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https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#1
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28759998/pharmacist-participation-in-acute-ischemic-stroke-decreases-door-to-needle-time-to-recombinant-tissue-plasminogen-activator
#2
Megan A Rech, Stephanie Bennett, Elisabeth Donahey
BACKGROUND: Pharmacists are an important member of the stroke team and aid in obtaining medication and medical history, providing education, managing blood pressure, reviewing exclusion criteria for recombinant tissue plasminogen activator (rtPA), and facilitating reconstitution and administration of rtPA. OBJECTIVE: To determine if pharmacist presence at bedside during acute ischemic stroke resulted in a reduction in door-to-needle (DTN) times. METHODS: This was a retrospective cohort study between January 1, 2011 and December 31, 2015 of patients who received rtPA for acute ischemic stroke in either the emergency department or hospital...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28754600/building-blocks-for-institutional-preparation-of-ctl019-delivery
#3
REVIEW
Joseph McGuirk, Edmund K Waller, Muna Qayed, Sunil Abhyankar, Solveig Ericson, Peter Holman, Christopher Keir, G Douglas Myers
Chimeric antigen receptor (CAR) T-cell therapy is an investigational immunocellular therapy that reprograms a patient's cytotoxic T cells to engage and eliminate malignant cells. CAR T-cell therapies targeting the CD19 antigen have demonstrated high efficacy in clinical trials for patients with B-cell malignancies and may potentially be available on a broader scale in the future. CAR T-cell therapy begins with the collection of a sufficient number of T cells from a patient's peripheral blood through leukapheresis...
July 25, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28735551/quality-of-pharmacist-managed-anticoagulation-therapy-in-long-term-ambulatory-settings-a-systematic-review
#4
Beenish S Manzoor, Wei-Han Cheng, James C Lee, Ellen M Uppuluri, Edith A Nutescu
OBJECTIVE: To perform a systematic review to evaluate the quality of warfarin anticoagulation control in outpatient pharmacist-managed anticoagulation services (PMAS) compared with routine medical care (RMC). DATA SOURCES: MEDLINE, SCOPUS, EMBASE, IPA, CINAHL, and Cochrane CENTRAL, from inception to May 2017. Search terms employed: ("pharmacist-managed" OR "pharmacist-provided" OR "pharmacist-led" OR "pharmacist-directed") AND ("anticoagulation services" OR "anticoagulation clinic" OR "anticoagulation management" OR "anticoagulant care") AND ("quality of care" OR "outcomes" OR "bleeding" OR "thromboembolism" OR "mortality" OR "hospitalization" OR "length of stay" OR "emergency department visit" OR "cost" OR "patient satisfaction")...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28679915/medications-related-emergency-admissions-causes-and-recommendations
#5
Namareq Aldardeer, Nabila Benslimane, Mohamed Khalifa
Adverse drug events could require a patient to visit the emergency department, many of these visits lead to hospital admissions. A retrospective study, October 2015 to March 2016, examined the severity and factors contributing to medications related emergency visits leading to admissions at King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. Out of 698 reviewed patients, 92 were medications related admissions. Adverse drug reactions were the primary cause (46.7%), drug prescribing (30...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28653261/future-enhanced-clinical-role-of-pharmacists-in-emergency-departments-in-england-multi-site-observational-evaluation
#6
Elizabeth Hughes, David Terry, Chi Huynh, Konstantinos Petridis, Matthew Aiello, Louis Mazard, Hirminder Ubhi, Alex Terry, Keith Wilson, Anthony Sinclair
Background There are concerns about maintaining appropriate clinical staffing levels in Emergency Departments. Pharmacists may be one possible solution. Objective To determine if Emergency Department attendees could be clinically managed by pharmacists with or without advanced clinical practice training. Setting Prospective 49 site cross-sectional observational study of patients attending Emergency Departments in England. Method Pharmacist data collectors identified patient attendance at their Emergency Department, recorded anonymized details of 400 cases and categorized each into one of four possible options: cases which could be managed by a community pharmacist; could be managed by a hospital pharmacist independent prescriber; could be managed by a hospital pharmacist independent prescriber with additional clinical training; or medical team only (unsuitable for pharmacists to manage)...
June 26, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28638496/effect-of-early-follow-up-after-hospital-discharge-on-outcomes-in-patients-with-heart-failure-or-chronic-obstructive-pulmonary-disease-a-systematic-review
#7
(no author information available yet)
BACKGROUND: Transitions in care can increase patients' vulnerability to adverse events. In particular, patients admitted for heart failure or chronic obstructive pulmonary disorder (COPD) have high rates of readmission and return emergency department visits. Heart failure patients have the highest 30-day readmission rates in Canada, and COPD patients comprise the highest volume of readmissions. Combined, these two conditions account for the largest number of emergency department returns...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28610634/medication-related-visits-in-a-pediatric-emergency-department-an-8-years-retrospective-analysis
#8
Cristiano Rosafio, Serena Paioli, Cinzia Del Giovane, Valentina Cenciarelli, Nilla Viani, Paolo Bertolani, Lorenzo Iughetti
BACKGROUND: There are limited data on the characterization of medication-related visits (MRVs) to the emergency department (ED) in pediatric patients in Italy. We have estimated the frequency, severity, and classification of MRVs to the ED in pediatric patients. METHODS: We retrospectively analyzed data for children seeking medical evaluation for a MRV over an 8 years period. A medication-related ED visit was identified by using a random pharmacist assessment, emergency physician assessment, and in case of conflicting events, by a third investigators random assessment...
June 13, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28557517/economic-value-of-pharmacist-led-medication-reconciliation-for-reducing-medication-errors-after-hospital-discharge
#9
Mehdi Najafzadeh, Jeffrey L Schnipper, William H Shrank, Steven Kymes, Troyen A Brennan, Niteesh K Choudhry
OBJECTIVES: Medication discrepancies at the time of hospital discharge are common and can harm patients. Medication reconciliation by pharmacists has been shown to prevent such discrepancies and the adverse drug events (ADEs) that can result from them. Our objective was to estimate the economic value of nontargeted and targeted medication reconciliation conducted by pharmacists and pharmacy technicians at hospital discharge versus usual care. STUDY DESIGN: Discrete-event simulation model...
October 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/28539101/evaluation-of-early-versus-late-postdischarge-medication-reconciliation-on-readmission-rates-and-emergency-department-visits
#10
Tina Joseph, Rebecca A Barros, Elise Kim, Bupendra Shah
BACKGROUND: The current literature speculates ideal postdischarge follow-up focusing on transitions from hospital to home can range anywhere between 48 hours and 2 weeks. However, there is a lack of evidence regarding the optimal timing of follow-up visit to prevent readmissions. OBJECTIVE: The purpose of this study is to evaluate the impact of early (<48 hours) versus late (48 hours-14 days) postdischarge medication reconciliation on readmissions and emergency department (ED) use...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28501031/-analysis-of-the-cochrane-review-non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care-cochrane-database-syst-rev-2016-11-cd011227
#11
Gonçalo Silva Duarte, Ricardo Martins Delgado, João Costa, António Vaz-Carneiro
In countries with diverse socioeconomic levels, in order to address the health care demands, the consideration of a wide array of strategies is needed; among these, non-medical prescription can be included. The objective of this revision was to ascertain whether non-medical prescription results in comparable clinical and patient-related outcomes to medical prescription. This systematic review was conducted in compliance with the standard Cochrane methodology. Clinical outcomes were compared between prescription carried out by non-medical health professionals and doctors, provided that the non-medical health professional prescribed with a high degree of autonomy, both in hospital and community practice, in countries with low, medium and high socioeconomic level...
January 31, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28490484/developing-a-decision-rule-to-optimise-clinical-pharmacist-resources-for-medication-reconciliation-in-the-emergency-department
#12
Sabrina De Winter, Peter Vanbrabant, Pieter Laeremans, Veerle Foulon, Ludo Willems, Sandra Verelst, Isabel Spriet
BACKGROUND: The process of obtaining a complete medication history for patients admitted to the hospital from the ED at hospital admission, without discrepancies, is error prone and time consuming. OBJECTIVES: The goal of this study was the development of a clinical decision rule (CDR) with a high positive predictive value in detecting ED patients admitted to hospital at risk of at least one discrepancy during regular medication history acquisition, along with favourable feasibility considering time and budget constraints...
May 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28488314/pharmacist-intervention-to-detect-drug-adverse-events-on-admission-to-the-emergency-department-two-case-reports-of-neuroleptic-malignant-syndrome
#13
F Leenhardt, D Perier, V Pinzani, I Giraud, M Villiet, A Castet-Nicolas, V Gourhant, C Breuker
WHAT IS KNOWN AND OBJECTIVE: Neuroleptic malignant syndrome (NMS) is a rare but severe adverse effect of antipsychotic drugs. CASE DESCRIPTION: We report two cases of NMS highlighted by clinical pharmacists in an emergency unit during summer. One of them was fatal. Medication reconciliation processes performed at admission identified treatment with loxapine for one of them and with loxapine and clozapine for the other. Interview of the patients highlighted clinical symptoms suggesting NMS, allowing the pharmacists to alert the medical team...
May 9, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28483008/medication-regimen-complexity-in-long-term-care-facilities-and-adverse-drug-events-related-hospitalizations
#14
Sammi Hiu Yi Tam, Jan D Hirsch, Jonathan H Watanabe
Adverse drug events (ADE) are a leading cause of mortality in the United States. Recent studies have demonstrated a high level of complex medication regimens in institutionalized residents. Evidence of the relationship between medication regimen complexity (MRC) and ADE-related rehospitalizations or emergency department (ED) visits is evolving. Therefore, there is a demand for better characterization and study of MRC as an objective identifier to quickly screen and prioritize high-risk patients for follow-up medication management therapy...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28479220/electronic-medication-complete-communication-strategy-for-opioid-prescriptions-in-the-emergency-department-rationale-and-design-for-a-three-arm-provider-randomized-trial
#15
Danielle M McCarthy, D Mark Courtney, Patrick M Lank, Kenzie A Cameron, Andrea M Russell, Laura M Curtis, Kwang-Youn A Kim, Surrey M Walton, Enid Montague, Abbie L Lyden, Stephanie J Gravenor, Michael S Wolf
BACKGROUND: Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. OBJECTIVES: To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC(2)) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. METHODS: The ED EMC(2) Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions...
May 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28478750/perception-survey-on-the-value-of-the-hospital-pharmacist-at-the-emergency-department
#16
Ángeles García-Martín, Charbel Maroun-Eid, Ainara Campino-Villegas, Belén Oliva-Manuel, Alicia Herrero-Ambrosio, Manuel Quintana-Díaz
OBJECTIVE: To determine the perception and evaluation of the Emergency pharmacist by the medical and nursing staff at the Emergency department. METHODS: A multicenter study based on a survey sent to the Spanish Society of Hospital Pharmacists (SEFH) for Emergency pharmacists (EPh) to distribute among the Emergency staff. Descriptive statistics were used, with a 95% confidence interval. RESULTS: 102 (12%) questionnaires were completed by 73 Emergency Physicians (71...
May 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28478719/comment-clinical-pharmacist-management-of-bacteremia-in-a-community-hospital-emergency-department
#17
Renee Petzel Gimbar
No abstract text is available yet for this article.
June 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28478718/reply-clinical-pharmacist-management-of-bacteremia-in-a-community-hospital-emergency-department
#18
C Dustin Waters, Kevin P Myers, Bryce J Bitton, Annie Torosyan
No abstract text is available yet for this article.
June 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28476877/incidence-of-clinically-relevant-medication-errors-in-the-era-of-electronically-prepopulated-medication-reconciliation-forms-a-retrospective-chart-review
#19
Kaitlin R Stockton, Maeve E Wickham, Simon Lai, Katherin Badke, Karen Dahri, Diane Villanyi, Vi Ho, Corinne M Hohl
BACKGROUND: To reduce medication discrepancies (unintended differences between a patient's outpatient and inpatient medication regimens), Canadian institutions have implemented medication reconciliation forms that are prepopulated with outpatient medication dispensing data. These may prompt prescribers to reorder discontinued medications or continue newly contraindicated medications. Our objective was to evaluate the incidence of medication discrepancies and errors of commission after the implementation of such forms...
May 5, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28469903/transitional-care-management-in-the-outpatient-setting
#20
Analiza Baldonado, Ofelia Hawk, Thomas Ormiston, Danielle Nelson
Patients who are high risk high cost (HRHC), those with severe or multiple medical issues, and the chronically ill elderly are major drivers of rising health care costs.1 The HRHC patients with complex health conditions and functional limitations may likely go to emergency rooms and hospitals, need more supportive services, and use long-term care facilities.2 As a result, these patient populations are vulnerable to fragmented care and "falling through the cracks".2 A large county health and hospital system in California, USA introduced evidence-based interventions in accordance with the Triple AIM3 focused on patient-centered health care, prevention, health maintenance, and safe transitions across the care continuum...
2017: BMJ Quality Improvement Reports
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