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Medication reconciliation

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https://www.readbyqxmd.com/read/29329310/medication-discrepancies-across-multiple-care-transitions-a-retrospective-longitudinal-cohort-study-in-italy
#1
Marco Bonaudo, Maria Martorana, Valerio Dimonte, Alessandra D'Alfonso, Giulio Fornero, Gianfranco Politano, Maria Michela Gianino
PURPOSE: Medication discrepancies are defined as unexplained differences among regimens across different sites of care. The problem of medication discrepancies that occur during the entire care pathway from hospital admission to a local care setting discharge (namely all types of settings dedicated to formal care other than hospitals) has received little attention in the medical literature. The present study aims to (1) determine the prevalence of medication discrepancies that occur during the entire care pathway from hospital admission to local care setting discharge, (2) describe the discrepancy and medication type, and (3) identify potential risk factors for experiencing medication discrepancies in patient care transitions...
2018: PloS One
https://www.readbyqxmd.com/read/29318695/risk-factors-for-medication-errors-at-admission-in-preoperatively-screened-patients
#2
Marieke M Ebbens, Kim B Gombert-Handoko, Muhammad Al-Dulaimy, Patricia M L A van den Bemt, Elsbeth J Wesselink
BACKGROUND: Preoperative screening (POS) may help to reduce medication errors at admission (MEA). However, due to the time window between POS and hospital admission, unintentional medication discrepancies may still occur and thus a second medication reconciliation at hospital admission can be necessary. Insight into potential risk factors associated with these discrepancies would be helpful to focus the second medication reconciliation on high-risk patients. OBJECTIVE: To determine the proportion of POS patients with MEA and to identify risk factors for MEA...
January 10, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29310711/impact-of-collaborative-pharmaceutical-care-on-in-patients-medication-safety-study-protocol-for-a-stepped-wedge-cluster-randomized-trial-medrev-study
#3
Géraldine Leguelinel-Blache, Christel Castelli, Clarisse Roux-Marson, Sophie Bouvet, Sandrine Andrieu, Philippe Cestac, Rémy Collomp, Paul Landais, Bertrice Loulière, Christelle Mouchoux, Rémi Varin, Benoit Allenet, Pierrick Bedouch, Jean-Marie Kinowski
BACKGROUND: Clinical pharmaceutical care has long played an important role in the improvement of healthcare safety. Pharmaceutical care is a collaborative care approach, implicating all the actors of the medication circuit in order to prevent and correct drug-related problems that can lead to adverse drug events. The collaborative pharmaceutical care performed during patients' hospitalization requires two mutually reinforcing activities: medication reconciliation and medication review...
January 8, 2018: Trials
https://www.readbyqxmd.com/read/29310708/the-pharms-patient-held-active-record-of-medication-status-feasibility-study-a-research-proposal
#4
Elaine Walsh, Laura J Sahm, Patricia M Kearney, Henry Smithson, David M Kerins, Chrys Ngwa, Ciara Fitzgerald, Stephen Mc Carthy, Eimear Connolly, Kieran Dalton, Derina Byrne, Megan Carey, Colin Bradley
Medication errors are a major source of preventable morbidity, mortality and cost and many occur at the times of hospital admission and discharge. Novel interventions (such as new methods of recording medication information and conducting medication reconciliation) are required to facilitate accurate transfer of medication information. With existing evidence supporting the use of information technology and the patient representing the one constant in the care process, an electronic patient held medication record may provide a solution...
January 8, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29309943/association-of-pretransplant-opioid-use-with-graft-loss-or-death-in-liver-transplantation-patients-with-model-of-end-stage-liver-disease-exceptions
#5
James N Fleming, David J Taber, Nicole A Pilch, Caitlin R Mardis, Rachael E Gilbert, Lytani Z Wilson, Neha Patel, Sarah Ball, Patrick Mauldin, Prabhakar K Baliga
BACKGROUND: Up to 77% of liver transplant candidates experience pain, with the majority prescribed opioids. Previous studies have shown increased readmissions and mortality in liver transplant recipients who were prescribed opioids prior to transplant. Our aim was to identify specific populations that are at the highest risk of deleterious outcomes with opioid use prior to transplant. STUDY DESIGN: This was a single-center retrospective cohort study of adult liver transplant recipients transplanted between 2010 and 2016 to assess the impact of pre-transplant opioid use on mortality and graft loss following liver transplantation...
January 5, 2018: Journal of the American College of Surgeons
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
#6
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/29300961/patient-portal-use-and-hospital-outcomes
#7
Adrian G Dumitrascu, M Caroline Burton, Nancy L Dawson, Colleen S Thomas, Lisa M Nordan, Hope E Greig, Duaa I Aljabri, James M Naessens
Objectives: To determine whether use of a patient portal during hospitalization is associated with improvement in hospital outcomes, 30-day readmissions, inpatient mortality, and 30-day mortality. Materials and Methods: We performed a retrospective propensity score-matched study that included all adult patients admitted to Mayo Clinic Hospital in Jacksonville, Florida, from August 1, 2012, to July 31, 2014, who had signed up for a patient portal account prior to hospitalization (N = 7538)...
December 28, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29299004/ambulatory-medication-reconciliation-in-dialysis-patients-benefits-and-community-practitioners-perspectives
#8
Jo-Anne S Wilson, Matthew A Ladda, Jaclyn Tran, Marsha Wood, Penelope Poyah, Steven Soroka, Glenn Rodrigues, Karthik Tennankore
Background: Ambulatory medication reconciliation can reduce the frequency of medication discrepancies and may also reduce adverse drug events. Patients receiving dialysis are at high risk for medication discrepancies because they typically have multiple comorbid conditions, are taking many medications, and are receiving care from many practitioners. Little is known about the potential benefits of ambulatory medication reconciliation for these patients. Objectives: To determine the number, type, and potential level of harm associated with medication discrepancies identified through ambulatory medication reconciliation and to ascertain the views of community pharmacists and family physicians about this service...
November 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29299002/care-gaps-in-the-electronic-discharge-medication-reconciliation-process-at-an-acute-care-facility
#9
Kelly MacDonald, Marsha Cusack, Su Qiong Rebecca Liang, Kilby Rinco
Background: Many patients experience adverse events at the time of discharge from hospital, and most of these events are medication-related. To improve patient safety, Health PEI (the health authority for Prince Edward Island) has made medication reconciliation a priority. The Queen Elizabeth Hospital in Charlottetown is one of the few Canadian hospitals with an electronic discharge process. A discharge report has been developed to provide pertinent information to patients at discharge, including a final medication list to be shared with the community pharmacy at the patient's discretion...
November 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29298192/helping-older-adults-improve-their-medication-experience-home-by-addressing-medication-regimen-complexity-in-home-healthcare
#10
Orla C Sheehan, Hadi Kharrazi, Kimberly J Carl, Bruce Leff, Jennifer L Wolff, David L Roth, Jennifer Gabbard, Cynthia M Boyd
In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules...
January 2018: Home Healthcare Now
https://www.readbyqxmd.com/read/29276763/a-description-of-patient-and-provider-experience-and-clinical-outcomes-after-heart-failure-shared-medical-appointment
#11
Lisa B Cohen, Melanie Parent, Tracey H Taveira, Sandesh Dev, Wen-Chih Wu
Background: Shared medical appointments (SMAs) are clinical visits in which several patients meet with 1 or more providers at the same time. Objective: To describe the outcomes of an interdisciplinary SMA for veterans recently discharged for heart failure (HF). Methods: A retrospective chart review for patients' readmission rates, survival, medication adherence, and medication-related problems. For qualitative outcomes, we performed semistructured interviews on 12 patients who had undergone HF SMAs and their respective caregivers focusing on care satisfaction, HF knowledge, disease self-care, medication reconciliation, and peer support...
December 2017: Journal of Patient Experience
https://www.readbyqxmd.com/read/29276301/impact-of-inpatient-automatic-therapeutic-substitutions-on-postdischarge-medication-prescribing
#12
Pooja J Shah, Jennifer L Cruz, Ashley L Pappas, Kayla M Waldron, Scott W Savage
Background: Automatic therapeutic substitution (ATS) is the act of therapeutic interchange, in which patients are transitioned from a nonformulary preadmission medication to an equivalent formulary medication upon admission. ATS protocols are able to provide several benefits; however, if medications are unreconciled at the time of discharge, then use may lead to duplication or omission resulting in adverse outcomes. The objective was to assess the impact of preidentified ATS protocol use during admission on duplication and omission postdischarge...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29273612/interprofessional-care-collaboration-for-patients-with-heart-failure
#13
Amanda Boykin, Danielle Wright, Lydia Stevens, Lauren Gardner
PURPOSE: An innovative collaborative care model to improve transitions of care (TOC) for patients with heart failure (HF) is described. SUMMARY: As part of a broad effort by New Hanover Regional Medical Center (NHRMC) to reduce avoidable 30-day hospital readmissions and decrease associated healthcare costs through a team-centered, value-based approach to patient care, an interprofessional team was formed to help reduce hospital readmissions among discharged patients with HF...
January 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29248986/the-impact-of-pharmacist-led-medication-reconciliation-during-admission-at-tertiary-care-hospital
#14
Khulood H Abdulghani, Mohammed A Aseeri, Ahmed Mahmoud, Rayf Abulezz
Background Medication errors represent the most common type of error that compromises patient safety, with approximately 20% believed to result in harm. Over 40% of these errors are believed to result from inadequate medication reconciliation during admission, transfer, and discharge of patients and many of these errors could be prevented if adequate medication reconciliation processes were in place. In an effort to minimize adverse events caused during these care transitions, the Joint Commission has stated medication reconciliation as one of its National Patient Safety Goals and health care providers and organizations are encouraged to perform the process at various patient care transitions...
December 16, 2017: International Journal of Clinical Pharmacy
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
#15
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/29248079/preliminary-findings-from-a-student-pharmacist-operated-transitions-of-care-pilot-service
#16
Kari Vavra, Matthew Paluzzi, Margaret de Voest, Sarah Raguckas, Martha Slot
BACKGROUND AND PURPOSE: Student pharmacists are well equipped to complete transitions of care (TOC) activities. This communication describes the implementation of a student-operated TOC pilot service at a community hospital and explores the clinical and educational findings of such a service. EDUCATIONAL ACTIVITY AND SETTING: Patients admitted to the hospital were included in the service if they had a primary care provider from an affiliated ambulatory care office...
January 2018: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29239778/accuracy-of-medication-histories-collected-by-pharmacy-technicians-during-hospital-admission
#17
Jena Jobin, Adriane N Irwin, Jana Pimentel, Matthew C Tanner
BACKGROUND: Transitioning activities that do not require clinical judgment from pharmacists to pharmacy technicians has been endorsed as a strategy to increase patient access to clinical pharmacy services. One role becoming increasingly common is using pharmacy technicians to collect the medication history within medication reconciliation processes. OBJECTIVE: To assess the ability of pharmacy technicians to gather a complete and accurate medication history during the inpatient admission process at a regional medical center...
August 19, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29236841/the-utility-of-the-records-medical-factors-associated-with-the-medication-errors-in-chronic-disease
#18
Hellen Lilliane da Cruz, Flávia Karla da Cruz Mota, Lorena Ulhôa Araújo, Emerson Cotta Bodevan, Sérgio Ricardo Stuckert Seixas, Delba Fonseca Santos
OBJECTIVE: This study describes the development of the medication history of the medical records to measure factors associated with medication errors among chronic diseases patients in Diamantina, Minas Gerais. METHODS: retrospective, descriptive observational study of secondary data, through the review of medical records of hypertensive and diabetic patients, from March to October 2016. RESULTS: The patients the mean age of patient was 62...
December 11, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29233434/assessing-students-knowledge-regarding-the-roles-and-responsibilities-of-a-pharmacist-with-focus-on-care-transitions-through-simulation
#19
Erini S Serag-Bolos, Aimon C Miranda, Shyam R Gelot, Sheetal P Dharia, Kristy M Shaeer
BACKGROUND AND PURPOSE: To evaluate the impact of a pharmacist-focused transitions of care (TOC) simulation on students' perceptions and knowledge of pharmacist roles in the healthcare continuum. Educational Activity and Setting: Two simulations, highlighting pharmacist roles in various practice settings, were conducted within the Pharmaceutical Skills courses in the third-year doctor of pharmacy curriculum. Patient cases were built utilizing electronic medical records (EMR). Students' knowledge was assessed before and after the simulations regarding pharmacist involvement in medication reconciliation, reduction in patient readmissions, reduction of inappropriate medication use, roles and communication on an interprofessional team, and involvement with health information technology (HIT) during care transitions...
July 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233279/pharmacy-student-engagement-in-the-evaluation-of-medication-documentation-within-an-ambulatory-care-electronic-medical-record
#20
Tatum Mead, Stephanie Schauner
BACKGROUND AND PURPOSE: An abundance of literature supports the benefits of electronic medical records (EMR) for improving overall healthcare quality. Identifying preventative care opportunities, reducing medical and medication related errors and incorporating clinical practice guidelines are just a few attributes of EMR implementation. The goals of this study were to engage experiential pharmacy students in the assessment of medication related documentation discrepancies in a newly implemented EMR system and to provide exposure to various aspects of conducting research...
May 2017: Currents in Pharmacy Teaching & Learning
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