Browsing by Author "Mamunuwa, A.M.V.G.N."

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A case series of duplication errors due to brand name confusion - experience from a Sri Lankan teaching hospital
(Sri lanka Medical Association, 2015) Mamunuwa, A.M.V.G.N.; Jayamanne, S.F.; Coombes, J.; Lynch, C.B.; Perera, D.M.P.; Pathiraja, V.M.; Shanika, L.G.T.; Mohamed, F.; Dawson, A.H.
INTRODUCTION AND OBJECTIVES: Confusion with drug names has been identified as a leading cause of medication errors. The majority of these errors result from look-alike or sound-alike drugs. This case series aims to provide examples of duplication errors due to brand confusion where there are no similarities in the names. METHOD: Information for this case series was extracted from a database prospectively collected from Colombo North Teaching Hospital as part of a study conducted to evaluate the impact of the addition of a clinical pharmacist to the standard inpatient care. RESULTS: Of 800 patients reviewed during the study period of 7 months, clinical pharmacist identified 8 cases of duplication errors due to prescribing both generic and brand names of the same drug, but with no similarities in names. Cases identified include a duplication of frusemide caused by the lack of awareness that 'Amifru' {a combination of frusemide and amiloride) contains frusemide. Similarly, a patient was prescribed 'H. Pylori Kit' plus the three individual drugs included in the 'Kif prescribed using their generic names. A patient was found to be taking two different brands of carbidopa plus levodopa not knowing the two contained the same drugs. CONCLUSION: Brand confusion does not necessarily arise from look-alike or sound-alike drug names. It can be due to numerous brands of generic ingredients and lack of awareness of drug names among the patients. Employing trained clinical pharmacists in the wards, educating patients on discharge drugs and appropriate labeling of medicines may prevent these errors.
Impact of medication counselling by pharmacists in patients with diabetes,attending rural and urban outpatient clinics in Sri Lanka.
(University of Kelaniya, 2020) Mamunuwa, A.M.V.G.N.
Introduction & Objective: The intervention of pharmacists in the management of diabetes is well studied throughout the world. Many countries include this practice to achieve target treatment outcomes of patients with diabetes. Our study assessed the effectiveness of pharmacist counselling on outpatient management of diabetes. Despite the high and rising prevalence of diabetes in Sri Lanka, this is the first study to evaluate a clinic-based pharmacy counseling service in the Sri Lankan diabetes population. Methods: 800 participants with diabetes attending outpatient clinics of two Sri Lankan hospitals were assigned to either intervention group (IG) or control group (CG). IG received pharmacist counseling for four consecutive monthly visits in addition to standard care. CG received standard care only. The effectiveness of the intervention was assessed in terms of glycaemic control, adherence to medicines, patients* knowledge regarding medicines and disease. Quality of life (QoL) and the detection and resolving of drug related problems. Data was analyzed using Statistical Package fbr the Social Science (SPSS) software. Nonparametric tests were used as the data did not follow normal distribution. Results: Age ranged from 23 to 87 years. 67. 25% were female. At the end of the study, 359 and 360 participants remained in the control and intervention groups respectively. The IG had a median HbAlc of 7.2% (IQR 1.5%) post-inte^ention compared with the CG median of 7.7% (IQR 1.95%) (p<0.05%). The IG had a median adherence score of 5 out of 8 (IQR 6-3.3) at baseline which increased to 7 (IQR 8-6) post-intervention (p<0.05). CG median score was 5.3 (IQR 7-4) and 5 (IQR 7-4.2) at baseline and post-intervention respectively. The IG had a median score of 53% (IQR 64% - 34%) for the medication related knowledge domain, which increased to 73.3% (IQR 81% - 65%) post-inte^ention (p<0.001) The CG score was 50% (IQR 63% - 34.25%) at baseline and 50% (IQR 63% ・ 33.47%) post¬intervention (P=0.84I). The IG had a median percentage score of 50.48% (IQR 59% -41%) for the QoL questionnaire, which increased to 51.13% (IQR 61% - 42.5%) post-inten^ention (P=0.001). The CG score was 49.19% (IQR 59% - 39%) at baseline and 49.06% (IQR 59% - 39%) post-intervention (P =0.659). A total of 252 DRPs were detected. Acceptance of pharmacy interventions was high with 75.64% of problems being totally or partially solved. Conclusion: Pharmacist counselling improved medication adherence, glycaemic control, patients' knowledge regarding medication management and quality of life of the patients. It is helpful in addressing and resolving the drug related problems. Thus, pharmacist counseling can effectively be used to improve the outpatient management of diabetes in Sri Lanka.
Importance of communicating medication changes to patients at discharge -a prospective case study
(Sri lanka Medical Association, 2015) Pathiraja, V.M.; Jayamanne, S.F.; Lynch, C.B.; Coombes, J.; Perera, D.M.P.; Mamunuwa, A.M.V.G.N.; Shanika, L.G.T.; Mohamed, F.; Dawson, A.H.
INTRODUCTION AND OBJECTIVES: Patients may inadvertently continue their previous medication regimen without understanding changes made by prescribers as part of in-patient care. Inadequate patient education at discharge can lead in some instances to readmission and increased morbidity. The objective of this study is to identify the importance of patient education with regard to changes to their medications. METHOD: This study was part of a prospective study carried out in two medical wards of Ragama teaching hospital to evaluate the effect of a clinical pharmacist's interventions on quality use of medicines. We identified cases from the control group of this study to illustrate the importance of patient education at discharge. RESULTS: From telephone follow-up (six days post discharge), only 89 of 337 patients in the control group reported being informed of changes to their pre-admission medications by a doctor or nurse. There were!24 cases where we have identified patients continuing at least one pre-admission medication which was stopped or changed while they were in hospital. A particular instance is a patient who continued to take sodium valproate post-discharge as per previous drug regimen after being diagnosed with valproate induced hepatitis. He was discharged on phenytoin. CONCLUSION: This study highlights the importance of ensuring patient education about changes made to existing medications whilst in hospital to ensure improved outcomes and reduce the risk of adverse events. The clinical pharmacist is well placed to assist medical teams by providing patients with appropriate education about medication changes and to provide appropriate educational material.
The role of pharmacist counselling in the control of diabetes
(Sri Lanka Medical Association, 2017) Mamunuwa, A.M.V.G.N.; Jayamanne, S.F.; Coombes, J.; de Silva, A.; Lynch, C.B.; Wickramasinghe, N.D.D.
INTRODUCTION & OBJECTIVES: Diabetes is a global health burden. Data in international literature prove the success of involving pharmacists to achieve glycaemic control. This is the first study in Sri Lanka on the impact of pharmacist counselling among outpatients with diabetes. The objective was to assess the impact of pharmacist counselling on glycaemic control of outpatients with diabetes. METHODS: A total of 400 consecutive patients with diabetes mellitus attending the outpatient diabetes clinics at Base Hospital, Dambadeniya, were randomized into either the intervention group (IG) or the control group (CG). IG received pharmacist counselling (verbal and written) for four consecutive monthly visits in addition to the standard care at the clinic, while the CG received standard care only. Glycaemic control was assessed for both groups with HbA1c measured at the end of the four monthly visits.RESULTS: Mean age of participants was 57.14±10.15 years and 67.5% were females. Non parametric tests were performed as data did not follow the normal distribution. On analysis of HbA1c data, the IG had a median of 7.2% (IQR: 8.2%-6.5%) whereas the CG had a median of 7.7% (IQR: 8.8%-6.9%). The IG patients had statistically lower HbA1c levels compared to the CG patients, according to the Mann-Whitney U test (p<0.05). HbA1c levels <8.00% indicate good/fair glycaemic control. 73.9% of the IG, but only 58% of the CG subjects had levels <8.00%. However, 9.1% of the IG and 10% of the CG had very poor glycaemic control (HbA1c level >10.00%). CONCLUSION: Pharmacist counselling in the outpatient clinics can improve the glycaemic control of patients with diabetes.