The unexploited potential of data systems tracking medicines utilization: an opportunity to improve access to oncology combination therapies.

Background: While progress has been made in oncology treatments, including the introduction of combination therapies, barriers affect patient access. There are approaches that could improve access including combination-specific pricing that allow the price to reflect whether a product is used in monotherapy or in combination. The feasibility of this solution requires data on the utilization of combination therapies.

Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population.

: Antibiotic use is common among hospitalized pediatric patients. However, inappropriate use, including excessive use of Watch antibiotics, can contribute to antimicrobial resistance, adverse events, and increased healthcare costs. Consequently, there is a need to continually assess their usage among this vulnerable population.

Global variation in antibiotic prescribing guidelines and the implications for decreasing AMR in the future.

Introduction: Antimicrobial resistance (AMR) has become a global burden, with inappropriate antibiotic prescribing being an important contributing factor. Antibiotic prescribing guidelines play an important role in improving the quality of antibiotic use, provided they are evidence-based and regularly updated. As a result, they help reduce AMR, which is a critical challenge in low- and middle-income countries (LMICs).

Oral cholera vaccine uptake, acceptance and confidence among residents of a high-risk township in Zambia: key insights for future vaccination programs.

Background: Oral cholera vaccines (OCVs) prevent cholera and save lives. Given the recent 2024 country-wide cholera epidemic in Zambia, we determined self-reported OCV uptake, acceptance and confidence among adults living in a high-risk, cholera-prone township in Zambia.

Methods: A descriptive cross-sectional study was conducted from April to August 2024, involving 385 randomly selected adult participants residing in the Kanyama township of Lusaka, Zambia.

Introduction of Biopharmaceuticals in Europe: A Cross-Sectional Study of Early Diffusion Patterns and Data Availability.

Background And Objectives: Biopharmaceuticals add value in the treatment of many diseases but different health systems in Europe face clinical and economic challenges with introducing them. Joint efforts across Europe are therefore essential to ensure their sustainable and equitable use. However, to date few cross-national comparative studies have assessed their introduction.

Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.

Background And Objective: Antimicrobial resistance (AMR) poses a formidable challenge to global public health, with low- and middle-income countries (LMICs) including Pakistan being particularly vulnerable. This study assesses the progress made in Pakistan following the Global Research Agenda for AMR, which builds on the key activities and goals of its national action plan to reduce AMR. The intention is to identify key gaps, achievements, and future areas of focus to help reduce rising AMR rates in Pakistan.

Barriers to Compliance with National Guidelines Among Children Hospitalized with Community-Acquired Pneumonia in Vietnam and the Implications.

: Community-acquired pneumonia (CAP) is the leading cause of death in infants aged 1-59 months. Concurrent with this, there is a need to prescribe antibiotics wisely in Vietnam due to concerns with rising antimicrobial resistance (AMR). Consequently, an urgent need has arisen to treat patients according to agreed guidelines.

Users' Perceptions of Access to and Quality of Public Health Services in Brazil: A Cross-Sectional Study in Metropolitan Rio de Janeiro, Including Pharmaceutical Services.

Background: This study evaluates one of the five regions of the state of Rio de Janeiro, Brazil, as part of a broader research project examining users' perceptions of the Unified Health System (SUS), which has already generated publications in previous phases. The aim was to assess users' perceptions of the SUS regarding access to and the quality of public health services, including pharmaceutical services, in the Metropolitan Region of Rio de Janeiro State.

Method: A cross-sectional study was conducted between January and August 2024 with 200 participants, using a 66-item survey addressing access to and the quality of SUS services, appointment scheduling, medication acquisition, and the pharmacist's role.

Public health financing in Brazil (2019-2022): an analysis of the national health fund and implications for health management.

Introduction: The Unified Health System (SUS) in Brazil provides free, universal health services to all inhabitants of the country. This study aims to describe the allocation of public health resources in Brazil, both overall and across regions, based on National Health Fund (FNS) data from 2019 to 2022. The goal is to provide an understanding of the profile and distribution of resources sourced exclusively from the federal government during this period.

Surge of branded generics and antimicrobial resistance: analyzing the antibiotic market dynamics in Pakistan through the WHO essential medicines and AWaRe lens.

Background: Access to safe and effective antibiotics is crucial in low- and middle-income countries (LMICs) coupled with reducing their overuse to reduce antimicrobial resistance (AMR). We sought to systematically analyze the extent of branded generic antibiotics in Pakistan, particularly Watch antibiotics, given concerns with AMR in Pakistan.

Research Design And Methods: Data on registered antibiotics was collected from the Drug Regulatory Authority of Pakistan (DRAP) and the Pharmaguides.

Current status and future direction of antimicrobial stewardship programs and antibiotic prescribing in primary care hospitals in Zambia.

Background: Antimicrobial Stewardship Programs (ASPs) intended to optimize antibiotic use will be more effective if informed by the current status and patterns of antibiotic utilisation. In Zambia's primary healthcare (PHC) settings, data on ASPs and antibiotic utilisation were inadequate to guide improvements. As a first step, this study assessed antibiotic prescribing and ASP core elements among PHC first-level hospitals (FLHs) in Zambia.

Drug-resistant tuberculosis treatment success predictors in Namibia.

Background: Drug-resistant tuberculosis (DR-TB) is a considerable barrier to ending TB globally by 2035. In most high TB-burden countries in the sub-Saharan region, drivers of DR-TB treatment success are unknown.

Objectives: To determine predictors and patterns of treatment success rates (TSRs) in DR-TB in Namibia to inform strategies of national TB programmes.

Knowledge, Attitudes, and Practices of Iraqi Parents Regarding Antibiotic Use in Children and the Implications.

Antibiotic misuse is a major global health issue, particularly in low- and middle-income countries (LMICs), where inappropriate use contributes to antimicrobial resistance (AMR). Inappropriate antibiotic use is exacerbated in LMICs by pressure from parents on physicians and pharmacists to prescribe and dispense antibiotics for their children, often for viral infections. There is currently limited knowledge of key issues in Iraq to improve future antibiotic use.

A retrospective clinical evaluation of the quality of antibiotic use in treating ear, nose and throat infections in ambulatory care setting of a teaching hospital in Ghana: findings and implications.

Background: Ear, nose and throat (ENT) infections are often associated with high levels of morbidity and mortality. Antibiotic overuse and misuse for most ENT infections have been reported, caused by a lack of expertise or uncertainties to distinguish between infection types. This study sought to determine the level of appropriateness of antibiotics for ENT infections and its associated factors in ambulatory care in a teaching hospital in Ghana to guide future policies given rising resistance rates.

Status and implications of the knowledge, attitudes and practices towards AWaRe antibiotic use, resistance and stewardship among low- and middle-income countries.

Background: There are concerns globally with rising rates of antimicrobial resistance (AMR), particularly in low- and middle-income countries (LMICs). AMR is driven by high rates of inappropriate prescribing and dispensing of antibiotics, particularly Watch antibiotics. To develop future interventions, it is important to document current knowledge, attitudes and practices (KAP) among key stakeholder groups in LMICs.

The budget impact analysis of nicotine replacement therapy among patients who smoke tobacco and have mental illness in South Africa and the implications.

Background: Tobacco use is the world's leading preventable cause of death, with the highest burden in low and middle-income countries (LMICs). Those who have mental illness are particularly vulnerable, with a smoking rate two to five times higher than that of the general population. Quitting smoking has demonstrated benefits for mental health, including reducing stress and improving the quality of life.

Current access, availability and use of antibiotics in primary care among key low- and middle-income countries and the policy implications.

Introduction: Antimicrobial resistance (AMR) poses a significant threat, particularly in low- and middle-income countries (LMICs), exacerbated by inappropriate antibiotic use, access to quality antibiotics and weak antimicrobial stewardship (AMS). There is a need to review current evidence on antibiotic use, access, and AMR, in primary care across key countries.

Areas Covered: This narrative review analyzes publications from 2018 to 2024 regarding access, availability, and use of appropriate antibiotics.

Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries.

Introduction: Antimicrobial resistance (AMR) presents a major global health threat, driven in part by the inappropriate use of antibiotics including in low- and middle-income countries (LMICs). Improving the quality of antibiotic use is a key rationale for the development of the WHO's AWaRe (Access, Watch and Reserve) system. There is a need to review the uptake of the AWaRe system since its launch to guide future practice.

Impact of COVID-19 pandemic on the prescribing pattern of oral anticoagulants in the English primary care setting: a population-based segmented interrupted time series analysis of over 53 million individuals.

Background: The COVID-19 pandemic disrupted healthcare delivery, impacting oral anticoagulants (OAC) prescribing due to increased thromboembolic risks, Vaccine-induced immune thrombotic thrombocytopenia, and guidelines favoring Direct Oral Anticoagulants (DOACs) over warfarin. Previous studies were limited to short-term analyses.

Research Design And Methods: A segmented interrupted time series analysis was conducted using the English primary care Prescription Cost Analysis data from March/2018-March/2024 to assess the impact of the first and second COVID-19 lockdowns in March and November 2020, respectively.

Point Prevalence Survey of Antibiotic Use in Level 1 hospitals in Zambia: Future Prospects for Antimicrobial Stewardship Programs.

Introduction: The inappropriate prescribing and use of antibiotics have contributed to the emergence and spread of antimicrobial resistance (AMR). In Zambia, there is a paucity of information on the prescribing patterns and use of antibiotics among hospitalized patients in level 1 hospitals. This study investigated antibiotic use in five level 1 hospitals in Lusaka, Zambia.

Knowledge, attitudes, motivations and expectations regarding antimicrobial use among community members seeking care at the primary healthcare level: a scoping review protocol.

Introduction: Inappropriate antibiotic use in (primary healthcare, PHC) settings fuels antimicrobial resistance (AMR), threatens patient safety and burdens healthcare systems. Patients' knowledge, attitudes, motivations and expectations play a crucial role in antibiotic use behaviour, especially in low-income and middle-income countries including South Africa. There is a need to ensure measures of antibiotic use, interventions and future guidance reflect cultural, community and demographic issues associated with patient views to reduce inappropriate use of antibiotics and associated AMR.

Identifying targets for antibiotic stewardship interventions in pediatric patients in Punjab, Pakistan: point prevalence surveys using AWaRe guidance.

Introduction: Surveillance of antibiotic use is crucial for identifying targets for antibiotic stewardship programs (ASPs), particularly in pediatric populations within countries like Pakistan, where antimicrobial resistance (AMR) is escalating. This point prevalence survey (PPS) seeks to assess the patterns of antibiotic use in pediatric patients across Punjab, Pakistan, employing the WHO AWaRe classification to pinpoint targets for intervention and encourage rational antibiotic usage.

Methods: A PPS was conducted across 23 pediatric wards of 14 hospitals in the Punjab Province of Pakistan using the standardized Global-PPS methodology developed by the University of Antwerp.

Knowledge, Attitudes, Motivations, Expectations, and Systemic Factors Regarding Antimicrobial Use Amongst Community Members Seeking Care at the Primary Healthcare Level: A Scoping Review.

Background/objectives: Antimicrobial resistance (AMR) is a major global health challenge, particularly in low- and middle-income countries (LMICs). Understanding the knowledge, attitudes, motivations, and expectations of community members regarding antimicrobial use is essential for effective stewardship interventions. This scoping review aimed to identify key themes relating to the critical areas regarding antimicrobial use among community members in primary healthcare (PHC), with a particular focus on LMICs.

Insulin therapy adherence and its associated factors among diabetic patients in a Ghanaian primary care hospital.

Background: Diabetes mellitus (DM) is a global health problem. Adherence to intensive insulin therapy is necessary to achieve better glycemic control in types 1 and 2 DM. This study aimed to evaluate the extent of adherence to insulin therapy, its predictors and to identify barriers to its adherence.

Community pharmacists' knowledge, beliefs, and perceived barriers toward vaccination services at community pharmacies: A cross-sectional study from Saudi Arabia.

Community pharmacists were recently authorized to provide vaccination services in Saudi Arabia. However, the implementation is still limited. Consequently, this study aimed to assess the knowledge, beliefs, and views of community pharmacists in the Qassim region regarding vaccines and vaccination services and to identify the barriers to providing such services.