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"medication reconciliation"

William R Doucette, Julia J Rippe, Caroline A Gaither, David H Kreling, David A Mott, Jon C Schommer
OBJECTIVES: To describe services provided by community pharmacies and to identify factors associated with services being provided in community pharmacies. DESIGN: Cross-sectional national mail survey. SETTING AND PARTICIPANTS: Pharmacists actively practicing in community pharmacies (independent, chain, mass merchandisers, and supermarkets). OUTCOME MEASURES: Frequency and type of pharmacy services available in a community pharmacy, including medication therapy management, immunization, adjusting medication therapy, medication reconciliation, disease state management, health screening or coaching, complex nonsterile compounding, and point-of-care testing...
October 21, 2016: Journal of the American Pharmacists Association: JAPhA
Lívia Falcão Lima, Bruna Cristina Cardoso Martins, Francisco Roberto Pereira de Oliveira, Rafaela Michele de Andrade Cavalcante, Vanessa Pinto Magalhães, Paulo Yuri Milen Firmino, Liana Silveira Adriano, Adriano Monteiro da Silva, Maria Jose Nascimento Flor, Eugenie Desirée Rabelo Néri
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...
July 2016: Einstein
Satya Surbhi, Kiraat D Munshi, Paula C Bell, James E Bailey
OBJECTIVES: First, to investigate the prevalence and types of drug therapy problems and medication discrepancies among super-utilizers, and associated patient characteristics. Second, to examine the outcomes of pharmacist recommendations and estimated cost avoidance through care transitions support focused on medication management. DESIGN: Retrospective analysis of the pharmacist-led interventions as part of the SafeMed Program. SETTING: A large nonprofit health care system serving the major medically underserved areas in Memphis, Tennessee...
October 6, 2016: Journal of the American Pharmacists Association: JAPhA
Sara Modig, Cecilia Lenander, Nina Viberg, Patrik Midlöv
BACKGROUND: There is an urgent need to improve patient safety in the area of medication treatment among the elderly. The aim of this study was to explore which improvement needs and strengths, relating to medication safety, arise from a multi-professional intervention in primary care and further to describe and follow up on the agreements for change that were established within the intervention. METHODS: The SÄKLÄK project was a multi-professional intervention in primary care consisting of self-assessment, peer-review, feedback and written agreements for change...
October 4, 2016: BMC Family Practice
L Cortejoso, R A Dietz, G Hofmann, M Gosch, A Sattler
BACKGROUND: Inappropriate pharmacotherapy among older adults remains a critical issue in our health care systems. Besides polypharmacy and multiple comorbidities, the age-related pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug reactions and medication errors. OBJECTIVE: The main target of this study was to describe the characteristics of pharmaceutical interventions in two geriatric wards (orthogeriatric ward and geriatric day unit) of a general teaching hospital and to evaluate the clinical significance of the detected medication errors...
2016: Clinical Interventions in Aging
Theresa Walker
No abstract text is available yet for this article.
October 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Jill S Bates, Larry W Buie, Lindsey B Amerine, Scott W Savage, Stephen F Eckel, Rachana Patel, John M Valgus, Kamakshi Rao, Rowell Daniels
PURPOSE: The outcomes of a patient-centered layered learning practice model (LLPM) in which the clinical specialist acted as the attending pharmacist and managed a pharmacy team to provide direct patient care were evaluated. METHODS: Two 30-day evaluations were conducted on the acute care malignant hematology and medical oncology services of the University of North Carolina Medical Center in 2011. The primary objective of this study was to design an LLPM that used a team to expand the pharmacist care services offered...
September 23, 2016: American Journal of Health-system Pharmacy: AJHP
Mohammad Haji Aghajani, Monireh Ghazaeian, Hamid Reza Mehrazin, Mohammad Sistanizad, Mirmohammad Miri
Medication errors are one of the important factors that increase fatal injuries to the patients and burden significant economic costs to the health care. An appropriate medical history could reduce errors related to omission of the previous drugs at the time of hospitalization. The aim of this study, as first one in Iran, was evaluating the discrepancies between medication histories obtained by pharmacists and physicians/nurses and first order of physician. From September 2012 until March 2013, patients admitted to the post CCU of a 550 bed university hospital, were recruited in the study...
2016: Iranian Journal of Pharmaceutical Research: IJPR
Shawn P Griffin, Joelle E Nelson
CONTEXT: Tacrolimus requires close therapeutic drug monitoring (TDM) to ensure efficacy and minimize adverse effects. Pharmacists are uniquely positioned on transplant teams to interpret levels and recommend therapy modifications. Their impact in the immediate postoperative setting has not been described previously. OBJECTIVE: To evaluate the impact of a clinical solid organ transplant pharmacist on nephrotoxicity, TDM, and revenue generation in adult kidney transplant recipients on tacrolimus...
September 14, 2016: Progress in Transplantation
Kelly L Hayward, Patricia C Valery, W Neil Cottrell, Katharine M Irvine, Leigh U Horsfall, Caroline J Tallis, Veronique S Chachay, Brittany J Ruffin, Jennifer H Martin, Elizabeth E Powell
BACKGROUND: Cirrhosis patients are prescribed multiple medications for their liver disease and comorbidities. Discrepancies between medicines consumed by patients and those documented in the medical record may contribute to patient harm and impair disease management. The aim of the present study was to assess the magnitude and types of discrepancies among patient-reported and medical record-documented medications in patients with cirrhosis, and examine factors associated with such discrepancies...
2016: BMC Gastroenterology
Brianna A da Silva, Mahesh Krishnamurthy
CASE DESCRIPTION: A 71-year-old female accidentally received thiothixene (Navane), an antipsychotic, instead of her anti-hypertensive medication amlodipine (Norvasc) for 3 months. She sustained physical and psychological harm including ambulatory dysfunction, tremors, mood swings, and personality changes. Despite the many opportunities for intervention, multiple health care providers overlooked her symptoms. DISCUSSION: Errors occurred at multiple care levels, including prescribing, initial pharmacy dispensation, hospitalization, and subsequent outpatient follow-up...
2016: Journal of Community Hospital Internal Medicine Perspectives
Mattia Altini, Marna Bernabini, Paolo Marchetti, Laura Orlando, Barbara Rebesco, Valeria Sirna
PURPOSE: Medication errors in oncology may cause severe damage to patients, professionals, and the environment. The Italian Ministry of Health issued Raccomandazione 14 to provide guidelines for prevention of errors while using antineoplastic drugs. This work aimed at analyzing Raccomandazione 14 through the different viewpoints of the hospital pharmacist, the nurse, the oncologist, and the hospital director. METHODS: Twenty-seven Italian healthcare organizations participated in a self-assessment survey evaluating compliance with Raccomandazione 14 within the oncology, hematology, and pharmacy departments...
August 29, 2016: Tumori
V Khalil, J M deClifford, S Lam, A Subramaniam
WHAT IS KNOWN AND OBJECTIVE: Medication errors on admission can persist throughout the episode of care and on to discharge leading to inappropriate management that can compromise patients' care. The aim of the study was to develop, implement and evaluate the role of pharmacist-led medication reconciliation and charting service for patients admitted to an Acute Assessment and Admission Unit via the Emergency Department in an electronic medication management environment at a metropolitan Australian hospital...
August 31, 2016: Journal of Clinical Pharmacy and Therapeutics
Denise M Kolanczyk, Rachel C Dobersztyn
IN BRIEF This article reviews potential challenges to and necessary considerations for ensuring the safe and effective use of insulin in the hospital setting. It offers practical suggestions for managing insulin-related issues regarding medication reconciliation, general inpatient management, and the use of concentrated insulin products.
August 2016: Diabetes Spectrum: a Publication of the American Diabetes Association
Joshua W Joseph, David T Chiu, Larry A Nathanson, Steven Horng
OBJECTIVES: To evaluate the sensitivity and specificity of a problem list automatically generated from the emergency department (ED) medication reconciliation. METHODS: We performed a retrospective cohort study of patients admitted via the ED who also had a prior inpatient admission within the past year of an academic tertiary hospital. Our algorithm used the First Databank ontology to group medications into therapeutic classes, and applied a set of clinically derived rules to them to predict obstructive lung disease, hypertension, diabetes, congestive heart failure (CHF), and thromboembolism (TE) risk...
October 2016: International Journal of Medical Informatics
María Beatriz Contreras Rey, Yolanda Arco Prados, Ernesto Sánchez Gómez
OBJECTIVE: To analyze the outcomes of a medication reconciliation process at admission in the hospital setting. To assess the role of the Pharmacist in detecting reconciliation errors and preventing any adverse events entailed. METHOD: A retrospective study was conducted to analyze the medication reconciliation activity during the previous six months. The study included those patients for whom an apparently not justified discrepancy was detected at admission, after comparing the hospital medication prescribed with the home treatment stated in their clinical hospital records...
July 2016: Farmacia Hospitalaria
Lucía Villamayor-Blanco, Leticia Herrero-Poch, Jose Carlos De-Miguel-Bouzas, M Carmen Freire Vazquez
OBJECTIVE: To describe and to analyse a new method of integrated medicines reconciliation in an electronic prescribing program results. METHOD: 12-month, prospective, observational, non-randomized and uncontrolled study, in which all patients who were admitted, during that year, to a general hospital of 450 beds. The electronic prescribing program was used for medication reconciliation as a means to multidisciplinary approach (nurses, doctors, pharmacists). This reconciliation was done at the time of hospital admission and reconciliation errors were measured...
September 2016: Farmacia Hospitalaria
Blanca Rodríguez Vargas, Eva Delgado Silveira, Irene Iglesias Peinado, Teresa Bermejo Vicedo
Background Care transitions are risk points for medication discrepancies, especially in the elderly. Objective This study was undertaken to assess prevalence and describe medication reconciliation errors during admission in elderly patients and to analyze associated risk factors. We also evaluate the effect of these errors on the length of hospital stay. Setting General surgery, orthopedics, internal medicines and infectious diseases departments of a 1070-bed Spanish teaching hospital. Method This is a prospective observational study...
October 2016: International Journal of Clinical Pharmacy
Alemayehu B Mekonnen, Tamrat B Abebe, Andrew J McLachlan, Jo-Anne E Brien
BACKGROUND: Medication reconciliation has been identified as an important intervention to minimize the incidence of unintentional medication discrepancies at transitions in care. However, there is a lack of evidence for the impact of information technology on the rate and incidence of medication discrepancies identified during care transitions. This systematic review was thus, aimed to evaluate the impact of electronic medication reconciliation interventions on the occurrence of medication discrepancies at hospital transitions...
2016: BMC Medical Informatics and Decision Making
Diane Murray, Cathy Sedgeworth, Moira Kinnear, Lesley Diack
AIM: To gather opinions from doctors and pharmacists to improve the design of the PICU MR form generated by the electronic prescribing and clinical notes system to support transfer of care from PICU to downstream wards that use paper systems. METHOD: A purposive sample of 10 forms covering a comprehensive range of medication information common to PICU patients was selected from practice between March 2014 and May 2014. Pharmacists (n=7) and doctors (n=9) who received these forms on downstream wards were invited to participate in semi-structured one-to-one interviews (n=20) with the PICU pharmacist within 48 hrs of receipt to explore their views about the form...
September 2016: Archives of Disease in Childhood
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