scholarly journals Pharmaceutical orientation at hospital discharge of transplant patients: strategy for patient safety

2016 ◽  
Vol 14 (3) ◽  
pp. 359-365 ◽  
Author(s):  
Lívia Falcão Lima ◽  
Bruna Cristina Cardoso Martins ◽  
Francisco Roberto Pereira de Oliveira ◽  
Rafaela Michele de Andrade Cavalcante ◽  
Vanessa Pinto Magalhães ◽  
...  
Keyword(s):  
Patient Safety ◽  
Drug Therapy ◽  
Hospital Discharge ◽  
Clinical Pharmacist ◽  
Multidisciplinary Team ◽  
Drug Related Problems ◽  
Negative Outcomes ◽  
Hospital Discharges ◽  
Cross Sectional ◽  
Transplant Patients

ABSTRACT Objective: To describe and analyze the pharmaceutical orientation given at hospital discharge of transplant patients. Methods: This was a cross-sectional, descriptive and retrospective study that used records of orientation given by the clinical pharmacist in the inpatients unit of the Kidney and Liver Transplant Department, at Hospital Universitário Walter Cantídio, in the city of Fortaleza (CE), Brazil, from January to July, 2014. The following variables recorded at the Clinical Pharmacy Database were analyzed according to their significance and clinical outcomes: pharmaceutical orientation at hospital discharge, drug-related problems and negative outcomes associated with medication, and pharmaceutical interventions performed. Results: The first post-transplant hospital discharge involved the entire multidisciplinary team and the pharmacist was responsible for orienting about drug therapy. The mean hospital discharges/month with pharmaceutical orientation during the study period was 10.6±1.3, totaling 74 orientations. The prescribed drug therapy had a mean of 9.1±2.7 medications per patient. Fifty-nine drug-related problems were identified, in which 67.8% were related to non-prescription of medication needed, resulting in 89.8% of risk of negative outcomes associated with medications due to untreated health problems. The request for inclusion of drugs (66.1%) was the main intervention, and 49.2% of the medications had some action in the digestive tract or metabolism. All interventions were classified as appropriate, and 86.4% of them we able to prevent negative outcomes. Conclusion: Upon discharge of a transplanted patient, the orientation given by the clinical pharmacist together with the multidisciplinary team is important to avoid negative outcomes associated with drug therapy, assuring medication reconciliation and patient safety.

scholarly journals Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

2020 ◽  
Vol 54 (4) ◽  
pp. 218-224
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar
Keyword(s):  
Drug Use ◽  
Clinical Pharmacist ◽  
Medication Review ◽  
Pediatric Patients ◽  
Potential Drug ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Rational Drug Use ◽  
Rational Drug

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

scholarly journals Participants' Opinion about Conduct of Morbidity and Mortality Conferences in Surgical Practice in a Tertiary Hospital, Ethiopia

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Berhanetsehay Teklewold ◽  
Tilahun Deresse ◽  
Goytom Kinfe ◽  
Henok Teshome
Keyword(s):  
Patient Safety ◽  
Multidisciplinary Team ◽  
Addis Ababa ◽  
Univariate Analysis ◽  
Tertiary Hospital ◽  
Morbidity And Mortality ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Morbidity And Mortality Conferences

BACKGROUND: Morbidity and mortality conference has both educational and quality improvement purposes. However clear evidences for the effectiveness of the morbidity and mortality conferences in improving patient safety is lacking.METHODS: A facility based cross sectional study was conducted at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, to assess participants’ opinion on benefits and functioning of morbidity and mortality conferences. Univariate analysis was used to determine the influence of professional type on participants’ opinion about the morbidity and mortality conferences.RESULT: A total of 98 participants completed the survey. The majority of the participants agreed that there was a structured system of case identification (67.3%), meeting format (72.4%), the conferences were conducted every month (79.6%), it is blame free (71.4%) and system of care was focus of discussion (70%). Most (88.8%) participants agreed that the conferences were important for improvement of patient safety and quality of care, whereas 67.3% of the participants believed that there is no written term of reference and prior dissemination of agendas. Only 40% agreed that there is multidisciplinary team involvement. Fifty one percent of them disagreed that there is a follow up on the implementation of the forwarded recommendations.CONCLUSION: Even though the majority of the participants were satisfied with the mortality and morbidity conferences, most disagreed on the presence of written term of reference, earlier dissemination of agendas, multidisciplinary team involvement and follow up on the implementation of the forwarded recommendations.

scholarly journals Polypharmacy and drug-related problems among people living with HIV/AIDS: a single center experience

2019 ◽  
Author(s):  
EMRE KARA ◽  
AHMET ÇAĞKAN İNKAYA ◽  
DUYGU AYDIN HAKLI ◽  
SALİH KUTAY DEMİRKAN ◽  
SERHAT ÜNAL
Keyword(s):  
Clinical Pharmacist ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Face To Face ◽  
Single Center Experience ◽  
Lower Education Level ◽  
Living With Hiv ◽  
Hiv Aids

Background/aim: The HIV-infected population is aging, and the concomitant comorbidities increase the likelihood of polypharmacy. There is a scarcity of data for determining drug-related problems in people living with HIV/AIDS (PLWHA). Materials and methods: This cross-sectional study was carried out between September 1, 2015, and July 1, 2016. All patients underwent a face-to-face interview with a clinical pharmacist. The 'PCNE Classification V 7.0.' was used classify incident drug-related problems (DRPs). Results: The mean age of the patients was 40.4±13.06 years. The rate of polypharmacy was 66.1% in patients with comorbidities and 12.3% in those without comorbidities (p<0.001). DRPs were more prominent in older patients (46 vs. 37 years, p<0.001), with longer duration of antiretroviral therapy (ART) (45 vs. 27 months, p=0.014), and with lower education level (p=0.013). Receiving >3 ART drugs was associated with more DRPs in the logistic regression model (odds ratio: 8.299, 95% confidence interval: 1.924–35.803). Fifty-eight interventions were performed in 45 (24.9%) patients. Clinical pharmacist interventions were performed in 18.9% of patients without polypharmacy and in 38.9% of patients with polypharmacy (p<0.001). Conclusion: DRPs and polypharmacy are common among elderly PLWHA. More interventions are warranted to boost the quality of life in aging PLWHA. Keywords: human immunodeficiency virus, polypharmacy, drug-related problems

scholarly journals Estimating the Prevalence of Alcohol Dependence in Europe Using Routine Hospital Discharge Data: An Ecological Study

2019 ◽  
Author(s):  
Emmert Roberts ◽  
Gayle Clark ◽  
Matthew Hotopf ◽  
Colin Drummond
Keyword(s):  
Alcohol Dependence ◽  
Hospital Discharge ◽  
Prediction Models ◽  
Discharge Rate ◽  
Diagnostic Category ◽  
Hospital Discharge Data ◽  
Hospital Discharges ◽  
Cross Sectional ◽  
Discharge Data ◽  
Prevalence Estimates

Abstract Aims This study aims to explore the feasibility of using routine hospital discharge data, at the level of countries within Europe, to estimate the general population prevalence of alcohol dependence (AD). Methods We utilised the European Core Health Indicators data tool to extract the annual rate of hospital discharges due to any wholly attributable alcohol condition as defined by the ICD-10. For those counties with data available, we systematically searched Medline, EMBASE, PsychINFO and Google for studies reporting an estimate of the prevalence of AD from national cross-sectional surveys. We compared these prevalence estimates with those developed from prediction models based on hospital discharge data. Results The rate of hospital discharges due to any condition from the F10 diagnostic category (mental and behavioural disorders due to alcohol) was moderately correlated with AD prevalence (r = 0.56), while the rate due to any condition from the K70 diagnostic category (alcoholic liver disease) was weakly correlated with AD prevalence (r = 0.21). Two-thirds of the estimates from cross-sectional surveys were not significantly different to those generated using the F10 discharge rate prediction model. Conclusions Country-level AD prevalence estimates generated using annual F10 hospital discharge rates are likely to provide information of some utility, particularly when limited other sources of information are available or when examining relative trends over time or between regions. There is, however, currently insufficient evidence to make a definitive recommendation to use hospital discharge data to estimate the absolute prevalence of AD per country in Europe.

scholarly journals Credentialing of Pediatric Pharmacists in Collaborative Drug Therapy Management

2019 ◽  
Vol 24 (2) ◽  
pp. 172-174
Author(s):  
Van Tran ◽  
Andrea McMunn ◽  
Jennifer Sterner-Allison ◽  
Sylvia Stoffella
Keyword(s):  
Drug Therapy ◽  
Clinical Pharmacy ◽  
Clinical Pharmacist ◽  
Multidisciplinary Team ◽  
Pediatric Patients ◽  
Medication Management ◽  
Position Statement ◽  
Therapy Management ◽  
Drug Therapy Management ◽  
Detailed Outline

Pediatric clinical pharmacists have evolved over the last 2 decades and have proven to be a key player in the multidisciplinary team. The American College of Clinical Pharmacy recently published (in 2015) a position statement on collaborative drug therapy management and comprehensive medication management. The Council on Credentialing in Pharmacy published a 2014 article on credentialing and privileging of pharmacists. Neither offered requirements for pediatric pharmacists in training and credentialing. This position statement provides a detailed outline defining adequate training for a pediatric clinical pharmacist in order to participate in collaborative drug therapy management for pediatric patients.

scholarly journals Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

2020 ◽  
Vol 54 (4) ◽  
pp. 237-243
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar
Keyword(s):  
Drug Use ◽  
Clinical Pharmacist ◽  
Medication Review ◽  
Pediatric Patients ◽  
Potential Drug ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Rational Drug Use ◽  
Rational Drug

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

scholarly journals FAST HUG: UMA FERRAMENTA PARA FARMÁCIA CLÍNICA NA ATENÇÃO E SEGURANÇA DO PACIENTE CRÍTICO

2018 ◽  
Vol 10 (2) ◽  
pp. 59-64
Author(s):  
Nayara Aparecida Maioli ◽  
Aline Fernanda dos Santos Ferrari ◽  
Tatiane Domingos dos Santos ◽  
Hernani Cesar Barbosa Santos
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Clinical Practice ◽  
Clinical Pharmacist ◽  
Drug Related Problems ◽  
Specific Training ◽  
Effective Care ◽  
Promote Patient Safety

FAST HUG is a check-listcomposed of seven essential items in daily prescription in patients hospitalized inthe Intensive Care Unit (ICU), allowing the identification of drug-related problems in these units, and seeks to ensure a safe, efficient and effective assistance to patients. The purpose of the discussion is to explain the advantages of using FAST HUG by clinical pharmacists in health care and safety of critically ill patients. In the literature review, it was observed that the FAST HUG to identify and prevent medication errors, promote patient safety, avoid problems arising from the care and maximize intensive care, and underline the importance of pharmaceutical care in clinical practice. Using FAST HUG ensures effective care and patient safety. Although there are still difficulties for specific training of intensive care clinical pharmacist, can be seen several clinical pharmacist action opportunities in the ICU.

scholarly journals IDENTIFICATION OF DRUG-RELATED PROBLEMS IN ADULTS WITH TUBERCULOSIS AT THE TEBET SUBDISTRICT HEALTH CENTER FROM JULY TO DECEMBER 2018

2020 ◽  
pp. 74-77
Author(s):  
ATIKA WAHYU PUSPITASARI ◽  
SAVIRA RAHMAWATI YUNAZ ◽  
LINA NADHILAH
Keyword(s):  
Drug Therapy ◽  
Health Center ◽  
Data Retrieval ◽  
Drug Dosage ◽  
Cross Sectional Study ◽  
Fixed Dose ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Combination Tablet ◽  
Dosage Error

Objective: Tuberculosis (TB) is a highly prevalent infectious disease caused by Mycobacterium tuberculosis. The recommended TB treatment is acombination of various antibiotics in the form of a fixed-dose combination tablet or kombipak; however, this increases the prevalence of drug-relatedproblems. Therefore, this study aimed to identify drug-related problems of patients receiving TB therapy at the Tebet Subdistrict Health Center fromJuly 2018 to December 2018.Methods: The study was designed as a cross-sectional study using the retrospective data retrieval method from prescriptions of patients withTB from July 2018 to December 2018. The classification system prepared by Cipolle, Strand, and Morley was used for the classification of drugrelatedproblems; this system includes unnecessary drug therapy, required additional drug therapy, ineffective drug, dosage error, and druginteraction.Results: The percentage of unnecessary drug therapy, required additional drug therapy, ineffective drug, dosage error, and drug interaction was2.85%, 6.89%, 1.54%, 12.46%, and 66.18%, respectively, with the occurrence of drug-related problems being the highest.Conclusion: The administration of anti-TB drugs can potentially cause drug-related problems. Therefore, the assessment needs to be optimizedbefore the administration of medications to patients and medications should be prescribed and monitored regularly to achieve rational drug use

Integration of clinical pharmacists into an ambulatory, pediatric hematology/oncology/transplant clinic

2018 ◽  
Vol 25 (3) ◽  
pp. 607-612 ◽  
Author(s):  
Kimberly D Defoe ◽  
Jennifer Jupp ◽  
Tara Leslie
Keyword(s):  
Drug Therapy ◽  
Clinical Pharmacist ◽  
Pharmacy Services ◽  
Medication History ◽  
Clinical Pharmacists ◽  
Pediatric Hematology ◽  
Transplant Patients ◽  
Medication Counseling ◽  
Data Collection Period ◽  
Collection Period

Objectives To describe key activities performed by a newly deployed clinical pharmacist in an outpatient pediatric hematology, oncology, transplant clinic. To demonstrate how utilization of the pharmacist evolved, as indicated by changes in frequency of key activities, during the first four months of integration. Design Clinical pharmacists were made consistently available in an outpatient clinic serving hematology, oncology, transplant patients and their families. A list of key activities, based on provincial clinical pharmacist standards, was created to provide a framework for the role. Over a four-month period, the pharmacists recorded the number of times activities were performed. Results Over the data collection period, obtaining best possible medication histories (203), providing medication counseling (150), and creating adherence aids (144) were the most commonly performed activities. In comparison to the first month, key activities increased by 73% in the fourth month. Notably, providing recommendations for drug therapy (156%), assessments of adherence (122%), and best possible medication history collection (88%) increased considerably. Conclusions The integration of a pharmacist into an outpatient pediatric hematology, oncology, transplant clinic resulted in the provision of several key clinical pharmacy services. As the role developed, activities were performed more frequently, demonstrating growth in utilization of the pharmacist.

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