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 medication discrepancy in the medication history at admission by implementing an IT-guided checklist. Setting Surgery ward focused on vascular and visceral surgery at a Swiss Cantonal Hospital. Method The study was divided into two phases, before and after implementation of an IT-guided checklist. For both phases a pharmacist collected and compared the medication history (defined as gold standard) with that of the admitting physician. Medication discrepancies were subdivided in omissions and commissions, incorrect medications or dose changes, and incorrect dosage forms or strength. Main outcome measure The proportion of patients with at least one medication discrepancy in the medication history before and after intervention was assessed. Results Out of 415 admissions, 228 patients that met the inclusion criteria were enrolled in the study, 113 before and 115 patients after intervention. After intervention, medication discrepancies declined from 69.9 to 29.6% (p < 0.0001) of patients, the mean medication discrepancy per patient was reduced from 2.3 to 0.6 (p < 0.0001), and the most common error, omission of a regularly used medication, was reduced from 76.4 to 44.1% (p < 0.001). Conclusion The implementation of the IT-guided checklist is associated with a significant reduction of medication discrepancies at admission and potentially improves the medication safety for the patient.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Huber T,Brinkmann F,Lim S,Schröder C,Stekhoven DJ,Marti WR,Egger RRdoi
10.1007/s11096-017-0545-0subject
Has Abstractpub_date
2017-12-01 00:00:00pages
1312-1319issue
6eissn
2210-7703issn
2210-7711pii
10.1007/s11096-017-0545-0journal_volume
39pub_type
杂志文章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: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 Community pharmacists' role in the primary health care, patient-centered services, beyond traditional dispensing services is well established in the developed world. However, this role is not fully established in low-middle-income countries including Pakistan. Objective To explore community pharmacists' per...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-020-01221-y
更新日期：2021-01-07 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：: ...
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 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:Possessing correct therapeutic information on oral contraceptives is an important prerequisite for the provision of sound advice to women who are using these products. OBJECTIVES:This study examines Egyptian pharmacists' knowledge of pharmacotherapeutic aspects of oral contraceptives as well as interest in ...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-016-0264-y
更新日期：2016-04-01 00:00:00
abstract：:Background The leukotriene receptor antagonist montelukast has been shown to rejuvenate aged brains in rats; however, data on humans are still scarce. Objective To investigate if montelukast may alleviate degenerative neurological changes using a register data. Setting Norwegian registry data analyses. Method The pres...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-020-01160-8
更新日期：2020-10-09 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 Oral anticoagulation therapy has proven beneficial impact on the prevention of thromboembolic events. However, the use of antocoagulatns also increases the risk of bleeds. To maximize the benefits and minimize the risks of the treatment, guidance on appropriate use of oral anticoagulants is essential. An in...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-019-00844-0
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:Responsible self-medication is an integral part of the health system that consists of community pharmacists counseling patients on treating minor illness using non-prescription medications. Systems for properly managing information can assist disease identification and clinical decision-making. OBJECTIVE:To...
journal_title：International journal of clinical pharmacy
pub_type： 共识发展会议,杂志文章
doi：10.1007/s11096-015-0223-z
更新日期：2016-02-01 00:00:00
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: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: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:There can be a lack of transfer of information between hospitals and community pharmacies following patient discharge, which puts patients at a high risk of suffering drug related problems (DRPs). Community pharmacy plays a vital role in identifying and solving these discharge DRPs and taking action before t...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-014-9935-8
更新日期：2014-06-01 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 Non-adherence to immunosuppressive medications following renal transplantation is a risk factor for rejection and graft loss. Despite the dire consequences, adherence lapses, both unintentional and intentional, are common and poorly understood. Objective The present study sets to compare the rates and deter...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-018-0652-6
更新日期：2018-10-01 00:00:00
abstract：:Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-011-9591-1
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:Replacement therapy in haemophilia plays an important role in the effective management of this rare bleeding disorder and requires a high level of knowledge and practical skills. OBJECTIVE:To evaluate and to compare the knowledge and skills about the medicines and their management among people with haemophi...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章,多中心研究
doi：10.1007/s11096-015-0207-z
更新日期：2016-02-01 00:00:00
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 Pharmacists are increasingly involved in patient care. This new role in a complex healthcare system with demanding patients may lead to moral dilemmas. There has been little research into pharmacy ethics, and existing data are limited by their retrospective nature and small sample sizes. A thematic overview...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-017-0561-0
更新日期：2018-02-01 00:00:00
abstract：UNLABELLED:Background Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the controversy and consensus. ...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-016-0360-z
更新日期：2016-10-01 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：: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 Allergic rhinitis represents a public health problem that is significantly prevalent in the global population and has been associated with asthma, a strong desire to sleep and a low quality of life. Objective This study aims to evaluate the prevalence, symptoms, control strategies and treatment, as well as ...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-020-01115-z
更新日期：2020-09-20 00:00:00
abstract：BACKGROUND:From 20 to 65 % of older adults receiving polypharmacy take at least one potentially inappropriate medication (PIM), leading to a high risk of adverse drug reactions. The term deprescribing was coined to describe a process of optimization of drug regimens through the withdrawal of PIMs. There is a paucity of...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-016-0279-4
更新日期：2016-04-01 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：OBJECTIVE:The aim of this study was to assess the situation regarding spontaneous adverse drug reaction reporting in the Czech Republic during a 5-year period (2005-2009). SETTING:Descriptive study was conducted using the data from the Czech State Institute for Drug Control pharmacovigilance database. METHODS:The dat...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-011-9527-9
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:Underuse of medication considered beneficial is particularly common in elderly patients. A new Screening Tool to Alert Doctors to the Right Treatment (START) has been published to identify potential prescribing omissions. OBJECTIVE:To quantify and characterize potential prescribing omissions of cardiovascul...
journal_title：International journal of clinical pharmacy
pub_type： 杂志文章
doi：10.1007/s11096-012-9635-1
更新日期：2012-06-01 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
