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de-prescribing pharmacy

Lelwala Guruge Thushani Shanika, Shaluka Jayamanne, Chandrani Nirmala Wijekoon, Judith Coombes, Dhineli Perera, Fahim Mohamed, Ian Coombes, Hithanadura Asita De Silva, Andrew Hamilton Dawson
Objective: To assess if a ward-based clinical pharmacy service resolving drug-related problems improved medication appropriateness at discharge and prevented drug-related hospital readmissions. Method: Between March and September 2013, we recruited patients with noncommunicable diseases in a Sri Lankan tertiary-care hospital, for a non-randomized controlled clinical trial. The intervention group received usual care and clinical pharmacy service. The intervention pharmacist made prospective medication reviews, identified drug-related problems and discussed recommendations with the health-care team and patients...
March 1, 2018: Bulletin of the World Health Organization
Sharon Elad, Kevin Zinchuk, Shuli Li, Corey Cutler, Jane Liesveld, Nathaniel Treister
BACKGROUND: Chronic graft-versus-host disease (cGVHD) frequently affects the oral mucosa and is generally responsive to topical immunomodulatory therapies. Clinicians may benefit from guidance in choosing the most appropriate therapy with respect to practicality and cost. OBJECTIVE: To assess the economic considerations related to topical immunomodulatory treatments for management of oral mucosal cGVHD and their practical implications. METHOD: Topical treatments used for management of oral cGVHD were obtained from the NIH Consensus document for ancillary and supportive care...
March 1, 2018: Biology of Blood and Marrow Transplantation
Esther Kuipers, Michel Wensing, Peter A G M De Smet, Martina Teichert
RATIONALE, AIMS, AND OBJECTIVES: Despite recommendations in prevailing guidelines to avoid the use of non-selective (NS) β-blockers in patients with asthma or COPD, on average, 10 patients per community pharmacy receive NS β-blockers monthly. The aim of our study was to identify the reasons of prescribers and pharmacists to treat asthma and COPD patients with NS β-blockers. METHODS: Fifty-three community pharmacists in the Netherlands selected patients with actual concurrent use of inhalation medication and NS β-blockers...
January 10, 2018: Journal of Evaluation in Clinical Practice
Jack Charles Collins, Carl Richard Schneider, Clare Louise Naughtin, Frances Wilson, Abilio Cesar de Almeida Neto, Rebekah Jane Moles
OBJECTIVES: To determine whether repeated mystery shopping visits with feedback improve pharmacy performance over nine visits and to determine what factors predict an appropriate outcome. DESIGN: Prospective, parallel, repeated intervention, repeated measures mystery shopping (pseudopatient) design. SETTING: Thirty-six community pharmacies in metropolitan Sydney, Australia in March-October 2015. PARTICIPANTS: Sixty-one University of Sydney pharmacy undergraduates acted as mystery shoppers...
December 14, 2017: BMJ Open
Katarina M Vučićević, Branislava R Miljković, Bojana C Golubović, Marija N Jovanović, Sandra D Vezmar Kovačević, Milica D Ćulafić, Milena M Kovačević, Johan J de Gier
BACKGROUND: During the initiation of treatment of a chronic disease, patients may have varying interests, expectations, concerns, and reasons to stop treatment, influencing compliance with prescribed treatment. Thus, healthcare professionals are expected to integrate these needs into medicines management. OBJECTIVES: To determine what information is important to patients; assess predictors of patients' interests, expectations, concerns, reasons to stop therapy; evaluate drug-related problems following initiation of therapy and summarize how pharmacists resolve them during patient-pharmacist counselling...
November 22, 2017: European Journal of General Practice
Marina Guimarães Lima, Juliana Álvares, Augusto Afonso Guerra, Ediná Alves Costa, Ione Aquemi Guibu, Orlando Mario Soeiro, Silvana Nair Leite, Margô Gomes de Oliveira Karnikowski, Karen Sarmento Costa, Francisco de Assis Acurcio
OBJECTIVE: To evaluate indicators related to the rational use of medicines and its associated factors in Basic Health Units. METHOD: This is a cross-sectional study carried out in a representative sample of Brazilian cities included in the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). The data were collected by interviews with users, medicine dispensing professionals, and prescribers; and described by prescription, dispensing, and health services indicators...
November 13, 2017: Revista de Saúde Pública
A D A Fernando, L M H Bandara, H M S T Bandara, S Pilapitiya, A de Silva
BACKGROUND: Intake of medicines and supplements is widespread among the professional athletes in developed countries and there are reports to suggest inappropriate self-administration of medicine. Data from South Asia on this area is lacking. This study examined self-medication practices with regard to use of allopathic and herbal/traditional medicines among national -level Sri Lankan athletes. RESULTS: 209 athletes from 15 national sport teams were assessed using an anonymous, interviewer administered questionnaire...
July 6, 2017: BMC Research Notes
Fannie Santoni, Valéry Antoine, Alberto di Castri, Maurice Viala, Laetitia Geronimi-Robelin, Cédric LeGuillou, Christine de Taddeo, Sophie Bastide, Claude Jeandel, Benoit de Wazieres
Polypharmacy, potentially inappropriate prescriptions and inadequate coordination between prescribers are among main factors explaining the occurrence of adverse drug events in elderly patients. Prospective and descriptive study of medication prescriptions for elderly patients during a continuous period of health-care: entry in an acute geriatric unit (T1), at discharge (T2) and two months after hospitalization (T3). A global iatrogenic risk was defined: presence of poly-pharmacy and/or PPI (Laroche criteria) and/or absence of quality indicators for prescription according to the French health authority...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Annelies C Ham, Suzanne C van Dijk, Karin M A Swart, Anke W Enneman, Nikita L van der Zwaluw, Elske M Brouwer-Brolsma, Natasja M van Schoor, M Carola Zillikens, Paul Lips, Lisette C P G M de Groot, Albert Hofman, Renger F Witkamp, André G Uitterlinden, Bruno H Stricker, Nathalie van der Velde
AIMS: To investigate the association between use of β-blockers and β-blocker characteristics - selectivity, lipid solubility, intrinsic sympathetic activity (ISA) and CYP2D6 enzyme metabolism - and fall risk. METHODS: Data from two prospective studies were used, including community-dwelling individuals, n = 7662 (the Rotterdam Study) and 2407 (B-PROOF), all aged ≥55 years. Fall incidents were recorded prospectively. Time-varying β-blocker use was determined using pharmacy dispensing records...
October 2017: British Journal of Clinical Pharmacology
Julie Redfern, Rufus Adesoji Adedoyin, Sandra Ofori, Raghupathy Anchala, Vamadevan S Ajay, Luciano De Andrade, Jose Zelaya, Harparkash Kaur, Dina Balabanova, Mahmoud U Sani
BACKGROUND: Prevention and optimal management of hypertension in the general population is paramount to the achievement of the World Heart Federation (WHF) goal of reducing premature cardiovascular disease (CVD) mortality by 25% by the year 2025 and widespread access to good quality antihypertensive medicines is a critical component for achieving the goal. Despite research and evidence relating to other medicines such as antimalarials and antibiotics, there is very little known about the quality of generic antihypertensive medicines in low-income and middle-income countries...
August 2016: BMJ Global Health
Billy Sin, Kwong Lau, Richard Tong, Josel Ruiz, Kimberly Sarosky, Robert DiGregorio, Shalom Butel, Sylvie de Souza
OBJECTIVE: We evaluated the feasibility and impact of prospective medication review (PMR) in the emergency department (ED). METHODS: This was a retrospective cohort study of all nonadmitted ED patients who were prescribed medication orders by ED clinicians from September 2014 to September 2015 to determine the time intervals utilized during each step of the medication use process and quantify the number of interventions conducted by the pharmacist and cost avoidance accrued from the interventions...
January 1, 2017: Journal of Pharmacy Practice
Giuseppina Barberi, Maria Cristina De Cola, De Cola Dell'Utri, Sara Melardi, Bernardo Alagna, Placido Bramanti, Antonio Cascio
The paper presents a snapshot of the incidence of antimicrobial-resistant microorganisms and antimicrobial consumption in an Italian rehabilitation center over a two-year period (2014-2015). Data on microorganism identification and antimicrobial susceptibility testing were obtained from the diagnostic laboratory of the hospital. A set of indicators was assessed, including the incidence density of resistant isolates per 1000 patient-days (IDRI). Data on antimicrobial consumption, semi-annually, obtained from the hospital pharmacy, were expressed as Defined Daily Dose (DDD) per 1000 patient-days...
April 2017: New Microbiologica
Emma Mares-García, Antonio Palazón-Bru, Álvaro Martínez-Martín, David Manuel Folgado-de la Rosa, Avelino Pereira-Expósito, Vicente Francisco Gil-Guillén
OBJECTIVES: To determine the magnitude of non-guideline-recommended prescribing (NGRP) of proton pump inhibitors (PPIs) in the general population, its associated factors and expense. METHODS: We undertook a cross-sectional observational study in three community pharmacies in a Spanish region in 2013 involving a total of 302 patients with a prescription for PPIs. The main variable was the NGRP of PPIs. Secondary variables were: gender, age, antidepressants, osteoporosis, osteoarthritis, prescription cost per month and total number of chronic diseases...
April 19, 2017: Current Medical Research and Opinion
Leila A Walker, Edward J Zambraski, Roger F Williams
INTRODUCTION: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain and inflammation by inhibiting prostaglandin synthesis. There is a high incidence of musculoskeletal injuries in the military, which would validate the widespread use of NSAIDs. This study determined the amount and specific types of NSAIDs being prescribed to U.S. Army active duty soldiers. METHODS AND MATERIALS: This study was a quantitative study which utilized an existing database of de-identified data; therefore, institutional review board approval was not required...
March 2017: Military Medicine
Laia Calvó-Perxas, Oriol Turró-Garriga, Joan Vilalta-Franch, Manuela Lozano-Gallego, Rosa de Eugenio, Fabián Márquez, Olga Carmona, Jordi Gich, Anna Manzano, Marta Viñas, Anna Mª Roig, Josep Garre-Olmo
BACKGROUND: Acetylcholinesterase inhibitors (AChEIs) and the N-methyl D-aspartate-antagonist memantine are indicated for the symptomatic treatment of Alzheimer's disease (AD). OBJECTIVES: Our aims were to describe the baseline characteristics of patients with AD according to prescription of these treatments after the diagnostic work-up to describe long-term trends in the use of these medications and to identify baseline characteristics associated with the frequency of use of each treatment...
April 2017: Drugs & Aging
Emily Behar, Christopher Rowe, Glenn-Milo Santos, Nina Santos, Phillip O Coffin
BACKGROUND: Improving the safety of prescribed opioids in clinical settings is a national priority. While co-prescribing naloxone is increasingly recommended, there is little understanding of the optimal way to implement this practice. METHODS: We developed and delivered an academic detailing intervention to 40 randomly selected opioid-prescribing primary care providers in San Francisco from February to May 2015. Process outcomes were tracked and included provider demographics, number and type of contact attempts, reason for refusal (if applicable), name of detailer, duration of intervention, topics covered, provider concerns, and follow-up plan...
February 2017: Family Medicine
Yuan-Yuan Wang, Ping Du, Fang Huang, Dong-Jie Li, Jun Gu, Fu-Ming Shen, Yuan-Ying Jiang
Whilst the 'Principles of clinical use of antibiotics' was released by the Ministry of Health of the People's Republic of China in 2004, limited research has been conducted to evaluate the quality of antibiotic use in real-world practice. In this study, we sought to examine antimicrobial prescribing patterns in a large tertiary hospital in Shanghai, China. De-identified outpatient and emergency department pharmacy records containing antimicrobials were extracted from the hospital electronic health records system...
December 2016: International Journal of Antimicrobial Agents
O Ferrández, O Urbina, S Grau, J Mateu-de-Antonio, M Marin-Casino, J Portabella, S Mojal, M Riu, E Salas
WHAT IS KNOWN AND OBJECTIVE: Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment...
April 2017: Journal of Clinical Pharmacy and Therapeutics
Daniela Oliveira de Melo, Caroline Godoi Rezende da Costa Molino, Eliane Ribeiro, Nicolina Silvana Romano-Lieber
Few Brazilian articles discuss the importance of pharmacy technicians who offer direct assistance to patients. This paper describes an experience of the training of pharmacy technicians in drug dispensing. A descriptive, cross-sectional study was conducted in the primary healthcare setting. The technicians were trained by the pharmacist to advise patients at the time of drug dispensing and to screen cases that needed pharmaceutical consultation. Problems were identified by verifying the prescription and return date for dispensing the medication as well as through direct questioning of the patients...
January 2017: Ciência & Saúde Coletiva
Daniela Oliveira de Melo, Lia Lusitana Cardozo de Castro
Objective: to describe the pharmaceutical inclusion process in a Basic Health Unit multidisciplinary team and evaluate results related to rational use and promotion of access to essential medicines. Methods: This is a descriptive, cross-sectional study conducted in a primary care health unit in the city of São Paulo. Pharmacist's activities were evaluated regarding the service structure and organization and prescribing quality improvement, guidance method creation, and implementation of clinical pharmacy service...
January 2017: Ciência & Saúde Coletiva
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