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medicines reconciliation

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
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
Maria Moss, Celine Bilbul, Jo Crook
INTRODUCTION: National guidance from National Institute for Health and Clinical Excellence (NICE), National Patient Safety Agency (NPSA), World Health Organization and the Royal Pharmaceutical Society has long highlighted the importance of accurate and timely medicines reconciliation (MR) in reducing medication errors for patients upon transfer of care setting.1 (-) 4 Current guidance for MR excludes children <16 years of age, where widespread use of off-label and unlicensed formulations puts this group of patients at a higher risk...
September 2016: Archives of Disease in Childhood
Adele Mott, Susan Kafka, Adam Sutherland
AIMS: To pilot a novel approach to providing pharmaceutical care to paediatric inpatients using structured referral and assessment tools. Using standardised referral criteria to ensure patients are assessed by appropriately skilled pharmacists. METHOD: Three wards of varying acuity and specialism were selected in a tertiary children's hospital in England - General Paediatric Ward (GPW), High Dependency Unit (HDU) and Haematology/Oncology Ward (HOW). The project ran for three months...
September 2016: Archives of Disease in Childhood
Sarah K Pontefract, James Hodson, John F Marriott, Sabi Redwood, Jamie J Coleman
BACKGROUND: Some hospital Computerized Physician Order Entry (CPOE) systems support interprofessional communication. The aim of this study was to investigate the effectiveness of pharmacist-physician messages sent via a CPOE system. METHOD: Data from the year 2012 were captured from a large university teaching hospital CPOE database on: 1) review messages assigned by pharmacists; 2) details of the prescription on which the messages were assigned; and 3) details of any changes made to the prescription following a review message being assigned...
2016: PloS One
Jim Sanders, Fastone Goma, Elliot Kafumukache, Mary Ngoma, Selestine Nzala
The last decade has seen a number of educational programs in family medicine begin throughout the African region as many countries have recognized that family medicine offers an efficient way to meet the growing health demands of their country. Zambia's health situation is similar to many countries in sub-Saharan Africa by having a wide array of compelling health demands and a health sector with a limited capacity to meaningfully respond. This paper describes the efforts to begin Zambia's first post-graduate training program for family medicine...
July 2016: Family Medicine
Babar Bashir, Doron Schneider, Mary C Naglak, Thomas M Churilla, Marguerite Adelsberger
OBJECTIVES: Factors that influence the likelihood of readmission for chronic obstructive pulmonary disease (COPD) patients and the impact of posthospital care coordination remain uncertain. LACE index (L = length of stay, A = Acuity of admission; C = Charlson comorbidity index; E = No. of emergency department (ED) visits in last 6 months) is a validated tool for predicting 30-days readmissions for general medicine patients. We aimed to identify variables predictive of COPD readmissions including LACE index and determine the impact of a novel care management process on 30-day all-cause readmission rate...
August 2016: Hospital Practice (Minneapolis)
Amanda H Lavan, Paul F Gallagher, Denis O'Mahony
The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers' lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission...
2016: Clinical Interventions in Aging
Christopher T Zemaitis, Ginger Morris, Maribeth Cabie, Osama Abdelghany, Lorraine Lee
BACKGROUND: Hospital readmission has been identified as a key quality indicator and a target for reducing health care spending. OBJECTIVE: To evaluate the impact of a pharmacy-facilitated medication reconciliation and patient education model with post discharge follow-up on 30-day readmissions. METHODS: This prospective, historical control study included all patients admitted during a 6-month period to a general medicine unit with the highest 30-day readmission rate at Yale-New Haven Hospital...
June 2016: Hospital Pharmacy
Eman A Hammad, Amanda Bale, David J Wright, Debi Bhattacharya
BACKGROUND: Transition of patients care between settings presents an increased opportunity for errors and preventable morbidity. A number of studies outlined that pharmacy-led medicine reconciliation (MR) might facilitate safer information transfer and medication use. MR practice is not well standardized and often delivered in combination with other health care activities. The question regarding the effects and costs of pharmacy-led MR and the optimum MR practice is warranted of value...
May 12, 2016: Research in Social & Administrative Pharmacy: RSAP
Olaf Rose, Hugo Mennemann, Carina John, Marcus Lautenschläger, Damaris Mertens-Keller, Katharina Richling, Isabel Waltering, Stefanie Hamacher, Moritz Felsch, Lena Herich, Kathrin Czarnecki, Corinna Schaffert, Ulrich Jaehde, Juliane Köberlein-Neu
BACKGROUND: Medication reviews are recognized services to increase quality of therapy and reduce medication risks. The selection of eligible patients with potential to receive a major benefit is based on assumptions rather than on factual data. Acceptance of interprofessional collaboration is crucial to increase the quality of medication therapy. OBJECTIVE: The research question was to identify and prioritize eligible patients for a medication review and to provide evidence-based criteria for patient selection...
2016: PloS One
Justin Mikell, S Cheenu Kappadath, Todd Wareing, William D Erwin, Uwe Titt, Firas Mourtada
To evaluate the 3D Grid-based Boltzmann Solver (GBBS) code ATTILA (®) for coupled electron and photon transport in the nuclear medicine energy regime for electron (beta, Auger and internal conversion electrons) and photon (gamma, x-ray) sources. Codes rewritten based on ATTILA are used clinically for both high-energy photon teletherapy and (192)Ir sealed source brachytherapy; little information exists for using the GBBS to calculate voxel-level absorbed doses in nuclear medicine. We compared DOSXYZnrc Monte Carlo (MC) with published voxel-S-values to establish MC as truth...
June 21, 2016: Physics in Medicine and Biology
M T Jiménez-Buñuales, M S Martínez-Sáenz, P González-Diego, M Vallejo-García, J Gallardo-Anciano, A Cestafe-Martínez
OBJECTIVES: The purpose of this study is to know the incidence rate of medication reconciliation at admission and discharge in patients of La Rioja and to improve the patient safety on medication reconciliation. MATERIAL AND METHODS: An observational prospective study, part of the Joint Action PaSQ, Work Package 5, European Union Network for Patient Safety and Quality of Care. The study has taken into account the definitions of the Institute for Safe Medication Practices...
June 2016: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
Khawla Abu Hammour, Rana Abu Farha, Iman Basheti
RATIONALE, AIMS AND OBJECTIVES: The primary aim of this study is to gain an insight into hospital pharmacists' current practice and perceptions towards medicine reconciliation and to identify common challenges preventing pharmacists from providing this service. METHODS: A cross-sectional study was conducted over 2 months (September-October 2015) at four Jordanian hospitals accredited by the Joint International Commission. A total of 76 pharmacists were recruited...
May 19, 2016: Journal of Evaluation in Clinical Practice
Malcolm Daniel, Alex Puxty, Barbara Miles
Improving work as part of clinical practice is challenging. Plans for improvement are often made, but not followed through. A recent experience of failure in an ICU led to a change in approach. Members of the multi-professional team committed to meet weekly to learn about quality improvement by working on improvement projects. The group selected four topics they wanted to work on. These were: a bundle for patients admitted with septic shock; early (≤4 hours) sedation vacation after admission to ICU to allow titration of sedation to effect; achieving ≥ 20 minutes of mobilisation per day in ventilated patients; and medicines reconciliation...
2016: BMJ Quality Improvement Reports
Erin Sarzynski, Hamza Hashmi, Jeevarathna Subramanian, Laurie Fitzpatrick, Molly Polverento, Michael Simmons, Kevin Brooks, Charles Given
BACKGROUND: Clinical summaries are electronic health record (EHR)-generated documents given to hospitalised patients during the discharge process to review their hospital stays and inform postdischarge care. Presently, it is unclear whether clinical summaries include relevant content or whether healthcare organisations configure their EHRs to generate content in a way that promotes patient self-management after hospital discharge. We assessed clinical summaries in three relevant domains: (1) content; (2) organisation; and (3) readability, understandability and actionability...
May 6, 2016: BMJ Quality & Safety
Lauren B Meade, Kathleen Heist Suddarth, Ronald R Jones, Aimee K Zaas, Terry Albanese, Kenji Yamazaki, Cheryl W O'Malley
PROBLEM: The Accreditation Council for Graduate Medical Education milestones were written by physicians and thus may not reflect all the behaviors necessary for physicians to optimize their performance as a key member of an interprofessional team. APPROACH: From April to May 2013, the authors, Educational Research Outcomes Collaborative leaders, assembled interprofessional team discussion groups, including patients or family members, nurses, physician trainees, physician educators, and other staff (optional), at 11 internal medicine (IM) programs...
April 19, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Saeed Al Shemeili, Susan Klein, Alison Strath, Saleh Fares, Derek Stewart
RATIONALE AND AIM: The structures and processes around the management of medicines for elderly, hospitalized patients are ill defined. This study aimed to determine consensus related to strategic and operational approaches in the United Arab Emirates. METHODS: A modified Delphi technique, consensus study with first round statements developed from systematic reviews related to medicines management. Normalization process theory and the theoretical domains framework were applied in the construction of statements, organized into key elements of medicines management: guidelines for medicines management, medicines reconciliation, medicines selection, prescribing and review, medicines adherence, medicines counselling, health professional training and evaluation research...
October 2016: Journal of Evaluation in Clinical Practice
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