Medication discrepancies in hospitalized cancer patients: Do we need medication reconciliation?

2020 ◽  
pp. 107815522094638
Author(s):  
Maram Abu Moghli ◽  
Rana Abu Farha ◽  
Khawla Abu Hammour
Keyword(s):  
Cancer Patients ◽  
Critically Ill ◽  
Medical Records ◽  
Medication Reconciliation ◽  
Treatment Plan ◽  
Common Type ◽  
University Hospital ◽  
High Rate ◽  
Convenience Sample ◽  
Medication Discrepancies

Objective This study aimed to identify and point out the number and types of medication discrepancies among cancer patients admitted to Jordan University Hospital. Method This is a cross-sectional observational study that was conducted on cancer patients in the internal medicine department at Jordan University Hospital, Amman, Jordan. During a period of six months, a convenience sample of cancer patients was recruited, and their medical records were reviewed to collect information regarding their demographics, clinical, and medication information. Also, patients’ Best Possible Medication History (BPMH) was collected using different methods, and a comparison between patients’ BPMH and their current medications was conducted where discrepancies were recognized. Results Seventy-eight medical records were reviewed, with a total of 166 discrepancies identified. Of these, 110 discrepancies (66.3%) were unintentional. Exactly 67.9% of the study participants ( n = 53) were found to have at least one unintentional discrepancy, with the most common type being omissions ( n = 71, 65.1%,) and the second most common type being additions ( n = 16, 14.7%). Most of the discrepancies ranged between low to moderate in severity. Fifty-six (33.7%) intentional undocumented discrepancies (documentation errors) were also identified. Conclusion This study revealed a high rate of medication discrepancies among hospitalized cancer patients, most commonly unintentional omissions. Nevertheless, undocumented intentional discrepancies can equally harm this critically ill population. So, do we need medication reconciliation in cancer patients? Yes. Cancer patients are critically ill, and therefore more effort should be paid towards implementing medication reconciliation services in their treatment plan.

scholarly journals Evaluation of bedbath in critically ill patients: impact of water temperature on the pulse oximetry variation

2010 ◽  
Vol 44 (4) ◽  
pp. 1039-1045 ◽  
Author(s):  
Aretha Pereira de Oliveira ◽  
Dalmo Valério Machado de Lima
Keyword(s):  
Water Temperature ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Age Groups ◽  
University Hospital ◽  
Convenience Sample ◽  
Level Ii ◽  
Before And After ◽  
Quasi Experimental ◽  
Water Temperature Data

This is a participant study, quasi-experimental, of a before and after type. A quantitative approach of biophysiological measures was used, represented by the saturation of oxygen measured by pulse oximeter (SpO2), and recorded on three occasions: before, during and after the bedbath in critically ill patients hospitalized at the ICU of a University Hospital in Brazil. Objective: to compare the SpO2 in various stages of the bath, with and without control of water temperature. Data collection was performed between December 2007 and April 2008 on a convenience sample consisting of 30 patients aged over 18 who had classification in TISS-28 from level II. Results show that water temperature control means a lower variation of SpO2 (p<0.05). No marked differences in variation of saturation between men and women or between age groups were established. In conclusion, heated and constant water temperature during the bedbath is able to minimize the fall of SpO2 that occurs while handling patients during procedures.

scholarly journals Low adherence to pneumococcal vaccination in lung cancer patients in a tertiary care university hospital in Southern Germany

2021 ◽  
Author(s):  
Arno Mohr ◽  
Mia Kloos ◽  
Christian Schulz ◽  
Michael Pfeifer ◽  
Bernd Salzberger ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Medical Records ◽  
Hepatitis A ◽  
Tertiary Care ◽  
Pneumococcal Vaccination ◽  
University Hospital ◽  
Lung Cancer Patients ◽  
Tick Borne Encephalitis ◽  
The University

Abstract IntroductionThe aim of this study was to investigate the adherence to vaccinations, especially pneumococcal vaccinations, in lung cancer patients.MethodsThe study was performed at the University Hospital Regensburg, Germany. All patients with a regular appointment scheduled between December 1, 2020, and April 29, 2021, and who provided informed consent were included. Available medical records, vaccination certificates and a questionnaire were analyzed.Results136 lung cancer patients (NSCLC n = 113, 83.1%, SCLC n = 23, 16.9%) were included. A correct pneumococcal vaccination according to national recommendations was performed in 9.4% (12/127) of patients.A correct vaccination was performed for tetanus in 50.4% (6/131), diphtheria in 34.4% (44/128), poliomyelitis in 25.8% (33/128), tick-borne encephalitis in 40.7% (24/59), hepatitis A in 45.5% (7/11), hepatitis B in 38.5% (5/13), shingles in 3.0% (3/101), measles in 50.0% (3/6), pertussis in 47.7% (62/130), influenza in 54.4% (74/136) and meningococcal meningitis in 0% (0/2).ConclusionAdherence to pneumococcal vaccinations, as well as other vaccinations, is rather low in lung cancer patients.

Abstract TP209: Effect of Chemotherapy on Stroke Risk in Cancer Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Takaya Kitano ◽  
Tsutomu Sasaki ◽  
Yasufumi Gon ◽  
Kenichi Todo ◽  
Shuhei Okazaki ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Propensity Scores ◽  
Stroke Risk ◽  
Cox Regression ◽  
Treatment Plan ◽  
University Hospital ◽  
Chemotherapy Group ◽  
Kaplan Meier ◽  
Increased Risk ◽  
The Impact

Introduction: Chemotherapy may be a cause of cancer-associated stroke, but whether it increases stroke risk remains uncertain. We aimed to clarify the impact of chemotherapy on stroke risk in cancer patients. Methods: We investigated 27,932 patients enrolled in a hospital-based cancer registry at Osaka University Hospital between 2007 and 2015. The registry collects clinical data, including cancer status (site and stage), on all patients treated for cancer. Of them, 19,006 patients with complete data were included. A validated algorithm was used to identify stroke events within 2 years of cancer diagnosis. Patients were divided based on whether their initial treatment plan included chemotherapy. The association between chemotherapy and stroke was analyzed using the Kaplan-Meier method and stratified Cox regression. Results: Of the 19,006 patients, 5,887 (31%) patients were in the chemotherapy group. Non-targeted chemotherapy was used in 5,371 patients. Stroke occurred in 44 patients (0.75%) in the chemotherapy group and 51 patients (0.39%) in the no-chemotherapy group. Kaplan-Meier curve analysis showed that patients in the chemotherapy group had a higher stroke risk than patients in the no-chemotherapy group (HR 1.84; 95% CI 1.23-2.75; Figure [A]). However, this difference was insignificant after adjustment for cancer status using inverse probability of treatment weighting with propensity scores (HR 1.20; 95% CI 0.76-1.91; Figure [B]). Similarly, in the stratified Cox regression model, chemotherapy was not associated with stroke after adjustment for cancer status (HR 1.26; 95% CI 0.78-2.03). These findings were consistent with analysis wherein the effect of chemotherapy was treated as a time-dependent covariate (HR 1.02; 95% CI 0.55-1.88). Conclusions: In this population, the elevated stroke risk in cancer patients who received chemotherapy was presumably due to advanced cancer stage; chemotherapy was not associated with the increased risk of stroke.

scholarly journals Physical therapy in infants and preschool children with burns: retrospective descriptive study

2020 ◽  
pp. 1-7
Author(s):  
Mikelini Ayumi Takino ◽  
Edna Yukimi Itakussu ◽  
Celita Salmaso Trelha ◽  
Paola Janeiro Valenciano ◽  
Dirce Shizuko Fujisawa
Keyword(s):  
Physical Therapy ◽  
Medical Records ◽  
Pediatric Patients ◽  
Descriptive Study ◽  
University Hospital ◽  
Burn Treatment ◽  
Convenience Sample ◽  
Traumatic Injuries ◽  
Breathing Techniques ◽  
Therapy Sessions

Introduction: Burns are traumatic injuries that occur due to external events, and particularities of pediatric patients make it more serious condition. Physical therapy is essential to the recovery of children victims of burns and it should be started early during hospitalization. Objective: Define initial and final physical therapy care in children victims of burns, during the period of hospitalization, in a Burn Treatment Centers (BTC). Methods: Retrospective and descriptive study by means of gathering information in medical records of children victims of burns, convenience sample, consisted of patients in the 0-6 age group, that were interned in BTC of University Hospital/ UEL, from January 2011 to February 2014. Results: Data from 102 medical records were collected, physical therapy was realized in 94 (92.1%) cases, being respiratory physical therapy, placements, motor physical therapy, orthosis indication and orientation. In the first, second, last but one and last sessions, the most used breathing techniques were clearence maneuvers; the general placements was the most used; during motor physical therapy, the gait /walking and orientation were used with more frequency in last assistance. Conclusion: The initial physical therapy emphasizes the clearence maneuvers for prevention and treatment of respiratory complications that threaten the survival of the patient. The activities focused on functionality were adressed throughout the hospital stay, especially in the final stage. The physical therapy sessions progressed from passive techniques to active, according to the evolution of patients

scholarly journals Reconciliation of medications upon the admission of patients to the cardiology sector of a university hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 0353
Author(s):  
Lorena S. Miranda ◽  
Ana L. Cavalcante ◽  
Rafael M. Pinheiro ◽  
Dayani Galato ◽  
Emília V. Silva
Keyword(s):  
Medical Records ◽  
Medication Reconciliation ◽  
Adverse Reactions ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Medical Prescription ◽  
Cross Sectional ◽  
Cardiology Department ◽  
The University

Introduction: The reconciliation of medications is an important process that impacts on patient safety during the level of care transition, a moment with high discrepancy rates that can lead to adverse reactions. Objective: To analyze the results of medication reconciliation in order to identify discrepancies between the medical prescription and the medications previously used by the patient. Method: A descriptive, cross-sectional study was conducted between May and November 2017 (until the second fortnight of the month), with patients admitted to the cardiology department of the University Hospital of Brasília. Data was collected through interviews with patients, relatives and/or caregivers, and through consultation of the medical records. The reconciliation of medications was performed daily, from Monday to Friday, within 48 hours of the patient’s admission to the unit, through a medication reconciliation form prepared by the author. Results: 90 patients were included in the study and a total of 297 discrepancies were found, 267 (90%) being intentional and 30 (10%), unintentional. Among the unintentional discrepancies, the most frequent was omission of medication in use by the patient (56%). Of the intentional discrepancies, the dosage modifications were more common in 45% of the cases. Conclusion: The reconciliation of medications was a crucial clinical service for the identification and resolution of unintentional discrepancies between previously used medications and hospital medical prescription.

scholarly journals Oral anti-tuberculosis drugs: An urgent medication reconciliation at hospitals in Indonesia

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Fauna Herawati ◽  
Eka Yuliantini Fahmi ◽  
Noer Aulia Pratiwi ◽  
Dewi Ramdani ◽  
Abdul Kadir Jaelani ◽  
...  
Keyword(s):  
Medical Records ◽  
Medication Reconciliation ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medication Discrepancies ◽  
Tuberculosis Patients ◽  
Medical Histories ◽  
Tuberculosis Therapy ◽  
Tertiary Care Hospitals

Background: Four oral anti-tuberculosis drugs are conceived to be the most effective ones to eradicate Mycobacterium tuberculosis bacteria and to obviate the resistant organisms. However, the patients' adherence and medication discrepancies are obstacles to achieving the goal. This study aimed to define the anti-tuberculosis drugs used in the hospitals and to detect the discrepancies in the continuity of the tuberculosis treatment.Design and Methods: This retrospective cross-sectional study was based on medical records of adult patients, and was conducted in two district tertiary care hospitals. Only 35 out of 136 patient records from Hospital A and 33 out of 85 records from Hospital B met the inclusion criteria.Results: The most common systemic anti-infective drugs in the study were ceftriaxone (51.80 DDD/100 patient-days) used in Hospital A and isoniazid (59.53 DDD/100 patient-days) used in Hospital B. The number of rifampicin prescriptions was less than that of isoniazid. Each patient received an average of two DDD/100 patient-days, which is an under dosage for an effective treatment.Conclusion: This study showed a medication discrepancy of Tuberculosis therapy. Tuberculosis patients’ medical histories are not under the full attention of treating physicians wherever they are admitted. Thus, medication reconciliation is needed to accomplish the goal of a Tuberculosis-free world in 2050.

The Effect of Chemotherapy on Stroke Risk in Cancer Patients

2020 ◽  
Vol 120 (04) ◽  
pp. 714-723
Author(s):  
Takaya Kitano ◽  
Tsutomu Sasaki ◽  
Yasufumi Gon ◽  
Kenichi Todo ◽  
Shuhei Okazaki ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Propensity Scores ◽  
Stroke Risk ◽  
Cox Regression ◽  
Treatment Plan ◽  
University Hospital ◽  
Chemotherapy Group ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Advanced Cancer Stage

Abstract Background Chemotherapy may be a cause of cancer-associated stroke, but whether it increases stroke risk remains uncertain. We investigated how chemotherapy affects stroke risk in cancer patients. Methods Of 27,932 patients in a hospital-based cancer registry (which contains clinical data on all patients treated for cancer at Osaka University Hospital) screened between 2007 and 2015, medical records of 19,006 patients with complete data were investigated. A validated algorithm was used to identify stroke events within 2 years of cancer diagnosis. Patients were divided based on whether their initial treatment plan included chemotherapy. The association between chemotherapy and stroke was analyzed using the Kaplan–Meier method and stratified Cox regression. Results Of 19,006 patients, 5,887 (31%) were in the chemotherapy group. Stroke occurred in 44 (0.75%) and 51 (0.39%) patients in the chemotherapy and nonchemotherapy group, respectively. Kaplan–Meier curve analysis showed that patients in the chemotherapy group had a higher stroke risk than those in the nonchemotherapy group (hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.23–2.75). However, this difference was insignificant after adjustment for cancer status using inverse probability of treatment weighting with propensity scores (HR 1.20; 95% CI 0.76–1.91). Similarly, in the stratified Cox regression model, chemotherapy was not associated with stroke after adjustment for cancer status (HR 1.26; 95% CI 0.78–2.03). Conclusion In our study, the elevated stroke risk in cancer patients who received chemotherapy was presumably due to advanced cancer stage; chemotherapy was not associated with the increased risk of stroke.

scholarly journals Importance of medication reconciliation in cancer patients

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ali Elbeddini ◽  
Anthony To ◽  
Yasamin Tayefehchamani ◽  
Cindy Xin Wen
Keyword(s):  
Drug Interactions ◽  
Cancer Patients ◽  
Patient Population ◽  
Medication Reconciliation ◽  
Hepatic Function ◽  
Clinical Impact ◽  
Medication History ◽  
Medication Discrepancies ◽  
Future Studies ◽  
Inappropriate Medications

AbstractCancer patients are a complex and vulnerable population whose medication history is often extensive. Medication reconciliations in this population are especially essential, since medication discrepancies can lead to dire outcomes. This commentary aims to describe the significance of conducting medication reconciliations in this often-forgotten patient population. We discuss additional clinical interventions that can arise during this process as well. Medication reconciliations provide the opportunity to identify and prevent drug–drug and herb–drug interactions. They also provide an opportunity to appropriately adjust chemotherapy dosing according to renal and hepatic function. Finally, reconciling medications can also provide an opportunity to identify and deprescribe inappropriate medications. While clinical impact appears evident in this landscape, evidence of economic impact is lacking. As more cancer patients are prescribed a combination of oral chemotherapies, intravenous chemotherapies and non-anticancer medications, future studies should evaluate the advantages of conducting medication reconciliations in these patient populations across multiple care settings.

Outcomes of Critically Ill Cancer Patients in a University Hospital Setting

1999 ◽  
Vol 160 (6) ◽  
pp. 1957-1961 ◽  
Author(s):  
JOHN P. KRESS ◽  
JEFFREY CHRISTENSON ◽  
ANNE S. POHLMAN ◽  
DARREN R. LINKIN ◽  
JESSE B. HALL
Keyword(s):  
Cancer Patients ◽  
Critically Ill ◽  
Hospital Setting ◽  
University Hospital

scholarly journals Pharmacy student-assisted medication reconciliation: Number and types of medication discrepancies identified by pharmacy students

2021 ◽  
Vol 19 (3) ◽  
pp. 2471
Author(s):  
Louise Deep ◽  
Carl R. Schneider ◽  
Rebekah Moles ◽  
Asad E. Patanwala ◽  
Linda L. Do ◽  
...  
Keyword(s):  
Patient Safety ◽  
Medication Reconciliation ◽  
Alimentary Tract ◽  
Common Type ◽  
Pharmacy Students ◽  
Transitions Of Care ◽  
Patient Harm ◽  
Medication Discrepancies ◽  
Retrospective Audit ◽  
Hospital Inpatients

Background: Medication reconciliation aims to prevent unintentional medication discrepancies that can result in patient harm at transitions of care. Pharmacist-led medication reconciliation has clear benefits, however workforce limitations can be a barrier to providing this service. Pharmacy students are a potential workforce solution. Objective: To evaluate the number and type of medication discrepancies identified by pharmacy students. Methods: Fourth year pharmacy students completed best possible medication histories and identified discrepancies with prescribed medications for patients admitted to hospital. A retrospective audit was conducted to determine the number and type of medication discrepancies identified by pharmacy students, types of patients and medicines involved in discrepancies. Results: There were 294 patients included in the study. Overall, 72% (n=212/294) had medication discrepancies, the most common type being drug omission. A total of 645 discrepancies were identified, which was a median of three per patient. Patients with discrepancies were older than patients without discrepancies with a median (IQR) age of 74 (65-84) vs 68 (53-77) years (p=0.001). They also took more medicines with a median (IQR) number of 9 (6-3) vs 7 (2-10) medicines per patient (p<0.001). The most common types of medicines involved were those related to the alimentary tract and cardiovascular system. Conclusions: Pharmacy students identified medication discrepancies in over 70% of hospital inpatients, categorised primarily as drug omission. Pharmacy students can provide a beneficial service to the hospital and contribute to improved patient safety by assisting pharmacists with medication reconciliation.

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