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Objective: To evaluate medication adherence, the effect of recall periods on self‐reported adherence and factors influencing medication adherence among patients of chronic diseases, such as hypertension and diabetes, particularly in the community. Methods: A cross‐sectional cohort study was conducted among individuals with hypertension and/or diabetes coming as outpatients in community camps organised in a cluster of urban slums. Responses towards questions regarding self‐reported quantitative and qualitative adherence for one week and one month along with information on pill burden, socio‐demographic and other factors were recorded using a mobile application. Results: Among 379 participants living in urban slum communities, who were prescribed anti‐hypertensive or oral anti‐diabetic medications previously, mean medication adherence over previous one week was 67.99% (standard deviation (SD) ± 38.32) and 6.87 (SD ± 3.62) on a ten‐point numeric scale. The medication adherence for one month showed a strong significantly positive correlation with that of 1 week for both percentage‐based (r = +0.910, 95% CI = 0.864 to 0.950, P <.0001) and Likert (ρ = +0.836, 95% CI = 0.803 to 0.863, P <.0001) scales. Age (r = 0.219, 95% CI = 0.120 to 0.313, P =.043) and pill burden (r = −0.231, 95% CI = −0.145 to −0.322, P <.0001) were found to significantly affect medication adherence. The odds of random blood sugar reduction were found to be significant (OR 1.98, 95% CI = 1.30 to 3.00, P =.001) with adequate adherence. A linear regression equation was developed to predict medication adherence percentage for a patient which was found to have 61.8% predictive power using multilayer perceptron modelling. Conclusion: Overall, medication adherence was sub‐optimal. Adherence assessments can be reliably performed using either one week or one month recall periods. With further refinement and validation, the regression equation could prove to be a useful tool for physicians. [ABSTRACT FROM AUTHOR]

What is known and objectives: A standard drug classification system and a fundamental measurement unit of drug consumption are prerequisites in a healthcare information system for generating quality data on drug use. Globally, the ATC/DDD (Anatomical Therapeutic Chemical Classification/Defined Daily Dose) system recommended by WHO is accepted as the international standard. However, owing to variability in body weight, it cannot be used directly in paediatric population. In our work, we aimed to develop a standard method of quantification of antibiotic consumption in paediatric population using a modified approach of the ATC/DDD system. Method: We developed a mathematical model in a simulated paediatric cohort (n = 1000) and calculated antibiotic consumption in units of days of therapy (DOT) and DDD/100 patient days (PD). We validated the model in an observational cohort (n = 38) of inpatients admitted in Paediatric Department of a tertiary care centre. Results: Model simulation showed near perfect positive correlation (R =.99‐1.00) between DOT and DDD/100 PD in discrete weight based sub‐cohorts (weight 1‐10 kg). In the validation cohort, consumption of antibiotics was 121.76 and 33.16 in terms of DOT and DDD/100 PD respectively. Strong positive correlation between the two units (R =.73) was obtained. The correlation was better in predefined age and weight categories as compared to the uncategorised consumption (R =.78‐.97). The model was proved validated when weight specific (in sub‐cohorts of patients weighing 4, 5, 7 kg) DDD/100 PD and DOT also showed near perfect positive correlation (R =.96‐.99). What is new and conclusion: Weight specific DDD/100 PD can be explored further as a tool to standardise the quantification and comparison of consumption of drugs in paediatric population. [ABSTRACT FROM AUTHOR]

Background. Ticagrelor has been accepted as a class I antiplatelet agent in patients undergoing percutaneous coronary angioplasty (PTCA). There have been cases reported on ticagrelor being associated with various cardiac conduction defects. But there is no evidence of QTc prolongation associated with the drug as of yet. Case Presentation. A 64-year-old male who underwent PTCA was given ticagrelor. A baseline electrocardiogram (ECG) showed a QTc of 402 ms. He returned after 1.5 months with complaints of shortness of breath. An ECG revealed a prolonged QTc of 468 ms. Ticagrelor was discontinued in view of ticagrelor-induced dyspnea and the patient was started on clopidogrel. The other medications were kept unchanged. The patient returned after a month without any complaints. A follow-up ECG showed a reduced QTc of 425 ms. Conclusion. We present a case of ticagrelor-induced QTc prolongation. To our knowledge, this is the first case to be reported on the same. The Naranjo algorithm for causality assessment gave a total score of 6 indicating that the adverse drug reaction falls under the probable category. [ABSTRACT FROM AUTHOR]

A letter to the editor discussing a case report on dysgeusia with amlodipine that was published in July 2006 issue is presented.