Game Analysis of Regulation for Online Prescription Drugs under Customer Feedback Mechanism

Objective To study the way to better regulate the online sales of prescription drugs,and to provide reference for the adjustment of relevant policies since the online sales of prescription drugs has become an inevitable trend.Methods A game model was constructed for the strategy choice of pharmaceutical e-commerce platform,customers and government departments based on differential game theory and Nash equilibrium game model to analyze the pure strategy Nash equilibrium,Nash equilibrium dominant strategy of each subject and the mixed strategy Nash equilibrium under different conditions.Besides,Matlab was used to carry out simulation analysis.Results and Conclusion The study shows that:(1)Improving the credibility of the government and reducing the cost of government regulation can not only make the pharmaceutical e-commerce platform operate with high quality,but also give greater play to government functions;(2)The greater the influence of social evaluation on pharmaceutical e-commerce platforms,the lower the cost of high-quality operation of pharmaceutical e-commerce platform,and the greater the probability of customer choosing real evaluation strategy;(3)The greater the customers’perception of potential risk,the greater the compensation,and the lower the cost of reporting.Then,the greater the probability that government departments will choose strict regulation.Finally,the model solution and simulation analysis are combined to provide countermeasures and suggestions for the safety regulation of online sales of prescription drugs.

A study on drug utilization and prescription habits of physicians in a government homeopathic hospital in West Bengal, India

Improper prescribing habits and inappropriate drug use lead to serious health and economic consequences. This study was undertaken to evaluate drug utilization services and prescription patterns of homeopathic doctors in a government homeopathic teaching hospital in India. METHODS： No standardized homeopathic drug use indicators are available. The researchers used indicators for health care setting （drug availability）-modified prescribing indicators and patient care indicators, based on World Health Organization＇s core drug use indicators. A cross- sectional, prospective, institutional, observational study of 2-month duration with record analysis was conducted on 600 patients visiting seven different outpatient departments （OPDs） for the first time at Mahesh Bhattacharyya Homeopathic Medical College ＆ Hospital, Howrah, West Bengal, India, using the developed indicators. RESULTS： Overall availability of prescribed drugs was quite satisfactory （92.28%）. Centesimal potencies accounted for the majority of prescriptions （74.76%）. There was a poor record of diagnosis （39.17%） except in the OPDs of Gynecology and Obstetrics （68.48%, P 〈 0.01） and Dermatology （64.58%, P 〈 0.01）. Records of investigational findings and ongoing therapies, if any, were also poor except OPDs of Gynecology and Obstetrics, and Pediatrics. Structure of prescriptions was maintained satisfactorily in all the OPDs. Though tendency of using ＇individualized homeopathy＇ predominated, there also existed the use of ＇polypharmacy＇. Mean consultation time was 5.9 min. Labeling was extremely poor and is an area needing improvement. The prescriptions were highly legible. CONCLUSION： This was a preliminary study, conducted for the first time in homeopathy using newly developed indicators that yield meaningful results. Further studies are necessary in order to evaluate the different factors involved and to plan future interventions to improve the quality of care in healthcare settings.

Does Direct-to-Consumer Prescription Drug Advertising Achieve a Mechanistic Fair Balance? A Critical Review of the Literature and Debate

The pharmaceutical industry is one of the most advertising-intensive industries.With the exponential growth of Direct-to-Consumer Prescription Drug Advertising(DTCA),there have been a large number of attempts to investigate the effectiveness of DTCA in various media,medications,and consumer groups.However,little attention has been paid to the history of the US Food and Drug Administration(FDA)regulations of DTCA and the status of DTCA practices in terms of regulatory compliance.Thus,this current study identifies a research gap in DTCA and highlights a new avenue that can be explored in future research.

A survey of analgesic and anti-inflammatory drug prescription for oral implant surgery

Aim:This study was conducted to determine the preferred analgesic and anti-inflammatory drugs prescribed by oral implantologists in India.Methods:A structured questionnaire was distributed to 332 dentists to gather information regarding their prescription habits for analgesics and anti-inflammatory drugs.Frequency distributions were computed by type of drug being prescribed and the protocol followed.Results:Analysis of data showed that majority of dentists(85.8%,n=285)prescribed conventional non-steroidal anti-inflammatory drugs(NSAIDs)for implant surgery.The most common prescription was ibuprofen with paracetamol combination(32.2%,n=107)followed by diclofenac(20.2%,n=67).Most dentists reported prescribing different NSAIDs for the same procedure in different patients(64.7%,n=215).Only,35.5%(n=118)followed the peri-operative protocol.Adjunctive prescription of steroids was done by only 33.7%(n=112).Conclusion:Our study illustrates that the general trend of analgesic and anti-inflammatory drug prescription for dental implant surgery among Indian dentists is mostly in accordance with the guidelines for pain management worldwide.However,it is noteworthy that a few dentists do prescribe drugs not primarily indicated for dental pain management and use widely varying protocols for the same.Therefore,in order to avoid potential complications,it is essential to raise awareness of among the dental practitioners of the appropriate indications and dosage regimen of specific drugs.

Survey of Shanghai Residents’ Perceptions of Buying Prescription Drugs Online

Objective To investigate the willingness of Shanghai residents to buy prescription drugs online.Methods By using e-questionnaire,Shanghai residents’perceptions of online prescription drugs were investigated,and 206 valid questionnaires were collected.Results and Conclusion 96.1%of the respondents knew the correct definition of prescription drugs.46.6%knew they could buy prescription drugs online.67.7%,through social media,knew they could buy prescription drugs online.72.3%knew a medical prescription should be required when buying prescription drugs online.And 83.5%refused to buy prescription drugs online because they were concerned about the quality and safety of drugs.The publicity of online-pharmacies and prescription drugs should be increased in China.Besides,the government supervision should be strengthened in the whole process of service to protect consumers’rights and benefits.Then,the channels of online purchase must be optimized for customers.Lastly,a medical insurance payment system should be set up for buying prescription drugs online.

Prescription practice of antihistamines for acute upper respiratory tract infections in pediatric patients in a local emergency department in Hong Kong

BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among primary practitioner and emergency physicians. The objectives are 1) to report the prevalence of antihistamine prescription for children less than 6 years old with acute upper respiratory infection and 2) to explore the associated factors for the prescription practice.METHODS: This is a cross-sectional study. All consecutive cases of paediatric patients aged 6 or below who presented to the emergency department during a study period of one week from April 1 to July 4, 2009 with diagnosis of acute upper respiratory infection were included. Totally 162 patients were included.RESULTS: Among the 162 cases, 141(87%) patients were prescribed one antihistamine of any group. Sixty(37%) patients were prescribed two or more antihistamines. In multivariate logistic regression model, age was found to be signi? cantly(P<0.001) associated with multiple antihistamine prescription(OR=1.042, 95%CI=1.02 to 1.06). Years of graduation of attending physician for more than 5 years was also a strong predictor of multiple antihistamine prescription(OR=4.654, 95%CI=2.20 to 9.84, P<0.001).CONCLUSION: In the local emergency department, patients' age and the years of graduation from medical school of the attending physician were predictors of multiple antihistamine prescription for acute upper respiratory infections for children aged less than 6.

Association between change of health care providers and pregnancy exposure to FDA category C, D and X drugs

Background Changing health care providers frequently breaks the continuity of care,which is associated with many health care problems.The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C,D and X drugs.Methods A 50% random sample of women who gave a birth in Saskatchewan between January 1,1997 and December 31,2000 were chosen for this study.The association between the number of changes in health care providers and with pregnancy exposure to category C,D,and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression,with adjusted odds ratios （ORs） and its 95% confidence intervals （C/s） as the association measures.Results A total of 18 568 women were included in this study.Rates of FDA C,D,and X drug uses were 14.35%,17.07%,21.72%,and 31.14%,in women with no change of provider,1-2 changes,3-5 changes,and more than 5 changes of health care providers.An association between the number of changes of health care providers and pregnancy exposure to FDA C,D,and X drugs existed in women without chronic diseases but not in women with chronic disease.Conclusion Change of health care providers is associated with pregnancy exposure to FDA category C,D and X drugs in women without chronic diseases.

Medicine prescription practices of homeopathic undergraduate students in West Bengal,India

OBJECTIVE： To our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students. METHODS： A cross-sectional study was carried out involving all the students from four government homeopathic schools of West Bengal, India. Ethical requirements were ensured and data were collected using self-administered questionnaires. Chi-square tests and logistic univariate regression analyses were performed to identify associations and differences. RESULTS： A total of 328 forms were completed. Of these, 264 （80.5%） homeopathic undergraduate students admitted of prescribing medicines independently and most （40.5%） said that they did this 2-3 times a year. The most common reasons for this were ＇urgency of the problem＇ （35.2%）, ＇previous experience with same kind of illness＇ （31.8%）, and ＇the problem too trivial to go to a doctor＇ （25.8%）. About 63.4% of the students thought that it was alright to independently diagnose an illness while 51.2% thought that it was alright for them to prescribe medicines to others. Common conditions encountered were fever, indigestion, and injury. Students who prescribed medicines were more likely to belong to Calcutta Homeopathic Medical College and Hospital （odds ratio = 5.8; 95% confidence interval 2.247-14.972）. Prescription by students gradually increased with academic years of homeopathic schools. Many students thought it was alright for students to diagnose and treat illnesses. CONCLUSION： Prescription of medicines by homeopathic undergraduate students is quite rampant and corrective measures are warranted.

妊娠期耳鼻咽喉科处方用药指南

由于妊娠期母体生理功能的改变,药物更易于通过胎盘进入胎儿体内。妊娠期用药不当可导致胎儿畸形或死亡。本文就耳鼻咽喉科常用的几类药物在妊娠期的应用指征做一编译,以供同道们参考。