Academic literature on the topic 'Medication-related problem'
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Journal articles on the topic "Medication-related problem"
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Goedken, Amber, Sharon Huang, Randal McDonough, Michael Deninger, and William Doucette. "Medication-Related Problems Identified Through Continuous Medication Monitoring." Pharmacy 6, no. 3 (August 20, 2018): 86. http://dx.doi.org/10.3390/pharmacy6030086.
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Community pharmacists performing Continuous Medication Monitoring (CoMM) systematically monitor each new prescription and refill dispensed for medication-related problems. The objectives for this study were to describe medication-related problems identified through CoMM and drug classes involved in problems. This 12-month pilot study used dispensing and clinical records from a single independent U.S. community pharmacy. Clinical records contain medication-related problems documented by the pharmacists. Problems identified for patients filling at least one prescription at the pharmacy and having at least one medication-related problem during the study period were included. A total of 8439 medication-related problems were identified for 1566 patients, an average of 5.4 problems per patient. Over 63% of problems were nonadherence. The drug class most often involved in problems was the central nervous system and analgesic class. Community pharmacists performing CoMM identified medication-related problems that might otherwise have gone undetected.
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Stevenson, Jennifer M., J. Graham Davies, and Finbarr C. Martin. "Medication-related harm: a geriatric syndrome." Age and Ageing 49, no. 1 (October 28, 2019): 7–11. http://dx.doi.org/10.1093/ageing/afz121.
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Abstract The WHO Global Patient Safety Challenge: Medication Without Harm recognises medication-related harm (MRH) as a global public health issue. Increased life-expectancy coupled with multimorbidity and polypharmacy leads to an increased incidence of MRH, especially in older adults: at a cost of approximately £400 million to the National Health Service (NHS) in England. Harm from medicines has long been recognised by geriatricians, and strategies have been developed to mitigate harm. In general, these have focused on the challenges of polypharmacy and appropriateness of medicines, but impact on the quality of life, clinical and economic outcomes has been variable and often disappointing. The problem of MRH in older adults will continue to grow unless a new approach is adopted. Emerging evidence suggests that we need to take a broader approach as described in our conceptual model, where well-recognised physiological changes are incorporated, as well as other rarely considered psychosocial issues that influences MRH. Parallels may be drawn between this approach and the management of geriatric syndromes. We propose there must be a greater emphasis on MRH, and it, of itself, should be considered as a geriatric syndrome, to bring the spotlight onto the problem and to send a clear signal from geriatric experts that this is an important issue that needs to be addressed using a co-ordinated and tailored approach across health and social care boundaries. This requires a more proactive approach to monitor and review the medicines of older adults in response to their changing need.
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MacTavish, Pamela, Tara Quasim, Martin Shaw, Helen Devine, Malcolm Daniel, John Kinsella, Carl Fenelon, Rakesh Kishore, Theodore J. Iwashyna, and Joanne McPeake. "Impact of a pharmacist intervention at an intensive care rehabilitation clinic." BMJ Open Quality 8, no. 3 (September 2019): e000580. http://dx.doi.org/10.1136/bmjoq-2018-000580.
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ObjectiveWhile disruptions in medications are common among patients who survive critical illness, there is limited information about specific medication-related problems among survivors of critical care. This study sought to determine the prevalence of specific medication-related problems detected in patients, seen after critical care discharge.DesignConsecutive patients attending an intensive care unit (ICU) follow-up programme were included in this single-centre service evaluation.SettingTertiary care regional centre in Scotland (UK).Participants47 patients reviewed after critical care discharge at an ICU follow-up programme.InterventionsPharmacists conducted a full medication review, including: medicines reconciliation, assessing the appropriateness of each prescribed medication, identification of any medication-related problems and checking adherence.MeasurementsMedication-related problems in patients following critical care discharge. Interventions and medication-related problems were systematically graded and risk factors were identified using an adapted version of the National Patient Safety Agency Risk Matrix.Main results69 medication-related problems were identified in 38 (81%) of the 47 patients. The most common documented problem was drug omission (29%). 64% of the medication-related problems identified were classified as either moderate or major. The number of pain medications prescribed at discharge from intensive care was predictive of medication-related problems (OR 2.02, 95% CI 1.14 to 4.26, p=0.03).ConclusionsMedication problems are common following critical care. Better communication of medication changes both to patients and their ongoing care providers may be beneficial following a critical care admission. In the absence of highly effective communication, a pharmacy intervention may contribute substantially to an intensive care rehabilitation or recovery programme.
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Patil, Anant D., Hritika Sharma, and Tanusri Tetarbe. "COVID-19 and concerns related to self-medication." International Journal of Basic & Clinical Pharmacology 9, no. 9 (August 25, 2020): 1475. http://dx.doi.org/10.18203/2319-2003.ijbcp20203638.
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The practice of self-care through self-medication is not uncommon. Self-medication is not just a problem of one country, the phenomenon is global. A systematic review has highlighted this wide spread problem. Self-medication can be based on self-belief, advice of a pharmacist or another person instead of consultation with a qualified healthcare professional. In the settings of poor access to health care services and issues related to affordability of paying for medical services, people practice self-medication as the righteous approach. Some people may consume medications without consultation of a healthcare professional citing reason of time saving. Certain drugs available as prescription medicine in one country may be available over the counter in another country. Furthermore, with digitalisation, people now have an easy access to the internet where they simply explore their symptoms and find the perceived suitable treatment for the same. Thus, the reasons and pattern of self-medications may differ based on different factors including type of population affordability, and country.
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Vervloet, Marcia, Hanneke E. Zwikker, Annemiek J. Linn, Ellen S. Koster, Suzan G. H. Gipmans, Maaike C. W. van Aarle, and Liset van Dijk. "The Development and Proof of Principle Test of TRIAGE: A Practical Question Set to Identify and Discuss Medication-Related Problems in Community Pharmacy." Pharmacy 8, no. 4 (September 27, 2020): 178. http://dx.doi.org/10.3390/pharmacy8040178.
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The pharmacy counter is a good place to identify and discuss medication-related problems. However, there is a lack of practical communication tools to support pharmacy technicians (PTs) in initiating a conversation with patients. This study aimed to develop and test a practical set of questions for PTs, called TRIAGE, to identify problems during encounters. TRIAGE was developed based on insight from the literature, focus groups with PTs and pharmacists, and input from patients and experts. In 10 community pharmacies, 17 PTs used TRIAGE during encounters with patients who collected their cardiovascular medication. For each encounter, PTs registered the identified problems and suggested solutions. A total of 105 TRIAGE conversations were held, 66 for first refill and 39 for follow-up refill prescriptions. In 15 (23%) first refill prescription encounters, a problem was identified. These problems concerned forgetting to take the medication, a complex medication regime or (fear of) side effects. In three (8%) follow-up refill prescription encounters, a problem was identified. Most of the problems were solved on the spot. Pharmacy technicians indicated that they identified medication-related problems with TRIAGE that otherwise would be left unnoticed. They appreciated TRIAGE as a useful instrument for starting the conversation with patients about medication use.
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Tharanon, Vichapat, Krongtong Putthipokin, and Phantipa Sakthong. "Drug-related problems identified during pharmaceutical care interventions in an intensive care unit at a tertiary university hospital." SAGE Open Medicine 10 (January 2022): 205031212210908. http://dx.doi.org/10.1177/20503121221090881.
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Introduction: Drug-related problems could potentially worsen the clinical outcomes in critically ill patients. Critically ill patients are generally considered more vulnerable to harm from drug-related problems due to frequent medication-related events and complicated clinical courses. However, drug-related problems identified by on-ward clinical pharmacists in medical intensive care units in Thailand are not well reported. This study reports clinically relevant data with the description of identified problems, common causes of drug-related problems, and pharmacists’ interventions performed in real world, so that it may serve as an educational material for pharmacists who implement a pharmaceutical care and participate in medical intensive care units. Methods: A retrospective descriptive study was conducted at a tertiary university hospital in Bangkok, Thailand, from January 2015 to December 2020. The drug-related problems were categorized according to Cipolle et al.’s classification. The severity of drug-related problems in this study was rated by modifying the definition of The National Coordinating Council for Medication Error Reporting and Prevention Taxonomy of Medication Error to report harm from drug-related problem-related patient outcomes. Results: A total of 698 drug-related problems were detected in 374 critically ill patients. The prevalence of drug-related problems occurring in critically ill patients admitted to the medical intensive care unit was 73.9%. The most frequent drug-related problems were dosage too high (27.7%), ineffective drug (17.2%), need for additional drug therapy (15.3%), unnecessary drug therapy (14.6%), dosage too low (14.3%), adverse drug reaction (9.7%), and non-adherence (1.2%). The severity of drug-related problems in the medical intensive care unit was assessed as a drug-related problem with no harm (78.2%). Pharmacists’ interventions were advised according to drug-related problem identification to provide personalized pharmacotherapy optimization in critically ill patients. Conclusion: The most frequent drug-related problem identified during pharmaceutical care interventions in the medical intensive care unit at tertiary university hospital is dosage too high. The severity of drug-related problems is mostly determined as drug-related problems with no harm.
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Doran, Elizabeth. "The View from the Emergency Department: An Emergency Medicine Pharmacist's Perspective." Senior Care Pharmacist 35, no. 6 (June 1, 2020): 240–42. http://dx.doi.org/10.4140/tcp.n.2020.240.
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A medication-focused review of older patients in the emergency department is important in identifying medication-related problems, differential diagnoses, and associated complications. With rapid triage, assessment, and diagnosis, the emergency department is inherently an area of empirical prescribing. Emergency department pharmacists are uniquely placed to review patients on presentation with a focus on both acute problem management and identifying and addressing long-standing medication issues.
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Doran, Elizabeth. "The View from the Emergency Department: An Emergency Medicine Pharmacist's Perspective." Senior Care Pharmacist 35, no. 6 (June 1, 2020): 240–42. http://dx.doi.org/10.4140/tcp.n.2020.240.
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A medication-focused review of older patients in the emergency department is important in identifying medication-related problems, differential diagnoses, and associated complications. With rapid triage, assessment, and diagnosis, the emergency department is inherently an area of empirical prescribing. Emergency department pharmacists are uniquely placed to review patients on presentation with a focus on both acute problem management and identifying and addressing long-standing medication issues.
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Wright, A., M. Krousel-Wood, E. J. Thomas, J. A. McCoy, D. F. Sittig, and A. B. McCoy. "Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs." Applied Clinical Informatics 06, no. 02 (2015): 334–44. http://dx.doi.org/10.4338/aci-2015-01-ra-0010.
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SummaryBackground: Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging.Objective: We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record.Methods: We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision.Results: The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%.Conclusions: We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across health-care settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes.Citation: McCoy AB, Wright A, Krousel-Wood M, Thomas EJ, McCoy JA, Sittig DF. Validation of a crowdsourcing methodology for developing a knowledge base of related problem-medication pairs. Appl Clin Inf 2015; 6: 334–344http://dx.doi.org/10.4338/ACI-2015-01-RA-0010
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Mgbahurike A. A and Wonte M. I. "Assessment of Medication Related Problems in Geriatrics Unit of Nigerian Tertiary Hospital." Journal of Medical Biomedical and Applied Sciences 8, no. 5 (May 17, 2020): 429–35. http://dx.doi.org/10.15520/jmbas.v8i5.228.
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Medication related problems are prevalent especially in the geriatric populationandcancause considerable patient morbidity and in some cases death as well as increased health expenditure. The elderly population is at increased risk for medication related problems as a result of age – related physiological changes and the presence of multiple chronic diseases. Aim: This study aimed to assess medication related problems (MRP) in University of Port Harcourt Teaching Hospital, with the objective to identify and categorize the MRP according to types as well as identify the most frequent MRP encountered and interventions made by the pharmacists. Method: The study was a retrospective study carried out among 200 geriatric patientsrandomly sampled, over 18months period (January 2018 to June 2019). Data extracted include patients’ demographic information, prescribed medication and number, medical condition, and pharmacist’s intervention (where available) using data collection form. Information collected were categorized and analyzed statistically. Result: showed that female geriatric patients (64.4%) were more than male (35.5%). Most (43%) of the studied population were in the range of 60yrs – 70yrs. Out of the 200 patients assessed, 157 (78.4%) had medication related problems. Drug- drug interaction was the most frequently (64.4%) occurred MRP, as most (62.5%) of the studied group had 6 -10 medications in one prescription, and 12.5% had more than 10 medications in one prescription. Following drug interaction was incorrect drug administration (18.5%). Of the population studied, 56.5% of the patients were using their medication inappropriately. The major contributing factors responsible for these MRPs were comorbidities, poly-pharmacy, and medication non- adherence. Conclusion: The study identified categories of medication related problem in the geriatric Unit of the hospital and the need for pharmacists’ interventions.
Dissertations / Theses on the topic "Medication-related problem"
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Star, Kristina. "Safety of Medication in Paediatrics." Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-197323.
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Background: In paediatrics, the limited documentation to guide medication, the lack of suitable dosage forms, and the continuous development in childhood present a scenario where safety of medication is a particular challenge. Aim: To explore reported adverse drug reactions (ADRs) and the challenges in prescribing and administering medicines in paediatrics, in order to identify and suggest areas needing international surveillance within medication safety and improvement in the clinical setting. Methods: Four exploratory studies were conducted. Worldwide reporting of suspected ADRs (individual case safety reports, ICSR) with ages 0-17 years were examined overall. Twenty published case reports and ICSRs for adolescents, who developed a rare and incompletely documented ADR (rhabdomyolysis) during antipsychotic medicine use, were analysed in-depth. Prescribed doses of anti-inflammatory medicines were studied in a UK electronic health record database. Transcribed focus group interviews with 20 registered nurses from four paediatric wards in Sweden were analysed for factors that may promote or hinder safe medication practices. Descriptive statistics, multiple regression, and content analyses were used. Results: Although, skin reactions and anti-infective medicines were most frequently reported, and more reported in paediatric patients than in adults, medication errors and adverse reactions related to psychostimulant medicines were reported with increased frequency during 2005 to February 2010. The in-depth case analysis emphasised the need for increased vigilance following changes in patients’ medicine regimens, and indicated that ICSRs could contribute with clinically valuable information. Prescribed dose variations were associated with type of dosage form. Tablets and capsules were prescribed with a higher dose than liquid dosage forms. Six themes emerged from the interviews: preparation and administration was complex; medication errors caused considerable psychological burden; support from nurse colleagues was highly valued; unfamiliar medication was challenging; clear dose instructions were important; nurses handling medications needed to be accorded higher priority. Conclusions: Age-specific screening of ICSRs and the use of ICSRs to enhance knowledge of ADRs and medication errors need to be developed. Access to age-appropriate dosage forms is important when prescribing medicines to children. To improve medication safety practices in paediatric care, interdisciplinary collaborations across hospitals on national or even global levels are needed.
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Abdul, Hadi Roza. "Avvikelser i receptlistan : En intervjustudie med patienter på apotek." Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-101940.
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Background: Medications are used to treat, cure, or relieve symptoms of diseases, but there is a risk with the use of medications. Drug-related-problems are known to increase morbidity and mortality. Incorrect medical list and discrepancies in these lists can lead to drug-related problems as side effects, hospitalization, non-compliance, drug interactions and overtreated or undertreated patients. Discrepancies can be for example: more prescriptions than necessary, outdated prescriptions, i.e., medicines that will not be used, prescriptions with incorrect dosing and missing prescriptions i.e., medicines used by patients that cannot be seen in the medication list. Purpose: The aim of this study was to investigate discrepancies in the Swedish prescription list "My saved prescriptions at the pharmacy". The secondary aim was to investigate how common it is to use this prescription list or the dosage label on the medicine packaging to know which medicines to use and which dosage. Methods: The data collection was performed by four pharmacy students at seven pharmacies in Sweden over a period of three weeks during Jan-Feb. 2021 where the prescription list was investigated together with patients to identify any discrepancies. The study included patients who was over 18 years old, spoke Swedish, had three or more prescribed drugs, and agreed to participate. Results A total of 215 patients were interviewed, where 61% had one or more discrepancies in their medication list. A total of 1717 prescriptions were analyzed, of which 10% were double prescriptions (n = 167), 8% outdated prescriptions (n = 141) and 3% prescriptions with the wrong dosage (n = 42). When analyzing the primary sources of information used by patients to know which medicine to use, the printout of the list "my saved prescriptions at the pharmacy” dominated (n = 72). Most used information source to know drug dosage was the dosage label on the medicine packaging (n = 112). Conclusions: It is important to have an updated and correct information in the medication list, to prevent drug-related-problems caused by discrepancies. It becomes even more important when we see that the medication list "My saved prescriptions at the pharmacy" and dosage label (containing the same information in the medication list), are the most used primary sources by patients to know which drug to use and in what dosage. Finally, results show a relationship between the number of prescribed drugs and the number of discrepancies that occur, and therefore we see more discrepancies in elderly patients who are usually ill and are being treated for several diseases. There are opportunities for further research to study e.g., which drug-related-problems are caused by discrepancies in the medication list as well as the degree of danger in these problems.Användning av läkemedel som avses behandla, lindra eller bota sjukdomar kan i vissa fall utgöra en risk för patientens hälsa. Läkemedelsrelaterade problem p.g.a. felmedicinering står för en stor andel av morbiditeten och mortaliteten bland patienter. En bidragande orsak är ofullständig information i patientens läkemedelslista. Syftet med studien var att undersöka antalet avvikelser som förekommer i receptlistan ”Mina sparade recept på apoteket”. Studiens sekundära syfte var att undersöka vilka informationskällor som användes av patienter för att veta vilka läkemedel som ska adminstreras och i vilken dos dosering. Studiens metod var att intervjua patienter som kom till apoteket för att hämta ut läkemedel till sig själva och uppfyllde inklusionskriterierna för att delta i studien. Studien utfördes av fyra farmaceutstudenter på sju olika apotek i fyra olika städer i Sverige som tillsammans med patienter gick igenom receptlistan för att identifiera avvikelser. Resultatet blev totalt 1717 recept som studerades varav 21% hade avvikelser. Av recepten var 10% dubbla recept (n = 167), 8% inaktuella recept (n = 141) och 3% recept med fel dosering (n = 42). Vid analys av primära informationskällor som används dominerade utskrift av listan ”Mina sparade recept på apoteket” (n = 72) resp. doseringsetiketten på läkemedelsförpackningen (n = 112). Resultaten visade även ett samband mellan ökade antal läkemedel och antalet avvikelser. Avvikelser i läkemedelslistan Mina sparade recept är vanligt förekommande därmed är listan inte alltid aktuell. Det är vanligt att denna lista och doseringsetikett på läkemedels-förpackningar används som primära källor av patienter under deras behandlingstid vilket kan innebära en risk för läkemedelsrelaterade problem. En gemensam nationell läkemedelslista är en möjlig lösning till att förebygga läkemedelsrelaterade problem orskade av infromationsbrist i läkemedelslistor. Det är dock nödvändigt med läkemedelsgenomgångar för att bibehålla uppdateringen av listan.
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Hellström, Lina. "Clinical pharmacy services within a multiprofessional healthcare team." Doctoral thesis, Linnéuniversitetet, Institutionen för naturvetenskap, NV, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-18293.
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Background: The purpose of drug treatment is to reduce morbidity and mortality, and to improve health-related quality of life. However, there are frequent problems associated with drug treatment, especially among the elderly. The aim of this thesis was to investigate the impact of clinical pharmacy services within a multiprofessional healthcare team on quality and safety of patients’ drug therapy, and to study the frequency and nature of medication history errors on admission to hospital. Methods: A model for clinical pharmacy services within a multiprofessional healthcare team (the Lund Integrated Medicines Management model, LIMM) was introduced in three hospital wards. On admission of patients to hospital, clinical pharmacists conducted medication reconciliation (i.e. identified the most accurate list of a patient’s current medications) to identify any errors in the hospital medication list. To identify, solve and prevent any other drug-related problems, the clinical pharmacists interviewed patients and performed medication reviews and monitoring of drug therapy. Drug-related problems were discussed within the multiprofessional team and the physicians adjusted the drug therapy as appropriate. Results: On admission to hospital, drug-related problems, such as low adherence to drug therapy and concerns about treatment, were identified. Different statistical approaches to present results from ordinal data on adherence and beliefs about medicines were suggested. Approximately half of the patients were affected by errors in the medication history at admission to hospital; patients who had many prescription drugs had a higher risk for errors. Medication reconciliation and review reduced the number of inappropriate medications and reduced drug-related hospital revisits. No impact on all-cause hospital revisits was demonstrated. Conclusion: Patients admitted to hospital are at high risk for being affected by medication history errors and there is a high potential to improve their drug therapy. By reducing medication history errors and improving medication appropriateness, clinical pharmacy services within a multiprofessional healthcare team improve the quality and safety of patients’ drug therapy. The impact of routine implementation of medication reconciliation and review on healthcare visits will need further evaluation; the results from this thesis suggest that drug-related hospital revisits could be reduced.Läkemedelsgenomgångar och läkemedelsavstämning - LIMM-modellen
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Flora, Deanna. "MEDICATION-RELATED PROBLEMS EXPERIENCED BY PATIENTS DURING TRANSITIONS TO ASSISTED LIVING." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2944.
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Medication reconciliation is a systematic and comprehensive review of medication regimens during care transitions aiming to prevent adverse drug events. Poorly executed transitions negatively impact patient welfare and cause financial burden. Medication-related problems (MRPs) experienced during transitions to an assisted living facility (ALF) were evaluated. Data was collected from pharmacy records for transitions to an ALF over three months, including demographics, medications, potentially inappropriate medications, and MRPs. MRPs were categorized and summarized using descriptive statistics. Forty-five patients (71% female) experienced 59 transitions. Average age was 85.6 years. Median length of stay away from the ALF was three days. There were averages of 18.3 pre-transition medications, 12.5 medications in the discharge orders and/or upon ALF admission, and 15.9 final medications. 979 MRPs were identified, mostly no indication documented, followed by underuse, overuse, and non-adherence. Many of the identified MRPs are potentially preventable. Interventions are needed to reduce MRPs during ALF transitions.
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Tse, Brittany, Jill Augustine, and Kevin Boesen. "Impact of a Nationwide Medication Therapy Management Program on Drug-Related Problems at the Medication Management Center in 2012." The University of Arizona, 2015. http://hdl.handle.net/10150/614023.
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Class of 2015 AbstractObjectives: To compare provider acceptance rates of medication therapy management (MTM) interventions initiated by a MTM center for potential drug-related problems in 2012. Interventions included cost-savings to patients, adherence to clinical guidelines, medication adherence, and safety initiatives. Methods: This retrospective cross-sectional project measured the provider acceptance rates of MTM interventions for Medicare Part D beneficiaries. Intervention count and acceptance rates were analyzed from the center’s MTM software and database that utilizes prescription claims analysis post-intervention to determine intervention success. A chi-square test was used to assess the statistical significance between the interventions. An alpha level of 0.5 was determined a-priori. This was a quality improvement project, and Institutional Review Board approved this project as exempt status. Results: The total percent of recommendations accepted was 35% (159,795 out of 455,898). The rate of acceptance was highest for safety interventions (51%), followed by cost (35%), adherence (12%), and guidelines (8%). The acceptance rates for the four intervention types were statistically different from each other (p-value <0.0001). Within each intervention type, the most frequently accepted interventions were: removal of medications from the Beer’s Criteria (8% of safety related changes); changes from a brand name, non-oral medication like eye drops and nasal sprays, to a generic within the same class (15% of cost-saving related changes); improved adherence to hypertension and diabetic medications (29% of adherence related changes); and adding an antihypertensive agent to diabetic patients (62% of clinical guideline related changes). Conclusions: Safety initiatives had the highest acceptance percentage of all four intervention types. Approving more safety interventions with medication use may reduce the risk of morbidity and mortality. Pharmacists providing MTM services may want to increase focus on drug safety as providers are accepting more safety interventions. More research is needed to determine why providers approve the other recommendations at lower rates.
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Al-Taani, Ghaith Mohammed Yousef. "Challenges in the provision of clinical pharmacy services to overcome medication-related problems." Thesis, Queen's University Belfast, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.669539.
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Pharmaceutical care and medicines management are terms which are often used interchangeably to describe the patient-centred services provided by pharmacists. The programme of research presented within this thesis evaluated a range of topics within this area of endeavour. The extent of pharmaceutical care provision within the community pharmacy setting was examined in a cross-sectional survey in N. Ireland and across 15 European countries. The findings indicated that community pharmacists' provision of comprehensive pharmaceutical care can be deemed as limited in Northern Ireland (mean score 41.4% of the total achievable score) and across Europe (scores ranged from 56.6% in England to 29.4% in Moldova). To inform the development of a definitive RCT for novel post-discharge medicines management clinic (MMC), a feasibility study was carried out, and identified a number of methodological challenges, in particular, challenges around patient recruitment, attrition rates and clinic scheduling. A series of risk assessment models was developed to help with the targeting of patients to be recruited for the RCT referred to above. These models were designed to forecast the likelihood of patient early readmission to hospital (within 30 and 8 to 30 days) and high-cost readmissions. Important risk factors for readmission identified included the Charlson age-adjusted co-morbidity score, respiratory- and genitourinary-related primary diagnoses and number of medications prescribed on discharge, and new patient targeting criteria for the RCT to explore the impact of the MMC was developed. A systematic content analysis revealed that the print media coverage of medicine-related adverse effects requires significant improvement in order to properly inform the public on this matter. Specifically, the reporting of adverse effects, in terms of medicines implicated and organ systems affected, did not correspond with those commonly cited in scientific journal articles. Findings from the present research help contextualise and provide evidence based advice on a number of issues which need to be addressed in pharmaceutical care / medicines management practice and research.
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Mushunje, Irvine Tawanda. "Willingness to pay for pharmacist-provided services directed towards reducing risks of medication-related problems." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1008053.
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Pharmacists as members of health care teams, have a central role to play with respect to medication. The pharmaceutical care and cognitive services which pharmacists are able to provide can help prevent, ameliorate or correct medication-related problems. There are however many barriers to the provision of these services and one of the barriers commonly cited by pharmacists is the lack of remuneration for their expert services. The aim of this study is to ascertain if patients in South Africa are willing to pay for pharmacist-provided services which may reduce medication related problems, and thereby determine the perceived value of the pharmacist-provided services, by patients. The study will also seek to determine factors that influence willingness to pay (WTP), including financial status, gender, race, age and level of education. In addition the perceived value of the pharmacist‘s role in patient care, by third party payers (SA Medical Aid providers) and their WTP for pharmacist-provided services (such as DSM) on behalf of patients through their monthly premiums will also be investigated. The study was conducted as a two-phase process: the first phase focused on the opinions of patients and the second phase on the medical aid companies. In phase-1 a convenience sample of 500 patients was recruited by fifty community pharmacies distributed throughout the nine South African provinces. Data collection, consisting of telephonic administration of the questionnaires, was conducted and the survey responses were captured on a Microsoft Excel® spreadsheet. All the captured information was analyzed using descriptive statistics, box and whisker plots, analysis of variance (ANOVA) and regression analysis. In phase-2, medical aid schemes that are registered with the Council of Medical Schemes (CMSs) of South Africa were included in this research. A fifteen point questionnaire was completed electronically via e-mail by willing medical aid participants. Data was analyzed using descriptive statistics only. Only 233 or 88.6 percent, of the 263 participating respondents, were willing to pay at least one rand towards pharmacist-provided services. On average respondents were willing to pay R126.76 as out-of-pocket expenses. Respondents‘ WTP increased as the risk associated with medication-related problems was reduced due to pharmaceutical care intervention. Of the 263 respondents who took part in this research, fifty percent were willing to pay at least R100 for a risk reduction of 30 percent, R120 for a 60 percent reduction and approximately R150 for a greater than 90 percent risk reduction. It was also found that the respondents‘ willingness to pay was influenced by their age, earnings, racial grouping, employment status, medical aid status and their level of satisfaction with pharmacist-provided care services. Of the thirty-one open medical aid schemes only eight (25.8 percent) participated in the study. Findings indicate that all the participating medical aid respondents were unwilling to pay for pharmacist-provided care services, although they perceived pharmacists as very influential healthcare providers and as having a significant role to play in reducing medication-related problems. In conclusion it was found that majority of participants were willing to pay for pharmacist-provided services directed towards reducing risks associated with medication-related problems. Until pharmacists are able to prove pharmaceutical care‘s utility and cost-effectiveness to third-party payers, pharmacists must look to the patient for reimbursement.
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Ghaswalla, Parinaz K. "Medication-Related Problems in Older Adults: A Focus on Underuse of Warfarin and Warfarin-Antibiotic Interactions." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/2631.
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The work presented in this dissertation focuses on two important medication-related problems in older adults, that is, untreated indication and drug-drug interactions, specifically with respect to a high-risk medication such as warfarin. Warfarin is a challenge to use in clinical practice due to its narrow therapeutic index, variability in dose-response and its interactions with numerous foods and drugs. This dissertation presents the research from two projects. In the first project the prevalence and predictors of warfarin use in nursing home (NH) residents with atrial fibrillation (AF), and use of secondary stroke prevention strategies was determined, in order to understand the patterns of anticoagulant use in frail NH residents and to identify patient characteristics associated with warfarin use. In the second project the effect of oral antibiotics on anticoagulation outcomes, when prescribed concomitantly with warfarin, was determined, in order to provide evidence on the clinical significance of warfarin-antibiotic interactions in older adults. In the first project a cross-sectional analysis of the prescription and resident files from the 2004 National Nursing Home Survey was done to determine the prevalence of AF and rates of use of warfarin and other anti-platelet agents, such as aspirin and clopidogrel. A multiple logistic regression model was used to determine factors associated with warfarin use. In this sample of older NH residents, 13% of residents had a diagnosis of AF, with indications for warfarin use and no contraindications to warfarin. From these patients, 30% received anticoagulant therapy with warfarin and 23% of the remaining patients received either aspirin or clopidogrel, suggesting that more than 50% of residents with AF did not receive any form of anticoagulant therapy. Non-white race, history of bleeding, and use of anti-platelet medications were associated with reduced odds of receiving warfarin. The second project was a retrospective medical record review of older patients from an outpatient anticoagulation clinic at a Veterans Affairs medical center. Results of the repeated measures ANOVA suggested a significant increase in post-antibiotic INR values with fluoroquinolones, azithromycin and amoxicillin. In addition, the percentage of patients with warfarin dose adjustments was significantly greater with fluoroquinolones and azithromycin as compared to cephalexin. No bleeding events were reported for any of these patients. In conclusion, the results of the projects suggest that there is underuse of warfarin in NH settings. Furthermore, antibiotics may be safely prescribed with warfarin in older adults as long as the INR is monitored closely.
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Peterson, Cecilia. "Characterization of drugrelated problems and associated factors at a clinical pharmacy-naïve hospital in the northern part of Sweden." Thesis, Umeå universitet, Farmakologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-131902.
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Vaughn, L. Michelle, Brian Cross, Larissa Bossaer, Emily K. Flores, Jason Moore, and Ivy A. Click. "Analysis of an Interprofessional Home Visit Assignment: Student Perceptions of Team-Based Care, Home Visits, and Medication-Related Problems." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6368.
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BACKGROUND AND OBJECTIVES: Interprofessional education (IPE) is recommended by many as a means by which to prepare clinicians for collaborative practice and a mechanism by which to improve the overall quality of health care. The objective of this study was to determine the impact of an interprofessional medicine-pharmacy student home visit experience on students’ self-assessments of skills and abilities related to team-based care and identification of medication-related problems. METHODS: Third-year medical and fourth-year pharmacy students completed an interprofessional home visit centered on identification of medication-related problems. Students were surveyed before and after the IPE assignment to assess changes in self-assessed skills and abilities. Survey items consisted of Likert-type statements on a 5-point scale (1=strongly disagree, 5=strongly agree) and free-text responses. Students also completed reflection papers regarding their experiences. RESULTS: Twenty-two medical and 20 pharmacy students conducted medication-focused interviews of 22 patients at home as interprofessional teams. Medical and pharmacy student self-assessments of skills and abilities related to team-based care and identification of medication-related problems improved after completion of the assignment. Both groups of students perceived an improvement in confidence regarding communication skills, both with patients and with other health professions students. Changes were reported on 12 survey items. Student feedback on the IPE experience was positive. CONCLUSIONS: Students’ self-perception of skills and abilities related to interprofessional team-based care and identification of medication-related problems are improved after IPE medication-focused home visit assignment. Student feedback supports the value of interprofessional patient care clinical experiences.
Books on the topic "Medication-related problem"
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Witters, Weldon L. Drugs and society. 2nd ed. Boston: Jones and Bartlett Publishers, 1988.
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Horne, Robert. Medication-related problems encountered by community nurses during domiciliary visits: An audit commissioned by South Downs NHS Trust and conducted in collaboration with the University of Brighton. [Brighton: University of Brighton, Department of Pharmacy], 1995.
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Thomas, Julie. Percentage of acute medication related problems presenting to the Emergency Department, St. Joseph's Hospital. 1997.
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O’Connell, Henry, and Brian Lawlor. Alcohol and substance abuse in older people. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0049.
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This chapter highlights the importance of alcohol use disorders (AUDs), inappropriate medication use (IMU) and use of illicit drugs in older people. Such problems are associated with considerable morbidity and will become more important with the ageing ‘baby-boomer’ generation in coming years. AUDs are under-detected, misdiagnosed and often completely missed in older populations. However, despite ageist and pessimistic assumptions, AUDs in older people are as amenable to treatment as in younger people. IMU in older people includes abuse of prescribed medications such as benzodiazepines and opiates, unnecessary treatment of medical and psychiatric conditions and toxic drug reactions related to inappropriate polypharmacy. Screening and treatment programmes for IMU could lead to considerable improvements in individual and population health. Misuse of illicit drugs, e.g. marijuana, cocaine, opioids and stimulants, by older people is not yet a major problem, but will probably become more prevalent and be a more important clinical issue for future generations of older people.
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Valpey, Robin, and Amy Crawford-Faucher. Behavioral Health Emergencies (DRAFT). Edited by Raghavan Murugan and Joseph M. Darby. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190612474.003.0016.
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Behavioral health emergencies typically involve agitation with autonomic instability. Many medical and psychiatric conditions can precipitate agitation that could necessitate rapid response interventions. Non-pharmacologic therapies can be useful to modulate agitation or delirium, but the mainstay of pharmacologic treatment is either antipsychotics or benzodiazepines, depending on the underlying problem. Psychosis and delirium generally respond better to antipsychotics, while mania, catatonia, toxidromes, withdrawal, and agitation from head injuries are more effectively treated with benzodiazepines. Prompt recognition of severe alcohol withdrawal can improve mortality; getting a history of other drug use, including “designer drugs” can help inform care. This chapter discusses the treatment of agitation, catatonia, medication-related disturbances, and intoxication and withdrawal during emergencies.
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Cohen, Stacy A., Margaret M. Haglund, and Larissa J. Mooney. Treatment Options for Older Adults with Substance-Use Disorders. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199392063.003.0010.
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Due to co-occurring medical disorders, psychosocial differences, functional and cognitive limitations related to aging, and the potential for multiple medication interactions, unique considerations must be made when addressing the diagnosis and treatment of SUDs among the elderly. Better information is needed on all fronts, from initial screening and assessment, to triaging to appropriate levels of care, to behavioral therapies and pharmacological treatment. Guidelines should help direct providers, families, and patients identify appropriate and individualized treatment programs. Encouragingly, outcomes appear to be as good, if not better, in the older population than in younger adults treated for SUDs. As the “baby boomer” population ages, more older adults will need treatment for illicit drug use, alcoholism, and the misuse of prescription medications. Greater education and awareness of this growing problem will increase attention paid by clinicians and policymakers allocating resources to address the treatment of SUDs in the older population.
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Langford, Bradley J. Implementation of a self-administered questionnaire to identify patients at risk of medication-related problems in the family health centre. 2004, 2004.
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Miller, Mark D. A Concise Review of Gerontology/Geriatric Medicine. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780195382242.003.0004.
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Chapter 3 reviews of gerontology and geriatric medicine. It presents background information on gerontology (physiologic changes of aging, the aging process), polypharmacy, the effects of medication in the elderly, sleep problems, and other issues related to older age. The importance of social support for the elderly is also discussed.
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Ritchie, Craig W. Psychopharmacology in older people. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0013.
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It is well recognised that older people are particularly sensitive to psychotropic medication. In general, pharmacological interventions in the elderly pose specific problems due to the patient exhibiting both altered pharmacokinetic drug profiles due to gerontological effects on absorption, distribution, metabolism and elimination of drug and pharmacodynamic effects related to aging and polypharmacy. Adherence to medication in later life also mediates sub-optimal pharmacological care. Finally, the effects of comorbidities which accumulate with advancing years should also influence prescribing practice in the elderly. The general principles underlying these changes and observations are discussed with specific examples listed to illustrate these points.
Book chapters on the topic "Medication-related problem"
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Jeffery, Sean M., and Noll Campbell. "Medication-Related Problems in Surgical Patients." In Principles and Practice of Geriatric Surgery, 1–29. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-20317-1_12-1.
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Jeffery, Sean M., and Noll Campbell. "Medication-Related Problems in Surgical Patients." In Principles and Practice of Geriatric Surgery, 159–87. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-319-47771-8_12.
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Midlöv, Patrik, Tommy Eriksson, and Annika Kragh. "Practical Problems Related to the Patients Medication Intake." In Drug-related problems in the elderly, 101–10. Dordrecht: Springer Netherlands, 2009. http://dx.doi.org/10.1007/978-90-481-2446-6_8.
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Marottoli, Richard A., Sean M. Jeffery, and Roshini C. Pinto-Powell. "Drug Usage in Surgical Patients: Preventing Medication-Related Problems." In Principles and Practice of Geriatric Surgery, 343–58. New York, NY: Springer New York, 2011. http://dx.doi.org/10.1007/978-1-4419-6999-6_27.
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Hanh, Jacky, Philip Hazell, and Isabelle Feijo. "The Pharmacist and Pharmacotherapy." In Longer-Term Psychiatric Inpatient Care for Adolescents, 153–60. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-1950-3_17.
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AbstractClinical pharmacy services aim to optimise health outcomes and improve patient safety throughout all steps of the medicines management pathway, by ensuring the quality use of medicines and minimising medication-related problems. The role of the pharmacist includes gathering and documenting medication histories, performing medication reconciliation and undertaking clinical medication reviews. These services support collaborative approaches between patients, carers and the multidisciplinary team to develop patient-centred medication management plans. The practice of pharmacotherapy at the Walker Unit shares features in common with prescribing in acute child and adolescent mental health inpatient units, but there are some differences. This chapter will in particular seek to highlight the characteristics of pharmacotherapy that are distinct to longer stay intensive psychiatric care.
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Hägg, Mary, and Natalie R. Morris. "Introducing IQoro: A Clinically Effective Oral Neuromuscular Treatment for Dysphagia." In Dysphagia - New Advances. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.101144.
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There is a clear need for new advances in treating dysphagia; healthcare professionals currently have a restricted range of options to treat swallowing problems and related conditions. Usual treatments for dysphagia are based on compensatory measures which allow patients to live within the limitations of their condition. These measures do not address the underlying cause of dysphagia: neurological and physiological dysfunction. A senior speech and language therapist working with young people with Cerebral Palsy bemoans the fact that official care pathway guidelines list only medication and surgical intervention as alternatives to treat drooling. Neither of which, she contends, is effective or desirable. Esophageal dysphagia causes reflux-based diseases, which are also poorly served by current treatment alternatives and are currently managed by medication, or remedied by surgical intervention. Medication reduces the symptoms of reflux but does nothing to address the underlying pathophysiology, muscular dysfunction, at the root of the problem. That now changes with IQoro: a simple, innovative treatment that is available to patients and healthcare professionals to address all of the above conditions. The chapter explains the physiological and neurological process of the functional swallow in detail, with illustrations and explanations. The efficacy of IQoro treatment is proven with evidence from internationally published scientific studies, case studies, an NHS service evaluation, and NICE briefings.
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Sun-Edelstein, Christina, and Alan M. Rapoport. "Frequent headaches with and without acute medication overuse." In Oxford Textbook of Headache Syndromes, edited by Michel Ferrari, Joost Haan, Andrew Charles, David W. Dodick, Fumihiko Sakai, and Christopher Kennard, 284–97. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198724322.003.0032.
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The term ‘chronic daily headache’ (CDH) encompasses those headache disorders in which headaches are present on at least 15 days per month. CDH is a significant problem worldwide. Compared to episodic headache disorders, it is associated with more disability, lower health-related quality of life and greater health care resource utilization. However, it remains under-recognized and undertreated. This chapter provides a summary of the management of several CDH subtypes, including chronic migraine, medication overuse headache and chronic cluster headache. International differences in CDH management, as documented in the medical literature and through comments from headache specialists around the world, are also discussed. In order to increase the awareness and treatment of CDH and reduce the associated societal and economic costs, further education, research and public health policies are needed.
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"Chapter 5. Assessing Medication-Related Problems (MRPs)." In How to Conduct a Comprehensive Medication Review: A Guidebook for Pharmacists. 2215 Constitution Avenue, N.W. Washington, DC 20037-2985: The American Pharmacists Association, 2014. http://dx.doi.org/10.21019/9781582122168.ch5.
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Ahmed, Ebtesam. "The contribution of the clinical pharmacist in palliative care." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 248–54. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0027.
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Pharmacists are exceptionally positioned to deliver expert medication consultation and teaching, thus creating a specialized role within the palliative care team to optimize and rationalize medication use. The role pharmacists play varies among different palliative care practice settings; however, all pharmacists participate in providing pharmaceutical care. Activities of pharmacists can include identifying and resolving adverse drug-related problems, reconciling medication, developing medication guidelines, helping patients and families with medication disposal, and providing medication counselling as well as patient psychological support. Pharmacy organizations support pharmacists as key members of interdisciplinary care, and there is growing recognition of the value of their contribution. This chapter reviews the role of clinical pharmacists and is based mainly on the situation in the US with additional information from other parts of the world. It highlights the positive impact of pharmacy practice through improved symptom control, identifying, preventing, and resolving medication-related problems.
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Sharma, Alok, Nandini Gokulchandran, Hemangi Sane, Sakshi Desai, Pooja Kulkarni, and Prerna Badhe. "Stem Cell Therapy for Learning Disability." In Learning Disabilities - Neurobiology, Assessment, Clinical Features and Treatments. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.101511.
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Learning disabilities (LDs) are caused by genetic and/or neurological factors that alter brain functioning and affect processes related to learning, which include dyslexia, dysgraphia, and dyscalculia. It hinders the child’s academic, social, and overall life skills. Current treatments for LD include medication and rehabilitation, focusing on management of symptoms. Thus, there is a need to explore newer treatments which will work at cellular level. Stem cell therapy is an evolving field of regenerative medicine and has shown great potential as a treatment strategy for various neuro-developmental and neurological disorders. It addresses the core underlying pathology and its benefits are enhanced when combined with standard treatments. This chapter focuses on various aspects of stem cell therapy in LD which includes the basics of stem cell therapy, rationale for use of stem cells, mechanism of action, monitoring tools like PET CT scan, and multidisciplinary rehabilitation. We have also enumerated our clinical experience and results of patients who underwent autologous bone marrow mononuclear cell transplantation combined with extensive rehabilitation. These patients showed a positive outcome, without any major adverse events. Nineteen out of 20 patients showed improvement in reading, writing, mathematical skills, attention, memory, problem-solving, comprehension skills, spelling, vocabulary, and overall increased academic performance.
Conference papers on the topic "Medication-related problem"
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Karuniawati, Hidayah, Zakky Cholisoh, Tanti Azizah Sujono, and Laila Nisaul Hekmah. "Identifying Medication-Related Problem in Secondary Stroke Prevention Therapy: A Cross-Sectional Study in Central Java, Indonesia." In 4th International Conference Current Breakthrough in Pharmacy (ICB-Pharma 2022). Paris, France: Atlantis Press, 2022. http://dx.doi.org/10.2991/978-94-6463-050-3_13.
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Wang, Yanda, Weitong Chen, Dechang PI, Lin Yue, Sen Wang, and Miao Xu. "Self-Supervised Adversarial Distribution Regularization for Medication Recommendation." In Thirtieth International Joint Conference on Artificial Intelligence {IJCAI-21}. California: International Joint Conferences on Artificial Intelligence Organization, 2021. http://dx.doi.org/10.24963/ijcai.2021/431.
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Medication recommendation is a significant healthcare application due to its promise in effectively prescribing medications. Avoiding fatal side effects related to Drug-Drug Interaction (DDI) is among the critical challenges. Most existing methods try to mitigate the problem by providing models with extra DDI knowledge, making models complicated. While treating all patients with different DDI properties as a single cohort would put forward strict requirements on models' generalization performance. In pursuit of a valuable model for a safe recommendation, we propose the Self-Supervised Adversarial Regularization Model for Medication Recommendation (SARMR). SARMR obtains the target distribution associated with safe medication combinations from raw patient records for adversarial regularization. In this way, the model can shape distributions of patient representations to achieve DDI reduction. To obtain accurate self-supervision information, SARMR models interactions between physicians and patients by building a key-value memory neural network and carrying out multi-hop reading to obtain contextual information for patient representations. SARMR outperforms all baseline methods in the experiment on a real-world clinical dataset. This model can achieve DDI reduction when considering the different number of DDI types, which demonstrates the robustness of adversarial regularization for safe medication recommendation.
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Protzenko, D., J. Nakache, M. Lombardi, L. Cesari, S. Honoré, S. de la Brosse, and G. Hache. "4CPS-232 Pharmacist-led medication review unveiled more medication-related problems in possibly medication-related hospitalisations than in unlikely medication-related hospitalisations in elderly patients." In 26th EAHP Congress, Hospital pharmacists – changing roles in a changing world, 23–25 March 2022. British Medical Journal Publishing Group, 2022. http://dx.doi.org/10.1136/ejhpharm-2022-eahp.223.
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Dwiyani, Fitri, and Amal C. Sjaaf. "Analysis of Pharmaceutical Installations Management at Kambang Hospital, Jambi." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.20.
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ABSTRACT Background: Hospital Pharmacy Installation (IFRS) was one of 5 revenue centres as well as being the primary support for the hospital which has full authority in managing various pharmaceutical preparations. Therefore, pharmaceutical supplies require careful and precise management through a one-door system. This study aimed to determine the management system and identify the various problems that exist in the pharmacy installation at Kambang Jambi Hospital. Subjects and Method: This study was a qualitative study conducted on IFRS at Kambang Jambi Hospital from August to September 2020. The data were obtained from primary data in the form of in-depth interviews with stakeholders related to IFRS and field observations, as well as secondary data in the form of document review. The data were collected by in-depth interview guide. The data was reported by 5 Whys Analysis diagram. Results: Based on field observations at IFRS Kambang Jambi Hospital, it was found that there were still many problems at almost every stage of pharmaceutical supply management starting from planning, procurement, receiving, storage, distribution, control, deletion, recording and reporting, as well as monitoring and evaluation. When the problem is identified more deeply using 5 Whys Analysis, the roots of these various problems are obtained, namely: 1) There has not been an adequate Pharmacy and Therapy Committee (KFT) in the management of the pharmaceutical installation at Kambang Jambi Hospital, 2) The majority of KFT members have assumed structural positions at Kambang Jambi Hospital so that it does not focus on KFT duties, 3) KFT does not regularly hold monthly meetings and evaluations, 4) The ineffective role of SPI at Kambang Jambi Hospital in monitoring and evaluating IFRS performance, 5) SIMRS still depends on outsiders not always standby at the hospital when there are problems. Conclusion: Re-organized the pharmacy and therapy committee to carry out a continuous review of the hospital formularies to be more effective and minimize medication errors. Keywords: IFRS, IFRS management, drug procurement, KFT. Correspondence: Fitri Dwiyani. Postgraduate Student for Hospital Administration Studies, Faculty of Public Health, University of Indonesia, Depok City, West Java. Email: fitridwiyani14@gmail.com. Mobile: 081221005831/081221005831 DOI: https://doi.org/10.26911/the7thicph.04.20
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De La Calle Riaguas, B., M. Guerro-Prado, MDP Briceño-Casado, P. Gómez-Espinosa, FJ Juliá-Luna, and MD Gil-Sierra. "5PSQ-081 Impact of pharmacy intervention on reduction of medication-related problems in elderly patients in a nursing home." In 26th EAHP Congress, Hospital pharmacists – changing roles in a changing world, 23–25 March 2022. British Medical Journal Publishing Group, 2022. http://dx.doi.org/10.1136/ejhpharm-2022-eahp.303.
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Blejan, Emilian Ionuţ, Gabriela Ciupitu, and Andreea Arsene. "Connecting the Customer Experience Concept with Pharmaceutical Care for Improving the Healthcare Status of Patients." In International Conference Innovative Business Management & Global Entrepreneurship. LUMEN Publishing, 2020. http://dx.doi.org/10.18662/lumproc/ibmage2020/19.
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Healthcare costs are rising worldwide, due to a series of factors related to increased spending on medication, aging, medication errors, adverse drug events and hospital admissions. Aging phenomenon is closely followed by an increasing burden of chronic diseases. New therapies used to treat chronic diseases have intensified the economic pressure on healthcare organizations. Pharmacists play an important role in lowering costs by reviewing the pharmacotherapy of patients. Pharmacists are also the link between the physician and the patient, providing free medical advice without the need for an appointment. Lowering the number of inappropriately prescribed drugs reduces the risk of adverse drug events that frequently contribute to prolonged and expensive hospital admissions. In the near future, a new approach is needed for long term results. Pharmacists will have to reshape the old concept of patient care, moving out of the negative feelings area derived from sickness and start to protect health instead of managing disease. It will result a shift from sick care to proactive healthcare experiences. Pharmacists will anticipate and solve patient’s problems before they can produce a displeasure. For maintaining a well-being state of patients is now necessarily to adopt or implement a patient centred strategy based on customer experience pillars. In Romania integrity matters most in customer experience, closely followed by personalization. In the new Era of pharmaceutical care, pharmacists will have to focus on patient experience and patient journey.
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Geeson, C., L. Wei, and BD Franklin. "6ER-018 Development and performance evaluation of the medicines optimisation assessment tool: a prognostic model to target hospital pharmacists’ input to prevent medication-related problems." In 24th EAHP Congress, 27th–29th March 2019, Barcelona, Spain. British Medical Journal Publishing Group, 2019. http://dx.doi.org/10.1136/ejhpharm-2019-eahpconf.615.
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Wycoff, Andrea, Hayley Treloar Padovano, and Robert Miranda, Jr. "Cannabis craving in response to alcohol cues in the laboratory and in daily life." In 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.30.
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Background: Cannabis use is prevalent among adolescents and young adults who drink alcohol. Compared to individuals who only drink alcohol, those who (co-)use both alcohol and cannabis are at greater risk of experiencing substance-related problems. One factor that could maintain patterns of co-use is the potential for one substance to elicit craving for another. This idea has been studied extensively in the alcohol and tobacco co-use literature but has yet to be applied to alcohol and cannabis co-use. Thus, the present study examined whether alcohol cues elicit cannabis craving in the lab and in daily life. Method: Participants were 54 adolescents and young adults ages 15 to 24 (M age = 19.69, SD = 2.04) who were enrolled in one of two medication trials targeting alcohol use and endorsed lifetime cannabis use. Participants were 51.9% female, 75.9% white, and 87.0% not Hispanic or Latino. Average age at first alcohol use was 15.28 (SD = 2.07), and average age at first cannabis use was 15.91 (SD = 2.37). Participants reported cannabis use on an average of 22.4% of the last 90 days via timeline follow-back. Participants also completed a lab cue-reactivity task where they rated cannabis craving when presented with alcohol and control cues. Finally, participants completed one week of ecological momentary assessment in their daily lives, reporting multiple times per day on their cannabis craving and the presence of alcohol cues in their surroundings. The data used in the present analyses were collected prior to randomization into medication condition and prior to taking any medications for the larger pharmacotherapy trials. Results: Results from mixed models demonstrated that baseline cannabis use frequency was positively related to lab cannabis craving, regardless of cue type, although this association was larger for control cues than for alcohol cues (b = -0.01, SE = 0.00, p = .004). In daily life, the presence of alcohol cues was associated with greater momentary cannabis craving (b = 0.57, SE = 0.25, p = .029). Finally, greater lab cannabis craving in response to alcohol cues predicted greater momentary cannabis craving across all moments in daily life (not solely when alcohol cues were present; b = 0.61, SE = 0.11, p < .001). Discussion: Results suggest that cannabis craving in the lab translates to daily-life cannabis craving across contexts, and that daily-life cannabis craving may be heightened in the presence of alcohol cues in individuals’ natural environments. Collectively, these findings support the idea that alcohol cues may elicit cannabis craving among adolescents and young adults who report a history of alcohol-cannabis co-use. Our findings may inform future work seeking to tailor cannabis use interventions among individuals who co-use cannabis with alcohol.
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Fox, Nicolle, Olivia Canella, and Jeffrey Wardell. "Medicinal versus recreational cannabis use among youth: A systematic review." In 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.08.
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Background: Adolescents and young adults have high rates of cannabis use. Although a sizeable portion of youth report that they use cannabis for medicinal reasons (Wardell et al., 2020; Wardell, in press), most research on youth cannabis use tends to focus on recreational use. It is important to understand how youth who use cannabis for medicinal reasons differ from those who use for recreational reasons. We aimed to review the limited research comparing youth engaging in medicinal cannabis use to those engaging in recreational cannabis use. Methods: A systematic literature search of three databases (PsychInfo, PubMed, MEDLINE) was conducted to identify studies that compared adolescents and/or young adults who engage in medicinal cannabis to those who engage in recreational cannabis use. Studies that defined medicinal cannabis use either as self-reported use of cannabis for therapeutic reasons or as obtaining authorization/prescription for medical cannabis from a healthcare provider were included. Only quantitative research studies published in a peer-reviewed journal were included. After conducting the initial search and removing duplicates, 748 abstracts were reviewed independently by two researchers. Any discrepancies were resolved by consensus in consultation with a third researcher. Results: A total of 13 articles met inclusion criteria. Outcome variables reported in the literature included cannabis use (frequency and amount), cannabis-related problems, use of other substances including illicit drug use or prescription medication misuse, and health-related variables such as mental health symptoms or physical pain. Overall, the literature suggests that youth who use cannabis medicinally are more likely to use greater amounts of cannabis, to use more frequently, and to use a variety of different forms of cannabis, relative to youth who use cannabis recreationally. Further, several studies reported that medicinal cannabis use among youth was associated with problems related to cannabis use, such as the risk for cannabis use disorder and problematic behaviour (e.g., driving under the influence). Several studies also found that medicinal (vs. recreational) cannabis use was related to poorer mental or physical health, although a couple of studies did not support this finding. However, the results were mixed regarding the associations between medicinal cannabis use and the likelihood of using other drugs. Conclusion: There is evidence that using cannabis for medicinal reasons is associated with greater cannabis consumption, cannabis-related problems, and negative health-related correlates among youth. Although there was some consistency in findings across studies, the limited number of studies make it difficult to draw firm conclusions. Causal inferences are difficult to make owing to the frequent reliance on cross-sectional designs. The findings are further complicated by the heterogeneous definition of medicinal cannabis use (i.e., self-report vs. medically authorized). Given that many young people engage in both medicinal and recreational cannabis use, it is difficult to fully disentangle the differences. Additional research is needed for a complete understanding of the unique outcomes associated with medical cannabis use among youth.
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"EPIDEMIOLOGICAL CHARACTERISTICS OF A SAMPLE OF PATIENTS WITH SUBSTANCE USE FROM THE PSYCHIATRIC CARE UNIT OF THE SOCIAL AFFAIRS SERVICE OF THE UNIVERSITY OF SALAMANCA." In 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021p019v.
Full textAbstract:
Introduction: University life presents changes and challenges that may affect the mental health of its community and be the onset of substance use. Aim: To study epidemiological characteristics in our sample to help to improve prevention and treatment for mental health problems related to substance use. Materials and Methods: The descriptive study is based on a sample of 49 people, 37 women and 12 men, members of the university community. A database was designed with clinical information about psychiatric patients obtained from the interview and entry sheets during the first visit. Results: 53,1% of the sample confirmed substance use. The mean age of patients was 22,35 years and 69,2% of them were women and 30,8% were men. Alcohol was the main used substance (80,8%), followed by tobacco (57,7%) and cannabis (30,8%). Most patients were from other provinces of Spain different from Salamanca (57,7%). Law and Social Sciences (38,5%) and Health Sciences (26,9%) were the most frequent academic fields. The main contact method was self-consultation (76,9%) and in most cases (46,2%) the reason of the consultation was not specific. After the interview, the main diagnosis impressions were major depressive disorder (19,2%), anxiety disorder (15,3%) and prodromal symptoms of psychosis (15,4%). Most of the patients were treated with a combination of medication and psychotherapy (42,3%). Conclusion: We should consider the possible impact of substance use in our patient’s mental health and take account of it when choosing their treatment. We should continue studying epidemiological characteristics to help to improve prevention measures and treatments in the future.
Reports on the topic "Medication-related problem"
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Suleman, Fatima. Do additional services provided by pharmacists reduce healthcare costs or the demand for healthcare? SUPPORT, 2017. http://dx.doi.org/10.30846/170113.
Full textAbstract:
The role of pharmacists includes dispensing medication, and the packaging and compounding of prescriptions. But over the last two decades these responsibilities have expanded to include ensuring the proper use of medication as well as identifying, preventing and resolving drug-related problems. Pharmacists also promote health services and provide educational information.