Abstract:
:Background Hepatic insufficiency can affect patient safety and should therefore be considered during drug therapy. Hospital admission offers an ideal point to screen for patients at risk and to adjust drug therapy accordingly. Objective To assess the number of patients admitted to hospital with clinically elevated liver parameters. To identify high-risk patients in need of potential drug therapy adjustment to liver function by calculation of liver scores. Finally, to investigate whether pre-hospital medication needed adjustment to liver function. Setting Patients admitted to surgical wards of a tertiary teaching hospital. Method Surgical patients were included in a 3-month retrospective study. A pharmacist-led screening process, including recording of elevated liver parameters and calculation of liver scores (Child-Pugh-score, Model of End-stage Liver Disase [MELD], MELDNa), was used to assess frequency of hepatic insufficiency and patients potentially needing medication adjustment. Additionally, pre-hospital medication was checked for contraindications and correct dosage with regard to liver function. Main outcome measure Percentage of surgical patients with clinically elevated liver parameters at admission, percentage of patients with hepatic insufficiency potentially needing drug therapy adjustment, and percentage of pre-hospital drug intakes not adjusted to liver function. Results Of 1200 patients, 130 (11%) had at least one clinically relevant elevated liver parameter at hospital admission. Of these, need for drug adjustment to liver function was found for 16-36%, depending on the liver score used (equivalent to 2-4% of all patients), with the highest number of patients detected by the MELD- and MELDNa-score. Pre-hospital medication concerned 719 drug intakes and was contraindicated in 2%, dosage not adjusted in 3%, and evaluation not possible in 44% of all drug intakes due to lack of information on the drug. Conclusion A significant proportion of patients admitted for surgery have clinically elevated liver parameters and potentially need medication adjustment. A pharmacist-led screening already at hospital admission can support the identification of patients with clinically relevant elevated liver parameters and patients at risk by calculating liver scores under routine conditions. Evaluation of drug adjustment to liver function is challenging, since no data are available in routine resources for a considerable number of drugs.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Strobach D,Poppele A,Mannell H,Andraschko M,Schiek S,Bertsche Tdoi
10.1007/s11096-019-00948-7subject
Has Abstractpub_date
2020-02-01 00:00:00pages
124-131issue
1eissn
2210-7703issn
2210-7711pii
10.1007/s11096-019-00948-7journal_volume
42pub_type
杂志文章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:BACKGROUND:Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective study. OBJECTIVE:To determine whi...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-013-9798-4
更新日期:2013-10-01 00:00:00
abstract::Background Medication discrepancies arising at care transitions are prevalent and are linked with adverse drug events and increased healthcare utilization. Evidence is lacking about which pharmacy-supported interventions at care transitions are most effective for both the patient and the healthcare system. Aim of the ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-019-00833-3
更新日期:2019-08-01 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 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 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::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
abstract::Background The treatment of heart failure patients is very complex and includes lifestyle modification as well as different pharmacological therapies. Polypharmacy is very common in such patients and they are at increased risk of potential drug-drug interactions and associated effects such as poor adherence, complianc...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-019-00918-z
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Drug safety has major implications for patients' lives. However, this concept is still considered new to some healthcare professionals. OBJECTIVE:This study aims to investigate the knowledge and awareness of Saudi healthcare professionals to pharmacovigilance (PV). Setting Governmental and private hospitals...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0165-5
更新日期:2015-12-01 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::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 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 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
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-0048-1
更新日期:2015-02-01 00:00:00
abstract::Background The inclusion of pharmacist in health care system is essential to ensure optimal patient care. However, with the passage of time, pharmacist's role has transcended from dispensing, compounding and counting of pills, to more sophisticated clinical duties. Objective To evaluate doctors' experience, perception...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-00991-9
更新日期:2020-04-01 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 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::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
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,多中心研究
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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: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
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journal_title:International journal of clinical pharmacy
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更新日期:2019-06-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0646-4
更新日期:2018-06-01 00:00:00
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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
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0371-9
更新日期:2016-10-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0619-7
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Communication between hospital and community pharmacists when a patient is discharged from hospital can improve the accuracy of medication reconciliation, thus preventing unintentional changes and ensuring continuity of supply. It allows problems to be resolved before a patient requires a further supply of m...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-013-9813-9
更新日期:2013-10-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9708-1
更新日期:2013-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s11096-019-00953-w
更新日期:2020-02-01 00:00:00