ABSTRACT Background: The need to search for reliable process indicators for effectiveness of anti-diabetic therapy have been expressed in the literature. Process indicators have been described as important processes that contribute to the achievement of outcomes. Objective: This study seek to identify and propose evidence based process indicators for good outcome (effectiveness) of anti-diabetic therapy in a Nigerian University Teaching Hospital. Methods: A crossectional study using questionnaire about degree of subjects’ knowledge/practice of lifestyle/dietary modification based on set criteria was conducted. Glycemic control based on latest monitoring tests and physician’s remark were extracted from case note of each selected subject. Sample Size, n=1200. Subjects were selected by systematic random sampling (Sampling Interval=1). Results: Three Hundred and Thirteen (77.7%) out of 403 subjects who had good glycemic control were effects of exercise those who had excellent knowledge about signs and symptoms of hyperglycemia, beneficial effects of exercise, treatment and excellent practice of self monitoring. About 311 (77.2%) out of 403 subjects who had good glycemic control were those who had excellent knowledge about dietary modification. Almost 308 (76.4%) out of 403 subjects who had good glycemic control were those who had excellent knowledge about lifestyle modification. Three Hundred and Six  (75.9%) out of 403 subjects who had good glycemic control were those who had excellent knowledge about complications of diabetes mellitus. Significant proportion of subjects who had excellent practice of lifestyle/dietary modification had good glycemic control. Conclusion: Evidence based process indicators for good outcome (effectiveness) of anti-diabetic therapy have been identified/proposed as degree of  knowledge about signs and symptoms of hyperglycemia, complications of  diabetes mellitus, beneficial effects of exercise, treatments, dietary modification and lifestyle modification. Other process indicators identified/proposed are degree of practice of self-monitoring, lifestyle and dietary modification.

The Islamic Republic of Iran provided a national action plan against antimicrobial resistance (NAP/AMR) for 2016-2021. In this study, we have dealt with the background and Iran’s efforts in this way, compare Iran’s NAP/AMR with other international programs, represent efficient policy options, and the evaluation indicators of each purpose of Iran NAP/AMR. The indicators of each group are represented through the consensus of three academic researchers.    Finally, our assessment reveals that performing a constant observation is highly required for a prearranged NAP/AMR. The political parties and stakeholders should punctually receive interpretable feedbacks; also, it is very important to conduct periodical assessments with the purpose of perceiving the purpose feasibility and determining the dimensions that require advancements.

Background:   The study aimed to investigate and rank the barriers affecting the development of pharmaceutical industry exports in Iran's AHP method. Methods: The research applied and descriptive method, a field documentary. The study's statistical population was all pharmaceutical organizations that operate in the direction of export to other countries; the study's statistical population consisted of business managers and professors working in the field of export and marketing managers of exporting pharmaceutical companies. The method of data collection was using a questionnaire. The data analysis method was a hierarchical analysis method using a decision tree. Results:  Evaluation of the results obtained for the barrier of workforce and knowledge of indicators of access to specialized and skilled labor in the field of drug production, skills and technical knowledge in the company in innovative design and development of new products, existing knowledge infrastructure for clinical trial studies In the country of origin, access to a specialized and skilled workforce in the field of drug export, the number of academic and research centers in the field of medicine, the relationship of academic and research centers in the field of medicine with industry and access to cheap labor and the necessary knowledge in compiling and collecting documents Necessary for export to target countries were approved. Conclusion: For many firms, the most important external factors that prevent barriers to entering international markets include tariff and non-tariff barriers, foreign exchange rates, fluctuations, competition in foreign markets, government policies, foreign trade practices, and different product and consumption standards. [18] Similarly, operational barriers include the terms of receipt and payment from foreign buyers, establishing transport arrangements, customs clearance, representation, and managing international distribution channels through international markets.

Background: Drug use evaluation studies are conducted to assess the pattern of prescribing and administration of a drug. Deep vein thrombosis is one of the most important clinical issues around the world. This study examined the pattern of enoxaparin consumption, one of the most widely used anticoagulants, for the prevention and treatment of thrombosis in a non-teaching hospital. Methods: In this cross-sectional prospective study, 117 patients receiving enoxaparin in different wards of Imam Sajjad Hospital in Ramsar, Iran, were studied. Data on how to prescribe and use enoxaparin were recorded in a questionnaire designed according to UpToDate recommendations. Demographic variables, prophylaxis, and therapeutic indications, prophylaxis and treatment doses, interval, and monitoring information were evaluated. Finally, the results were compared with UpToDate suggestions. Results: The mean age of patients was 68.9 years, and 52.1% were men. Enoxaparin was prescribed for 35.9% of patients as prophylaxis, and 64.1% received this drug for treatment. Overall, prophylactic doses were inappropriately administered in 41.5% of patients. Improper therapeutic doses were also prescribed for 52% of subjects. Conclusion: The results of this study showed that the dosage and interval of enoxaparin administration were significantly inappropriate. It seems the prescribers must have more adherence to the valid and reliable enoxaparin guidelines for more rational practices.

Background: Cystic fibrosis (CF) is a progressive, life-threatening, and autosomal disease, which is most prevalent in Europe, North America, and Australia. This genetic disorder does not have a curative treatment, and current medications to manage CF including Tobramycin, are associated with high economic costs to the healthcare system, and noticeable out-of-pocket and time costs to patients and their families. Dornase alfa, is a recombinant human DNAse, and is an advanced therapeutic intervention. It has been indicated in clinical trials that Dornase alfa elevates FEV1 in CF patients, and enhances lung function. Therefore, this study was designed to evaluate the cost-utility of Dornase alfa compared with Tobramycin in the management of CF patients’ symptoms. Methods: A Markov model was developed based on previous similar studies to determine the cost-utility of Dornase alfa in comparison with Tobramycin. The time horizon of the model and the length of the cycles were assumed 10 years and 28 days, respectively. Results: Based on the cost-utility analysis, from the health system's perspective, Dornase alfa indicated 0.174 higher effectiveness in patients’ QALY than Tobramycin, and resulted in 27,517,260 Rials reduction in costs in the time horizon of 10 years. Conclusion: It is concluded that Dornase alfa could be considered as a cost-effective strategy in the treatment of CF patients associated with increased benefits compared to Tobramycin.