Journal of Pharmacoeconomics and Pharmaceutical Management http://jppm.tums.ac.ir/index.php/jppm Tehran University of Medical Sciences en-US Journal of Pharmacoeconomics and Pharmaceutical Management 2383-4498 The quality of life in hemodialysis patients referring to hospitals of Zahedan University of Medical Sciences http://jppm.tums.ac.ir/index.php/jppm/article/view/30 <p><strong>Background:</strong> Patients with chronic and advanced kidney failure, who undergo hemodialysis treatment due to various drug therapies, encounter basic problems in their life style; consequently, these conditions affect both their physical and psychosocial state. The main purpose of this study was to determine the quality of life of hemodialysis patients referred to Zahedan University of Medical Sciences in Khatam-Al-Anbia and Ali-Ebnabitaleb hospitals in 2017.</p> <p><strong>Methods:</strong> This is a descriptive-analytical study. All patient participants (n=129) referring to Zahedan hemodialysis clinics completed a questionnaire which included two sections: demographic data (7 questions) and Kidney Diseases Quality of Life (KDQOL) (24 questions) whose validity and reliability had been confirmed in previous studies. Data analysis was conducted through SPSS software v. 19 using statistical tests such as ANOVA and Independent T-test.</p> <p><strong>Results:</strong> Of 129 hemodialysis patients, %58.9 were men. %41.2 of participants were 46-65 years old. The duration of kidney failure in %63.6 of patients was between 1 to 5 years. The participants’ mean (SD) score of quality of life was 42.51±1.21. Moreover, results revealed that there was a statistically significant relationship between quality of life and age (P = 0.048) and kidney disease state (P=0.026). A positive and significant association was also observed between education (P=0.03), sex (P=0.04), Job (P=0.04), income level (P=0.043) and quality of life.</p> <p><strong>Conclusion:</strong> The findings of the current study showed that illiteracy or elementary education, Joblessness, and low income may increase duration of dialysis and reduce the quality of life in dialysis patients. Thus, it is necessary to provide these patients with more social support and take their welfare condition into account.</p> Maryam Seraji Davoud Shojaeezadeh Roya Sadeghi ##submission.copyrightStatement## 2018-12-08 2018-12-08 3 1/2 1 4 Regular inspection and committing major malpractices: Case of Pakdasht pharmacies http://jppm.tums.ac.ir/index.php/jppm/article/view/34 <p><strong>Background<em>: </em></strong>It is necessary to regulate the pharmacies’ services to maintain their qualities for providing services to patients. One side that should be considered is to prevent pharmacy malpractices. Depending on the types and recurrences of illegal acts, regulatory affairs and enforcements could reduce malpractices in health care providers. The aim of this study was to evaluate the efficacy of pharmacy inspection.</p> <p><strong>Method:</strong> In this study, we evaluated the efficacy of pharmacy inspection on preventing probable malpractices<strong>. </strong>Data were collected from inspection forms provided by Vice-Chancellor’s Office in Food and Drug Supervision in Shahid Beheshti University of Medical Sciences and were filled by inspectors between January 2013 and April 2014. Seven major illegal acts are considered in this study including pharmacist absences during the pharmacy opening hours, delivery of Non Prescription Drugs (NPDs) without pharmacist supervision, existence of expired drugs in pharmacy, existence of counterfeit drugs or cosmetics in pharmacy, existence of any illegal narcotic or amphetamine drugs without Drug-Sale-License, inappropriate drug storage condition, and insufficient consideration in Galenic formulation. The inspections were assessed in all 26 private pharmacies in Pakdasht, Tehran, Iran.</p> <p><strong>Results:</strong> The results showed that the scores of second inspection in quantitative assessment became better than the first one. The average score of existence of illegal drugs in the second inspection was soared to 89.92 from 58.11 in the first inspection. According to the qualitative assessment, the number of malpractices, except delivery of prescription drugs and inappropriate storage condition had decreased entirely from the first to the last inspection. Existence of illegal narcotics and amphetamines in pharmacy reduced from 13% to zero.</p> <p><strong>Conclusion:</strong> Pharmacy inspection could reduce malpractices if it is performed routinely and the penalties are strict and suitable.</p> Mansoureh Sabbagh-Bani-Azad Bardia Varastehmoradi ##submission.copyrightStatement## 2018-12-08 2018-12-08 3 1/2 5 11 On the consideration of well-being and quality of life in hemodialysis patients http://jppm.tums.ac.ir/index.php/jppm/article/view/33 <p><strong>Background<em>: </em></strong>Since identifying different aspects of well-being and its relationship with quality of life of the patients affected by chronic kidney disease is a very important issue, this study aims at considering the relationship between well-being and quality of life in hemodialysis patients referring to Zahedan University of Medical Sciences’ affiliated hospitals in 2016.</p> <p><strong>Methods</strong>: In this descriptive analytic study, population included all individuals who referred regularity to hemodialysis section of Zahedan hospitals (129 Patients). As our data-gathering instruments, we used two questionnaires: a well-being questionnaire and a kidney disease quality of life (KDQOL) questionnaire. The data were analyzed using independent t-test, ANOVA, and Pearson correlation coefficient through SPSS v. 19.</p> <p><strong>Results</strong>: The patients’ mean score of well-being was 138.95± 21.9 and their mean score of quality of life was 43.62± 6.38. According to the findings of this study, there was a reverse correlation between emotional aspect and limitation of emotional role, but their relationship was statistically significant (p= 0.02, r= -0.27); there was a statistically significant relationship between social aspect and social performance (p= 0.04, r= 0.24); there was a statistically significant relationship between mental aspect and social performance (p= 0.004, r= 0.32); there was a reverse correlation between emotional aspect and burden of kidney disease, but their relationship was statistically significant (p= 0.012, r= -0.28); similarly, there was a reverse correlation between physical aspect and burden of kidney disease, but the relationship between them was statistically significant (p= 0.03, r= -0.20). Moreover, the relationship between spiritual aspect and sexual performance was statistically significant (p= 0.05, r= 0.22).&nbsp; The relationship between mental aspect and sexual performance as well (p= 0.03, r= 0.25).</p> <p><strong>Conclusion</strong>: The results revealed that there is a relationship between different aspects of Well-being and quality of life of the hemodialysis patients. Therefore, paying enough attention to these patients’ needs can have positive consequences and promote their quality of life; finally, we will experience a decrease in their death rate and treatment costs.</p> Iraj Zareban Maryam Seraji Davood Shojaeezadeh Fatemeh Rakhshani ##submission.copyrightStatement## 2018-12-08 2018-12-08 3 1/2 12 16 A new approach in identifying and evaluating quality risks in the pharmaceutical industry http://jppm.tums.ac.ir/index.php/jppm/article/view/70 <p><strong>Background<em>: </em></strong>Failure Mode and Effects Analysis (FMEA) is a highly structured and systematic technique for risk analysis, commonly used in all procedures of the pharmaceutical industry, from the design of the production facility and new product development to the product release. The important part of this method is the identification of risks and determining the risk priorities.</p> <p><strong>Methods: </strong>This study has been carried out in two steps: in the first step, all possible quality related risks have identified through literature review and interviews with experts of the pharmaceutical industry, subsequently these experts validated recognized risks. In the next step, the valid risks analyzed and evaluated through the combination of FMEA and Fuzzy TOPSIS methods.</p> <p><strong>Results:</strong> More than 100 main quality risks were identified in the pharmaceutical manufacturing companies. These risks originate from the redundant practices and processes of the industry. Consequently, twenty of the identified risks recognized as effective risks in the industry. Human errors in production, inadequate supervision on conduction of qualification of the production machineries, improper qualification in design and implementation of the heating, ventilation, and air-conditioning (HVAC) system, lack of standard procedures for handling of the non-conforming products, inadequate supervision on conduction of cleaning validation of the production facilities, and weakness in the documentation have been recognized as the most important risks in this study.</p> <p><strong>Conclusion:</strong> Risks survey results can point to the prominence of the quality assurance unit and its vital but partially neglected role in the generic pharmaceutical industry.</p> Mohammad Hajimolaali Abbas Kebriaeezadeh Akbar Abdollahiasl Hossein Safari Alireza Yektadoost ##submission.copyrightStatement## 2018-12-08 2018-12-08 3 1/2 17 20 A cost minimization analysis of Azelastine/Fluticasone combination nasal spray versus Azelastine and Fluticasone nasal sprays monotherapy in moderate to severe allergic rhinitis in Iran http://jppm.tums.ac.ir/index.php/jppm/article/view/51 <p><strong>Background<em>: </em></strong>Allergic Rhinitis (AR) is a symptomatic disorder which is due to allergen exposure and IgE inflammatory pathway activation in respiratory tract. The present study’s purpose was to assess Azelastine/Fluticasone combination nasal spray cost-effectiveness in comparison with Azelastine and Fluticasone nasal sprays monotherapy, in mild to moderate AR patients in Islamic Republic of Iran (I.R.I.) health care system.</p> <p><strong>Methods:</strong> A literature review was performed in order to compare the effectiveness of Fluticasone/Azelastine (50<strong>μ</strong>g/125μg) with Fluticasone (50μg) and Azelastine (125<strong>μ</strong>g). The search was conducted in PubMed, ISI, Scopus, Cochrane, CRD York and Google Scholar based on a predefined PICO of the study. According to confirmed equal clinical effectiveness of two arms, a cost minimization analysis was done. As micro costing, direct medical costs (drugs` costs, GP office visits, office visit and allergy-related tests), based on official tariffs in Iran were calculated in a 14-day time horizon. Because of model’s time horizon, which was less than 1 year, discount rate was not applied.</p> <p><strong>Results:</strong> The result of literature search were two RCTs in which the combination form had been compared with each of the spray of Azalastine and Fluticasone. Azelastine/Fluticasone would save 2.05$ per patient for each course of treatment; and therefore recognized as cost-effective.</p> <p><strong>Conclusions:</strong> This study showed that Azelastine/Fluticasone combination was the cost saving alternative.</p> Nayyereh Ayati Delara Babaie Shekoufeh Nikfar Erfan Rohani Marzieh Nosrati Pardis Zaboli ##submission.copyrightStatement## 2018-12-08 2018-12-08 3 1/2 21 23