VNU Journal of Science: Medical and Pharmaceutical Sciences
The Journal of Science was established in 1985 for the publication of national and international research papers in all fields of natural sciences and technology, social sciences and humanities. Since then, the journal has grown in quality, size and scope and now comprises a dozen of serials spanning academic research. With the rapid expansion of the field of Economics, the VNU Journal of Science is delighted to announce the launch of the VNU Journal of Science: Medical and Pharmaceutical Sciences (JS: MPS) since 2016. This serial publication provides researchers with the opportunity to publish research covering aspects in these areas in the popular VNU Journal of Science series. As a fully open access publication, the journal will provide maximum exposure for published articles, making the research available to all to read and share. The journal will be published quarterly in June, December. Scope JS: MPS is an open access journal publishing double-blinded peer-reviewed research papers, communications and reviews dealing with Basic medical and pharmaceutical sciences, Clinical medicine and pharmacy, Dentistry, Drug, Economics of health care, Health sciences, Medicine, Medical practice, Nursing, Public health, Pharmaceuticals, Pharmaceutical sciences and Pharmaceutical policy. Publication Ethics VNUJS is committed to maintaining the highest standards of publication ethics and takes all possible measures against any publication malpractices. The journal follows the guidelines and recommendations of the Committee on Publication Ethics (C.O.P.E) to ensure ethical publishing practices. Plagiarism is strictly prohibited and will not be tolerated. Any form of plagiarism, including but not limited to copying, paraphrasing, or reusing previously published work without proper attribution, will result in rejection of the manuscript and potential sanctions against the author. VNUJS utilizes DoIt as plagiarism detection software to verify the originality of submitted manuscripts. The publication ethics statement with full detail of the responsibilities of authors, reviewers and editors can be found here. Peer Review Process Any manuscript followed the journal’s scope and author guideline will be assigned to the managing editors. All manuscripts have undergone editorial screening and anonymous double-blind peer-review by the at least one independent expert in the field. The managing editor makes an editorial decision, which is subject to endorsement by the Editor – in - Chief. The journal publishing process can be found in detail here. Article Processing Charge Authors do not have to pay any Article Processing Charges for their submissions to VNU Journal of Science. Abstracting and Indexing
Vancomycin Dose Adjustment Guided by Therapeutic Drug Monitoring in Adult Patients at Phenikaa University Hospital
Objective: To describe the real-world implementation of vancomycin therapeutic drug monitoring (TDM) based on area under the concentration–time curve (AUC) estimation and dose adjustment in adult patients at Phenikaa University Hospital. Methods: A retrospective observational study was conducted using medical records of adult patients who were prescribed vancomycin from July 2025 to March 2026. Data collected included patient characteristics, microbiological findings, vancomycin utilization and concomitant medications, nephrotoxicity, as well as TDM practices. Dose adjustments were performed based on AUC estimation using SmartDoseAI® software, with a therapeutic target of AUC 400–600 mg·h/L. Results: A total of 62 patients receiving vancomycin were included, of whom 43 underwent TDM and dose adjustment. The proportion of patients receiving appropriate loading doses and initial maintenance doses in accordance with the hospital’s vancomycin TDM protocol was 93.5%. Vancomycin was predominantly prescribed empirically. Renal function was monitored at least once weekly in 85% of patients. Among the 43 patients analyzed, the proportion achieving target AUC increased significantly from 53.5% to 81.4% after the first dose adjustment. Further studies are warranted to optimize and individualize loading and initial maintenance dosing to improve early target attainment. Conclusion: Compliance with loading and initial maintenance dosing was generally good at Phenikaa University Hospital. TDM and vancomycin dose adjustment contributed to optimizing therapeutic target attainment and enhancing treatment safety. Further research is needed to individualize initial dosing strategies to improve early achievement of target AUC.
Copyright (c) 2026 VNU Journal of Science: Medical and Pharmaceutical Sciences
Current Status of Antibiotic Use at Duc Giang General Hospital and Phenikaa University Hospital in 2025
Objective: To analyze the current situation of antibiotic use and compare antibiotic use patterns at Duc Giang General Hospital (DGH) and Phenikaa University Hospital (PhenikaaMec). Method: A retrospective, descriptive cross-sectional study based on inpatient antibiotic use data from June to December 2025 at DGH and PhenikaaMec. Results: During the study period, DGH had 40 antibiotics with a value of VND 6.31 billion. PHU used 55 antibiotics with a value of VND 3.76 billion. The antibiotic consumption level at DGH was higher than at PhenikaaMec, at 75.7 and 60.0DDD/100 bed-day, respectively. Third-generation cephalosporins had the highest value of DDD/100 bed-day at both hospitals: 27 at the DGH and 23.1 at the PhenikaaMec. Among these, ceftriaxone was the most consumed antibiotic in both hospitals. Regarding antibiotics in the priority management group, meropenem was the most frequently used antibiotic in both hospitals, with similar DDD/100 bed-day (1.78 at the DGH and 1.94 at the PhenikaaMec). According to departments, the Infectious Diseases Department and the Urology Department at DGH have the highest antibiotic usage rates, with DDD/100 bed-day exceeding 180. Meanwhile, at PhenikaaMec, the Intensive Care Unit leads in usage with a rate exceeding 170. Based on the WHO's AWaRe classification system, the proportion of Watch antibiotics used is high at 76.2% (DGH) and 67.0% (PhenikaaMec). Conclusion: The study shows that antibiotic consumption levels are relatively high in both hospitals. Increased management of antibiotic use is needed, especially in departments with high consumption rates, to ensure rational antibiotic use.
Analysis of the Implementation of Therapeutic Drug Monitoring-guided Vancomycin Dosing in Pediatric Patients at Duc Giang General Hospital
Objectives: i) To describe vancomycin use and dose adjustments based on AUC estimated using a Bayesian approach in pediatric patients at Duc Giang General Hospital; and ii) To identify factors associated with the risk of AUC target non-attainment at the first TDM of vancomycin. Methods: A prospective study was conducted from March 2025 to September 2025. Neonatal and pediatric patients receiving intravenous vancomycin underwent TDM, and doses were adjusted to achieve the target AUC of 400–600 mg·h/L. AUC values were estimated using a Bayesian approach with SmartDoseAI® software. Multivariable logistic regression analysis was performed to identify factors associated with the risk of AUC target non-attainment. Results: A total of 70 pediatric patients were included. Target AUC attainment increased significantly from 41.4% to 84.3% after the first dosing adjustment. Overall, 92.9% of patients achieved the target AUC at least once during treatment. Multivariable logistic regression analysis showed that estimated glomerular filtration rate (eGFR/10 mL/min) was independently associated with both subtherapeutic exposure (AUC < 400 mg·h/L, OR = 1.45, p = 0.004) and supratherapeutic exposure (AUC > 600 mg·h/L, OR = 0.48, p < 0.001). Conclusion: AUC-guided vancomycin dosing using a Bayesian approach improved target attainment in pediatric patients. Baseline renal function and the initial maintenance dose should be considered to enhance the probability of early AUC target attainment.
Evaluation of Outpatient Azithromycin Prescribing Practices at 108 Military Central Hospital
Objective: To analyze the appropriateness of indications, dosages, and durations of outpatient azithromycin prescriptions at the 108 Military Central Hospital. Methods: A retrospective, cross-sectional descriptive study was conducted on all outpatient prescriptions containing oral azithromycin from October 1st to December 31st, 2025. The appropriateness of prescriptions was evaluated against the brand name product label, the 3rd Edition of the Vietnamese National Drug Formulary, and the diagnostic and treatment guidelines issued by the Ministry of Health. Results: Analysis of 238 patients (mean age 42.1 years; 62.2% male) showed that azithromycin was primarily prescribed for skin and soft tissue infections (32.8%), upper respiratory tract infections (31.1%), and genital infections (26.9%). The rates of appropriate indications and dosing regimens were notably high, at 89.1% and 88.2%, respectively. However, the rate of appropriate treatment duration was only 42.9%. Up to 57.1% of all prescriptions extended beyond the recommended duration; alarmingly, 100% of the prescriptions for genital infections had an inappropriate duration. Conclusion: Practices of outpatient azithromycin prescribing at the facility demonstrated excellent adherence to recommended indications and dosages; however, the inappropriate prolongation of treatment duration remains a significant issue. The hospital should urgently implement Antimicrobial Stewardship interventions, with a focus on integrating a clinical decision support system to control the duration of prescriptions. This is essential to protect patients from cardiovascular risks and to mitigate the development of multidrug-resistant bacteria.
Utilization of Anidulafungin in Intensive Care Units at 108 Military Central Hospital
Objective: To assess the utilization of anidulafungin in intensive care units (ICUs) at 108 Military Central Hospital. Subject and method: A retrospective cross-sectional descriptive study was conducted based on medical records of patients who received anidulafungin in intensive care units during the study period. Result: A total of 44 patients were included in the analysis, with a median age of 53 (42.8–67.3) years; males accounted for 70.5%. Patients commonly had multiple comorbidities, with liver disease being the most prevalent (47.7%), 25,0% had concomitant bacterial infections, mainly pneumonia and bloodstream infections. Major risk factors for invasive fungal infections included prolonged ICU stay (100.0%), use of broad-spectrum antibiotics (97.7%), abdominal surgery (75.0%), and solid organ transplantation (54.6%). Fungal investigations were performed in 40.9% of patients, of which 88.9% yielded positive results. Candida species were the predominant pathogens, with Candida albicans accounting for 33.3%. Anidulafungin was exclusively used as monotherapy (100%), with no cases of combination therapy with other antifungal agents., with a median treatment duration of 5.5 (4-7.3) days. Anidulafungin was predominantly prescribed for empirical (36.4%) and prophylactic (43.2%) indications, whereas targeted therapy was limited. A loading dose of 200 mg was administered in 81,8% of patients, while a maintenance dose of 100 mg/day was used in 97.7%. Most patients did not require modification of antifungal therapy. Adverse events included elevated liver enzymes (6.8%) and hypokalemia (11.4%), which were observed during the treatment period. The rate of unfavorable clinical outcomes was 45.5%. Conclusion: Anidulafungin was generally used with maintenance dosing consistent with current guidelines. However, suboptimal use of loading doses and limited utilization of fungal diagnostics indicate gaps in clinical practice. The high rate of unfavorable outcomes highlights the need for optimization of antifungal therapy and increased use of microbiological diagnostics to improve treatment effectiveness and mitigate antifungal resistance.
The Outcomes of the Implementation of Antimicrobial Prophylaxis Procedure with the Participation of the Pharmacists at the Department of Orthopaedics & Trauma, Thanh Nhan Hospital
Objective: The study aimed to evaluate the results of implementing the prophylactic antibiotic protocol issued by Thanh Nhan Hospital at the Department of Orthopedics, with the participation of clinical pharmacists through analyzing the level of compliance and indicators related to the effectiveness, safety and cost of antibiotic use. Subjects and methods: The prospective interventional study was conducted from April to September 2025 on patients with surgical indications at the Department of Orthopedics who met the selection and exclusion criteria according to the prophylactic antibiotic protocol. Results: A total of 127 patients were included in the study. The overall adherence rate was 79.5%, with 100% of patients fully meeting the criteria for antibiotic selection and route of administration. In addition, high adherence was also recorded for dosage (96.1%) and timing of prophylactic antibiotic administration (95.3%). No cases of surgical site infection were reported. During the implementation period, antibiotic cost savings were estimated at 383.000 to 453.000 VND per patient. Conclusion: The implementation of the surgical antimicrobial prophylaxis protocol with the participation of clinical pharmacists helped improve adherence to the professional protocol, did not increase the rate of surgical site infection, ensured treatment effectiveness and safety, and optimized antibiotic costs.
Evaluation of the Results of Clinical Pharmacological Intervention in Switching Antibiotic Administration from Intravenous to Oral in Patients with Community-acquired Pneumonia at the Respiratory Department of Hanoi Children's Hospital
Background: Intravenous-to-oral (IV-PO) antibiotic conversion is an effective strategy to optimize antibiotic use, reduce treatment costs, and minimize complications associated with prolonged intravenous therapy. However, no official IV-PO conversion guideline has been implemented at Hanoi Children’s Hospital. Objectives: To evaluate the effectiveness of clinical pharmacy intervention on IV-PO antibiotic conversion in pediatric patients with community-acquired pneumonia (CAP) at the Respiratory Department of Hanoi Children’s Hospital. Methods: A retrospective longitudinal descriptive study was conducted in two phases. In the pre-intervention phase, 158 pediatric patients aged 2 months to 5 years diagnosed with CAP and treated from March 1st to March 31st, 2025 were evaluated to assess the current status of IV-PO conversion. In the intervention phase, 137 CAP patients treated from June 14th to August 14th, 2025 were retrospectively reviewed to evaluate the effectiveness of clinical pharmacy intervention. Eligible patients received intravenous antibiotics for at least 48 hours and met IV-PO conversion criteria. Descriptive statistical analysis was performed using Microsoft Excel and SPSS version 20.0. Results: More than 94% of patients in both phases were eligible for IV-PO conversion. The IV-PO conversion rate increased significantly from 6.66% before intervention to 94.07% after intervention. Conclusions: Clinical pharmacy intervention was feasible and effective in improving IV-PO conversion rates and optimizing antibiotic use in pediatric patients with CAP.
Colistin Use in Critically Ill Burn Patients: Issues of Augmented Renal Clearance and Nephrotoxicity
Objective: To analyze the characteristics of augmented renal clearance (ARC) and nephrotoxicity in burn patients treated with colistin in the Emergency Resuscitation Department at Le Huu Trac National Burn Hospital. Subject and method: A retrospective cross-sectional study was conducted using medical records of burn patients hospitalized in the Emergency Resuscitation Department at Le Huu Trac National Burn Hospital from January 2024 to December 2025. Cox proportional hazards regression analysis was performed to identify factors associated with colistin-induced nephrotoxicity. Results: The median age of patients was 39.5 years, with males accounting for 82.9%. Most patients had severe burns (grade III or higher). A loading dose of colistin was administered in 88.1% of patients, with a median maintenance intravenous dose of 9 MIU/day. ARC was observed in 59.6% of patients at least once during hospitalization. Among patients with ARC, treatment response rates were 75% in those receiving >9 MIU/day and 59% in those receiving ≤9 MIU/day. Colistin-associated nephrotoxicity occurred in 31% of patients, with a median onset time of 7.5 days. The probability of nephrotoxicity increased over the duration of colistin therapy. Cox regression analysis identified age (HR = 1.04; 95% CI: 1.01–1.07; p = 0.018) and hypotension (HR = 4.07; 95% CI: 1.60–10.35; p = 0.003) as independent risk factors for nephrotoxicity. Conclusion: A high prevalence of ARC was observed among burn patients receiving colistin. In patients with ARC, colistin doses >9 MIU/day tended to be associated with better treatment response. Age and hypotension were independent risk factors increasing the likelihood of nephrotoxicity.
Analysis of Susceptibility Patterns and MIC Distributions of Five Gram-negative Bacterial Species Against Aminoglycosides in Intensive Care Units at 108 Military Central Hospital
Objectives: To investigate five common Gram-negative bacteria in the ICU and to analyze the antibiotic susceptibility and MIC distribution of the aminoglycoside group for the isolated strains. Materials and Methods: A cross-sectional descriptive study was conducted. Microbiological data were extracted from the laboratory management software between June 1, 2025, and December 31, 2025. We screened for the five most common Gram-negative bacteria: A. baumannii, K. pneumoniae, E. coli, P. aeruginosa, and K. aerogenes, then collected and analyzed the data. Results: Analysis of 443 microbiological samples showed that A. baumannii and K. pneumoniae were the two most common Gram-negative strains. E. coli remained highly sensitive to aminoglycosides, specifically 91.7% to amikacin and 60-70% to gentamicin and tobramycin. Similarly, K. pneumoniae was sensitive to gentamicin (71.2%), amikacin (54.8%), and tobramycin (36.3%). In contrast, a critical resistance situation was observed in A. baumannii and K. aerogenes, with sensitivity rates dropping to approximately 10%. MIC distribution data showed that amikacin maintains good efficacy against E. coli (90%) and K. pneumoniae (55%) at MIC ≤4 mg/L, ensuring that therapeutic targets can be reached with the standard dose of 15 mg/kg. Conclusion: Aminoglycosides maintain high efficacy against E. coli and K. pneumoniae, yet face significant challenges due to high resistance rates in P. aeruginosa and A. baumannii. MIC distribution data serves as a critical foundation for empirical antibiotic selection and TDM protocols to optimize dosing for critically ill patients.
Analysis of the List of Drugs Used at Phenikaa University Hospital in 2025
Objective: to analyze the structure of the drug formulary used at Phenikaa University Hospital in 2025. Methods: A retrospective cross-sectional descriptive study was conducted on the entire drug formulary used at the hospital from January 1st, 2025 to December 31, 2025. Data were collected and analyzed using descriptive statistics, ABC, VEN, and ABC/VEN matrix methods. Results: The drug formulary included 1,186 items with a total expenditure of VND 55.8 billion, categorized into 14 pharmacological groups. Anti-infective agents accounted for 19.74%, antineoplastic and immunomodulating agents for 16.88%, and diagnostic radiopharmaceuticals (notably FDG) contributed significantly (17.95% of total expenditure). Imported drugs predominated (66.95% of items; 68.33% of expenditure). Additionally, generic drugs accounted for a high proportion (80.1% of items; 75.86% of expenditure). ABC analysis showed that group A represented 14.59% of items but 79.92% of total expenditure. VEN analysis indicated that essential drugs (E) accounted for 86.77% of total expenditure. By ABC/VEN matrix, the AE group contributed the largest share (71.56% of total expenditure), whereas the CE group comprised the highest number of items (49.58%) but a low expenditure (4.09%). The AN group accounted for a small proportion (1.14% of total expenditure). Conclusion: The drug list is highly concentrated in specialized therapeutic groups, with AE category drugs accounting for the largest expenditure share (71.56%). These findings provide a scientific basis for the hospital to refine its formulary and optimize procurement planning in future operational phases.
Evaluating the Effectiveness of Guideline-Directed Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction at Hanoi Heart Hospital
Objectives: This study aimed to evaluate the effectiveness of adherence to evidence-based prescribing in patients with heart failure with reduced ejection fraction (HFrEF) at Hanoi Heart Hospital. Methods: A retrospective study was conducted, collecting data from patients during both inpatient and outpatient treatment phases. Adherence to Guideline-Directed Medical Therapy (GDMT) was calculated using the scoring system from the QUALIFY study. Hospitalizations were identified through outpatient medical records. Results: The study included 360 HFrEF patients. At the time of discharge, 95% of patients were prescribed at least one GDMT medication. During the outpatient phase, 97.9% of patients were prescribed at least one GDMT drug class, and 93.9% were prescribed at least two classes. GDMT adherence scores showed a progressive increase from the time of discharge to one month post-discharge. Poor adherence to GDMT was significantly associated with a elevation in all-cause and heart failure-related hospitalizations within 12 months following discharge (p < 0,05). Conclusions: Poor adherence to GDMT is associated with an increased risk of heart failure-related readmission within 12 months. Patients should be prescribed evidence-based heart failure therapies, with dosages titrated toward target levels or the maximum tolerated doses to improve clinical outcomes.
Sedation, Anesthesia, Analgesic Use and Associated Adverse Events During Pediatric Cardiac Catheterization at Vietnam National Children’s Hospital
Objectives: To describe the characteristics of sedative, anesthetic, and analgesic use, the incidence of adverse events (AEs), and associated factors in pediatric cardiac catheterization at Vietnam National Children’s Hospital (VNCH). Methods: Data of 208 patients age under 18 underwent diagnostic and/or interventional cardiac catheterization at VNCH from January to May 2024 was retrospectively collected from medical records. Multivariable logistic regression analysis was performed to evaluate the associations between patient characteristics, medication use, and AEs. Results: Endotracheal intubation (ETI) was used in 81.73% of cases, with multimodal anesthesia (sevoflurane, propofol, fentanyl, paracetamol) predominating. The rate of overall AE was 19.23%, mostly defined as “possible” in Naranjo scale, mainly cardiovascular (13.94%) and respiratory (7.21%) while neurological AE was of 1.92% only. Multivariable analysis identified ETI with adjusted odd ratio (aOR) of 9.81, combined procedures (aOR 4.17), male sex (aOR 5.64), and propofol dose (aOR 0.48) as independent factors associated with AEs. Conclusions: ETI with multimodal anesthesia is the main strategy in pediatric cardiac catheterization with acceptable rate of encountered AE. The ETI, diagnostic–interventional procedures, and male sex and propofol dose being independently associated with overall, cardiovascular, and respiratory AEs, respectively.
Developing a Cardiovascular Drug-disease Interaction List and Evaluating the Effectiveness of its Management at Dong Da General Hospital
Background: Drug–disease interactions (DDSIs) significantly affect treatment safety and effectiveness, particularly in cardiovascular patients with multimorbidity and polypharmacy. Objectives: To develop a list of cardiovascular drug–disease interactions and evaluate the effectiveness of drug information provision in DDSI management at Dong Da General Hospital. Methods: A cross-sectional study combined with a pre–post intervention design was conducted. A DDSI list was developed from multiple references and implemented in clinical practice. Prescription data were collected across three phases: pre-intervention, post-DDSI list implementation, and post-drug information intervention. Results: The DDSI list included 39 active ingredients across 7 ATC groups, with 128 clinically significant contraindicated interactions. The DDSI rate decreased significantly from 0.108% pre-intervention to 0.062% after list implementation and further to 0.0045% after drug information provision (p < 0.001). Conclusions: Drug information provision combined with a DDSI list significantly reduced DDSI occurrence in prescribing practice and represents a feasible approach in settings without clinical decision support systems.
Practice Patterns of Infusion-related Reaction Prophylaxis in Breast Cancer Patients Receiving Chemotherapy at K Hospital
Objective: To analyze the status of premedication and its association with the incidence of infusion-related reactions (IRRs) in breast cancer patients receiving chemotherapy. Subject and method: A prospective descriptive study was conducted among 219 patients aged ≥18 years diagnosed with breast cancer and receiving inpatient chemotherapy at the Departments of Internal Medicine 5 and 6, K Hospital, from January 1, 2024, to March 31, 2024. Result: The mean age was 50.4 ± 10.2 years; 48.4% of patients received taxane-containing regimens requiring IRR prophylaxis. IRR prophylaxis was administered in 72.6% of patients, including all taxane-containing regimens. A combination of dexamethasone, diphenhydramine, and famotidine (63.6%) was the most common premedication regimen, similarly observed in both taxane-containing (68.6%) and non-taxane regimens (53.7%). Assessment of guideline adherence showed that 50.3% of prophylaxis was appropriate, while 49.7% was inappropriate, including 44.7% overprophylaxis and 5.0% inadequate prophylaxis. 16.4% of patients witnessed IRRs, of whom 5.5% required discontinuation of infusion. A history of previous IRR was linked to an increased risk of both any-grade IRR and infusion discontinuation (p<0.05). Prior pruritus and inadequate prophylaxis was significantly associated with a noticeably higher risk of IRR (p<0.05) but not infusion discontinuation (p>0.05). Notably, over-prophylaxis showed no association with IRR risk of any severity or infusion discontinuation (p>0.05). Conclusion: Approximately half of the patients received inappropriate IRR prophylaxis, mainly due to over-prophylaxis. Prior IRR, prior-cycle pruritus, and inadequate prophylaxis are associated with IRR outcomes, highlighting the importance of guideline adherence and individualized prophylaxis strategies.
Current Status of Treatment Adherence to High-dose Methotrexate Regimens at the National Institute of Hematology and Blood Transfusion
High-dose methotrexate (HDMTX) is an important component of many cancer treatment regimens but has the risk of causing serious toxicity, especially on the kidneys, liver and hematology. Therefore, strict adherence to HDMTX usage and monitoring instructions is necessary to ensure safety and treatment effectiveness for patients. The study was conducted with the aim of evaluating compliance with HDMTX treatment instructions at the National Institute of Hematology and Blood Transfusion. Subjects and Methods: A retrospective descriptive study was conducted on 214 patients who received high-dose methotrexate from January 2023 to June 2024, with a total of 382 treatment cycles. Results: The adherence rates to the HDMTX regimen regarding urinary alkalinization, fluid replacement, and leucovorin rescue were 91.10%, 29.84%, and 66.52%, respectively. Conclusion: Adherence to the treatment protocol remains suboptimal, indicating the need to strengthen compliance in clinical practice.
Direct Medical Costs in the Treatment of Prostate Cancer at Friendship Hospital in the Period of 2020-2025
Introduction: Prostate cancer is one of the most common cancers in men, ranking second worldwide in terms of new cases with more than 1,4 million cases according to GLOBOCAN 2022. In Vietnam, although the age-standardized rate remains low, the disease still has a high number of cases and shows an increasing trend over time. This study aimed to analyze the direct medical costs of prostate cancer treatment at Friendship Hospital from 2020 to 2025. Methods: A retrospective cross-sectional descriptive study was conducted on 94 patients, with a total of 1.392 treatment sessions at Huu Nghi Hospital from 2020 to 2025. Results: The average annual direct medical costs for stages II, III, and IV were 38.828.950 VND, 46.577.947 VND and 69.659.116 VND, respectively, increasing with disease severity. Hormone therapy and surgery accounted for the largest cost components, with hormone therapy costs rising markedly in advanced stages. Conclusion: Most prostate cancer patients were diagnosed at late stages. Treatment costs increased with disease progression, with hormone therapy and surgery as the main cost drivers. Strengthening screening and early detection is necessary to reduce the financial burden on both the healthcare system and patients.
Current Practice of High-Dose Methotrexate Use in Osteosarcoma Patients at Vinmec Times City Hospital
Objective: To describe current high-dose methotrexate use in osteosarcoma patients at Vinmec Times City Hospital from January 2023 to September 2025, as a basis for developing a standardized protocol with clinical pharmacist involvement. Methods: A retrospective cohort study was conducted using medical records of osteosarcoma patients receiving methotrexate at doses ≥500 mg/m². The HD-MTX process was described at predefined points: pre-infusion, infusion start, and 4, 24, 48, 72, and x hours after infusion. Results: A total of 342 cycles from 45 patients were analyzed. Complete pre-infusion laboratory assessment was performed in 73.1% of cycles. All cycles received hydration and urinary alkalinization, and achieved urine pH ≥7. However, 11.4% had alkalinization duration < 4 hours, 46.8% had Tpre NaHCO₃ < 40 mEq/L, and only 33.6% achieved infusion rate ≥125 mL/m²/h. MTX target concentrations were achieved in 75.1%, 97.0%, and 53.0% at T₂₄, T₄₈, and T₇₂, respectively; median Tₓ was 69 hours. Adverse events occurred in 303/342 cycles (88.6%), mainly vomiting (27.8%), nausea (23.7%), elevated AST (73.9%) and ALT (66.2%). Conclusion: HD-MTX use remained suboptimal regarding alkalinization duration, NaHCO₃ dosing, infusion rate, and management of supratherapeutic MTX levels. A standardized protocol and proactive monitoring model with clinical pharmacist participation are needed.
Impact of Adverse Drug Events on Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients: A Study in a Provincial Oncology Hospital in Vietnam
Adjuvant endocrine therapies used in the treatment of breast cancer may cause multiple adverse drug events (ADEs), which can reduce patients’ quality of life and hinder treatment adherence if not properly managed. A cross-sectional study was conducted at Provincial Oncology Hospital among patients who had been prescribed tamoxifen or aromatase inhibitors (AIs) for at least 3 months. ADEs occurring within the previous 4 weeks were recorded and their severity assessed using a 4-point Likert scale, based on a 21-item symptom questionnaire. Treatment adherence was evaluated using the 12-item Adherence to Refills and Medications Scale (ARMS). Among 243 participants (mean age 54,4 ± 10,1 years; 93.4% postmenopausal; 72.8% stage II disease; 53.1% receiving AIs), with a total of 774 events recorded, 199 patients (81.9%) reported at least one ADE and 63 patients (25.9%) experienced at least one severe ADE. Musculoskeletal adverse events were the most frequently reported (26.2%), followed by vasomotor adverse events such as hot flashes (13.0%). The overall non-adherence rate was 48.6%, primarily due to forgetting or missing medication when being careless. Multivariate analysis showed that the occurrence of ADEs was significantly associated with treatment adherence. Specifically, patients experiencing at least one ADE were significantly less likely to adhere to treatment (OR = 0.015; 95%CI: 0.002–0.116), and adherence decreased as the number of ADEs increased (p < 0.001). These findings highlight the importance of early detection and effective management of ADE, as well as strengthening patient education to improve adherence, thereby contributing to better treatment outcomes and improved quality of life.
Analysis of Prescribed and Compounded Anticancer Drugs at Phenikaa University Hospital
This study was conducted to analyze the anticancer drug formulary and evaluate compounding outcomes at Phenikaa University Hospital during the period from October 2025 to March 2026 using a retrospective descriptive design. The study results showed that the total expenditure on anticancer medications was VND 13.88 billion, accounting for 21.69% of the hospital’s total drug expenditure. Among these, monoclonal antibodies and antibody–drug conjugates accounted for the highest proportion of drug costs (60.66%), particularly Pembrolizumab. This finding reflects the current trend in oncology treatment, shifting from conventional chemotherapy toward modern therapeutic approaches with greater efficacy in improving survival outcomes across various malignancies.Analysis of the chemotherapy compounding formulary revealed that the total value of centralized compounded medications was 10.32 billion VND, the residual drug waste after compounding was valued at 620.228 million VND, accounting for 5.93% of the total prescribed anticancer drug expenditure. These findings indicate a substantial discrepancy between the prescribed doses and the actual administered doses to patients (5.93%). Therefore, centralized compounding and dose sharing of anticancer agents are essential strategies to minimize drug wastage, reduce occupational exposure risks for healthcare personnel, and mitigate environmental contamination.
Analysis of the Current Status of Consumable Medical Supplies Usage, Cost Structure, and Health Insurance Reimbursement Rates in Surgery at Phenikaa University Hospital in 2025
A retrospective cross-sectional descriptive study was conducted at Phenikaa University Hospital in 2025 to analyze the utilization status, cost structure, and the affordability of Health Insurance (HI) for medical consumables and artificial implants. Results: The cost of medical supplies accounted for 26.53% of the total value of hospital inventory (exceeding 43.8 billion VNĐ). Within this, the budget was primarily concentrated on specialized medical supplies (38.90%) and replacement/ implant materials (15.03%). Notably, high-value items accounted for 79.93% of the total expenditure despite making up only a small proportion of the total number of items. Compared to common medical supplies, which are 100% covered by Health Insurance, high-tech implants frequently exceeded reimbursement caps. This led to significant variation in patient co-payments, ranging from 1.47 million to over 30.2 million VNĐ per case, depending on the specific type of material selected. Conclusion: The cost structure of medical supplies at the hospital shows strong differentiation, heavily concentrated in high-tech categories. These results highlight the urgent need to apply pharmacoeconomic/ health economic analysis to optimize material selection. Such measures are essential to ensure the balance of the Health Insurance fund and reduce the financial burden on surgical patients.
Analysis the Results of Centralized Procurement Bidding at the Provincial Level for the Period 2024-2025 in the Three Cities of Hanoi, Hai Phong, Da Nang
This study analyzed the results of centralized drug procurement bidding at the provincial level in Hanoi, Hai Phong, and Da Nang during the 2024–2025 period, in the context of the implementation of Law on Bidding No. 22/2023/QH15 and newly issued regulations on pharmaceutical bidding. A retrospective descriptive study was conducted on nine bidding packages comprising a total of 5,550 drug items. The overall winning bid rate was 81,4%, with notable differences among the three localities in terms of procurement scope, contract duration, and drug category structure. Da Nang implemented the most comprehensive centralized procurement model, covering originator drugs, generic medicines, and traditional herbal medicines, whereas Hanoi adopted a selective procurement approach that provided greater autonomy to healthcare institutions. Hai Phong conducted procurement frequently with large-scale drug lists; however, no originator drug bidding packages were organized throughout the two-year study period. Generic medicines accounted for the majority of procured items in all three localities, particularly drugs classified in technical groups 1 and 2. The study results indicate that the centralized local-level pharmaceutical procurement model was implemented flexibly according to the needs and management orientations of each locality.
Current Situation of Prescription of Anti-Depression Medications at Hanoi Mental Hospital
To analyze antidepressant prescribing patterns and assess potential drug–drug interactions in inpatients with depression at Hanoi Mental Hospital. Methods: A retrospective descriptive study was conducted on 71 inpatient medical records of patients diagnosed with depression (ICD-10 codes F32, F33) from 2024 to 2025. Data on patient characteristics, medication use, treatment regimens, dose appropriateness according to Ministry of Health guidelines, and potential drug–drug interactions were collected. Drug interactions were identified using Drug.com and Medscape databases. Results: Most patients received combination therapy (95.77%), with the most common regimen including antidepressants, antipsychotics, and sedative agents. Selective serotonin reuptake inhibitors (SSRIs) were the most frequently prescribed class, with sertraline being the predominant drug. Drug dosages were generally consistent with national guidelines. A total of 11 potential drug–drug interaction pairs were identified, mainly associated with risks of QT interval prolongation and serotonin syndrome. Notably, discrepancies in interaction severity classification were observed between the two databases. Conclusions: Antidepressant use in this setting was generally appropriate in terms of drug selection and dosing. However, the high rate of polypharmacy may increase the risk of potential drug–drug interactions. Careful evaluation of combination therapy and interpretation of interaction data from multiple sources, in conjunction with clinical context, are essential to optimize treatment safety.
Analysis of Medication Prescribing in Outpatients with Asthma at Dong Da General Hospital in 2024
Objective: To analyze prescribing patterns in outpatients with bronchial asthma at Dong Da General Hospital. Methods: A retrospective descriptive study was conducted using medical records of asthma patients from June to December 2024. Disease status and treatment regimens were collected and analyzed across two periods (T1: June–September; T2: October–December), with changes in disease severity and treatment steps assessed over time. Results: Most patients had mild airflow obstruction, increasing from 71.5% in T1 to 80.5% in T2; 30% showed improvement while 12% worsened. ICS/LABA combination therapy was the predominant maintenance treatment (70–80%), mainly at step 4. Despite changes in disease severity, treatment regimens remained largely unchanged. Conclusions: Outpatient treatment predominantly involved ICS + LABA. However, changes in treatment steps did not fully correspond to changes in disease severity.
Analysis of Inhaler Technique and Treatment Adherence among Outpatients with Chronic Obstructive Pulmonary Disease at Dong Da General Hospital in 2025
Objective: To analyze inhaler use and assess treatment adherence among outpatients with chronic obstructive pulmonary disease (COPD) at Dong Da General Hospital. Methods: A descriptive study was conducted through direct interviews with COPD patients to evaluate inhaler technique and treatment adherence. Results: A high proportion of patients demonstrated incorrect inhaler technique, with 68.5% in the MDI group and 67.9% in the DPI group. The most common errors were poor coordination between actuation and inhalation for MDI (40.7%) and failure to exhale fully before inhalation for DPI (39.5%). Treatment adherence was suboptimal, with only 35-40% of patients achieving good adherence according to the ARMS scale. The main reasons for medication non-adherence included forgetting to take medication, intentional non-use, and discontinuation due to health-related issues, whereas non-adherence to medication refilling was primarily associated with forgetting to obtain medication and running out of medication. Conclusions: Incorrect inhaler technique and poor treatment adherence remain common among COPD patients. These issues are largely related to patient behaviors and medication-use habits, highlighting the need to strengthen patient education on inhaler technique and implement strategies to improve adherence in clinical practice.
Effectiveness of Insulin-use Counseling Among Outpatients with Diabetes at Hung Ha General Hospital
Objective: The study aimed to evaluate the effectiveness of insulin-use counseling among outpatients with diabetes at Hung Ha General Hospital. Subjects and methods: An interventional study was conducted among outpatients with diabetes at Hung Ha General Hospital from February 1st to September 30th, 2025. Results: A total of 148 patients fulfilled the inclusion criteria and completed the study. Medication adherence increased significantly from 76.4% to 85.8% following the counseling intervention (p < 0.001). The majority of drug-related problems (DRPs) associated with insulin-use behaviors identified at baseline were resolved after the intervention, with a 61.3% reduction in the total number of DRP. The proportion of patients experiencing hypoglycemia decreased from 54% to 41.9% (p < 0.05). Additionally, injection-site adverse drug reactions (ADRs), including bleeding, bruising, and pruritus, declined from 10.8% to 6.7%. Conclusion: Insulin-use counseling significantly improved medication adherence, reduced insulin-related drug-related problems (DRPs), and lowered the incidence of hypoglycemia among outpatients with diabetes mellitus. These findings highlight the essential role of pharmaceutical counseling in optimizing outpatient diabetes management.
Implementation of SGLT2 Inhibitor Use and Clinical Outcomes in Outpatients with Type 2 Diabetes or Heart Failure at Duc Giang General Hospital
Objectives: this study aimed to evaluate the implementation of SGLT2 inhibitor (SGLT2i) prescribing regulations and to describe clinical outcomes in outpatients with type 2 diabetes mellitus (T2DM) or heart failure (HF). Methods: A descriptive longitudinal study was conducted from February to September 2025. Patients who met the priority criteria for SGLT2i therapy and were prescribed these agents were included. Clinical, laboratory, and prescription data were collected at baseline and during follow-up. Medication adherence was assessed using medication possession ratio (MPR), with ≥80% considered acceptable adherence. Results: A total of 222 patients receiving SGLT2i were included (mean age 71.5 ± 10.0 years; 54.5% female). Among them, 64.4% had T2DM 35.6% had HF. The proportion of patients achieving MPR ≥ 80% was 77.9%. In the T2DM subgroup, HbA1c decreased by 1.06% after 3 months (p < 0.001). In the HF subgroup, ejection fraction (EF) improved from 35.3% to 48.7% (p < 0.001). Estimated glomerular filtration rate (eGFR) showed a modest initial decline but stabilized after 6 months. Most adverse drug reactions were mild to moderate. Conclusions: Implementation of prescribing regulations improved access to SGLT2i therapy in routine clinical practice. Observed improvements in glycemic control and cardiac function suggest potential benefits; however, these findings should be interpreted cautiously due to the observational design and concomitant therapies.