about 49% of prescriptions.

Using combined medication to simplify medication frequency is able to reduce the medication frequency significantly and improve medication adherence. Furthermore, this should also improve patient recovery, reduce drug hazards and result in less drug wastage.

Canada calls for national drug shortage registry [article]

Therapeutics No Responses »

Oct 022011

The Canadian Pharmacist Association is looking for a way to track drug shortages. They would like to get drug manufactures and hospitals to participate in a national reporting system. It’s a great idea and one that I think could provide value.

Bacteria everywhere run scared as vancomycin gets new life

Therapeutics No Responses »

Aug 292011

vancomycin medGadget: “Scientists from the Scripps Research Institute have successfully reengineered vancomycin. They have reported their findings in the Journal of the American Chemical Society. This research could be a solution in the treatment of patients infected with highly resistant bacteria. Vancomycin is often considered the antiobiotic of last resort, if other antibiotics have failed to do the job. But the emergence of vancomycin-resistant bacteria is becoming a major health problem. Vancomycin works by binding the D-alanyl-D-alanine terminal dipeptide of peptidoglycan precursors, used by bacteria for constructing their cell walls. By binding it, the bacteria can not use the peptidoglycan anymore and they die. But certain bacteria have altered their peptidoglycan by replacing an amide with an ester, resulting in vacomycin resistance.

The reengineered vancomycin can bind the altered peptidoglycan and kill the bacteria once again using the same mechanism as described above. But besides binding the altered peptidoglycan, this new antibiotic can bind the original peptidoglycan as well. It took Dale L. Boger and his team some serious chemical engineering to redesign vancomycin into this new antibiotic. In the article down below you can read the report how they managed to synthesize this altered antibiotic and exchange a single atom in the vancomycin to reinstate its antimicrobial activity.”

Vancomycin is an oldie, but a goodie. It continues to be useful despite its age. Several drugs have been developed over the years to replace it, but for one reason or another the newer agents tend to fall out of favor. With that said, vancomycin won’t last forever as bacteria are slowing finding ways to combat its mechanism of action. So instead of finding a new drug, someone decided to alter the old one. Go figure.

MedKeeper acquires DoseResponse

Medication Safety 2 Responses »

Oct 192010

It looks like MedKeeper is making a play in the therapeutic monitoring market by acquiring DoseResponse, a web-based outpatient anticoagulation management system from Keystone Therapeutics. The press release can be found here.

Outpatient anticoagulation therapy, i.e. warfarin management, became a big deal when JCAHO made it one of their national patient safety goals a few years back. I’m specifically referring to National Patient Safety Goal 3E: Reducing Harm from Anticoagulation Therapy. If you feel like giving yourself a headache you can read through the entire Abulatory Health Care National Patient Safety Goals (PDF). I wouldn’t recommend it.
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“What’d I miss?” – Week of July 4, 2010

What'd I miss 2 Responses »

Jul 092010

As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
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Monday morning musings

Cool Technology, What'd I miss 2 Responses »

Apr 122010

For some, weekends are a good time to sit around and relax. I tend to do that in the early morning hours of the weekends because the house is quiet and it doesn’t take away from any of the activities that happen during the “normal hours”. It gives me time to catch up on things that I like to do; surf the net and read articles.
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“What’d I miss?” – Week of March 21, 2010

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Mar 262010

Suffusion theme by Sayontan Sinha

Jerry Fahrni

Model for scheduling complex medication regimens

Canada calls for national drug shortage registry [article]

Bacteria everywhere run scared as vancomycin gets new life

“What’d I miss?” – Week of July 4, 2010

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