Статті в журналах з теми "Patient medication education"
Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: Patient medication education.
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-50 статей у журналах для дослідження на тему "Patient medication education".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте статті в журналах для різних дисциплін та оформлюйте правильно вашу бібліографію.
1
Davidhizar, Ruth, and Mildred J. Powell. "Patient Medication Education Groups." Hospital Topics 65, no. 1 (January 1987): 21–24. http://dx.doi.org/10.1080/00185868.1987.10543576.
2
Talbot, Brooke. "Improving patient medication education." Nursing 48, no. 5 (May 2018): 58–60. http://dx.doi.org/10.1097/01.nurse.0000531909.68714.85.
3
Kinrys, Gustavo, Alexandra K. Gold, John J. Worthington, and Andrew A. Nierenberg. "Medication disposal practices: Increasing patient and clinician education on safe methods." Journal of International Medical Research 46, no. 3 (January 11, 2018): 927–39. http://dx.doi.org/10.1177/0300060517738681.
Анотація:
Recent research suggests that the nation’s water supply is contaminated with trace pharmaceuticals that exert a negative environmental and public health impact. Incorrect medication disposal methods (e.g. flushing medications down the toilet or drain) are a significant factor contributing to the presence of medication compounds in the aquatic environment. In this commentary, we provide a summary of the existing data on pharmaceuticals in the nation’s water as well as the role of improper medication disposal methods on water contamination. We discuss statistics on improper medication disposal practices among patients and clinicians as well as recent advances in proper medication disposal methods as a solution to this problem. Currently, many patients and clinicians are not aware of proper medication disposal practices. We summarize the importance of patient and clinician education in advancing environmental-safe medication disposal methods.
4
Heyduk, Loretta J. "Medication Education: Increasing Patient Compliance." Journal of Psychosocial Nursing and Mental Health Services 29, no. 12 (December 1991): 32–35. http://dx.doi.org/10.3928/0279-3695-19911201-10.
5
Norman, Sarah, Erica Davis, and Lisa W. Goldstone. "Impact of pharmacist-led or co-led medication education groups on patient outcomes: A literature review." Mental Health Clinician 2, no. 4 (October 1, 2012): 86–90. http://dx.doi.org/10.9740/mhc.n117932.
Анотація:
Introduction: Psychiatric pharmacists lead groups for patients with mental health disorders in a variety of locations. It is unknown whether these groups are effective in increasing patient knowledge and adherence or reducing negative healthcare outcomes. It is also unclear whether certain modalities of pharmacist-led medication education groups are more effective than others. Methods: A literature search using MEDLINE and PsycINFO was performed using the search terms “medication,” “patient education,” “pharmacy” or “pharmacist,” and “psychiatric” or “behavioral” or “mental.” Full text articles of randomized controlled trials or those with a pre-post study design that reported outcomes of a pharmacist-led or coled medication group were included. Results: Six studies were included in the review, many of which were limited by small sample sizes and confounding factors. These studies suggest that pharmacist-led group medication education can improve cardiac risk factors in patients with diabetes, increase inhaler medication compliance in patients with asthma or chronic obstructive pulmonary disease, and improve the ability of pediatric patients and their parents to manage asthma. Elderly patients' ability to manage their medications improved in one study, but was only shown to be significant for patients using four or more medications in another study. Appropriate medication use by psychiatric outpatients was significantly improved with a pharmacist intervention while decreasing total drug and salary costs. Discussion: Group interventions provided by pharmacists can be successful in improving patient care outcomes for a variety of disease states in diverse patient populations such as pediatrics and geriatrics. Further research is needed to evaluate the full impact of pharmacist-led medication education groups on outcomes such as patient attitudes, knowledge, patient ability to self-manage medications, adherence, and utilization of health care resources.
6
Pandolfe, Frank, Adam Wright, Warner V. Slack, and Charles Safran. "Rethinking the outpatient medication list: increasing patient activation and education while architecting for centralization and improved medication reconciliation." Journal of the American Medical Informatics Association 25, no. 8 (May 17, 2018): 1047–53. http://dx.doi.org/10.1093/jamia/ocy047.
Анотація:
Abstract Objective Identify barriers impacting the time consuming and error fraught process of medication reconciliation. Design and implement an electronic medication management system where patient and trusted healthcare proxies can participate in establishing and maintaining an inclusive and up-to-date list of medications. Methods A patient-facing electronic medication manager was deployed within an existing research project focused on elder care management funded by the AHRQ, InfoSAGE, allowing patients and patients’ proxies the ability to build and maintain an accurate and up-to-date medication list. Free and open-source tools available from the U.S. government were used to embed the tenets of centralization, interoperability, data federation, and patient activation into the design. Results Using patient-centered design and free, open-source tools, we implemented a web and mobile enabled patient-facing medication manager for complex medication management. Conclusions Patient and caregiver participation are essential to improve medication safety. Our medication manager is an early step towards a patient-facing medication manager that has been designed with data federation and interoperability in mind.
7
Grant, Betty. "Improving patient satisfaction through medication education." Nursing 42, no. 3 (March 2012): 12–14. http://dx.doi.org/10.1097/01.nurse.0000411418.98785.f3.
8
Carr, Frances, Peter Tian, Jeffrey Chow, Jennifer Guzak, Jean Triscott, Pamela Mathura, Xing Sun, and Bonnie Dobbs. "Deprescribing benzodiazepines among hospitalised older adults: quality improvement initiative." BMJ Open Quality 8, no. 3 (August 2019): e000539. http://dx.doi.org/10.1136/bmjoq-2018-000539.
Анотація:
Benzodiazepines are recognised as being potentially inappropriate medications for seniors due to their considerable side-effect profile, yet they are commonly prescribed and infrequently discontinued (deprescribed). The study’s primary objective was the deprescription or the dose reduction of benzodiazepines among newly hospitalised seniors using a patient education intervention. A 3-month duration quality improvement study based on the plan–do–study–act model was conducted across two units (3C and 4D) in the Glenrose Rehabilitation Hospital to improve benzodiazepine deprescribing among newly admitted seniors (65 years or older) who were using benzodiazepines. The primary outcome measure was the number of eligible patients who had benzodiazepine deprescribing initiated. A patient education intervention comprising a structured medication review, written patient education (the Eliminating Medications Through Patient Ownership of End Results (EMPOWER) brochure) and at least one brief supportive counselling session by the clinical pharmacist or physician was applied to all eligible patients. All 12 eligible patients consented to benzodiazepine deprescribing; however, only 11 of them (92%) initiated benzodiazepine deprescribing. Six of the 11 patients (55%) had their benzodiazepines discontinued, with the 5 remaining patients (45%) achieving greater than 50% dosage reduction. Seven patients (64%) experienced side effects during the deprescribing process, with over half (57%, n=4) of these seven patients experiencing worsening anxiety symptoms. Five of the 11 patients (45%) required benzodiazepine substitute medications. The use of a structured patient education intervention involving the use of a structured medication review, written patient education material and one-on-one patient counselling can promote benzodiazepine deprescribing. Although worsening anxiety was frequently observed, this was easily managed by the substitution of a more appropriate and clinically indicated medication, which was well tolerated and acceptable by all of our participants. Targeted screening for the presence of anxiety would help to guide the deprescribing process and the need for medication substitution.
9
Ferrario, Catherine G. "Geropharmacology." AACN Advanced Critical Care 19, no. 1 (January 1, 2008): 23–37. http://dx.doi.org/10.4037/15597768-2008-1005.
Анотація:
Advanced practice nurses’ challenge in managing older adults’ medication regimens from an evidence base is difficult because older adults are vulnerable to medication errors and adverse drug reactions related to a number of factors. Predicting patients’ responses to drugs is compounded during critical illness, adding to the heterogeneity and unpredictability of drug effects that are prevalent premorbidly. In the first part of this 2-part continuing education series, sources of medication errors and older adults’ vulnerability are discussed, including normal changes of aging affecting pharmacokinetics and pharmacodynamics, polypharmacy, self-medicating, patient-family noncompliance, and inappropriately prescribed medications. In the second part, drug classes and drugs posing particular problems for older adults and cautions for acute care and critical care nurses who manage the medications of older adults are highlighted.
10
Gavin, Leiha, and Theresa Frey. "Assessment of a pharmacist-run medication education group for inpatient psychiatric patients." Mental Health Clinician 2, no. 4 (October 1, 2012): 94–99. http://dx.doi.org/10.9740/mhc.n118039.
Анотація:
The goal of this study was to assess the patient knowledge gained from the new pharmacist-run inpatient medication education group that was recently started on the inpatient psychiatry unit at the William S. Middleton VA Hospital in Madison, Wisconsin. The primary objective was to compare the scores from the modified Medication Understanding and Use Self-Efficacy Scale (MUSE) medication adherence tool and modified Frequency, Intensity, and Burden of Side Effects Ratings (FIBSER) medication side effects tool between patients who attended the new group versus patients who did not attend the group. The results for the MUSE and FIBSER scores for those who attended the medication education group were slightly lower than those who did not attend the group; however, none of the scores showed any statistical differences. The medication education group on the inpatient psychiatric unit at the William S. Middleton VA was developed to increase patients' knowledge about their medications and to increase patients' access to pharmacists.
11
Davis, Christopher R., Edward C. Toll, Paul M. Bevis, and Helena P. Burden. "Improving patient safety through education: how visual recognition skills may reduce medication errors on surgical wards." Nursing Reports 2, no. 1 (December 22, 2011): 1. http://dx.doi.org/10.4081/nursrep.2012.e1.
Анотація:
Medication errors compromise patient safety and cost £500m per annum in the UK. Patients who forget the name of their medication may describe the appearance to the doctor. Nurses use recognition skills to assist in safe administration of medications. This study quantifies healthcare professionals’ accuracy in visually identifying medications. Members of the multidisciplinary team were asked to identify five commonly prescribed medications. Mean recognition rate (MRR) was defined as the percentage of correct responses. Dunn’s multiple comparison tests quantified inter-professional variation. Fifty-six participants completed the study (93% response rate). MRRs were: pharmacists 61%; nurses 35%; doctors 19%; physiotherapists 11%. Pharmacists’ MRR were significantly higher than both doctors and physiotherapists (P<0.001). Nurses’ MRR was statistically comparable to pharmacists (P>0.05). The majority of healthcare professionals cannot accurately identify commonly prescribed medications on direct visualization. By increasing access to medication identification resources and improving undergraduate education and postgraduate training for all healthcare professionals, errors may be reduced and patient safety improved.
12
Erdeljac, Hilary, Stephanie Yager, Megan McClain, Sarah Wall, Carolyn Presley, Edmund Folefac, and Ashley Rosko. "Pharmacist-Led Audits for Older Adults With Cancer Yield Significant Interventions." Innovation in Aging 4, Supplement_1 (December 1, 2020): 208. http://dx.doi.org/10.1093/geroni/igaa057.672.
Анотація:
Abstract Older adults with cancer have comorbidities that require medical management and confounders of chemotherapy and supportive medications exacerbate polypharmacy. A multidisciplinary team model was created to address these needs within the Cancer Aging and Resiliency (CARE) clinic. To reconcile medications for accuracy, compliance, side effects, and effectiveness, a pharmacist-led audit includes identification of potential therapeutic duplications, drug-drug interactions, or potential medication inappropriateness identified using Beers criteria. A pharmacist led review of patient’s prescriptions can identify drug therapy problems (DTP) and result in safer medication management. METHODS: A retrospective review of pharmacy specific interventions was conducted using CARE Clinic patient data from February 2016 to October 2019 evaluating data from n=259 patients. RESULTS: A preliminary analysis of n=137 patients who had received medication reconciliation were included. The mean number of medications per patient was 13.1 ± 5.7 and 457 DTP were identified leading to 523 medication related interventions. There was an average of 3.3 DTP per patient. The most common types of DTP included medication reconciliation (n=137, 30.0%), potentially inappropriate medication (PIM) (n=74, 16.2%), administration/technique (n=35, 7.7%), and drug-drug interaction (n=28, 6.1%). The most frequent types of interventions involved education to the patient (n=166, 31.7%), medication reconciliation (n=137, 26.2%), medication discontinuation (n=84, 16.1%), patient to discuss further with physician (n=39, 7.5%), and medication initiated (n=35, 6.7%). Updated results involving approximately 259 patients will be presented. CONCLUSION: Comprehensive medication review within a multidisciplinary setting for the management of older adults with cancer can reduce polypharmacy and inappropriate medication use.
13
Joplin, Samantha, Rick van der Zwan, Fredrick Joshua, and Peter K. K. Wong. "Medication Adherence in Patients with Rheumatoid Arthritis: The Effect of Patient Education, Health Literacy, and Musculoskeletal Ultrasound." BioMed Research International 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/150658.
Анотація:
Background. Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease affecting <1% of the population. Incompletely controlled RA results in fatigue, joint and soft tissue pain, progressive joint damage, reduced quality of life, and increased cardiovascular mortality. Despite an increasing range of disease modifying agents which halt disease progression, poor patient adherence with medication is a significant barrier to management.Objective. The goal of this review was to examine the effectiveness of measures to improve patient medication adherence.Methods. Studies addressing treatment adherence in patients with RA were identified by trawling PsycINFO, Medline, Cochrane, Pubmed, and ProQuest for studies published between January 2000 and October 2014. Articles were independently reviewed to identify relevant studies.Results. Current strategies were of limited efficacy in improving patient adherence with medications used to treat RA.Conclusion. Poor medication adherence is a complex issue. Low educational levels and limited health literacy are contributory factors. Psychological models may assist in explaining medication nonadherence. Increasing patient knowledge of their disease seems sensible. Existing educational interventions appear ineffective at improving medication adherence, probably due to an overemphasis on provision of biomedical information. A novel approach to patient education using musculoskeletal ultrasound is proposed.
14
Dunkley, Kisha A., Doneisha Evelyn, Veronica Timmons, and Tara T. Feller. "Implementation of a medication education training program for student pharmacists employed within an academic medical center." American Journal of Health-System Pharmacy 77, no. 3 (January 4, 2020): 206–13. http://dx.doi.org/10.1093/ajhp/zxz309.
Анотація:
Abstract Purpose To describe the implementation of a student pharmacist medication education training program (the REWARDS Method), to determine if training was effective in preparing employed student pharmacists to provide medication education, and to assess medication education completion rates. Summary Hospital readmissions are often attributable to poor transitions of care (TOC), and medication education prior to discharge may improve TOC. To expand upon existing medication education efforts, the Johns Hopkins Hospital Adult Inpatient Pharmacy (AIP) designed and implemented the REWARDS Method, a training program to prepare employed second- and third-year student pharmacists to provide medication education. The REWARDS Method includes 6 distinct steps, which incorporate student self-directed and pharmacist-facilitated learning. Students were trained to provide patient education targeting 4 classes of high-risk medications (anticoagulants, inhalers, insulin, and naloxone) on multiple inpatient units served by the AIP. A total of 43 hours of pharmacist time was needed to complete training for the 10 employed student pharmacists. A survey was used to assess preparedness for completing medication education. Survey responses indicated that participants were sufficiently to exceedingly prepared to perform medication education. The division’s completion rate for patients requiring education was 79% in 2017, compared to 86% in 2018 (p = 0.006). Conclusion The REWARDS Method is an effective training program that successfully incorporated employed student pharmacists into medication education efforts. Our study demonstrated high rates of students successfully completing training and an increase in the rate of patient education completion.
15
Zatarain, Lauren Azure, Jessica Ashford, and David Bivens. "Improving the quality of the consenting and education process for patients starting on oral oncology medications." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 82. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.82.
Анотація:
82 Background: Oral oncology medication prescribing is on the rise nationwide. Given that these medications are self-administered, drug compliance is a concern. Appropriate patient education directly impacts drug adherence. Prior to the process improvement initiative in our community based medical oncology clinic, implied consent was obtained while educating patients on side effects and written informed consent was documented 0% of the time. This creates a patient safety and risk management problem. Methods: Our clinic implemented a new process for consenting and educating patients starting on new oral oncology medications from April – October 2015. The plan/do/study/act performance improvement technique was utilized. A new consent form was created for oral oncology medications meeting ASCO/ONS safety standards. The consent and education packets were placed centrally in the office and coincided with an initiative to improve consenting for IV chemotherapy. Providers were in-serviced to contact the nurse prior to patients exiting clinic to initiate the new prescription and begin the patient education process. Reminder checklists were placed in exam rooms to trigger the provider to communicate with nursing staff. Outcome measures included data on the percent of patients with written informed consent in health record and percent of patients with patient education handouts in health record prior to drug start. Data on percent of patients for whom the provider notified nurse prior to end of clinic visit were collected as a balance measure. Results: Over a 6 month period, 101 consecutive patients initiated on oral oncology drugs were included in the data analysis. The baseline mean improved from 0% to 75% for obtaining written informed consent (p chart, 3 sigma). The baseline mean improved from 37% to 80% for documenting patient education in health record prior to oral oncology medication start (p chart, 3 sigma). Conclusions: There was significant improvement in obtaining written informed consent and providing patient education prior to oral oncology drug start after implementation of new clinic processes.
16
Kaupp, Kristin, Samantha Scott, Laura V. Minard, and Tessa Lambourne. "Optimizing patient education of oncology medications: A quantitative analysis of the patient perspective." Journal of Oncology Pharmacy Practice 25, no. 6 (April 18, 2019): 1445–55. http://dx.doi.org/10.1177/1078155219843675.
Анотація:
Background With the ever-increasing complexity of cancer treatments, oncology medication patient education is becoming a progressively important component of cancer care. Despite this, cancer patients frequently report that they receive inadequate information and feel that their education needs have not been met. Objective To explore patients' perspectives of optimal oncology medication education across Nova Scotia. Methods This was a descriptive survey of adult medical, hematological and gynaecological oncology outpatients receiving intravenous chemotherapy within the Nova Scotia Health Authority between January 26 and April 30, 2018. Results One hundred forty-two responses were included; 41% and 47% of respondents reported being satisfied or very satisfied with their oncology medication education, respectively; 30% and 43% of respondents would like the opportunity to receive education or follow-up from a hospital pharmacist, respectively. Respondents with post-secondary education were found to have 2.82 higher odds of wanting to make an appointment for education with a hospital pharmacist. Conclusions Patients were generally satisfied with their oncology medication education despite the majority not receiving education from a hospital pharmacist. Patients with a higher level of formal education were more likely to want the opportunity to schedule an appointment for education with and/or receive follow-up from a hospital pharmacist. The oncology medication education participants received in the past appeared to align with their education preferences. Findings from this research can be used to optimize the limited time healthcare professionals have to provide meaningful and effective oncology medication patient education and improve patient-centered care.
17
Goldstone, Lisa W., Shannon N. Saldaña, and Amy Werremeyer. "Pharmacist provision of patient medication education groups." American Journal of Health-System Pharmacy 72, no. 6 (March 15, 2015): 487–92. http://dx.doi.org/10.2146/ajhp140182.
18
Vetter, Thomas R., Michelle E. Downing, Sean C. Vanlandingham, Kristen M. Noles, and Arthur M. Boudreaux. "Predictors of Patient Medication Compliance on the Day of Surgery and the Effects of Providing Patients with Standardized yet Simplified Medication Instructions." Anesthesiology 121, no. 1 (July 1, 2014): 29–35. http://dx.doi.org/10.1097/aln.0000000000000175.
Анотація:
Abstract Background: Anesthesiologists are responsible for optimizing patients’ preoperative medications, including maximizing their compliance with preoperative medication instructions. The authors hypothesized that a standardized, simplified instruction sheet presented and verbally reinforced during the preanesthesia clinic visit would improve patient medication compliance on the day of surgery. Methods: An unmatched case-control design was applied, with nonrandomized, preintervention (controls) and postintervention (cases) data collected. In the preintervention group, patient education/instruction regarding taking medications on the day of surgery continued in the existing, unstandardized manner. In the postintervention group, patients were given a simplified, multicolored Preoperative Patient Medication Instruction Sheet, which was consistently verbally reviewed with patients. Group differences and independent variable associations were analyzed with conventional inferential biostatistics. Results: A total of 521 and 531 patients were enrolled in the preintervention group and postintervention group, respectively. Of this, 309 patients (60%) of preintervention group versus 391 patients (74%) of postintervention group (P < 0.001) were compliant with their preoperative medication instructions on the day of surgery. Use of the Preoperative Medication Instruction Sheet (adjusted odds ratio [aOR] = 1.83; P < 0.001), Caucasian race (aOR = 1.74; P = 0.007), and recalling receiving both verbal/written preoperative medication instructions (aOR = 1.51; P = 0.006) were associated with greater patient medication compliance. Older age (aOR = 0.67; P = 0.014) and higher American Society of Anesthesiologists status (aOR = 0.60; P = 0.004) were associated with lesser patient medication compliance. Conclusions: A standardized, multicolored, pictorial Preoperative Patient Medication Instruction Sheet, with patient communication in both verbal/written forms, seems to improve patient medication compliance on the day of surgery. African-Americans, older patients, and those with greater comorbidities may require a more concerted effort to achieve an adequate preoperative medication compliance.
19
Maleki, Sam, Marliese Alexander, Chen Liu, Danny Rischin, Senthil Lingaratnam, and Tsien Fua. "Radiation oncology outpatient medication management needs and service gaps – A cross-sectional study of patients and clinicians." Journal of Oncology Pharmacy Practice 26, no. 4 (September 25, 2019): 846–52. http://dx.doi.org/10.1177/1078155219875210.
Анотація:
Background Patients receiving radiotherapy for the treatment of cancer can have complex medication requirements related to the management of side-effects and impaired swallowing ability. This study surveyed patients and clinicians to identify service gaps and unmet medication management needs. Methods Patient and clinician surveys were developed by a multidisciplinary team based on previously validated questionnaires. The patient survey focused on medication use and adherence. The clinician survey was based around a clinical case study and focused on identifying service gaps and practice variations. This survey was disseminated to radiation oncologists, pharmacists and nurses involved with the care of head and neck or lung cancer patients in Victoria. Results A total of 93 surveys were completed including 53 patient surveys and 40 clinician surveys. Radiotherapy patients reported high medication usage with up to 53% taking five or more medications daily. When asked the same set of questions relating to medication education requirements, patients receiving polypharmacy reported greater needs (72%) than recognised by the surveyed multidisciplinary clinician group (58%). They also reported a non-adherence rate of 46%. In addition, further disparities were identified in clinician practices and their approach to clinical situations which may result in conflicting advice and confusion for patients. Conclusion While recognising deficiencies relating to the provision of medication information, oncologists, nurses and pharmacists underestimated patient needs for medication information, education and follow-up. Findings support the rationale for integration of pharmacy services within the radiotherapy clinics to support patient care and bridge service gaps relating to medication management.
20
McDonald, Danielle, Rupal Mansukhani, Suzannah Kokotajlo, Frank Diaz, and Christine Robinson. "Effect of Nursing Education on Optimization of Medication Reconciliation in the Pediatric Emergency Department." Journal of Pediatric Pharmacology and Therapeutics 23, no. 3 (June 1, 2018): 203–8. http://dx.doi.org/10.5863/1551-6776-23.3.203.
Анотація:
OBJECTIVE This study was conducted to evaluate the impact of education on optimizing medication histories in a single-center pediatric emergency department. METHODS This was a prospective, 2-phase study of 200 patients ages 21 years and younger who presented to the pediatric emergency department in January and February 2017. In phase I of the study, 100 patients were interviewed by both a nurse and a pharmacist. Between phases I and II, the pharmacist educated each nurse and disseminated standardized education materials. In phase II, 100 additional patients were interviewed by both a nurse and a pharmacist. Discrepancies were quantified in both phases of the study. The primary outcome was the distribution of total discrepancies in medications identified. Total discrepancies were defined as a composite of medication name, dose, route, frequency, and time of last dose. RESULTS A total of 200 medication histories were collected over phases I and II. In phase I (n = 79), the pharmacist identified 185 medications, 88 of which were also identified by the nurse. In phase II (n = 82), the pharmacist identified 180 medications, 95 of which were also identified by the nurse. The distribution of discrepancies per patient and per medication was significantly reduced in regard to dose, route, and frequency documentation. CONCLUSION Although improvement was observed, barriers beyond a knowledge deficit exist to limit accuracy of medication histories collected by nurses.
21
Vaismoradi, Mojtaba, Sue Jordan, Flores Vizcaya-Moreno, Ingrid Friedl, and Manela Glarcher. "PRN Medicines Optimization and Nurse Education." Pharmacy 8, no. 4 (October 26, 2020): 201. http://dx.doi.org/10.3390/pharmacy8040201.
Анотація:
Medicines management is a high-risk and error prone process in healthcare settings, where nurses play an important role to preserve patient safety. In order to create a safe healthcare environment, nurses should recognize challenges that they face in this process, understand factors leading to medication errors, identify errors and systematically address them to prevent their future occurrence. “Pro re nata” (PRN, as needed) medicine administration is a relatively neglected area of medicines management in nursing practice, yet has a high potential for medication errors. Currently, the international literature indicates a lack of knowledge of both the competencies required for PRN medicines management and the optimum educational strategies to prepare students for PRN medicines management. To address this deficiency in the literature, the authors have presented a discussion on nurses’ roles in medication safety and the significance and purpose of PRN medications, and suggest a model for preparing nursing students in safe PRN medicines management. The discussion takes into account patient participation and nurse competencies required to safeguard PRN medication practice, providing a background for further research on how to improve the safety of PRN medicines management in clinical practice.
22
Shah, Nandi, and Kristen Kulasa. "Diabetes Medication Reconciliation at Hospital Discharge." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A424. http://dx.doi.org/10.1210/jendso/bvab048.866.
Анотація:
Abstract Background: During hospital discharge, patients are at high risk for medication discrepancies as they transition from hospital to home. This study aims to evaluate the prevalence of medication errors at hospital discharge for diabetes medications in patients who received an endocrinology consultation for diabetes and explore interventions to improve the accuracy of discharge medication reconciliation. Methods: All patients (n=3018) who received an endocrinology consultation for diabetes at a tertiary care medical center from October 2017 to December 2019 were included. A retrospective chart review was performed to collect the following information on each patient: primary service from which the patient was discharged, hospital site, month and year of discharge date, and whether each patient’s medication reconciliation for diabetes medications at hospital discharge was in agreement with the inpatient diabetes team’s recommendations. Patients who were discharged on medications discordant from those recommended by the inpatient diabetes service were subcategorized into three groups: 1) one medication incorrect 2) more than one medication incorrect and 3) the primary service did not notify the consult team of patient’s discharge or request final recommendations for diabetes medications prior to discharge. Based on the findings of this study, an educational intervention was implemented in November 2019 to the Hospital Medicine services regarding diabetes discharge medication reconciliation. Results: Of the 3018 patients who received an endocrinology consultation for diabetes at a tertiary university medical center, 2279 patients (76%) were discharged on correct medications, 165 patients (5%) were discharged with one incorrect medication, 443 patients (15%) were discharged with more than one incorrect medication, and 121 patients (4%) were discharged without final discharge recommendations from the diabetes service. There was no significant variation based on discharging service or month of the year. After an educational intervention was implemented in November 2019 to the Hospital Medicine service on the existence and use of a comprehensive diabetes discharge order set, the percentage of patients discharged on correct medications improved to 92% (11/12 patients) compared to prior 81% (44/54 patients). Conclusion: Despite detailed discharge medication recommendations including patient education detailing the recommended regimen by the endocrinology diabetes service, a significant number of patients were discharged by providers across all services on diabetes medications discrepant with the diabetes service’s recommendations. Educational efforts improved the rate of correct medications at discharge on the Hospital Medicine service, and additional educational interventions with other services may be helpful in improving medication reconciliation accuracy.
23
Christy, Shannon, Billy Sin, and Suzanna Gim. "Impact of an Integrated Pharmacy Transitions of Care Pilot Program in an Urban Hospital." Journal of Pharmacy Practice 29, no. 5 (July 9, 2016): 490–94. http://dx.doi.org/10.1177/0897190014568674.
Анотація:
Purpose: To evaluate the effectiveness of an integrated Pharmacy Transitions of Care (PTC) pilot program on reducing hospital readmissions and improving patient satisfaction. Methods: This prospective observational cohort study compares patients who participated in the PTC program to a control of usual hospital discharged patients during January through April 2014. The PTC program provided discharge medication review, medication counseling, delivery of medications to bedside, clinic scheduling, and follow-up phone calls. The primary outcome measure was 30-day readmissions. Secondary outcomes included emergency department (ED) visits, pharmacist interventions, and patient satisfaction. Results: Seventy patients participated in the PTC program. Compared to the control (n = 725), the study group had decreased 30-day all-cause readmissions (5.7% vs 13.8%, P = .08), 30-day readmissions for the same diagnosis (2.9% vs 8.1%, P = .18), and ED visits (18.6% vs 25%, P = .82). Twenty-five interventions during discharge medication review included discontinuation of unnecessary medications and correction of medication dose or frequency. The majority of patients were satisfied with the medication education provided (94%) and the timely delivery of prescriptions to bedside (96%). Conclusion: There was no significant difference in 30-day readmission rates. However, pharmacists were able to make a positive impact on patient satisfaction and improve understanding of medications during discharge.
24
Schoenthaler, Antoinette M., Brian S. Schwartz, Craig Wood, and Walter F. Stewart. "Patient and Physician Factors Associated With Adherence to Diabetes Medications." Diabetes Educator 38, no. 3 (March 22, 2012): 397–408. http://dx.doi.org/10.1177/0145721712440333.
Анотація:
Purpose The purpose of this study was to examine the influence of patient and physician psychosocial, sociodemographic, and disease-related factors on diabetes medication adherence. These factors were also examined as effect modifiers of the association between quality of the patient-physician relationship and medication adherence. Methods Data were collected from 41 Geisinger Clinic primary care physicians and 608 of their patients with type 2 diabetes. Adherence to oral hypoglycemic medications was calculated using a medication possession ratio based on physician orders in electronic health records (MPREHR). MPREHR was defined as the proportion of total time in the 2 years prior to study enrollment that the patient was in possession of oral hypoglycemic medications. Linear regression was used to examine the influence of patient- and physician-level factors on adherence. Effect modification of the patient-physician relationship-adherence association was evaluated by adding the main effects of the individual-level factors and their cross-products to the models. Results In adjusted analyses, satisfaction with the physician’s patient education skills, patient beliefs about the need for their medications, and lower diabetes-related knowledge were associated with better adherence to oral hypoglycemic medications. Shorter duration of time with diabetes and taking only oral hypoglycemic medications were also associated with better adherence. Finally, the association between shared decision making and medication adherence was significantly modified by patients’ level of social support. Conclusions This study identified several patient-, physician-, and disease-related factors that should be targeted to maximize the potential for developing tailored adherence-enhancing interventions within the context of a collaborative patient-physician relationship.
25
Tawfik, Bernard, Harmony Bowles, Zoneddy R. Dayao, Richard C. Lauer, and Janet Abernathy. "Pharmacist-driven oral oncolytic medication education and consent." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 44. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.44.
Анотація:
44 Background: The number and type of oral oncolytic therapy in oncology is expanding rapidly. Oral oncolytics have serious side effect potential and patient education has been shown to reduce adverse events. Pharmacist driven interventions have been shown to safety and adherence. The University of New Mexico Comprehensive Cancer Center (UNM CCC) initiated and then improved upon a pharmacist driven patient education and consent process for oral oncolytic therapy. Methods: A pharmacist driven education and consent process was initiated at UNM CCC and monitored from August 2016 to October 2018. The intervention initially used a message generated by an order in the Electronic Medical Record (EMR) to alert the pharmacist of new oral oncolytic prescriptions. Initial uptake by providers was low so education regarding this order was presented to providers. Outpatient pharmacy staff were instructed not to release first fill oral oncolytic prescriptions without notifying the pharmacist educator. Lastly, hematology and oncology fellows notified the pharmacist educator of patients discharged directly from the hospital with a new oncolytic prescription. The metric measured was the percent of patients on oral oncolytic therapy who were educated and consented by the pharmacist for oral oncolytic medications filled at UNM CCC. Statistical analysis included run charts with 95% Confidence Intervals and t-tests with two tails, assuming unequal variation between groups and an alpha of 0.05. Results: The initial monthly education and consent rate was 17.9% followed by 45.5% the following month. This quickly grew to an average of 87.0% (95% CI 55.7-118.2) for the subsequent 15 months which achieved control. Additional changes were made as part of the PDSA cycle which increased the education rate to 95.7% (95% CI 84.4-107.1). These two periods were statistically significantly different (p = 0.0025). Conclusions: A pharmacist driven program for education and consent upon initiation of oral oncolytics is possible and can successfully educate the majority of patients. Future expansions of this program will include ensuring patient adherence and educating patients who fill oral oncolytics outside UNM CCC.
26
Segal, Eve M., Megan R. Flood, Robert S. Mancini, Robert T. Whiteman, Gregory A. Friedt, Adam R. Kramer, and Mark A. Hofstetter. "Oral Chemotherapy Food and Drug Interactions: A Comprehensive Review of the Literature." Journal of Oncology Practice 10, no. 4 (July 2014): e255-e268. http://dx.doi.org/10.1200/jop.2013.001183.
Анотація:
Oral chemotherapies are associated with medication and food interactions. It is essential that health care providers evaluate patients' concurrent medications to provide accurate patient education, therapeutic monitoring, and alternative recommendations whenever oral chemotherapy is prescribed.
27
Sam, Gloria K., Jobin Thomas, Riya Alexander, and Sheen Ann Varughese. "ASSESSMENT & EVALUATION ON THE KNOWLEDGE, ATTITUDE & PRACTICE TOWARDS MEDICATION THERAPY MANAGEMENT AMONG COMMUNITY OF DAVANGERE CITY." Asian Journal of Pharmaceutical and Clinical Research 10, no. 4 (April 1, 2017): 380. http://dx.doi.org/10.22159/ajpcr.2017.v10i4.16889.
Анотація:
Objectives: The prime objective of this study is to assess knowledge, attitude, and practice (KAP) toward medications in a community of Davangere city.Methods: This community-based study was conducted for 6 months using medication therapy management aspects. Ethical clearance was obtainedfrom the Institutional Ethical Committee. Patients above 18 years of age who were willing to participate were included in the study. The data werecollected using specific data collection forms, and KAP toward medications of each patient was assessed using KAP questionnaire. Medicationadherence was analyzed using Morisky Medication Adherence Scale 4. Patient counseling about disease, medication, and lifestyle modification wasgiven, and the orally taking household drugs were segregated according to class and specific clinical uses.Results: Out of 129 patients, 58.1% were male. Out of 19 diseases encountered during the study, diabetes mellitus (32.56%) and hypertension(25.58%) were most prevalent. Majority of patients (63.57%) were prescribed with cardiovascular agents. Paracetamol was found as a commonhousehold drug. Sixty-nine percent of patients were procuring medication directly from the pharmacy and the remaining 31% were procuring theirmedication after consulting the physician. Mean scores of KAP in basal and endpoint assessment were compared using Student’s t-test. p value wasfound to be <0.000.Conclusion: The study tried to entitle the name of pharmacist as a patient educator who gives proper guidance to the patient and family membersabout the disease, domestic drug management, lifestyle modification, etc. The result of efficient patient counseling will be reflected on the properadherence of patient toward the medication and improved quality of life.Keywords: Knowledge, attitude and practice (KAP), Medication therapy management (MTM), Morisky medication adherence Scale – 4 (MMAS-4),patient education.
28
Allison, Kristen. "Adherence through education: A call to clinicians to educate all patients on medication use." Mental Health Clinician 2, no. 4 (October 1, 2012): 83–85. http://dx.doi.org/10.9740/mhc.n117761.
Анотація:
Medication nonadherence contributes to lack of achievement of desired therapeutic outcomes. This article reviews the evidence supporting patient education as a one of the tools to promote medication adherence. Patient education and provision of tools to help patients overcome adherence barriers are effective ways to improve medication adherence.
29
Divakaruni, Anupama, Elizabeth Saylor, and Alison P. Duffy. "Assessing the need for improved strategies and medication-related education to increase adherence for oral anticancer medications in the young adult oncology population." Journal of Oncology Pharmacy Practice 24, no. 5 (April 7, 2017): 337–42. http://dx.doi.org/10.1177/1078155217703790.
Анотація:
Rationale Oral anticancer medication adherence is a critical factor in optimizing cancer treatment outcomes and minimizing toxicity. Although potential adherence barriers exist, it is not well understood how these factors impact adherence. Methods This is a prospective, single-center, patient survey-based study conducted at the University of Maryland Greenebaum Comprehensive Cancer Center including 18- to 39-year-old patients who have been actively taking an oral anticancer medication for at least one month from 1 April 2013 to 1 April 2016. The primary objective of this study is to describe institutional practices for medication education and adherence monitoring practices as perceived by young adult patients at the University of Maryland Greenebaum Comprehensive Cancer Center and to describe practice consistency with recommendations from the American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards. The secondary objectives include patient-reported facilitators and barriers to oral anticancer medication adherence. Results Seventeen patients completed the survey; 24% ( n = 4) of patients denied receiving information about what to do in case of a missed dose. The most common facilitators of adherence include understanding of disease and treatment (88%, n = 15), perceived severity of illness (82%, n = 14), and use of oral anticancer medications (82%, n = 14). The most common barriers to adherence are side effects (59% n = 10), forgetfulness (47%, n = 8), and depressive symptoms (35%, n = 6). Conclusion Based on patient-reported guideline adherence, improvement is needed in including family, caregivers, and others in the education process as well as providing education about plan for missed doses and drug–drug and drug–food interactions. The strengths of the current medication education and adherence monitoring practices as perceived by the young adult patient population include education about the purpose and goals of treatment, the planned duration and schedule, side effects, and when to seek medical attention. The data collected from this survey can aid in future development and implementation of interventions aimed at improving medication adherence, such as integrating clinical pharmacy services into oral chemotherapy monitoring and education process.
30
Bowen, Jane F., Melissa E. Rotz, Brandon J. Patterson, and Sanchita Sen. "Nurses’ attitudes and behaviors on patient medication education." Pharmacy Practice 15, no. 2 (June 30, 2017): 930. http://dx.doi.org/10.18549/pharmpract.2017.02.930.
31
GONG, Jue, and SuoDi ZHAI. "Advances in multimedia-based patient education on medication." Pharmaceutical Care and Research 13, no. 1 (February 28, 2013): 50–53. http://dx.doi.org/10.5428/pcar20130115.
32
Fletcher, Monica, Jane Coomber, Margaret Lester, Karin Yeatts, and Samantha Walker. "ALLIED HEALTH PRACTITIONER EDUCATION AND PATIENT MEDICATION REGIMENS." Chest 130, no. 4 (October 2006): 165S. http://dx.doi.org/10.1378/chest.130.4_meetingabstracts.165s-a.
33
Sequeira, ReginaldP. "Patient safety in medical education: Medication safety perspectives." Indian Journal of Pharmacology 47, no. 2 (2015): 135. http://dx.doi.org/10.4103/0253-7613.153417.
34
Wilcox, Susan R., Mark S. Saia, Heather Waden, Susan J. McGahn, Michael Frakes, Suzanne K. Wedel, and Jeremy B. Richards. "Medication Administration in Critical Care Transport of Adult Patients with Hypoxemic Respiratory Failure." Prehospital and Disaster Medicine 30, no. 4 (July 16, 2015): 431–35. http://dx.doi.org/10.1017/s1049023x1500494x.
Анотація:
AbstractIntroductionCritical care transport (CCT) teams must manage a wide array of medications before and during transport. Appreciating the medications required for transport impacts formulary development as well as staff education and training.ProblemAs there are few data describing the patterns of medication administration, this study quantifies medication administrations and patterns in a series of adult CCTs.MethodsThis was a retrospective review of medication administration during CCTs of patients with severe hypoxemic respiratory failure from October 2009 through December 2012 from referring hospitals to three tertiary care hospitals.ResultsTwo hundred thirty-nine charts were identified for review. Medications were administered by the CCT team to 98.7% of these patients, with only three patients not receiving any medications from the team. Fifty-nine medications were administered in total with 996 instances of administration. Fifteen drugs were each administered to only one patient. The mean number of medications per patient was 4.2 (SD=1.8) with a mean of 1.9 (SD=1.1) drug infusions per patient.ConclusionsThese results demonstrate that, even within a relatively homogeneous population of patients transferred with hypoxemic respiratory failure, a wide range of medications were administered. The CCT teams frequently initiated, titrated, and discontinued continuous infusions, in addition to providing numerous doses of bolused medications.WilcoxSR, SaiaMS, WadenH, McGahnSJ, FrakesM, WedelSK, RichardsJB. Medication administration in critical care transport of adult patients with hypoxemic respiratory failure. Prehosp Disaster Med. 2015;30(4):1-5.
35
Ehret, Megan J., and Matthew Wang. "How to increase medication adherence: What works?" Mental Health Clinician 2, no. 8 (February 1, 2013): 230–32. http://dx.doi.org/10.9740/mhc.n132973.
Анотація:
Many studies have aimed to identify risk factors contributing to medication nonadherence with the goal of developing interventions to improve adherence rates. Several different intervention strategies have been studied. Psychoeducation, cognitive-behavioral therapy, and motivational interviewing have all positively influenced medication adherence and combinations of these approaches may bring about better results than one approach alone. In addition, pharmacists' intervention through answering patients' questions, performing follow up phone calls, offering additional education, and changing of medications or doses, may help the patient and ultimately lead to an increase in medication adherence and disease state improvement.
36
Khorassani, Farah, Shannon Tellier, and Demetra Tsapepas. "Pharmacist’s Role in Improving Medication Adherence in Transplant Recipients With Comorbid Psychiatric Disorders." Journal of Pharmacy Practice 32, no. 5 (March 19, 2018): 568–78. http://dx.doi.org/10.1177/0897190018764074.
Анотація:
Medication nonadherence rates are high in both the transplant and psychiatric populations. The consequence of medication nonadherence posttransplant is graft rejection and psychiatric decompensation, highlighting the importance of optimizing adherence to medication regimens. Pharmacists may work with transplant patients with psychiatric comorbidity to improve medication adherence through identifying patient-specific barriers and recommending an appropriate intervention. Multiple evidence-based practices for improving nonadherence have been detailed in the transplant and psychiatric population. Medication adherence aids, medication management, patient education, and motivational interviewing are all strategies that may be used to improve adherence. Selecting which interventions to make will be based on the reasons for a patient’s nonadherence. Most patients benefit from medication management, patient education, and medication adherence aids. Selection of medication adherence aids may be based on patient demographics, technology literacy, and preference. Motivational interviewing may be considered in patients with intentional nonadherence relating to a lack of insight into their illness or the importance of taking medication. Pharmacists may promote adherence and potentially improve patient outcomes in transplant recipients with comorbid psychiatric disorders through assisting patients with designing a tailored medication adherence plan.
37
Hart, Kristin M., Amelia S. Gennari, and Christine M. Ruby. "A Geriatric Pharmacy Resident's Clinical and Educational Activities During Weekly interprofessional Team Meetings." Senior Care Pharmacist 35, no. 3 (March 1, 2020): 136–44. http://dx.doi.org/10.4140/tcp.n.2020.136.
Анотація:
OBJECTIVES: To describe and gather further details about the clinical and educational activities that were documented by the geriatric pharmacist resident during both weekly interprofessional Acute Care for the Elderly (ACE) rounds as well as bedside patient counseling. DESIGN: Retrospective chart review (quality improvement project). SETTING: Inpatient geriatric service at University of Pittsburgh Medical Center (UPMC). PATIENTS: Medical learners selected one complex patient from the geriatric service for ACE rounds each week. ACTIVITIES: The geriatric pharmacist resident provided clinical information and medication education to the interprofessional team and to the patient and/or family at their bedside. Activities were documented in a newly developed template. MAIN OUTCOME MEASURES: Patient demographics, medication categories, discrepancies and dosing changes, time-in-rounds, and team members. RESULTS: De-identified data from 18 patients (72.2% female, average age 82.5 ± 9.18 years) over a 6-month period were collected and analyzed. The geriatric pharmacist resident provided most education to the team on antibiotics, antidepressants, over-thecounters (OTCs), and prescription pain medications during ACE rounds. They provided most education to the patient/family on prescription pain medications, antidepressants, OTCs, and anticoagulants. The pharmacist resident identified 38 medication discrepancies (72.2% of patients had ≥ 1 discrepancy, range 0-7) and clinically significant drug-drug interactions in 15 patients. The pharmacist resident recommended dosing changes in 12 patients and therapeutic alternatives in 11 patients. The ACE rounds lasted on average 26.6 [± 6.42] minutes and included medicine, pharmacy, social work, nurse case management, nursing, and nutrition and rehabilitative services when necessary. CONCLUSION: The results provide insight into both the clinical and educational activities of the geriatric pharmacist resident in support of interprofessional rounds.
38
Liu, Wei, Elizabeth Manias, and Marie Gerdtz. "Exploring power relations embedded in medication communication processes on general medical wards." Qualitative Research Journal 14, no. 2 (July 8, 2014): 161–78. http://dx.doi.org/10.1108/qrj-06-2013-0041.
Анотація:
Purpose – The purpose of this paper is to examine power relations embedded in verbal and non-verbal medication communication processes that involve nurses, doctors, pharmacists and patients in two general medical wards of an acute care hospital. Design/methodology/approach – This paper reports on the findings of an ethnographic study investigating medication communication processes in hospital spatial environments. It was theoretically informed by the work of Norman Fairclough. Data collection methods comprising video-recordings and video reflexive focus groups were employed. Fairclough's critical discourse analytic framework guided data analysis. Findings – Four different forms of power relations between clinician-patient, nurse-doctor, clinician-organisation and multidisciplinary interactions were uncovered. Nurses asserted their professional autonomy when communicating with doctors about medications by offering specific advice on medical prescribing and challenging medication decisions. Video reflexivity enabled nurses to critically examine their contribution to medication decision-making processes. Clinicians of different disciplines openly contested the organisational structure of patient allocation during medical discussions about management options. Clinicians of different disciplines also engaged in medication communication interchangeably to accomplish patient discharge. Originality/value – An investigation of existing power relations embedded in medication communication processes within specific clinical contexts can lead to a better understanding of medication safety practices. Video reflexive focus groups are helpful in encouraging clinicians to reflect on their practice and consider ways in which it could be improved in how power relations are played out.
39
Sanjeevi, Sujatha, and Angela Cocoman. "Mental health nurses' confidence in applying pharmacological knowledge: a survey." British Journal of Mental Health Nursing 9, no. 4 (November 2, 2020): 1–9. http://dx.doi.org/10.12968/bjmh.2019.0031.
Анотація:
Background/Aims The literature highlights gaps on how nurses apply pharmacology knowledge to their medication management, particularly in relation to knowledge on the mechanism of action and drug interactions. The aim of this study was to research a sample of mental health nurses to explore their confidence, knowledge and skills in applying their pharmacological knowledge. Methods A paper-based survey questionnaire was distributed to 209 mental health nurses working in direct patient care in Ireland. A total of 129 completed the questionnaire with a response rate of 61.7%. Results The vast majority of mental health nurses were confident in their knowledge of pharmacological principles to medication management, in relation to dosage, formulation, adverse effects, and predictable side effects, including patient education and medication information. Nurses were less confident in their knowledge of pharmacodynamics related to their knowledge on the mechanism of action, and on the pharmacokinetics of drug clearance. This may negatively impact on their ability to educate patients about their medications. Conclusions The findings suggest that there is need for an increased focus on continuing education on pharmacology for nurses at service level, particularly on the mechanism of action and clearance of commonly used medications in order for nurses to more effectively support patients to manage their medications.
40
Waters, Barbara M., Louise Jensen, and Richard N. Fedorak. "Effects of Formal Education for Patients with Inflammatory Bowel Disease: A Randomized Controlled Trial." Canadian Journal of Gastroenterology 19, no. 4 (2005): 235–44. http://dx.doi.org/10.1155/2005/250504.
Анотація:
BACKGROUND: Patients with inflammatory bowel disease (IBD) suffer physical dysfunction and impaired quality of life (QOL), and need frequent health care. They often lack knowledge about their disease and desire more education. Educational interventions for other chronic diseases have demonstrated reduced health care use and increased knowledge, medication adherence and QOL.METHOD: Sixty-nine participants were randomly assigned to formal IBD education and standard of care (pamphlets and ad hoc physician education) or standard of care alone. Assessment of IBD knowledge and QOL occurred at baseline, immediately posteducation and eight weeks posteducation. Participants documented medication adherence and health care use in diaries. Patient satisfaction was assessed at the end of the study.RESULTS: The education group had higher knowledge scores (P=0.000), perceived knowledge ratings (P=0.01) and patient satisfaction (P=0.001). There was a lower rate of medication nonadherence and health care use for the education group, but the differences were not significant. QOL indices did not change. Significant correlations were found for increased health care use in patients with poorer medication adherence (P=0.01) and lower perceived health (P=0.05).CONCLUSION: Formal IBD patient education improves knowledge, perceived knowledge and patient satisfaction. Further study of long-term effects may better demonstrate potential benefits for QOL, medication adherence and health care use.
41
Gilbert, Julia, and Jeong-ah Kim. "To err is human: medication patient safety in aged care, a case study." Quality in Ageing and Older Adults 19, no. 2 (June 11, 2018): 126–34. http://dx.doi.org/10.1108/qaoa-11-2017-0048.
Анотація:
Purpose The purpose of this paper is to explore an identified medication error using a root cause analysis and a clinical case study. Design/methodology/approach In this paper the authors explore a medication error through the completion of a root cause analysis and case study in an aged care facility. Findings Research indicates that medication errors are highly prevalent in aged care and 40 per cent of nursing home patients are regularly receiving at least one potentially inappropriate medicine (Hamilton, 2009; Raban et al., 2014; Shehab et al., 2016). Insufficient patient information, delays in continuing medications, poor communication, the absence of an up-to-date medication chart and missed or significantly delayed doses are all linked to medication errors (Dwyer et al., 2014). Strategies to improve medication management across hospitalisation to medication administration include utilisation of a computerised medication prescription and management system, pharmacist review, direct communication of discharge medication documentation to community pharmacists and staff education and support (Dolanski et al., 2013). Originality/value Discussion of the factors impacting on medication errors within aged care facilities may explain why they are prevalent and serve as a basis for strategies to improve medication management and facilitate further research on this topic.
42
VanDaele, Madeline A., Jordan O. Smith, and Jessica Bovio Franck. "Effectiveness of a clinical decision-support tool on adherence to prescribing and practice guidelines of high-risk antidepressant medications in geriatric patients." Mental Health Clinician 11, no. 3 (May 1, 2021): 181–86. http://dx.doi.org/10.9740/mhc.2021.05.181.
Анотація:
Abstract Introduction TCAs and paroxetine, a SSRI, are associated with safety risks in geriatric patients because of anticholinergic properties. The purpose of this project was to evaluate the impact of a clinical decision-support tool (CDST) on adherence with medication prescribing and practice guidance to enhance patient safety. Methods Mental health clinical pharmacy specialists and clinical pharmacy leadership led a multidisciplinary creation and integration of a CDST within a Veterans Health Administration EHR. The CDST focused on the following elements when prescribing TCAs and paroxetine in geriatric patients: clinical justification for initiation of the medication, provision of patient/caregiver education specific to the medication prescribed, evaluation of comprehension of education provided, medication reconciliation, and follow-up completed within 30 days of medication initiation. Following activation of the CDST in the EHR, measures were evaluated before intervention and after intervention. Results After intervention, an increase was observed in the primary outcome of the proportion of patients having documentation of all of the following: clinical justification for medication initiation, provision of patient/caregiver education, evaluation of comprehension of education provided, medication reconciliation, and follow-up completed within 30 days of medication initiation (P = .01). Individual proportions of patients with documented medication reconciliation and follow-up completed within 30 days significantly increased. All other secondary outcomes numerically increased but did not reach statistical significance. Discussion Improvement was seen in adherence with prescribing and practice guidance following the implementation of the CDST. This suggests the beneficial role of CDSTs within the EHR to optimize patient safety.
43
Lin, Mingqian, Douglas W. Hackenyos, Daqin Mao, Feng Qing Wang, John Kalil Erban, and Susan K. Parsons. "Utilizing patient navigators to enhance oral chemotherapy education and safety for at-risk patients." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 43. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.43.
Анотація:
43 Background: Oral anticancer drugs are increasingly being used as standard therapy. At Tufts Medical Center Cancer Center, 10% of patients on active cancer treatment are receiving oral chemotherapy. To address barriers to medication education and timely management of treatment effects, we began an initiative involving our pharmacy specialist who reviews newly-started oral chemotherapy treatments for safety concerns, dose appropriateness, and drug interactions. In response to the cultural-linguistic needs of our Chinese patients (20% of our patients, largest minority group) and unique challenges of our patients of lower SES (40% of our patients), we are also leveraging patient navigators (PN) to improve timely care and understanding of and adherence to oral cancer medications for our most vulnerable patients. Methods: PN regularly interact with patients and work closely with the care team to address patients’ concerns. Formal PN visits with patients in clinic are documented in the EMR. To assess the scope of issues related to oral chemotherapy and/or supportive care drugs (e.g. anti-nausea, anti-constipation) and the potential impact in using PN, we reviewed PN encounter notes from the first 6 months of 2016 to identify patient-reported issues. Results: In reviewing 492 PN encounter notes from the first 6 months of 2016 (111 patients were navigated), 138 (28%) of all patient encounters involved assistance related to oral chemotherapy, supportive care drugs, and/or comorbidities medications. Examples of patient-reported issues include confusion about purpose and/or type of drug, dosing scheduling, side effects management, and logistical challenges (e.g. refills, copays, specialty pharmacy orders). Conclusions: From the PN encounter notes, we identified a need for more formalized patient-centered interventions to enhance education, monitoring, and patient-provider communication about oral chemotherapy to proactively resolve medication-related issues. We are piloting an evidence-based approach involving pharmacist-PN-patient teaching sessions, tailored patient education tools, and scheduled check-ins between PN and patients adapted from the MASCC Oral Agent Teaching Tool model.
44
Nasiff, Maria Elena. "Medication Reconciliation and Patient Education at a Primary Care Office in South Florida." Alternative, Complementary & Integrative Medicine 7, no. 1 (February 28, 2021): 1–13. http://dx.doi.org/10.24966/acim-7562/100143.
Анотація:
Mediation reconciliation is a process that is crucial for ensuring drug safety among patients who demonstrate low medication adherence. Medication reconciliation at the Primary Care office is achieved by educating patients about the purpose of prescribed medicines, drug-to-drug, and drug-to-food interactions. Besides, patients are consulted about interactions between conventional and complementary and alternative medicine, and the dangers of consuming substances (illicit drugs, alcohol, nicotine) together with prescribed drugs. This approach is planned to be accomplished by means of combining printed medication reconciliation lists followed by open-ended questions included to check patients’ pharmacovigilance and conduct patient engagement. In addition, the innovative approach of the present project is inclusion of patients’ significant others in the process of advancing their treatment adherence. Direct participation of patients and their family member in medication reconciliation is expected to bring significant positive results. This project is valuable for advanced nurse practicing because it demonstrates the new ways to improve nurse-patient interactions, advance communication with patients’ family members and in overall, advance their pharmacovigilance.
45
Marzaioli, Viviana, Mary Canavan, Alex Donnolly, Siobhan Wade, Alexander Fraser, Tim O'Sullivan, Sinead Harney, Arthritis Ireland, Douglas J. Veale, and Ursula Fearon. "Knowledge of disease, diagnosis, adherence and impact of research in an Irish cohort of patients with inflammatory arthritis." HRB Open Research 4 (May 28, 2021): 60. http://dx.doi.org/10.12688/hrbopenres.13274.1.
Анотація:
Background: Patient engagement with clinicians results in shared decision making and increased adherence to medication. However, in order for strong patient: clinician partnerships to be achieved, communication barriers need to be identified. Therefore, the aim of this study was to examine the level of understanding of inflammatory arthritis patients and the need for strong patient-partnership in research. Methods: An online anonymous survey was distributed to patients living with inflammatory arthritis which addressed questions about diagnosis, routine tests, medications and how they work, medication adherence, disease flare, heredity, pregnancy, and patient involvement in research. Results: There were 1,873 respondents, 1416 of which had inflammatory arthritis (IA)- rheumatoid arthritis (RA) (65.8%) and psoriatic arthritis (PsA) (34.2%). They were predominantly female (RA 86%, PsA 85 %), aged 55±13 and 50±12 years. Less than 35% of patients had an understanding of diagnostic tests, what was measured and the implication for disease, with 75.5% also concerned about heredity. There was a high level of understanding of how specific medications treat inflammatory arthritis (72.9%). Adherence was also very high (>87%), with the main reasons for stopping medication without the advice of their clinician, ‘feeling better’ and ‘side effects’ however a significant proportion of patients (69.9%) reported a disease-flare following cessation of medication. Patients (31%) were also concerned that inflammatory arthritis reduced their chances of getting pregnant, with only 8% believing arthritis medications were safe to take during pregnancy. Finally, only 9% of patients had ever been asked to participate in a research study. Conclusions: This study demonstrates a need for the development of stronger patient-partnerships with clinicians and researchers in relation to patient education and engagement with research, to create a platform where patients can have meaningful input and involvement in future research studies.
46
Szkiladz, Andrew, Katherine Carey, Kimberly Ackerbauer, Mark Heelon, Jennifer Friderici, and Kathleen Kopcza. "Impact of Pharmacy Student and Resident-Led Discharge Counseling on Heart Failure Patients." Journal of Pharmacy Practice 26, no. 6 (June 24, 2013): 574–79. http://dx.doi.org/10.1177/0897190013491768.
Анотація:
Purpose: Many health systems have implemented interventions to reduce the rate of heart failure readmissions. Pharmacists have the training and expertise to provide effective medication-related education. However, few studies have examined the impact of discharge education provided by pharmacy students and residents on patients hospitalized with heart failure exacerbations. Methods: This was a nonrandomized intervention study evaluating the impact of a pharmacy student and resident-led discharge counseling program on heart failure readmissions. The primary end point was the 30-day heart failure readmission rate. Secondary end points included self-reported patient understanding of medications, number of medication errors documented, and estimated associated cost avoidance. Results: A total of 86 and 94 patients were enrolled into the intervention and control groups, respectively. No statistically significant difference in readmission rates was detected between the intervention and the control groups. Thirty-four medication errors and discrepancies were documented, or 1 for every 2.5 patients counseled, resulting in an estimated cost avoidance of $4241 for the institution. Eighty-nine percent of patients who received discharge counseling agreed they had a better understanding of their medications after speaking with a pharmacy resident or student. Conclusions: There was no statistically significant difference in readmission rates; however, several medication errors were prevented, and a large percentage of patients expressed an improved understanding of their medications.
47
Richler, Matthew J., Sara Yousaf, Stephen W. Hwang, and Norman F. Dewhurst. "Descriptive study of homeless patients’ perceptions that affect medication adherence." American Journal of Health-System Pharmacy 76, no. 17 (August 16, 2019): 1288–95. http://dx.doi.org/10.1093/ajhp/zxz139.
Анотація:
Abstract Purpose Results of a study to elucidate perceptions, attitudes, and beliefs about prescribed medications held by hospitalized patients who are homeless are reported. Methods A qualitative descriptive study involving semistructured interviews was conducted to gather information and characterize hospitalized homeless patients’ views and attitudes regarding medication use, with a focus on medication nonadherence. Medication nonadherence has been shown to be a factor contributing to higher rates of emergency department visits, increased hospital lengths of stay, and increased healthcare costs in homeless populations. Interviews were conducted during patients’ admissions to the internal medicine service of a tertiary care, inner-city hospital. Interviews were audio-recorded and transcribed. Data were analyzed using conventional qualitative content analysis to generate data-driven codes and themes. Results Twelve interviews were conducted (median patient age, 48.5 years). Eight patients (66.7%) were living in a shelter, and 11 (91.7%) had a mental illness. Patients were prescribed a median of 4 medications at the time of hospital admission. Four themes were identified: (1) a new appreciation of medications was acquired during hospitalization, (2) medications were perceived as necessary for maintaining health, (3) there was an interest in receiving medication education, and (4) concerns were expressed regarding medication adverse effects. Conclusion In interviews conducted during hospital admission, homeless patients expressed positive perceptions about the necessity of their medications but also concerns about medication adverse effects. Interventions to improve adherence may be successful if directed toward addressing treatment-related concerns.
48
Rovell, Kristine M., Jennifer B. Bradle, and Kimberly Kruesi. "Implementation of Targeted Medication Education for Improved Patient Satisfaction." Journal of Obstetric, Gynecologic & Neonatal Nursing 41 (June 2012): S156—S157. http://dx.doi.org/10.1111/j.1552-6909.2012.01362_54.x.
49
Esmaeili, Reza, Mohammad Matlabi, Abduljavad Khajavi, Ehsan Aliasghari, and Moosa Sajjadi. "Factors Affecting Adherence to Antihypertensive Medication: Results from a Rural Population Study in East of Iran." Global Journal of Health Science 9, no. 5 (October 27, 2016): 286. http://dx.doi.org/10.5539/gjhs.v9n5p286.
Анотація:
<p><strong>INTRODUCTION: </strong>Medication therapy is one of the most important interventions for the control of hypertension and its complications, but patient nonadherence to prescribed antihypertensive medication is a challenge. This study was conducted to measure medication adherence and examine its determinants in patients with hypertension in a rural population of Iran.</p><p><strong>METHODS: </strong>This cross-sectional study was conducted on 422 patients with hypertension covered by the healthcare network of Bajestan, Razavi Khorasan Province, Iran. Medication adherence was measured by using the Persian version of the 8 items Morisky Medication Adherence Scale (MMAS-8). The Chi-square test and Spearman’s correlation coefficient were used to examine the relationship between the determinants of medication adherence in SPSS.</p><p><strong>RESULTS: </strong>The mean age of the patients was 65.02±8.88 years. Of the total of 422 patients, 299 (70.9%) were female. Based on the MMAS-8, medication adherence was high in 39.6% of the patients, moderate in 10.9% and low in 49.5%. The variables that correlated significantly with the level of medication adherence included age (P=0.032), education (P=0.022), income (P=0.001), the satisfaction of patients-physician communication (P=0.006), physician based education (P= 0.003), occupation, time interval of physician’s consultation (P=0.001), medication regime complexity (P=0.001), medications meals frequency (P=0.001), side effects (P=0.081) duration of the disease (P=0.015), comorbidities (P=0.001), smoking (P=0.047), patient’s ability to read medication instruction (P=0.011), the patient’s beliefs about the effectiveness of medications (P=0.001) and the patient’s beliefs about the effectiveness of health system (P=0.001). The variables of gender (P=0.147), marital status (P=0.054), and distance problems to the health center (P=0.181) were not significantly correlated with the level of medication adherence.</p><p><strong>CONCLUSION:</strong> The results of the present study revealed a low medication adherence in half of the patients with hypertension due to various personal and socioeconomic determinants as well as factors associated with the health system, therapy-related factors, disease-related factors and patient-related factors. Purposeful interventions therefore appear essential to improving medication adherence in rural populations with a focus on the effect of each determinant of medication adherence.</p>
50
Lin, Mingqian, Douglas W. Hackenyos, Susan K. Parsons, Angie Mae Rodday, Rachel Murphy-Banks, Ruth Ann Weidner, and Nicole Savidge. "Pilot study to assess a pharmacist- and medication navigator-led intervention of oral anticancer medication (OAM) adherence." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 58. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.58.
Анотація:
58 Background: While advances in OAM make treatment more convenient for patients, OAM must be taken and handled correctly. Studies show gaps in patients’ knowledge of taking/handling OAM, suboptimal adherence, and worse outcomes. A prior study at our institution showed low patient understanding of OAM taking (30%) and handling (15%). Other pharmacist (RPh)- or nurse-led interventions have included patient education, short-term follow-up, and reminder tools. No studies have examined multisession interventions co-led by an RPh and medication navigator (MN). This ongoing pilot study assesses the feasibility of such an intervention, its impact on patients’ understanding and adherence, and patient acceptability. Methods: Patients at our institution met with an RPh and MN for an education and teach-back session at OAM initiation (T1). Patients were given a Drug Information Sheet and Medication Calendar as educational tools. Patients were then invited to enroll in a multisession intervention, including an RPh-led re-education at the first refill (T3) and MN-led boosters (T2, T4). At each session, teach-back responses were recorded and participants completed study measures and evaluations. Preliminary results on T1 and T2 are presented. Results: To date, 37 (95%) patients enrolled at T1 and 33 completed the MN-led booster a week later (T2). At T1 and T2, 85% of participants demonstrated sufficient understanding of OAM taking and handling. However, despite high levels of self-reported adherence, 48% lacked knowledge about when or where to get a refill. At T1 (32%) and T2 (60%), of patients raised issues that were not previously shared with their clinical team. Patients were highly satisfied with the intervention and found the education session, booster, and educational tools useful. Conclusions: While data collection is ongoing, preliminary results suggest this intervention is feasible, enhances patient understanding and adherence to their medications, and is acceptable to patients undergoing OAM treatment. Integration of RPh and MN into oncology teams can enhance care delivery and provide timely assistance for OAM-related issues, providing insight into future models of care.