Abstract:
:Background Medication reconciliation (MedRec) at discharge is a cumbersome but necessary process to reduce the risk of medication errors at transitions of care. The main barriers to implementing such a process are the large number of professionals involved and a lack of collaboration among caregivers. Objective This study was designed to assess the need for a medication reconciliation form at discharge in an orthopaedic surgical ward. Setting The study was conducted in the orthopaedic surgery ward among inpatients at a 407-bed French teaching hospital. Method We first performed a retrospective audit to evaluate the quality of discharge medication information in the medical record, after which a 5-week prospective study was conducted in 2013. All patients admitted to the orthopaedic surgery unit who had at least two chronic diseases and three medications underwent MedRec at discharge. We designed a Best Possible Medication at Discharge List (BPMDL) to be completed by hospital staff and transmitted to community caregivers. Mean outcome measures We assessed the completeness of medication information in the medical records, discrepancies between medications noted on the BPMDL and those prescribed on the discharge order, and the value of the BPMDL for stakeholders. Results Thirty patients were included in the study. Only 4 % of medical records contained a discharge summary with complete medication information. In 67 % of cases, treatment discontinuations at admission were justified, and medications were reintroduced before discharge, while 107 treatments (45 %) were added but not prescribed on discharge orders. Discontinuations prior to discharge were justified in 60 % of cases (treatments were ended or supportive treatment was required during hospitalization). An average of 2.1 treatments were prescribed on discharge orders (vs. 9.4 prescribed on the BPMDL). Patients, general practitioners (GP), and physicians in long-term care settings (PLTCS) rated the format, content, and readability of the BPMDL as satisfactory, and it was found to be of value for patients and PLTCS to support medication information. Because of the very low response rate among GP (10 %), we were unable to determine their satisfaction with the MedRec discharge process. Conclusion The transmission of patient medication information at discharge is often lacking. As such, the BPMDL appears to have value to both patients and community health providers. Because this study was conducted within a single surgical unit, further study in other surgical wards is needed to assess generalizability.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Monfort AS,Curatolo N,Begue T,Rieutord A,Roy Sdoi
10.1007/s11096-016-0292-7subject
Has Abstractpub_date
2016-08-01 00:00:00pages
838-47issue
4eissn
2210-7703issn
2210-7711pii
10.1007/s11096-016-0292-7journal_volume
38pub_type
杂志文章abstract:BACKGROUND:A quick CYP2C19*2 genotyping assay can be useful in personalised antiplatelet-therapy. OBJECTIVE:To apply a rapid point-of-care (POC) CYP2C19*2 genotyping assay for personalisation of antiplatelet therapy in patients undergoing percutaneous coronary intervention (PCI) and to compare this POC assay to two la...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0269-6
更新日期:2016-04-01 00:00:00
abstract::Background Drug related problems (DRPs) are frequent and cause suffering for patients and substantial costs for society. Multi-dose drug dispensing (MDDD) is a service by which patients receive their medication packed in bags with one unit for each dose occasion. The clinical decision support system (CDSS) electronic ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-9976-z
更新日期:2014-10-01 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::It is widely acknowledged that patients-particularly those late in life-are frequently exposed to the harms of medication. To minimize these harms, several frameworks have been developed by which prescribing can be optimized. In the context of diminishing life expectancy, these frameworks can be used to reduce medicat...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0148-6
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Older patients receiving home health care are particularly at risk of receiving potentially inappropriate medications compared to community-dwelling population. Data on appropriateness of prescribing in these patients is limited. OBJECTIVE:To investigate the prevalence, patterns and determinants of potentia...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0125-0
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Computerised physician order entry (CPOE) and the integration of a pharmacist in clinical wards have been shown to prevent drug related problems (DRPs). OBJECTIVES:The primary objective was to make an inventory of the DRPs and resident pharmacist on-ward interventions (PIs) identified in a geriatric acute c...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-013-9821-9
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Generic uptake will increasingly be promoted by governments in the face of increasing healthcare costs and global economic uncertainties. OBJECTIVE:The purpose of this study was to investigate attitudes towards generic substitution among community pharmacists, with a focus on the perception of the efficacy,...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0227-8
更新日期:2016-02-01 00:00:00
abstract::Background The challenges of under-reporting of adverse drug reactions have been identified as a major setback for the pharmacovigilance system worldwide. Direct reporting by health care consumers has been adopted in some developed and developing countries with a positive impact in improving pharmacovigilance activiti...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-020-01141-x
更新日期:2020-09-09 00:00:00
abstract::Background The survival rate of prostate cancer is relatively higher than other cancers, therefore, the health-related quality of life (HRQoL) becomes a critical issue for the patients. There are limited quality of life data evaluating the difference between androgen deprivation therapy and non-androgen deprivation th...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-019-00854-y
更新日期:2019-08-01 00:00:00
abstract:CASE (DESCRIPTION):We report the case of a 38-year-old woman treated with lamotrigine who experienced multi-organ dysfunction. The patient received the drug at the dose of 100 mg per day. One week later, the treatment was suspended because of an extensive body rash. Twenty-four hours later, the patient appeared drowsy ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0158-4
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Patients with advanced cancers are at high risk for bone metastases, which accelerate bone resorption and skeletal complications. Therefore, bisphosphonates, which are strong inhibitors of bone resorption, are widely used to prevent pathological fractures, pain and tumour-induced hypercalcaemia. Intravenous ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-9994-x
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The growth of pharmaceutical expenditure and patients' out of pocket has motivated policy makers to encourage patients to substitution of brands medicines with their generic alternatives called generic substitution. OBJECTIVES:As the patients are final decision makers to accept generic substitution, the aim...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0085-4
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Granulocyte colony-stimulating factor administration is an important component of supportive therapy in chemotherapy-induced leukopenia. Although patient response to granulocyte colony-stimulating factor administration is known to vary, the factors responsible for poor response have not been identified. OBJ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9703-6
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:In Qatar, home diagnostic tests are available over the counter in community pharmacies. While possibly beneficial, these tests have the potential for harm if they are used in the absence of pharmacist counseling. OBJECTIVES:To determine the public views, level of awareness and use of home diagnostic tests a...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9687-2
更新日期:2012-12-01 00:00:00
abstract::Background Dose banding (DB) is a strategy to rationalise antineoplastic production at Hospital Pharmacy Aseptic Compounding Units (ACUs) and to reduce patient's waiting time. DB allows for optimizing workflows and workloads, facilitating adoption of new technologies, and increasing safety, quality and efficiency of t...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0714-9
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:The combined post-operative use of diuretics and/or renin-angiotensin-aldosterone system (RAAS) inhibitors may increase the risk of nonsteroidal anti-inflammatory drug (NSAID) associated renal failure because of a drug-drug interaction. OBJECTIVE:The aim of this study was to investigate the effect of the sh...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9631-5
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Neonatal and paediatric patients are especially vulnerable to serious injury as a result of medication errors due to their small size, physiological immaturity and limited compensatory abilities. The prescription chart remains an essential form of communication of prescribing decisions and instructions. Modi...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-0014-y
更新日期:2014-12-01 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 Taking regular medication has been shown to have an impact on the daily lives of patients and their families. Objective To explore the medication-related experiences of patients and their families when a child or young person is prescribed regular medication. Setting A specialist U.K. paediatric hospital. M...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0756-z
更新日期:2019-02-01 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::Background Little is known with regards to the prognostic factors for patients with suspected or diagnosed Heparin-Induced Thromobocytopenia (HIT). The role of patient and therapy characteristics may play a role in predicting the outcome. Aim of the review To investigate the role of patient and therapy characteristic...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-020-01166-2
更新日期:2020-10-12 00:00:00
abstract::Background Medication discrepancies often occur at transition of care such as hospital admission and discharge. Obtaining a complete and accurate medication history on admission is essential as further treatment is based on it. Objective The goal of this study was to reduce the proportion of patients with at least one...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-017-0545-0
更新日期:2017-12-01 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:A range of extended/enhanced pharmacy services (EPS) are increasingly being offered in community pharmacies following a global paradigm shift in professional pharmacy practice from a product-oriented focus to a patient-centered approach. A number of pharmacy/pharmacist characteristics have been reported to i...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0127-y
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of pharmacotherapy follow-up (PF) on metabolic control and clinical outcomes in type 2 diabetic patients. SETTING:Six community pharmacies (4 intervention and 2 control) in the Curitiba metropolitan region (Brazil). MAIN OUTCOME MEASURE:Glycosylated Haemoglobin A1 (HbA1) and fasting ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9493-2
更新日期:2011-04-01 00:00:00
abstract::Background Adherence to oral antidiabetics plays a pivotal role in controlling diabetes. Healthcare workers evaluate this adherence when visited by patients. Objectives The primary objective of this study was to validate the existing LMAS-14 (Lebanese Medication Adherence Scale) in Lebanese diabetic adults. The second...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01197-9
更新日期:2020-11-17 00:00:00
abstract:BACKGROUND:With increasing deregulation of prescription-only medicines and drive for self-care, pharmacists have greater scope to manage more conditions. This brings added responsibility to be competent healthcare professionals who deliver high quality evidence-based patient care. OBJECTIVE:This study sought to establ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9586-y
更新日期:2012-02-01 00:00:00
abstract::Background Pharmacists' involvement in patient care has improved the quality of care and reduced medication errors. However, this has required a lot of work that could not have been accomplished without documentation of interventions. Several means of documenting errors have been proposed in the literature but without...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0384-4
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Drug use in pregnancy is often reason of concern for mothers and their physicians. However, only few studies investigated predictors of drug use in pregnancy. OBJECTIVES:To examine maternal characteristics as predictors of medication use in the 6 months before pregnancy and during the first 6 months of preg...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-013-9750-7
更新日期:2013-06-01 00:00:00
abstract::Background Coeliac disease affects 1% of the population, but 75% remain undiagnosed. Objective To conduct a case finding feasibility and efficacy study for the detection of coeliac disease in community pharmacies. Setting Six community pharmacies across Sheffield, UK. Method A prospective study was performed using a p...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-019-00793-8
更新日期:2019-04-01 00:00:00