Publications (12)28.07 Total impact
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Article: Use of dried blood spots to study excipient kinetics in neonates.
Bioanalysis 12/2011; 3(24):2691-3. · 3.22 Impact Factor -
Article: Development and validation of a dried blood spot LC-MS/MS assay to quantify ranitidine in paediatric samples.
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ABSTRACT: A novel approach has been developed to determine ranitidine in paediatric samples using dried blood spots (DBS) on Guthrie cards (Whatman 903). A selective and sensitive HPLC-MS/MS assay has been developed and validated using small volumes of blood (30 μl). A 6 mm disc was punched from each DBS and extracted with methanolic solution of the internal standard (IS) nizatidine. This was further subjected to solid phase extraction (SPE), followed by reversed phase HPLC separation, using a XBridge™ C18 column and mobile phase 10 mM ammonium acetate/methanol (98:2 v/v) with a flow rate of 0.3 mL/min. This was combined with multiple reaction monitoring (MRM) mass detection using electrospray ionisation (ESI). The calibration curve for ranitidine was found linear over the range 10-500 ng/mL (r=0.996). The limit of quantification (LOQ) of the method was validated at 10 ng/mL. Accuracy and precision values for within and between days were <20% at the LOQ and <15% at all other concentrations. The validated DBS method was successfully applied to a clinical study employing 81 samples from 36 paediatric patients.Journal of pharmaceutical and biomedical analysis 08/2011; 56(5):1057-63. · 2.45 Impact Factor -
Article: Dried blood spot assay for estimation of metronidazole concentrations in rats and its application in single animal drug pharmacokinetic study.
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ABSTRACT: An HPLC-UV-dried blood spot (DBS) method for the estimation of metronidazole (MTZ) in rat whole blood is reported. Method employs Ahlstrom 226 sample collection paper and DBS samples were prepared by spotting with 30 μl of whole blood (spiked calibration standards/quality control samples/in vivo study samples). A 6mm disc was punched from each DBS and extraction was carried out using water containing the internal standard (tinidazole). The calibration for MTZ was linear over 2.5-50 μg/ml concentration range. Accuracy (% bias) and precision (expressed as % Coefficient of variation) values for within and between day were <20% at the lower level quality control sample (LQC) and <15% at all other concentrations tested. The limit of quantification (LOQ) of the method was 2.5 μg/ml. The validated method was applied for the analysis of in vivo pharmacokinetic (PK) study samples after intravenous administration of MTZ to a rat. Whole blood PK parameters observed in this study were in compliance with literature based PK parameters. The DBS sampling approach was found to be useful in a single animal pharmacokinetic study.Journal of chromatography. B, Analytical technologies in the biomedical and life sciences 06/2011; 879(19):1713-6. · 2.78 Impact Factor -
Article: Statin prescribing in Northern Ireland and England pre and post introduction of the quality and outcomes framework.
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ABSTRACT: The objective of this research was to examine differences in patterns of statin prescribing between Northern Ireland and England both before and after the introduction of the Quality and Outcomes Framework (QOF). Primary care practices in Northern Ireland and England. Method Northern Ireland practices were matched with practices in England, statin prescribing data and QOF achievement scores (for the first year post-QOF) were obtained. Crude prescribing data from matched practices were manipulated to provide a data set of Defined Daily Doses (DDDs)/1,000 patients and cost/DDD/1,000 patients for each statin drug entity covering 1 year before and after the introduction of QOF. QOF achievements were converted into percentage scores for matched practices. Cost per defined daily dose (DDD) per 1,000 patients. Significantly less statins (DDD/1,000 patients) were dispensed in Northern Ireland compared with the matched region in England both before and after the introduction of QOF (P < 0.001). However, significantly more statins were dispensed in both regions after the introduction of QOF. As a result of the introduction of QOF, the cost/DDD/1,000 patients rose by pound13.17 in NI, but fell by pound3.76 in the matched region in England. Strategies should be considered to educate prescribers on cost-effectiveness by increasing their awareness of the negative budgetary impact resulting from early adoption of new and expensive statins and by encouraging generic prescribing.Pharmaceutisch Weekblad Scientific Edition 10/2009; 32(1):43-51. · 0.92 Impact Factor -
Article: The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia--an exploratory study.
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ABSTRACT: To develop a method that prospectively assesses adherence rates in paediatric patients with acute lymphoblastic leukaemia (ALL) who are receiving the oral thiopurine treatment 6-mercaptopurine (6-MP). A total of 19 paediatric patients with ALL who were receiving 6-MP therapy were enrolled in this study. A new objective tool (hierarchical cluster analysis of drug metabolite concentrations) was explored as a novel approach to assess non-adherence to oral thiopurines, in combination with other objective measures (the pattern of variability in 6-thioguanine nucleotide erythrocyte concentrations and 6-thiouric acid plasma levels) and the subjective measure of self-reported adherence questionnaire. Parents of five ALL patients (26.3%) reported at least one aspect of non-adherence, with the majority (80%) citing "carelessness at times about taking medication" as the primary reason for non-adherence followed by "forgetting to take the medication" (60%). Of these patients, three (15.8%) were considered non-adherent to medication according to the self-reported adherence questionnaire (scored > or = 2). Four ALL patients (21.1%) had metabolite profiles indicative of non-adherence (persistently low levels of metabolites and/or metabolite levels clustered variably with time). Out of these four patients, two (50%) admitted non-adherence to therapy. Overall, when both methods were combined, five patients (26.3%) were considered non-adherent to medication, with higher age representing a risk factor for non-adherence (P < 0.05). The present study explored various ways to assess adherence rates to thiopurine medication in ALL patients and highlighted the importance of combining both objective and subjective measures as a better way to assess adherence to oral thiopurines.European Journal of Clinical Pharmacology 07/2009; 65(11):1105-12. · 2.85 Impact Factor -
Article: System of Objectified Judgement Analysis (SOJA) as a tool in rational and transparent drug-decision making.
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ABSTRACT: Drug selection should be a rational process that embraces the principles of evidence-based medicine. However, many factors may affect the choice of agent. It is against this background that the System of Objectified Judgement Analysis (SOJA) process for rational drug-selection was developed. This article describes how the information on which the SOJA process is based, was researched and processed.Expert Opinion on Pharmacotherapy 11/2007; 8 Suppl 1:S5-14. · 3.20 Impact Factor -
Article: InforMatrix as an alternative tool in rational and transparent drug-decision making.
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ABSTRACT: InforMatrix is a decision matrix technique by means of which a group of experts on a subject (health condition) determine, on the basis of agreed criteria, an order of merit for the various available treatment options for that condition. The goal of the InforMatrix program is to make a rational selection of first-choice medications or drugs following the evaluation of the clinical value of available therapeutic agents. This paper describes the InforMatrix methodology, and also provides an explanation of the various selection criteria that are used by the InforMatrix technique of drug selection.Expert Opinion on Pharmacotherapy 11/2007; 8 Suppl 1:S31-6. · 3.20 Impact Factor -
Article: Matrix models and STEPS: concluding remarks.
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ABSTRACT: This paper provides an overview of the use of matrix models within the context of Pharmacotherapy. It also discusses the application of these matrix models to the Safe Therapeutic Economic Pharmaceutical Selection (STEPS) approach used in Northern Ireland.Expert Opinion on Pharmacotherapy 11/2007; 8 Suppl 1:S65-7. · 3.20 Impact Factor -
Article: Safe Therapeutic Economic Pharmaceutical Selection (STEPS): development, introduction and use in Northern Ireland.
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ABSTRACT: A number of medicine selection methods have been used worldwide for formulary purposes. In Northern Ireland, integrated medicines management is being developed, and related projects have been carried out. This paper deals with the description of the STEPS (Safe Therapeutic Economic Pharmaceutical Selection) programme. The paper outlines the development of STEPS and its application as an element of a cost-effective medicines-management process in Northern Ireland.Expert Opinion on Pharmacotherapy 11/2007; 8 Suppl 1:S57-63. · 3.20 Impact Factor -
Article: The impact of the internet on the practice of general practitioners and community pharmacists in Northern Ireland.
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ABSTRACT: The objective of this study was to gain an insight into the use of the internet for practice-related purposes by community pharmacists and general practitioners (GPs) in Northern Ireland, and to gather information about their experiences relating to patients and the internet. A postal questionnaire survey of all community pharmacies (n=522) and all GPs practising in Northern Ireland (n=1081). A total of 542 completed questionnaires were returned, giving an overall response rate of 34%. The majority of respondents had access to the internet in their workplace, and approximately 60% of respondents in each profession accessed health-related websites on up to five occasions per week. Of those who did not access health-related websites, lack of time was the main reason cited. The most popular sites for both professions were online journals. Significant differences were found in the activities undertaken by the two professions whilst online. Significantly more GPs than community pharmacists reported searching for disease-related (non-drug) information, using web-based disease management tools or reading online journal articles. Few respondents reported recommending websites to patients, although significantly more GPs than pharmacists did so. Significantly more pharmacists had been approached or felt challenged by patients who had downloaded information from the internet. GPs were more likely to communicate with colleagues about patients by email but neither profession reported frequent correspondence with patients by email. Both professions used the internet regularly as a source of health-related information and both had to deal with 'internet-informed', (or sometimes misinformed) patients. Community pharmacists were more likely to feel challenged by these patients and GPs sometimes had to deal with unnecessarily worried patients or patients with unrealistic expectations. Both professions will have to change working practices to accommodate the impact of the internet. This will have significant future training implications.Informatics in primary care 02/2007; 15(4):231-7. -
Article: Impact of Modified System of Objectified Judgement Analysis (SOJA) methodology on prescribing costs of ACE inhibitors.
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ABSTRACT: System of Objectified Judgement Analysis (SOJA) is a structured approach to the selection of drugs for formulary inclusion. How- ever, while SOJA is a very important advance in drug selection for formulary purposes, it is hospital based and can only be applied to one indication at a time. In SOJA, cost has been given a primary role in the selection process as it has been included as a selection criterion from the start. Cost may therefore drive the selection of a particular drug product at the expense of other basic criteria such as safety or efficacy. The aims of this study were to use a modified SOJA approach in the selection of ACE inhibitors (ACEIs) for use in a joint formulary that bridges primary and secondary care within a health board in Northern Ireland, and to investigate the potential impact of the joint formulary on prescribing costs of ACEIs in that health board. The modified SOJA approach involved four phases in sequence: an evidence-based pharmacotherapeutic evaluation of all available ACEI drug entities, a separate safety/risk assessment analysis of products containing agents that exceeded the pharmacotherapeutic threshold, a budget-impact analysis and, finally, the selection of product lines. A comprehensive literature review and expert panel judgement informed the selection of criteria (and their relative weighting) for the pharmacotherapeutic evaluation. The resultant criteria/scoring system was circulated (in questionnaire format) to prescribers and stakeholders for comment. Based on statistical analysis of the latter survey results, the final scoring system was developed. Drug entities that exceeded the evidence threshold were sequentially entered into the second and third phases of the process. Five drug entities (11 currently available in the UK) exceeded the evidence threshold and 22 of 26 submitted product lines containing these drug entities satisfied the safety/risk assessment criteria. Three product lines, each containing a different drug entity, were selected for formulary inclusion after budget impact analysis was performed. The estimated potential annual cost savings for ACEIs (based on estimated annual usage in defined daily doses) for this particular health board was 42%. The modified SOJA approach has a significant contribution to make in containing the costs of ACEIs. Applying modified SOJA as a practical method for all indications will allow the development of a unified formulary that bridges secondary and primary care.Clinical Drug Investigation 02/2006; 26(9):485-94. · 1.82 Impact Factor -
Article: Evaluation of a hospital-based community liaison pharmacy service in Northern Ireland.
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ABSTRACT: To evaluate the impact of a hospital based community liaison pharmacy service on a range of outcomes in patients aged more than 55 years and taking more than 3 prescribed drugs, who had been admitted to the medical unit of a district general hospital in Northern Ireland. Having recruited 243 patients, a total of 162 patients completed the full protocol (81 randomly assigned to intervention and 81 to control; mean age of control patients 75 years; mean age of intervention patients 73 years). The interventions by the community liaison pharmacist included: preparation of an accurate medication record following a full review of current medication use; medication counselling; provision of a medicines record sheet informing the patient how to take their drugs; provision of a pharmaceutical discharge letter detailing changes made to drug therapy (this was faxed to the patient's GP and community pharmacist on the day of discharge); provision of a Medicines Helpline. The key findings were as follows: problems were identified in 80% of the intervention patients' prescription charts, 49% of which related to drug omissions from the patients' domiciliary prescriptions. The GP practice record was the most accurate (mean error rate 12.6%) while the GP referral letter was the least accurate (mean error rate 47.3%) source of medication information. Drugs patients brought to hospital were also an inaccurate source (mean error rate 44.0%). The intervention group patients, when compared with control patients, had a significant reduction (P = 0.005) in drug mismatch between drugs prescribed at discharge and taken at home, and had a greater knowledge of their drug regimen 10-14 days after discharge (P < 0.001). The vast majority of patients (96%) felt that the provision of a medicine helpline was a useful service. The study indicated clear benefits from the involvement of a hospital based community liaison pharmacist in achieving seamless pharmaceutical care between the primary and secondary healthcare settings.Pharmacy World amp Science 04/2004; 26(2):114-20. · 1.22 Impact Factor
Top co-authors
Top Journals
Institutions
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2009
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University of Jordan
- Department of Biopharmaceutics and Clinical Pharmacy
Amman, Amman, Jordan
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2006–2009
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Queen's University Belfast
- School of Pharmacy
Belfast, NIR, United Kingdom
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2007
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The School of Pharmacy
- School of Pharmacy
Lisburn, NIR, United Kingdom
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