scholarly journals Identification and solution of drug-related problems in the neurology unit of a tertiary hospital in China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Pengpeng Liu ◽  
Guangyao Li ◽  
Mei Han ◽  
Chao Zhang
Keyword(s):  
Tertiary Care ◽  
Patient Treatment ◽  
Major Type ◽  
Drug Related Problems ◽  
Dose Selection ◽  
Nasogastric Feeding ◽  
Factors Associated ◽  
Clinical Pharmacists ◽  
Medication Therapy ◽  
Medication Error Reporting

Abstract Background The prevalence and characteristics of drug-related problems (DRPs) and factors associated with the occurrence of DRPs in the neurology unit in China remain unknown. This study aimed to determine the prevalence, characteristics and severity ratings of DRPs and identify factors associated with the occurrence of DRPs in the neurology unit of a tertiary care and academic teaching hospital in China. Methods A retrospective study of DRPs and pharmacists’ interventions for neurology patients was performed during a non-consecutive 24-month study period. Patient demographics and clinical characteristics, and pharmacist’s intervention records were collected. The characteristics and severity ratings of DRPs were categorized using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.00 and the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification respectively. Results A total of 242 DRPs were detected for 974 admitted patients, an average of 0.25 DRPs per patient. Treatment safety was the major type of DRPs (106;43.8%) followed by treatment effectiveness (78;32.2%). The primary causes of DRPs were drug selection (124;44.1%) and dose selection (92;32.7%). Clinical pharmacists provided 525 interventions, and most interventions occurred at the prescriber level (241;45.9%). A total of 91.4% of these interventions were accepted, contributing to solving 93.0% of the identified problems. The majority of DRPs (210;86.8%) were rated at severity categories B to D (causing no patient harm). Multiple logistic regression showed that creatinine clearance, number of medications used, nasogastric feeding, diabetes, and infectious diseases were associated with more frequent DRPs (p < 0.05). Conclusions DRPs are relatively common in the neurology unit in China, with primary causes of drug and dose selection, and clinical pharmacists can effectively reduce and prevent DRPs to optimize medication therapy.

scholarly journals Identification and resolution of drug-related problems in a tertiary hospital respiratory unit in China

2019 ◽  
Vol 41 (6) ◽  
pp. 1570-1577
Author(s):  
Yulin Zhu ◽  
Cheng Liu ◽  
Yong Zhang ◽  
Qingping Shi ◽  
Yiqiu Kong ◽  
...  
Keyword(s):  
Treatment Effectiveness ◽  
Mainland China ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Patient Treatment ◽  
Major Type ◽  
Respiratory Care ◽  
Drug Related Problems ◽  
Patient Counseling ◽  
Treatment Safety

Abstract Background The prevalence of drug-related problems in patients hospitalized at respiratory care units is unknown in mainland China. Objective To identify and categorize drug-related problems in a respiratory care unit in China. Setting Respiratory care unit in a tertiary university hospital in China. Methods Clinical pharmacy services were introduced and documented during an 18-months study period. The problems were categorized using the Pharmaceutical Care Network Europe DRP classification tool V8.02. Main outcome measures Problems and causes of drug-related problems, interventions proposed, and outcome of pharmacy recommendations. Results A total of 474 patients were reviewed, 164 patients had DRPs (34.6%). Total 410 problems were identified, an average of 2.5 per patient. Treatment effectiveness was the major type of problem detected (219; 53.4%) followed by treatment safety (140; 34.1%). The most common causes of the problems were patient-related (25.8%), drug selection (24.0%), and drug use process (23.4%). Pharmacist made 773 interventions; average 1.9 per drug-related problem. A total of 96.2% of these interventions were accepted leading to solving 81.9% of the identified problems. Conclusion There is a high prevalence of drug-related problems in patients hospitalized at the respiratory unit of this clinic. Clinical pharmacists should focus on improving prescribing practice and patient counseling.

scholarly journals Drug-Related Problems and Pharmacist Interventions in Inpatients with Chronic Kidney Disease

2020 ◽  
Vol 11 (1) ◽  
pp. 960-966
Author(s):  
Savitha R S ◽  
Madhan Ramesh ◽  
Manjunath S Shetty ◽  
Kiran K K
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Poor Quality ◽  
Patient Treatment ◽  
Healthcare Team ◽  
Positive Contribution ◽  
Care Hospital ◽  
Drug Related Problems ◽  
Pharmacist Interventions

Studies report poor quality and break in the care of chronic kidney disease (CKD) patients due to complex pharmacotherapy, frequent dose changes and adherence issues. The addition of clinical pharmacists on the healthcare team will enable improved quality of care. The aim of the study is to characterize drug-related problems (DRPs) among CKD patients and intervene to improve patient outcomes. This prospective, interventional study was carried out in the admitted inpatients of a tertiary care hospital during the period October 2018 to May 2019. Patients admitted to inpatient wards of nephrology, medicine, surgery and orthopedics who was diagnosed with chronic kidney disease of any stage and etiology and who gave consent to participate were included in the study. Patients diagnosed with cancer and/or receiving chemotherapy, significant liver disease, as evidenced by Child-Pugh grades B and C, and those with substance abuse disorders were excluded from the study. A clinical pharmacist reviewed the patient treatment chart to identify drug-related problems and communicated appropriate suggestions or recommendations to the nephrologist or attending physician. Identified DRPs were categorized according to 'The Pharmaceutical Care Network Europe Foundation (PCNE) classification V 6.2. All DRPs and pharmacist interventions were documented appropriately. Among 833 patients included in the study, a total of 250 DRPs were identified from 245 patients. DRPs occurred at a rate of 1.02 per patient in the study population. The most common DRPs were adverse drug reactions (P2.1) (40.4%), followed by the effect of treatment not optimal (P1.2) (28%). The most common drug classes involved were antibiotics, tramadol, insulin, and oral antidiabetic drugs. Dose change and the new drug started were the most common interventions made. Pharmacists can make positive contribution in caring for patients with CKD.

scholarly journals Drug-Related Problems among Hospitalized Surgical Elderly Patients in China

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Long Meng ◽  
Can Qu ◽  
Xia Qin ◽  
Huali Huang ◽  
Yongsheng Hu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Drug Related Problems ◽  
Dose Selection ◽  
Medication Error Reporting ◽  
Hospitalized Elderly ◽  
Tertiary Teaching ◽  
Actual Harm ◽  
Vulnerable Patient ◽  
Tertiary Teaching Hospital ◽  
Treatment Safety

There is a lack of data on drug-related problems (DRPs) among elderly patients from surgical departments. The current study is aimed at identifying and categorizing types of DRPs and assessing the severities of the DRPs. Medication orders for hospitalized patients aged ≥65 years from six surgery departments were reviewed to determine DRPs over 6 months in a tertiary teaching hospital of Chongqing, China. DRPs were classified based on the Pharmaceutical Care Network Europe classification V8.02. The severity ratings of the DRPs were assessed using the National Coordinating Council for Medication Error Reporting and Prevention classification. A total of 53,231 medication orders from 1,707 elderly patients were reviewed, and 1,061 DRPs were identified. Treatment safety (44.9%) was the most common DRP type. Drug selection (43.1%) and dose selection (43.1%) were the major causes of DRPs. A total of 75.1% of the DRPs were classified into severity categories B to D (causing no or potential harm), and 24.9% were classified as categories E to H (causing actual harm). DRPs are common in hospitalized elderly surgical patients. Pharmacists should provide medication order reviews in this vulnerable patient population.

scholarly journals ASSESSMENT OF DRUG RELATED PROBLEMS IN PATIENTS WITH CHRONIC DISEASES IN THE GENERAL MEDICINE UNITS OF A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 9 (12) ◽  
pp. 194 ◽  
Author(s):  
Mannu Meria Wincent ◽  
D. Potrilingam ◽  
Anagha V. ◽  
Sajith Chacko Jacob ◽  
Andhuvan G.
Keyword(s):  
Chronic Diseases ◽  
Tertiary Care ◽  
General Medicine ◽  
Care Hospital ◽  
Drug Related Problems ◽  
Dose Selection ◽  
Chi Square ◽  
Medicine Department ◽  
Drug Choice ◽  
Hospital Stays

Objective: Patients with chronic diseases are more prone to develop drug-related problems (DRPs), which can further worsen their quality of life. The aim of this study was to determine factors and medications associated with DRPs in patients with chronic disease.Methods: This prospective interventional study was conducted for a duration of 6 mo in the in-patients of general medicine department of PSG Hospital, Coimbatore. DRPs were identified, assessed and recorded as per pharmaceutical care network Europe (PCNE) V5.01 criteria. Chi-square and correlation test were used to analyze the data for identifying factors associated with DRPs.Results: A total of 137 patients were enrolled for the study, of which 66 patients developed DRPs. The most prevalent DRP was found to be drug choice problem. The major causes of DRPs were found to be drug and dose selection. Antidiabetic drugs were found to be more associated with drug-related problems. The incidence of drug-related problems was high in patients aged between 50 to 59 y. Association between gender, length of hospital stays and polypharmacy with DRPs was found to be statistically significant. 58.33% of the total drug-related problems were completely solved and 19.05% were partially solved.Conclusion: The incidence of DRPs in the General Medicine department of the hospital was high. The use of an appropriate tool such as PCNE may assist pharmacists and other healthcare professionals to systematically identify, categorize and report drug-related problems.

Side Effects of Chemotherapy and Cancer Treatment in Tertiary Care Teaching Hospital

2016 ◽  
Vol 2 (1) ◽  
pp. 62-78
Author(s):  
. Hemraj ◽  
Raj Kumar ◽  
Sourabh Kosey ◽  
Amit Sharma ◽  
Nalini Negi
Keyword(s):  
Side Effects ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Informational Needs ◽  
Cross Sectional ◽  
Clinical Pharmacists ◽  
Medical College ◽  
Related Information ◽  
The Common ◽  
Chemotherapy Patients

To determine the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. This was a single center, observational cross-sectional study conducted at department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. A face to face interview was conducted. Information collected included chemotherapy related side effects after last chemotherapy experience, the most worrisome side effects, overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. In this study, hundred patients were enrolled out of them 48 were male and 52 were female. When differential calculations was done, common side effects or adverse effects of chemotherapy in the patients of breast, lung cancer, Ovarian Cancer, Colon cancer, Prostate cancer, Lymphoma Cancer, Cervix cancer where there is much irregular medicine intake 57.4% may be due to common problem of joint pain reported by all the patients under study, with the consecutive problem of nausea and vomiting. The high prevalence of chemotherapy related side effects among local patients is a major concern and findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists and physicians to help in side effect management. This study shows the common problems reported by the patients when they are suffering from cancer condition, according to their incidence perceptions as experienced by the patient, this will allow the physician and clinical pharmacist to effectively counsel and manage the common symptoms as reported prior to its occurrence in the patient, so that withdrawal can be checked.

Neonatal Outcome of Macrosomia

2020 ◽  
Vol 40 (2) ◽  
pp. 114-119
Author(s):  
Subhash Chandra Shah ◽  
Anusmriti Guragain ◽  
Shreejana Pandey ◽  
Ajaya Kumar Dhakal
Keyword(s):  
Maternal Age ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Pregnancy Induced Hypertension ◽  
Factors Associated ◽  
Adverse Neonatal Outcome ◽  
Induced Hypertension ◽  
Appropriate For Gestational Age ◽  
Prolonged Hospital

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

scholarly journals EVALUATION OF FACTORS ASSOCIATED WITH MORTALITY AMONGST PATIENTS ADMITTED TO A TERTIARY CARE MEDICAL CENTER FOR COVID-19 INFECTION

2021 ◽  
Vol 77 (18) ◽  
pp. 3123
Author(s):  
Anish Samuel ◽  
Ashesha Mechineni ◽  
Robin Craven ◽  
Wilbert Aronow ◽  
Mourad Ismail ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Factors Associated ◽  
Tertiary Care Medical Center

Development of an Emergency Revisit Score for Patients With Drug-Related Problems

2021 ◽  
pp. 875512252110117
Author(s):  
Jesus Ruiz Ramos ◽  
Laura Gras-Martin ◽  
Ana María Juanes Borrego ◽  
Marta Blazquez-Andion ◽  
Mireia Puig Campmany ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Receiver Operating Curve ◽  
Drug Related Problems ◽  
Derivation Cohort ◽  
Factors Associated ◽  
Final Score ◽  
Anticholinergic Burden ◽  
Risk Categories ◽  
Frequent Reason

Background: Drug-related problems (DRPs) are a frequent reason for emergency departments (EDs) visits. However, data about the risk factors associated with EDs revisits are limited. Objective: To develop and validate a predictive model indicating the risk factors associated with EDs revisit within 30 days of the first visit. Methods: A retrospective cohort study was conducted involving patients who attended an ED for DRPs related to cardiovascular drugs. A 30-day prediction model was created in a derivation cohort by logistic regression. An integer score proportional to the regression coefficient was assigned to the variables with P < .100 in the multivariate analysis. Results: 581 patients (mean age: 80.0 [12.6] years) were included, 133 (22.9%) revisited the ED within 30 days from discharge. Six factors (chronic kidney disease, chronic heart failure, visit to an ED in the preceding 3 months, high anticholinergic burden, DRPs associated with heparin, and safety-related DRPs) were identified as risk factors and combined into a final score, termed the DREAMER score. The model reached an area under the receiver operating curve values of 0.72 (95% confidence interval [CI] = 0.67-0.77) in the referral cohort and 0.71 (95% CI = 0.65-0.74) in the validation cohort ( P = .273). Three risk categories were generated, with the following scores and estimated risks: low risk (0-8 points): 11.6%; intermediate risk (9-14 points): 21.3%; and high risk (>14 points): 41.2%. Conclusion and Relevance: The DREAMER score identifies patients at high risk for ED revisit within 30 days from the first visit for a DRPs, being a useful tool to prioritize interventions on discharge.

scholarly journals Sociocultural and health system factors associated with mortality among febrile inpatients in Tanzania: a prospective social biopsy cohort study

2018 ◽  
Vol 3 (1) ◽  
pp. e000507 ◽  
Author(s):  
Michael E Snavely ◽  
Michael J Maze ◽  
Charles Muiruri ◽  
Lilian Ngowi ◽  
Flora Mboya ◽  
...  
Keyword(s):  
Health System ◽  
Community Education ◽  
Conditional Logistic Regression ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Seeking ◽  
Factors Associated ◽  
Northern Tanzania ◽  
System Factors ◽  
At Home

IntroductionCommunicable diseases are the leading causes of death in Tanzania despite the existence of effective treatment tools. We aimed to assess the sociocultural and health system factors associated with mortality from febrile illness in northern Tanzania.MethodsWe interviewed febrile inpatients to determine prevalence of barriers in seeking or receiving care and grouped these barriers using the Three Delays model (delays at home, in transport and at healthcare facilities). We assessed 6-week mortality and, after matching on age, gender and severity of illness, measured the association between delays and mortality using conditional logistic regression.ResultsWe enrolled 475 children, of whom 18 (3.8%) died, and 260 adults, of whom 34 (13.0%) died. For children, home delays were not associated with mortality. Among adults, a delay in care-seeking due to not recognising severe symptoms was associated with mortality (OR: 3.01; 95% CI 1.24 to 7.32). For transport delays, taking >1 hour to reach a facility increased odds of death in children (OR: 3.27; 95% CI 1.11 to 9.66) and adults (OR: 3.03; 95% CI 1.32 to 6.99). For health system delays, each additional facility visited was associated with mortality for children (OR: 1.59; 95% CI 1.06 to 2.38) and adults (OR: 2.00; 95% CI 1.17 to 3.41), as was spending >4 days between the first facility visit and reaching tertiary care (OR: 4.39; 95% CI 1.49 to 12.93).ConclusionOur findings suggest that delays at home, in transport and in accessing tertiary care are risk factors for mortality from febrile illness in northern Tanzania. Interventions that may reduce mortality include community education regarding severe symptoms, expanding transportation infrastructure and streamlining referrals to tertiary care for the sickest patients.

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