Suchergebnisse

Tuberculosis (TB) remains one of the leading killers among bacterial diseases worldwide. In the Philippines, the prevalence of culture-positive TB is estimated to be 5 per 1000 and that for sputum smear-positive pulmonary TB is 2 per 1000 based on the 2007 National Prevalence Survey. In addition, the prevalence of metabolic syndrome among Filipinos is 5 percent or approximately 5 million people have diabetes (DM) in the Philippines. With the Philippines being endemic for TB, compounded by an upward trend of DM, there is a need to jointly address this tandem disease interaction. This study aims to mount a coordinated response to TB/DM with the following expectations: 1) improve the case detection rate for TB, 2) facilitate early management among patients, and 3) prevent a significant number of severe disease and deaths.Mixed methods are used to achieve the objectives including a systematic review and gray literature to estimate the magnitude of co-morbidity with TB and DM, records review specifically medical records on clinical charts of patients, cross-sectional survey on knowledge, attitudes, and practices of health care providers on TB/DM screening and care, focus group discussions comprising of program managers and technical advisors of the National Tuberculosis Program, and costing exercise on bidirectional screening of TB in diabetic patients and vice versa. Given the government's commitment to the nationwide control of TB, the underexplored frontier of TB among diabetic patients can be among the stretch goals toward increased case detection, management and prevention efforts. Likewise, the increasing prevalence of diabetes in the country and the associated risk of TB transmission in a TB-endemic population suggest the need for raising awareness on the need for TB screening. However, there is a body of programmatic and operational research questions to answer before an integrated approach to bidirectional screening can actually be implemented.

This study was designed to address the issue of compliance of physicians and drugstores to the provisions of Generics Act of 1988. Furthermore, it aims to explore the awareness of consumers on generic medicines to explain current trends and practices in drug prescribing, dispensing, and use. The study utilized a cross-sectional design. It is a descriptive study that assessed four variables: generic drug prescription, generic drug substitution/dispensing, price menu cards, and use of generic drugs. The country was divided into six zones, namely: North Luzon, South Luzon, NCR, Visayas, Mindanao, and ARMM. Stratified cluster random sampling was used to identify which provinces and cities would be included in the study.Data collection techniques used include the following: a survey of consumers coming out of a drugstore (a total of 1,160 respondents), key informant interview of 30 physicians, and focus group discussion with 6 to 11 patients/watchers per zone.The survey revealed that five out of six drugs were written with generic names, with doctors in the public sector prescribing generics significantly more often than those in the private sector. Factors that positively affect generics prescribing behavior are patient's welfare, compliance, patient's financial situation, and fear of punishment. Quality concerns, lack of regulation by FDA, poor recall, patient's preference, and personal experience are factors that negatively affect generics prescribing behavior. Less than half of the consumers were offered with generic alternatives, and even less number of consumers actually asked for the alternative. There is preference for branded medicines over generics. The consumers more likely to purchase generic medicines consulted a public facility, knew the requirement to write generic name, and was influenced by friends and relatives. Because there is already high compliance from drug prescribers, government efforts should now focus on the drugstores and consumers. Drugstore compliance should be regularly monitored, and consumers empowered on their right to know alternatives. Bioequivalence tests should be done to finally put an end to concerns on the quality of generic medicines.