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Drug reconciliation

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https://www.readbyqxmd.com/read/29124665/evaluation-of-definite-anaphylaxis-drug-allergy-alert-overrides-in-inpatient-and-outpatient-settings
#1
Adrian Wong, Diane L Seger, Sarah P Slight, Mary G Amato, Patrick E Beeler, Julie M Fiskio, David W Bates
INTRODUCTION: Drug-allergy interaction (DAI) alerts are generated when a known adverse sensitivity-inducing substance is prescribed. A recent study at our institution showed that providers overrode most DAI alerts, including those that warned against potentially life-threatening 'anaphylaxis'. OBJECTIVE: The aim of this study was to determine the rate of anaphylaxis overrides, the reasons for these overrides, whether the overrides were appropriate, and if harm occurred from overrides...
November 9, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29123600/activities-performed-by-pharmacists-integrated-in-family-health-teams-results-from-a-web-based-survey
#2
Ulrika Gillespie, Lisa Dolovich, Simone Dahrouge
Objectives: Family health teams (FHTs), an interprofessional primary care practice model, were established in Ontario in 2005. As of October 2014, 191 FHT organizations were in operation, and 111 (58%) included one or several pharmacists. The objective of this study was to document the focus of pharmacist activities in FHTs. Approach: We invited all 155 known FHT pharmacists to a web-based survey. The survey was constructed using information obtained from previously done semi-structured telephone interviews with pharmacists working in FHTs...
November 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29121197/higher-accuracy-of-complex-medication-reconciliation-through-improved-design-of-electronic-tools
#3
Jan Horsky, Elizabeth A Drucker, Harley Z Ramelson
Objective: Investigate the accuracy of 2 different medication reconciliation tools integrated into electronic health record systems (EHRs) using a cognitively demanding scenario and complex medication history. Materials and Methods: Seventeen physicians reconciled medication lists for a polypharmacy patient using 2 EHRs in a simulation study. The lists contained 3 types of discrepancy and were transmitted between the systems via a Continuity of Care Document. Participants updated each EHR and their interactions were recorded and analyzed for the number and type of errors...
November 7, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29103240/the-need-for-medication-reconciliation-increases-with-age
#4
Rima Rappaport, Zeev Arinzon, Jacob Feldman, Shiloh Lotan, Rachel Heffez-Aizenfeld, Yitshal Berner
BACKGROUND: Medication reconciliation (MR) at hospital admission, transfer, and discharge has been designated as a required hospital practice to reduce adverse drug events. OBJECTIVES: To perform MR among elderly patients admitted to the hospital and to determine factors that influence differences between the various lists of prescribed drugs as well as their actual consumption. METHODS: We studied patients aged 65 years and older who had been admitted to the hospital and were taking at least one prescription drug...
October 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29069119/do-combined-pharmacist-and-prescriber-efforts-on-medication-reconciliation-reduce-postdischarge-patient-emergency-department-visits-and-hospital-readmissions
#5
Michelle Baker, Chaim M Bell, Wei Xiong, Edward Etchells, Peter G Rossos, Kaveh G Shojania, Kelly Lane, Tim Tripp, Mary Lam, Kimindra Tiwana, Derek Leong, Gary Wong, Jin-Hyeun Huh Huh, Emily Musing, Olavo Fernandes
BACKGROUND: Although medication reconciliation (Med Rec) has demonstrated a reduction in potential adverse drug events, its effect on hospital readmissions remains inconclusive. OBJECTIVE: To evaluate the impact of an interprofessional Med Rec bundle from admission to discharge on patient emergency department visits and hospital readmissions (hospital visits). METHODS: The design was a retrospective, cohort study. Patients discharged from general internal medicine over a 57-month interval were identified through administrative databases...
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29052117/clinical-impact-of-an-interdisciplinary-patient-safety-program-for-managing-drug-related-problems-in-a-long-term-care-hospital
#6
Oreto Ruiz-Millo, Mónica Climente-Martí, Ana María Galbis-Bernácer, José Ramón Navarro-Sanz
Background Medication reviews intended to identify drug-related problems (DRPs) have been researched in primary care, acute care and nursing homes rather than in long-term care hospitals (LTCHs). Objectives To assess the clinical impact of an interdisciplinary pharmacotherapy quality improvement and patient safety program in elderly patients with polypharmacy admitted to an LTCH. Setting An interventional, longitudinal, prospective study was conducted in a Spanish LTCH Method A total of 162 elderly (≥ 70 years) patients with polypharmacy (≥ 5 medications) were included...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29049325/effect-of-therapeutic-interchange-on-medication-reconciliation-during-hospitalization-and-upon-discharge-in-a-geriatric-population
#7
Jessica S Wang, Robert L Fogerty, Leora I Horwitz
BACKGROUND: Therapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange. METHODS AND FINDINGS: Secondary analysis of a transitions of care study. We included patients over age 64 admitted to a tertiary care hospital between 2009-2010 with heart failure, pneumonia, or acute coronary syndrome who were taking a medication in any of six commonly-interchanged classes on admission: proton pump inhibitors (PPIs), histamine H2-receptor antagonists (H2 blockers), hydroxymethylglutaryl CoA reductase inhibitors (statins), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and inhaled corticosteroids (ICS)...
2017: PloS One
https://www.readbyqxmd.com/read/29040609/improving-patient-safety-and-efficiency-of-medication-reconciliation-through-the-development-and-adoption-of-a-computer-assisted-tool-with-automated-electronic-integration-of-population-based-community-drug-data-the-rightrx-project
#8
Robyn Tamblyn, Nancy Winslade, Todd C Lee, Aude Motulsky, Ari Meguerditchian, Melissa Bustillo, Sarah Elsayed, David L Buckeridge, Isabelle Couture, Christina J Qian, Teresa Moraga, Allen Huang
Background and Objective: Many countries require hospitals to implement medication reconciliation for accreditation, but the process is resource-intensive, thus adherence is poor. We report on the impact of prepopulating and aligning community and hospital drug lists with data from population-based and hospital-based drug information systems to reduce workload and enhance adoption and use of an e-medication reconciliation application, RightRx. Methods: The prototype e-medical reconciliation web-based software was developed for a cluster-randomized trial at the McGill University Health Centre...
October 11, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29035964/medication-safety-programs-in-primary-care-a-scoping-review
#9
Hanan Khalil, Monica Shahid, Libby Roughead
BACKGROUND: Medication safety plays an essential role in all healthcare organizations; improving this area is paramount to quality and safety of any wider healthcare program. While several medication safety programs in the hospital setting have been described and the associated impact on patient safety evaluated, no systematic reviews have described the impact of medication safety programs in the primary care setting. A preliminary search of the literature demonstrated that no systematic reviews, meta-analysis or scoping reviews have reported on medication safety programs in primary care; instead they have focused on specific interventions such as medication reconciliation or computerized physician order entry...
October 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29026754/medication-discrepancies-and-potentially-inadequate-prescriptions-in-elderly-adults-with-polypharmacy-in-ambulatory-care
#10
Juan Víctor Ariel Franco, Sergio Adrián Terrasa, Karin Silvana Kopitowski
OBJECTIVES: The objective of this study is to describe the frequency and type of medication discrepancies (MD) through medication reconciliation and to describe the frequency of potentially inadequate prescription (PIP) medications using screening tool of older persons' prescriptions criteria. DESIGN: Cross-sectional comparison of electronic medical record (EMR) medication lists and patient's self-report of their comprehensive medication histories obtained through telephone interviews...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29023830/drug-management-in-acute-kidney-disease-report-of-the-adqi-xvi-meeting
#11
M Ostermann, L S Chawla, L G Forni, S L Kane-Gill, J A Kellum, J Koyner, P T Murray, C Ronco, S L Goldstein
AIMS: To summarize and extend the main conclusions and recommendations relevant to drug management during acute kidney disease (AKD) as agreed at the 16(th) Acute Disease Quality Initiative (ADQI) consensus conference. METHODS: Using a modified Delphi method to achieve consensus, experts attending the 16(th) ADQI consensus conference reviewed and appraised the existing literature on drug management during AKD and identified recommendations for clinical practice and future research...
October 11, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28955400/systemic-anticancer-therapy-sact-for-lung-cancer-and-its-potential-for-interactions-with-other-medicines
#12
Ryan Panchal
BACKGROUND: Systemic anticancer therapy, comprising chemotherapy agents alongside targeted therapies and immunotherapy, is clinically indicated for late-stage lung cancer. It is delivered in regimens often containing multiple anticancer agents as well as supportive care medicines to reduce side effects, raising potential for polypharmacy and therefore the possibility of drug-drug interactions with medicines taken for comorbidities. A pharmacy-led process commonly performed to assist safe prescribing in secondary care is medicines reconciliation; its benefit in minimising interactions involving systemic anticancer therapy medicines has not been assessed previously...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/28947434/discrepancies-in-drug-histories-at-admission-to-gastrointestinal-surgery-internal-medicine-and-geriatric-hospital-wards-in-central-norway-a-cross-sectional-study
#13
Janne Kutschera Sund, Olav Sletvold, Trude Cecilie Mellingsæter, Randi Hukari, Torstein Hole, Per Einar Uggen, Petra Thiemann Vadset, Olav Spigset
OBJECTIVES: To compare discrepancies in drug histories among patients acutely admitted to different hospital wards, classify the discrepancies according to their potential clinical impact and identify appropriate selection criteria for patients that should be subject to a detailed drug history at admission. DESIGN: Cross-sectional study. SETTING: Two gastrointestinal surgery wards and one geriatric ward at St Olav's University Hospital in Trondheim and two general internal medicine wards at Ålesund Hospital in Ålesund, Norway...
September 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28943817/a-pilot-project-for-clinical-pharmacy-services-in-a-clinic-for-children-with-medical-complexity
#14
James Tjon, Lori Chen, Michael Pe, Jennifer Poh, Marina Strzelecki
OBJECTIVE: The primary objective of the project was to assess the impact of clinical pharmacy services in a clinic for children with medical complexity. Secondary objectives were to identify and characterize the drug-related needs of these patients and to describe and develop the role of a pharmacist in the clinic. METHODS: This was a prospective descriptive study in which a clinical pharmacist staffed the clinic for children with medical complexity for 11 weeks, from January to March 2011...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28929979/pharmacists-as-care-providers-for-stroke-patients-a-systematic-review
#15
Jade E Basaraba, Michelle Picard, Kirsten George-Phillips, Tania Mysak
BACKGROUND: Pharmacists have become an integral member of the multidisciplinary team providing clinical patient care in various healthcare settings. Although evidence supporting their role in the care of patients with other disease states is well-established, minimal literature has been published evaluating pharmacist interventions in stroke patients. The purpose of this systematic review is to summarize the evidence evaluating the impact of pharmacist interventions on stroke patient outcomes...
September 20, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28894710/incidence-of-medication-discrepancies-and-its-predicting-factors-in-emergency-department
#16
Morvarid Zarif-Yeganeh, Mansoor Rastegarpanah, Gholamreza Garmaroudi, Molouk Hadjibabaie, Hojjat Sheikh Motahar Vahedi
BACKGROUND: This study was conducted to evaluate the incidence of medication discrepancies and its related factors using medication reconciliation method in patients admitted to the emergency department of Tehran University of Medical Sciences hospitals. METHODS: In this cross-sectional study, 200 adult patients with at least one chronic disease that used two regular prescription medications were included in 2015. After 24 h of admission, demographic data and patient's home medications were collected...
August 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28894309/reliability-of-best-possible-medication-histories-completed-by-non-admitted-patients-in-the-emergency-department
#17
Nicole MacDonald, Leslie Manuel, Haley Brennan, Erin Musgrave, Richard Wanbon, George Stoica
BACKGROUND: Accreditation standards have outlined the need for staff in emergency departments to initiate the medication reconciliation process for patients who are at risk of adverse drug events. The authors hypothesized that a guided form could be used by non-admitted patients in the emergency department to assist with completion of a best possible medication history (BPMH). OBJECTIVE: To determine the percentage of patients in the non-acute care area of the emergency department who could complete a guided BPMH form with no clinically significant discrepancies (defined as no major discrepancies and no more than 1 moderate discrepancy)...
July 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28840436/optimising-patient-safety-using-pharmaceutical-intervention-in-domiciliary-hospitalization
#18
Ana Mafalda Brito, Ana Margarida Simões, Armando Alcobia, Filipa Alves da Costa
Introduction The domiciliary hospitalization unit (DHU) is an innovative model of care provision, where hospital care is transferred to the patients' home. However, this shift adds a care transition layer to the process, which may increase the probability of medication errors to occur. Method A pharmacist has been integrated into the DHU team to improve medication use. We developed an observational study documenting his intervention for 6 months. Information about the patient's drug therapy before admission, during hospitalization and after hospital discharge were gathered, enabling comparison of possible discrepancies that may happen during care transitions...
August 23, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28795285/polypharmacy-and-potential-drug-drug-interactions-in-emergency-department-patients-in-the-caribbean
#19
Darren Dookeeram, Satesh Bidaisee, Joanne F Paul, Paula Nunes, Paula Robertson, Vidya Ramcharitar Maharaj, Ian Sammy
Background Potential Drug-Drug Interactions (DDI) account for many emergency department visits. Polypharmacy, as well as herbal, over-the-counter (OTC) and combination medication may compound this, but these problems are not well researched in low-and-middle-income countries. Objective To compare the incidence of drug-drug interactions and polypharmacy in older and younger patients attending the Emergency Department (ED). Setting The adult ED of a tertiary teaching hospital in Trinidad. Methods A 4 month cross sectional study was conducted, comparing potential DDI in older and younger patients discharged from the ED, as defined using Micromedex 2...
August 9, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28738985/intraoperative-handoffs-among-anesthesia-providers-increase-the-incidence-of-documentation-errors-for-controlled-drugs
#20
Richard H Epstein, Franklin Dexter, David M Gratch, David A Lubarsky
BACKGROUND: When electronic anesthesia records are compared to pharmacy transactions, discrepancies in total doses of controlled drugs are commonly found (≈16% of cases), potentially affecting patient safety and placing hospitals at risk for regulatory action. Errors (≈5%) persisted even with near real-time drug reconciliation feedback to providers. A study was conducted to test the hypothesis of greater risks of discrepancy for longer-duration cases and for intraoperative handoff involving a permanent handoff of care...
August 2017: Joint Commission Journal on Quality and Patient Safety
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