Abstract：
BACKGROUND:Medication discrepancies may occur at transitions in care and negatively impact patient outcomes. OBJECTIVE:To determine if involving clinical pharmacists in hospital care, medication reconciliation and discharge medication plan communication can reduce medication discrepancies with a prospective, randomized, blinded, controlled trial. SETTING:A large, tertiary care, academic medical center. METHOD:The intervention consisted of clinical pharmacist medication reconciliation, patient education and improved communication of the discharge medication plan, as devised by the hospital physician and care team, to primary care physicians and community pharmacists. Medication discrepancies were identified by blinded research pharmacists who reviewed primary care physician and pharmacy records at discharge through 90 days post-discharge to create 30- and 90-day medication lists. MAIN OUTCOME MEASURE:Rate of medication discrepancies compared across groups. RESULTS:A total of 592 subjects from internal medicine, family medicine, cardiology and orthopedic services were evaluated for this study. Clinically important medication discrepancies in the primary care physician record were different between groups 30 days after hospital discharge following a clinical pharmacist's intervention. The mean number of medication discrepancies per patient for the enhanced group being nearly half the number in the control group. However, this effect did not persist to 90 days post-discharge and did not extend to community pharmacy records. CONCLUSION:The present study demonstrates the involvement of pharmacists in hospital care, medication reconciliation and discharge medication plan communication may affect the quality of the outpatient medical record.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Farley TM,Shelsky C,Powell S,Farris KB,Carter BLdoi
10.1007/s11096-014-9917-xsubject
Has Abstractpub_date
2014-04-01 00:00:00pages
430-7issue
2eissn
2210-7703issn
2210-7711journal_volume
36pub_type
杂志文章abstract：:Bridging the gap between hospital and primary care is important as transition from one healthcare setting to another increases the risk on drug-related problems and consequent readmissions. To reduce those risks, pharmacist interventions during and after hospitalization have been frequently studied, albeit with variab...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-015-0093-4
更新日期：2015-06-01 00:00:00
abstract：:Background Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used pharmaceutical agents worldwide. NSAIDs are considered nephrotoxic and should therefore be used with caution or be avoided completely in high risk patients, such as chronic kidney disease (CKD) patients. Objective This study aim...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-016-0298-1
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:Improper disposal of medications potentially poses a significant environmental risk and storage of expired and unused medications in households provides an increased risk of accidental childhood poisonings. OBJECTIVE:The objective of this study was to investigate the storage and disposal habits of medicatio...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-012-9652-0
更新日期：2012-08-01 00:00:00
abstract：:Practice-based networks can serve as effective mechanisms for the development of the profession of pharmacists, on the one hand by supporting student internships and on the other hand by collection of research data and implementation of research outcomes among public health practice settings. This paper presents the c...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,评审
doi：10.1007/s11096-014-9954-5
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:The scope of pharmacist services for patients with pulmonary disease has primarily focused on drug related outcomes; however pharmacists have the ability to broaden the scope of clinical services by performing diagnostic testing including quality spirometry testing. Studies have demonstrated that pharmacists...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,评审
doi：10.1007/s11096-015-0160-x
更新日期：2015-10-01 00:00:00
abstract：OBJECTIVE:Linezolid represents an important advance in the treatment of methicillinresistant staphylococci. Its effectiveness should be preserved by appropriate uses. The aims of this survey were to describe the use of linezolid in clinical practice and to assess its overall safety. METHODS:This retrospective observat...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-011-9576-0
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:For patients accessing specialist palliative care day services, medication is prescribed routinely to manage acute symptoms, treat long-term conditions or prevent adverse events associated with these conditions. As such, the pharmacotherapeutic burden for these patients is high and polypharmacy is common. Co...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-014-9932-y
更新日期：2014-06-01 00:00:00
abstract：:Background Rheumatoid arthritis is a chronic, autoimmune disease in which treatment has evolved with a variety of therapeutic classes. Biological disease-modifying antirheumatic drugs have improved therapy; however, the continued long-term use of these drugs with sustained safety and efficacy remains a challenge. Obje...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-020-01171-5
更新日期：2020-10-21 00:00:00
abstract：:Background Patient centred communication can improve pharmaceutical care, but is not well described for pharmacists. Aim of the review To provide a comprehensive and accessible overview of the concept of patient centred communication for the pharmacy practice. Method A scoping review and thematic analysis was undertak...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,评审
doi：10.1007/s11096-017-0508-5
更新日期：2017-12-01 00:00:00
abstract：:Background The Middle East region has one the highest prevalence rates of diabetes in the world. Little is known about the determinants of adherence and the role of knowledge in diabetes self-management within these populations. Objective To investigate the relationship between patients knowledge of diabetes therapeut...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,多中心研究
doi：10.1007/s11096-016-0375-5
更新日期：2017-02-01 00:00:00
abstract：:Background Pharmacist-physician collaboration can lead to many positive outcomes. However, collaboration between healthcare providers is complex and rarely performed optimally. Objectives To study physician-pharmacist collaboration in hospital settings, from the physician's point of view. Setting Eight regional non-te...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-016-0395-1
更新日期：2016-12-01 00:00:00
abstract：OBJECTIVES:Diabetes mellitus is a chronic progressive disease characterized by numerous health complications. Medication adherence is an important determinant of therapeutic outcome. Few studies on medication adherence have been published from the Arab countries. Therefore, the objective of this pilot study was to asse...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-011-9561-7
更新日期：2011-12-01 00:00:00
abstract：UNLABELLED:Background Potentially inappropriate medications (PIMs) are often found in high proportion among the elderly population. The STOPP criteria have been suggested to detect more PIMs in European elderly than the Beers criteria. Objective This study aimed to determine the prevalence of PIMs and potential prescri...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,多中心研究
doi：10.1007/s11096-016-0337-y
更新日期：2016-10-01 00:00:00
abstract：: ...
journal_title：International journal of clinical pharmacy
pub_type：
doi：10.1007/s11096-018-0759-9
更新日期：2019-02-01 00:00:00
abstract：:Background Community pharmacy is undergoing a transition, shifting focus from traditional roles to the provision of cognitive pharmaceutical services. However, traditional activities performed by community pharmacists reduce the amount of available time for implementing and providing such services. Therefore, hamperin...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-019-00852-0
更新日期：2019-08-01 00:00:00
abstract：CASE:We report a 32-year old relapse case of Visceral leishmaniasis, treated with Paromomycin who belonged from a endemic zone of Bihar state, India. After confirmation, he was treated with Amphotericin B, followed by Liposomal Amphotericin B in full course and even in higher dose. But after each therapy, the patient e...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-011-9544-8
更新日期：2011-10-01 00:00:00
abstract：BACKGROUND:In end-of-life care, symptoms of discomfort are mainly managed by drug therapy, the guidelines for which are mainly based on expert opinions. A few papers have inventoried drug prescriptions in palliative care settings, but none has reported the frequency of use in combination with doses and route of adminis...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-015-0094-3
更新日期：2015-10-01 00:00:00
abstract：:Background The management of multiple long-term medicines of patients with chronic diseases creates a burden for patients. However, limited research is performed on its impact on patients' daily lives. Objective The aim of this study was to explore the impact of cardiovascular medication on different daily life aspect...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-018-0601-4
更新日期：2018-04-01 00:00:00
abstract：:Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigate...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,评审
doi：10.1007/s11096-017-0519-2
更新日期：2017-10-01 00:00:00
abstract：:Background Valproate is a widely prescribed antiepileptic drug for generalized epilepsies, due to the extensive knowledge on its efficacy since it is on the market for many decades. However, a large number of new antiepileptic medicines was introduced into clinical practice and may be better options for treatment, con...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,meta分析
doi：10.1007/s11096-018-0641-9
更新日期：2018-06-01 00:00:00
abstract：:Background Due to recent EU warnings and restrictions on the combined use of renin-angiotensin-aldosterone system (RAAS)-acting agents, and the seriousness of the associated harm, we analyzed the prescription of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) as dual therapy o...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-016-0378-2
更新日期：2016-12-01 00:00:00
abstract：:This commentary identifies studies that have compared commercially available DI databases, and discusses improvements in study methodology that might better guide clinicians in selecting resources for their practice setting. We also provide suggestions for future direction of research in this area with an eye towards ...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,评审
doi：10.1007/s11096-011-9522-1
更新日期：2011-08-01 00:00:00
abstract：:Background Inappropriate use of antibiotic treatment for pharyngitis by community pharmacists is prevalent in developing countries. Little is known about how the pharmacists identify patients with bacterial pharyngitis. Objective To ascertain the appropriateness of diagnosis of streptococcal pharyngitis among Thai com...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-016-0373-7
更新日期：2016-10-01 00:00:00
abstract：UNLABELLED:Sequential antimicrobial therapy is an important part of antimicrobial stewardship and intends to improve the timeliness of switch to oral antimicrobials. The aim of this study was to assess the impact of the introduction of guidelines and criteria for switching to oral antimicrobials. SETTING:The study was...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-010-9475-9
更新日期：2011-04-01 00:00:00
abstract：:Background In the Netherlands, a nationwide Medication Record System based on pharmacy dispensing data is used to obtain information about patients' actual medication use. However, it is not clear to what extent the information of the Nationwide Medication Record System corresponds to the medication information obtain...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-019-00839-x
更新日期：2019-06-01 00:00:00
abstract：:Background Despite the importance placed on the concept of the multidisciplinary team in relation to intermediate care (IC), little is known about community pharmacists' (CPs) involvement. Objective To determine CPs' awareness of and involvement with IC services, perceptions of the transfer of patients' medication inf...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-016-0377-3
更新日期：2016-12-01 00:00:00
abstract：:Background The direct oral anticoagulants (DOACs) offer several advantages over warfarin in the management atrial fibrillation, including the provision of fixed dosing without a requirement for regular monitoring. Recently however the subject of DOAC monitoring has been probed after several post-hoc analyses demonstra...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-019-00830-6
更新日期：2019-06-01 00:00:00
abstract：:Background Little is known about the extent of drug-related problems (DRPs) in community-dwelling older adult patients with chronic diseases in mainland China. Setting A medication therapy review service at a community health center in Chongqing, China. Objective To identify and categorize DRPs along with pharmacists'...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-017-0587-3
更新日期：2018-04-01 00:00:00
abstract：:Background After radical cystectomy, delayed return of bowel function is relatively common. Although studies investigating on the best modality for delivering nutritional support to this patient group are limited, parenteral nutrition was standard of care in those patients at the urological ward of the University Hosp...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-019-00800-y
更新日期：2019-04-01 00:00:00
abstract：:Background In most scenarios, anaesthesiologists titrate opioids to control nociceptive surgical stress based on intraoperative haemodynamic changes. Remifentanil was reported to cause more profound cardiovascular depression than sufentanil. A concern is that this direct cardiovascular depression might counteract the ...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-020-01094-1
更新日期：2020-10-01 00:00:00
