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https://www.readbyqxmd.com/read/29337859/effects-of-pharmacists-interventions-on-inappropriate-drug-use-and-drug-related-readmissions-in-people-with-dementia-a-secondary-analysis-of-a-randomized-controlled-trial
#1
Maria Gustafsson, Maria Sjölander, Bettina Pfister, Jörn Schneede, Hugo Lövheim
Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug-drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmacists' interventions on use of PIMs, risk of emergency department visits, and time to institutionalization. Furthermore, a descriptive analysis was conducted of circumstances associated with drug-related readmissions...
January 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29317936/what-does-it-take-to-change-practice-perspectives-of-pharmacists-in-ontario
#2
Paul A M Gregory, Beatriz Teixeira, Zubin Austin
Background: This is a time of rapid change in the profession of pharmacy. Anecdotally, there are concerns that the pace, extent and rate of practice evolution are lagging. There is little evidence documenting the influencers and mechanisms that drive practice changes forward in pharmacy in Canada. Methods: An exploratory qualitative method was selected, using both one-on-one interviews with self-categorized typical pharmacists and larger focus groups to provide context and confirmation of themes generated through interviews...
January 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29317397/factors-associated-with-availability-of-anticoagulation-reversal-agents-in-rural-and-community-emergency-departments
#3
Brett A Faine, Julie Amendola, Jordan Homan, Azeemuddin Ahmed, Nicholas Mohr
PURPOSE: Results of a study of anticoagulation reversal agent availability in rural and community hospital emergency departments (EDs) are reported. METHODS: A cross-sectional telephone survey was conducted to test the hypothesis that anticoagulation reversal agents are not commonly stocked in low-volume EDs. In phase 1 of the study, a physician, pharmacist, or nurse manager at a sample of EDs in 1 state was surveyed to characterize anticoagulation reversal agent availability and the presence or absence of reversal protocols; in phase 2, follow-up qualitative interviews were conducted with hospital pharmacists selected by purposive sampling to identify barriers to availability...
January 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29310993/consensus-methodology-to-determine-minor-ailments-appropriate-to-be-directed-for-management-within-community-pharmacy
#4
Hamde Nazar, Zachariah Nazar, Andre Yeung, Mike Maguire, Alex Connelly, Sarah P Slight
BACKGROUND: National Health Service (NHS) 111, a medical helpline for urgent care used within the England and Scotland, receives significant numbers of patient calls yearly for a range of clinical conditions. Some are considered high acuity and mainly directed to urgent and emergency care. Low acuity conditions are also directed to these costly, overburdened services. Community pharmacy is a recognised setting for effective low acuity condition management and could offer an alternative...
January 4, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29302017/effectiveness-of-a-pharmacist-led-medication-review-programme-on-medication-appropriateness-and-hospital-readmissions-among-geriatric-in-patients-in-hong-kong
#5
P Kc Chiu, A Wk Lee, T Yw See, F Hw Chan
INTRODUCTION: Geriatric in-patients are at risk of drug-related problems. This study aimed to determine whether a pharmacist-led medication review programme could reduce inappropriate medications and hospital readmissions among geriatric in-patients in Hong Kong. METHODS: A prospective controlled study was conducted from December 2013 to September 2014 in the geriatric unit of a regional hospital in Hong Kong. A total of 212 subjects were allocated to receive either routine care or pharmacist intervention that included medication reconciliation, medication review, and medication counselling...
January 5, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29301226/impact-of-pharmacist-conducted-comprehensive-medication-reviews-for-older-adult-patients-to-reduce-medication-related-problems
#6
Whitney J Kiel, Shaun W Phillips
Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization...
December 31, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29295829/medication-therapy-management-after-hospitalization-in-ckd-a-randomized-clinical-trial
#7
Katherine R Tuttle, Radica Z Alicic, Robert A Short, Joshua J Neumiller, Brian J Gates, Kenn B Daratha, Celestina Barbosa-Leiker, Sterling M McPherson, Naomi S Chaytor, Brad P Dieter, Stephen M Setter, Cynthia F Corbett
BACKGROUND AND OBJECTIVES: CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Patients with CKD stages 3-5 not treated by dialysis who were hospitalized for acute illness were recruited...
January 2, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29290741/identifying-barriers-and-facilitators-at-affect-community-pharmacists-ability-to-engage-children-in-medication-counseling-a-pilot-study
#8
Olufunmilola Abraham, Dayna S Alexander, Loren J Schleiden, Delesha M Carpenter
OBJECTIVES: This study aimed to describe the barriers and facilitators that influence community pharmacists' ability to provide medication counseling to pediatric patients. METHODS: Semistructured interviews (n = 16) were conducted with pharmacy staff at 3 community pharmacies in 2 Eastern states. The interview guide elicited pharmacy staff experiences interacting with children and their perceived barriers and facilitators to providing medication counseling. Transcripts were reviewed for accuracy and a codebook was developed for data analysis...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29280137/multi-site-investigation-of-strategies-for-the-implementation-of-cyp2c19-genotype-guided-antiplatelet-therapy
#9
Philip E Empey, James M Stevenson, Sony Tuteja, Kristin W Weitzel, Dominick J Angiolillo, Amber L Beitelshees, James C Coons, Julio D Duarte, Francesco Franchi, Linda J B Jeng, Julie A Johnson, Rolf P Kreutz, Nita A Limdi, Kristin A Maloney, Aniwaa Owusu Obeng, Josh F Peterson, Natasha Petry, Victoria M Pratt, Fabiana Rollini, Stuart A Scott, Todd C Skaar, Mark R Vesely, George A Stouffer, Russell A Wilke, Larisa H Cavallari, Craig R Lee
CYP2C19 genotype-guided antiplatelet therapy following percutaneous coronary intervention is increasingly implemented in clinical practice. However, challenges such as selecting a testing platform, communicating test results, building clinical decision support processes, providing patient and provider education, and integrating methods to support the translation of emerging evidence to clinical practice are barriers to broad adoption. In this report, we compare and contrast implementation strategies of 12 early adopters, describing solutions to common problems and initial performance metrics for each program...
December 26, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29277130/an-interdisciplinary-academic-detailing-approach-to-decrease-inappropriate-medication-prescribing-by-physician-residents-for-older-veterans-treated-in-the-emergency-department
#10
Jason M Moss, William E Bryan, Loren M Wilkerson, Heather A King, George L Jackson, Ryan K Owenby, Courtney H Van Houtven, Melissa B Stevens, James Powers, Camille P Vaughan, William W Hung, Ula Hwang, Alayne D Markland, Richard Sloane, William Knaack, Susan Nicole Hastings
OBJECTIVE: To evaluate the impact of an academic detailing intervention delivered as part of a quality improvement project by a physician-pharmacist pair on (1) self-reported confidence in prescribing for older adults and (2) rates of potentially inappropriate medications (PIMs) prescribed to older adults by physician residents in a Veteran Affairs emergency department (ED). METHODS: This quality improvement project at a single site utilized a questionnaire that assessed knowledge of Beers Criteria, self-perceived barriers to appropriate prescribing in older adults, and self-rated confidence in ability to prescribe in older adults which was administered to physician residents before and after academic detailing delivered during their emergency medicine rotation...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29276268/improved-outcomes-and-cost-savings-associated-with-pharmacist-presence-in-the-emergency-department
#11
Matthew W McAllister, Joshua G Chestnutt
Purpose: The study sought to determine whether the inclusion of a pharmacist on the emergency department (ED) resuscitation team was associated with improved compliance with the Advanced Cardiac Life Support (ACLS) guidelines and patient survival. The study also evaluated cost avoidance associated with a pharmacist providing clinical services to the ED. Methods: Cardiac arrest event records were evaluated for compliance with ACLS guidelines as well as for whether or not a pharmacist was involved as a member of the resuscitation team...
June 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29273607/benzodiazepine-use-and-cognitive-decline-in-the-elderly
#12
REVIEW
Jenna D Picton, Adriane Brackett Marino, Kimberly Lovin Nealy
PURPOSE: Published evidence on the relationship between benzodiazepine exposure and altered cognition in the geriatric population is reviewed. SUMMARY: Benzodiazepines constitute one of the most commonly prescribed medication classes and are used primarily for management of anxiety and insomnia. Despite strong recommendations based on high-quality evidence warning of the potential cognitive adverse effects of benzodiazepine use, particularly in patients 65 years of age or older, published literature suggests that a substantial proportion of the U...
January 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29273028/implementation-of-a-novel-population-panel-management-curriculum-among-interprofessional-health-care-trainees
#13
Catherine P Kaminetzky, Lauren A Beste, Anne P Poppe, Daniel B Doan, Howard K Mun, Nancy Fugate Woods, Joyce E Wipf
BACKGROUND: Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees...
December 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29248878/systematic-review-and-meta-analysis-of-the-effectiveness-of-pharmacist-led-medication-reconciliation-in-the-community-after-hospital-discharge
#14
Duncan McNab, Paul Bowie, Alastair Ross, Gordon MacWalter, Martin Ryan, Jill Morrison
BACKGROUND: Pharmacists' completion of medication reconciliation in the community after hospital discharge is intended to reduce harm due to prescribed or omitted medication and increase healthcare efficiency, but the effectiveness of this approach is not clear. We systematically review the literature to evaluate intervention effectiveness in terms of discrepancy identification and resolution, clinical relevance of resolved discrepancies and healthcare utilisation, including readmission rates, emergency department attendance and primary care workload...
December 16, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29247094/oral-medicine-modification-for-older-adults-a-qualitative-study-of-nurses
#15
Aoife Mc Gillicuddy, Abina M Crean, Maria Kelly, Laura Sahm
OBJECTIVE: Oral medicines are frequently modified (eg, tablets crushed) for older adults. However, these modifications can have clinical, legal and/or ethical implications. Nurses bear responsibility for medicine administration and hence, perform these modifications. The aim of this study was to investigate the knowledge, attitudes and beliefs of nurses about oral medicine modification for older adults. DESIGN: A qualitative study was conducted using semi-structured, face-to-face interviews with nurses providing care to older adults in acute and long-term care settings...
December 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29239004/providing-comprehensive-medication-management-in-telehealth
#16
Melissa E Badowski, Scot Walker, Shaffeeulah Bacchus, Sandy Bartlett, Juliana Chan, Kelly A Cochran, Scott Coon, Michelle Liedtke, Brad Phillips, Taylor White
The goal of this white paper is to provide direction for clinical pharmacists providing telehealth. Telehealth care is rapidly emerging to improve patient access to health care and optimize patient health outcomes. With the increasing ability to access electronic health record portals, as many as 75 million telehealth encounters are expected in North America annually. Although electronic "point of access" undoubtedly increases the use of medical and pharmacy services, the real value of telehealth lies in improved access to patients in remote areas lacking adequate medical and pharmacy services and to high-risk patients requiring frequent monitoring...
December 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29236288/disaster-preparedness-biological-threats-and-treatment-options
#17
Navaneeth Narayanan, Clifton R Lacy, Joseph E Cruz, Meghan Nahass, Jonathan Karp, Joseph A Barone, Evelyn Hermes-DeSantis
Biological disasters can be natural, accidental, or intentional. Biological threats have made a lasting impact on civilization. This review will focus on agents of clinical significance, bioterrorism, and national security; specifically Category A agents (anthrax, botulism, plague, tularemia, and smallpox), as well as briefly discuss other naturally-emerging infections of public health significance including Ebola virus (also a Category A agent) and Zika virus. The role of the pharmacist in disaster preparedness and disaster response is multifaceted and important...
December 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29235228/experiences-of-singapore-nurses-as-second-victims-a-qualitative-study
#18
Shi Teng Chan, Betty Peck Chui Khong, Lynnette Pei Lin Tan, Hong-Gu He, Wenru Wang
Nurses, like other healthcare professionals, such as physicians, pharmacists, and therapists, are susceptible to unanticipated patient harm, in which they suffer as second victims due to the immense personal and professional impact from the adverse event. The aim of the present study was to explore the psychological responses, coping strategies, and support needs of Singapore nurses as second victims of adverse events. A descriptive qualitative study was adopted. Eight participants (6 women and 2 men) who had been involved in an adverse event were interviewed and audio-recorded...
December 12, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/29233609/development-of-a-template-to-facilitate-reflection-among-student-pharmacists
#19
Rhian Deslandes, Cherie Lucas, Mary Louise Hughes, Efi Mantzourani
BACKGROUND: Reflective practice activities utilizing appropriate tools enhance learning during and after experiential placements. Reflective tools described in the literature, used to support students on traditional placements of a duration of at least two weeks, sit at the unstructured end of a continuum (completely unstructured to just minimal structure). Additionally, non-traditional settings in role-emerging placements are of value as an alternative for experiential education. There were no reflective tools in the literature to provide a means of supporting pharmacy students as novice reflectors in non-traditional settings...
December 8, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29233428/training-student-pharmacists-to-administer-emergency-pediatric-influenza-vaccine-a-comparison-of-traditional-vs-just-in-time-training
#20
Colleen M Terriff, Kimberly McKeirnan
INTRODUCTION: This study compared traditional training (TT) and just-in-time training (JITT) of P3 student pharmacists regarding interest, confidence, and comfort pre- and post-training (primary objective); and assessment and administration competency (secondary objective) during a simulated influenza vaccination clinic. METHODS: Student pharmacists were randomized 1:1 to receive either TT or JITT, completed pre- and post-training surveys assessing interest, confidence and comfort; and evaluated on performance during a simulated emergency infant vaccination...
July 2017: Currents in Pharmacy Teaching & Learning
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