The impact of medication reconciliation and review in patients using oral chemotherapy

2022 ◽  
pp. 107815522110669
Author(s):  
Emeline Darcis ◽  
Jana Germeys ◽  
Marnik Stragier ◽  
Pieterjan Cortoos
Keyword(s):  
Medication Review ◽  
Interrater Reliability ◽  
Medication Reconciliation ◽  
Hospital Pharmacist ◽  
Oral Chemotherapy ◽  
Future Research ◽  
Kappa Statistics ◽  
Medication List ◽  
Medication Appropriateness Index ◽  
The Impact

Background and aim Verifying and reviewing a patients medication list can detect and reduce drug related problems (DRPs). However little is known about its effects in patients using oral chemotherapy. The aim of this study was to evaluate the impact of these interventions and the adapted Medication Appropriateness Index (aMAI) as a tool to carry out a medication review. Methods A case-control study was carried out. The hospital pharmacist performed a medication reconciliation and medication review, using the aMAI tool, in 54 patients starting oral chemotherapy. Discrepancies, DRP's and associated pharmaceutical interventions were reported via the electronic patient record (EPR). After one month, the acceptance rate was measured and the aMAI score recalculated. Kappa statistics were used to test intra- and interrater reliability. Results The medication list in the EPR was incomplete in 74,1% of patients with an average of 2.4 errors per patient. After medication review, the aMAI score decreased significantly from 7.2 to 5.4 (SD  =  4,7; p <0.001), indicating an improvement in the appropriateness of the drugs patients were taking. Acceptance rates were 41,4% and 53,2% for advices resulting from medication reconciliation and medication review respectively. Kappa values of 0.90 and 0.70 respectively indicate good intra- and interrater reliability. Discussion and conclusion The study shows that medication reconciliation can identify and address discrepancies. Furthermore, medication review seems to ensure that drug treatment better meets patient needs. The aMAI was a reliable tool. Future research will have to determine the clinical relevance of these interventions.

scholarly journals Engaging hospital patients in the medication reconciliation process using tablet computers

2018 ◽  
Vol 25 (11) ◽  
pp. 1460-1469 ◽  
Author(s):  
Jennifer E Prey ◽  
Fernanda Polubriaginof ◽  
Lisa V Grossman ◽  
Ruth Masterson Creber ◽  
Demetra Tsapepas ◽  
...  
Keyword(s):  
Medication Review ◽  
Medication Safety ◽  
Medication Reconciliation ◽  
Adverse Drug Events ◽  
Medication List ◽  
Medication Discrepancies ◽  
Home Medication ◽  
Verbal Participation ◽  
Hospital Patients ◽  
Home Medication Review

Abstract Objective Unintentional medication discrepancies contribute to preventable adverse drug events in patients. Patient engagement in medication safety beyond verbal participation in medication reconciliation is limited. We conducted a pilot study to determine whether patients’ use of an electronic home medication review tool could improve medication safety during hospitalization. Materials and Methods Patients were randomized to use a toolbefore orafter hospital admission medication reconciliation to review and modify their home medication list. We assessed the quantity, potential severity, and potential harm of patients’ and clinicians’ medication changes. We also surveyed clinicians to assess the tool’s usefulness. Results Of 76 patients approached, 65 (86%) participated. Forty-eight (74%) made changes to their home medication list [before: 29 (81%),after: 19 (66%),p = .170].Before group participants identified 57 changes that clinicians subsequently missed on admission medication reconciliation. Thirty-nine (74%) had a significant or greater potential severity, and 19 (36%) had a greater than 50-50 chance of harm.After group patients identified 68 additional changes to their reconciled medication lists. Fifty-one (75%) had a significant or greater potential severity, and 33 (49%) had a greater than 50-50 chance of harm. Clinicians reported believing that the tool would save time, and patients would supply useful information. Discussion The results demonstrate a high willingness of patients to engage in medication reconciliation, and show that patients were able to identify important medication discrepancies and often changes that clinicians missed. Conclusion Engaging patients in admission medication reconciliation using an electronic home medication review tool may improve medication safety during hospitalization.

scholarly journals Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

2010 ◽  
Vol 1 (1) ◽  
pp. 11
Author(s):  
Sarah M. Westberg ◽  
Kathrine Beeksma
Keyword(s):  
Internal Medicine ◽  
Nursing Staff ◽  
Medication Reconciliation ◽  
Future Research ◽  
Original Research ◽  
Educational Initiative ◽  
Medicine Clinic ◽  
Internal Medicine Clinic ◽  
The Impact ◽  
Competency Assessments

Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic. Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation. Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting. Type: Original Research

scholarly journals 43 Addressing Polypharmacy in the Frail Older Person - the WIDE (Wholistic, Integrated, Deprescribing, Evaluation) Review

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Clare Kinahan ◽  
Nazir Soomro ◽  
Florrie Daniels ◽  
Wafaa Hussain ◽  
Helen Heery
Keyword(s):  
Medication Review ◽  
Hospital Pharmacist ◽  
Intervention Group ◽  
Cost Savings ◽  
Primary Care Providers ◽  
Control Group ◽  
Care Providers ◽  
Start Criteria ◽  
The Impact ◽  
Medication Appropriateness

Abstract Background People are living longer, with more chronic conditions and are prescribed more medications according to disease specific guidelines. The WIDE Review is an innovative model of comprehensive medication review devised to treat the whole patient. Frail patients are twice as likely to be prescribed inappropriate medications and are more vulnerable to their harmful effects. Use of the STOPP/START criteria and the Medication Appropriateness Index (MAI) have been shown to improve patient outcomes. This study examined the impact and cost effectiveness of pharmacist led WIDE Reviews. Methods This quantitative prospective cohort study was conducted over 8 weeks in a Model 3 hospital. Inclusion criteria: inpatients age > 65 years; prescribed > 6 regular medications and screened positive for frailty (PRISMA 7 score >3). Critically ill patients were excluded. Eligible patients were randomly allocated to intervention or control group. The intervention group received a pharmacist led WIDE Review: Wholistic (establishing patients' priorities), Integrated (collaborating with primary care providers), Deprescribing Evaluation of medication harms versus benefits. Medications were screened using the STOPP/START criteria and the MAI was calculated. In conjunction with the patients and their consultants, deprescribing plans were devised and communicated to their GPs and community pharmacists Results A total of 20 intervention and 20 control group patients were enrolled. Patient characteristics (age, sex and length of stay) were similar for both groups. 65% of STOPP and 62% of START criteria were addressed in the intervention group versus 12% and 5% respectively in the control group. In the intervention group 83 medications were stopped, 23 dose reduced and the total MAI score was reduced by 64%. Cost savings to the annual drug budget alone represented a 9:1 return on investment of hospital pharmacist time. Conclusion Pharmacists performing WIDE Reviews significantly improved medication appropriateness and realised compelling cost savings. A larger scale study of this innovative approach to medication review is planned.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

Pengaruh Lintas Budaya Pada Pemasaran Internasional Dengan Pendekatan Perilaku Konsumen

2017 ◽  
Vol 1 (2) ◽  
pp. 168-176
Author(s):  
Endy Gunanto ◽  
Yenni Kurnia Gusti
Keyword(s):  
Consumer Behavior ◽  
Marketing Strategy ◽  
Consumer Culture ◽  
International Organization ◽  
Future Research ◽  
Special Issue ◽  
Cross Culture ◽  
Several Variables ◽  
Cultural Orientations ◽  
The Impact

In this article we present a conceptual of the effect of cross culture on consumer behavior incorporating the impact of globalization. This conceptual idea shows that culture inûuences various domains of consumer behavior directly as well as through international organization to implement marketing strategy. The conceptual identify several factors such as norm and value in the community, several variables and also depicts the impact of other environmental factors and marketing strategy elements on consumer behavior. We also identify categories of consumer culture orientation resulting from globalization. Highlights of each of the several other articles included in this special issue in Asia region. We conclude with the contributions of the articles in terms of the consumer cultural orientations and identify directions for future research.

Aviation and the Microbiome

2020 ◽  
Vol 91 (8) ◽  
pp. 651-661
Author(s):  
Joshua T. Davis ◽  
Hilary A. Uyhelji
Keyword(s):  
Psychological Health ◽  
Aviation Safety ◽  
Autism Spectrum ◽  
Unintended Consequences ◽  
Microbial Colonization ◽  
Future Research ◽  
Aerospace Medicine ◽  
Medical Certification ◽  
Physical Disorders ◽  
The Impact

INTRODUCTION: Although the impact of microorganisms on their hosts has been investigated for decades, recent technological advances have permitted high-throughput studies of the collective microbial genomes colonizing a host or habitat, also known as the microbiome. This literature review presents an overview of microbiome research, with an emphasis on topics that have the potential for future applications to aviation safety. In humans, research is beginning to suggest relationships of the microbiome with physical disorders, including type 1 and type 2 diabetes mellitus, cardiovascular disease, and respiratory disease. The microbiome also has been associated with psychological health, including depression, anxiety, and the social complications that arise in autism spectrum disorders. Pharmaceuticals can alter microbiome diversity, and may lead to unintended consequences both short and long-term. As research strengthens understanding of the connections between the microbiota and human health, several potential applications for aerospace medicine and aviation safety emerge. For example, information derived from tests of the microbiota has potential future relevance for medical certification of pilots, accident investigation, and evaluation of fitness for duty in aerospace operations. Moreover, air travel may impact the microbiome of passengers and crew, including potential impacts on the spread of disease nationally and internationally. Construction, maintenance, and cleaning regimens that consider the potential for microbial colonization in airports and cabin environments may promote the health of travelers. Altogether, the mounting knowledge of microbiome effects on health presents several opportunities for future research into how and whether microbiome-based insights could be used to improve aviation safety.Davis JT, Uyhelji HA. Aviation and the microbiome. Aerosp Med Hum Perform. 2020; 91(8):651–661.

INNOVATIVE ARCHITECTURAL IDEAS OF THE FUTURE DWELLINGS

2020 ◽  
Vol 2 (2) ◽  
pp. 67-75
Author(s):  
Dzhyhil Yu. ◽  
Keyword(s):  
Personal Responsibility ◽  
Traffic Noise ◽  
Modern World ◽  
Future Research ◽  
Housing Design ◽  
Residential Architecture ◽  
Planning Decisions ◽  
National University ◽  
Methodological Principles ◽  
The Impact

Residential architecture has one of the most conservative styles based on its specifics. However, today this type of architecture seeks to actively respond to changes in the modern world. These changes are caused by multiple factors, among them are: technological and information progress; lack of resources and environmental pollution; military conflicts and population migration etc. The purpose of this article is to summarize the experience of the Department of Architectural Environment of Lviv Polytechnic National University over housing issues and outline the methodological principles of innovation in designing both individual houses and the architectural environment of residential formations. While writing this article, we analyzed the 15-year experience of Architectural Environment's Department diploma projects. The unique feature of these projects is the priority on the design of the environment. The evolution of diploma project topics is revealed on multiple distinctive examples such as the reconstruction of old buildings in Lviv and the construction of prefabricated homes and container-type housing. Futuristic settlements are represented in projects such as “The Ocean Settlements” and “Prykarpatsk - the City of Future”. Research projects were developed to study current trends in housing design and the impact of innovative technologies on planning decisions. These projects discoursed the protection of housing from traffic noise and issues related to environmental preservation. Innovative architectural ideas of future housing, developed by students in these projects, are based on a combination of aesthetic, technical, and social components of architecture. The conclusion indicates that when educating future architects, it is important to teach them the basics of the craft, as well as the ability to defend their innovative ideas. The emphasis is placed on the importance of educating the architect's personal responsibility for their own design solutions. It is stated that professional motivation and the ability to constantly renew previously acquired knowledge and skills will be among the main tasks in training future architects.

The Effect of Internal Corporate Social Responsibility on Job Satisfaction: An Empirical Study on Jordanian Pharmaceutical Companies

2020 ◽  
Vol 8 (2) ◽  
pp. 112
Author(s):  
Sura Altheeb ◽  
Kholoud Sudqi Al-Louzi
Keyword(s):  
Job Satisfaction ◽  
Corporate Social Responsibility ◽  
Social Responsibility ◽  
Quantitative Research ◽  
Skills Development ◽  
Future Research ◽  
Pharmaceutical Companies ◽  
Corporate Social ◽  
The Impact ◽  
Positive Results

The current research investigates the impact of internal corporate social responsibility on job satisfaction in Jordanian pharmaceutical companies. Quantitative research design and regression analysis were applied on a total of 302 valid returns that were obtained in a questionnaire based survey from 14 pharmaceutical companies among employees, supervisors and managers. The results showed that internal corporate social responsibility was significantly related to job satisfaction and three of its dimensions, namely working conditions, work life balance and empowerment contributed significantly to job satisfaction, whereas employment stability and skills development had no contribution. This study implies that Jordanian pharmaceutical companies have to try their best to promote and facilitate internal corporate social responsibility among their employees in an effort to improve their job satisfaction, which will eventually yield positive results for the company as a whole. In light of these results, the research presented many recommendations for future research; the most important ones were the application of this study in other sectors, cultures, and countries, and using of multi method for collecting data.

The impact of patient narratives on medical students’ perceptions of shared decision making: A randomized controlled trial

2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Shared Decision Making ◽  
Medical Training ◽  
Controlled Trial ◽  
Future Research ◽  
Shared Decision ◽  
Randomized Controlled ◽  
Information Text ◽  
The Impact

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.

Roundtable Discussion of the Impact of the 4th World Symposium on Pulmonary Hypertension

2009 ◽  
Vol 8 (2) ◽  
pp. 89-94
Author(s):  
Robyn J. Barst ◽  
Marc Humbert ◽  
Ivan M. Robbins ◽  
Lewis J. Rubin ◽  
Robyn J. Park
Keyword(s):  
New York ◽  
Pulmonary Hypertension ◽  
Vascular Diseases ◽  
Assistant Professor ◽  
Associate Professor ◽  
Future Research ◽  
Columbia University ◽  
School Of Medicine ◽  
Maryland School ◽  
The Impact

A discussion among attendees of the 4th World Symposium on Pulmonary Hypertension took place to share “an insider's look” into the current and future research and treatment implications in pulmonary hypertension. Myung H. Park, MD, guest editor of this issue of Advances in Pulmonary Hypertension, Assistant Professor of Medicine and Director, Pulmonary Vascular Diseases Program, Division of Cardiology, University of Maryland School of Medicine, Baltimore, moderated the discussion. Participants included Robyn Barst, MD, Professor Emerita, Columbia University, New York; Marc Humbert, MD, PhD, Universite Paris-Sud, French Referal Center for Pulmonary Hypertension, Hopital Antoine-Beclere, Assistance Publique Hopitaux de Paris, Clamart, France; Ivan Robbins, MD, Associate Professor of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; and Lewis J. Rubin, MD, Clinical Professor, Department of Medicine, University of California, San Diego.

Sign in / Sign up

Export Citation Format

Share Document