Drug-related problems (DRP) cause preventable negative health outcomes, especially during hospital admissions. The aim of our study was to examine the prevalence and characteristics of DRP in regular clinical pharmacy, as well as to determine those factors associated with a higher risk of DRP in the hospital setting. We analyzed data from a standardized registry database of regular pharmacy practice (2015- 2016). DRP were classified according to the Pharmaceutical Care Network Europe v6.2 classification. Cross-sectional data were obtained from 1602 adults admitted to medical wards. Crude and adjusted binary logistic regressions were performed to identify associations between potential risk factors and DRP. Overall DRP prevalence was high across medical specialties (45,1%), in a population characterized by advanced age, polypharmacy and multimorbidity. Problems leading to DRP were mainly classified into two domains (effectiveness and adverse reactions), being drug and dose selection the most frequent causes. Interventions were accepted and DRP were totally or partially solved in 74.1% and 4.81% of cases, respectively. In the adjusted model polypharmacy, allergies, BMI > 25 kg/m2 and clearance < 30 mL/min were associated with a higher risk of DRP. The participation of clinical pharmacists into multidisciplinary teams promotes the detection and solution of DRP. Polypharmacy, obesity, renal impairment and allergy are associated with a higher risk of DRP during admission.

/pdf/drug-related-problems-in-clinical-practice-a-cross-sectional-3fx0lrwzcx.pdf

Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions.

Objectives To study the impact of clinical pharmacist interventions (PIs) on antimicrobial prescriptions in terms of physician acceptance rates, clinical benefits and antimicrobial use/cost outcomes. Methods This study retrospectively analysed the impact of antimicrobial PIs over a 2-year period (October 2012 to October 2014) in a private non-teaching 164-bed hospital without a formal antimicrobial stewardship programme. Excluded from the study were outpatients and patients admitted to the intensive care unit or the emergency department. The PIs focused on appropriate indication and appropriate dosage; drug adverse events, allergies, intolerance and interactions; sequential therapy; therapeutic de-escalation; excessive duration of treatment and therapeutic drug monitoring. Carbapenems and linezolid were classified as special-vigilance drugs. Amoxicillin-clavulanic, piperacillin-tazobactam and vancomycin were classified as preferred drugs. Clinical benefits evaluated in accordance with internal guidelines, were classified as enhancing appropriate antimicrobial prescription or potentially reducing toxicity. Antimicrobial use and expenditure were compared with that of the previous 2-year period. Results 386 PIs were implemented in 303 patients. The overall acceptance rate was 83.4%. The acceptance rate for appropriate prescription PIs was significantly lower than for toxicity PIs (73.7% vs 90.9%; p Conclusions PIs on antimicrobial prescriptions may be effective in enhancing appropriate use of antimicrobials, reducing their toxicity, reducing the use of special-vigilance drugs and reducing overall antimicrobial cost.

/pdf/impact-of-clinical-pharmacist-intervention-on-antimicrobial-1ae7e4kd4z.pdf

Impact of clinical pharmacist intervention on antimicrobial use in a small 164-bed hospital.

Background Direct oral anticoagulants (DOACs) have revolutionised anticoagulant pharmacotherapy. However, DOAC-related medication incidents are known to be common. Objective To assess medication incidents associated with DOACs using an error theory and to analyse pharmacists’ contributions in minimising medication incidents in hospital in-patients. Setting A large University academic hospital in the West Midlands of England. Methods Medication incident data from the incident reporting system (48-months period) and pharmacists’ interventions data from the prescribing system (26-month period) relating to hospital in-patients were extracted. Reason’s Accident Causation Model was used to identify potential causality of the incidents. Pharmacists’ intervention data were thematically analysed. Main outcome measure (a) Frequency, type and potential causality of DOAC-related incidents; (b) nature of pharmacists’ interventions. Results A total of 812 reports were included in the study (124 medication incidents and 688 intervention reports). Missing drug/omission was the most common incident type (26.6%, n = 33) followed by wrong drug (16.1%, n = 20) and wrong dose/strength (11.3%, n = 14). A high majority (89.5%, n = 111) of medication incidents were caused by active failures. Patient discharge without anticoagulation supply and failure to restart DOACs post procedure/scan were commonly recurring themes. Pharmacists’ interventions most frequently related to changes in pharmacological strategy, including drug or dose changes (38.1%, n = 262). Impaired renal function was the most common reason for dose adjustments. Conclusion Prescribers’ active failure rather than system errors (i.e. latent failures) contributed to the majority of DOAC-related incidents. Reinforcement of guideline adherence, prescriber education, harnessing pharmacists’ roles and mandating renal function information in prescriptions are likely to improve patient safety.

/pdf/direct-oral-anticoagulant-related-medication-incidents-and-5e5c52ef0e.pdf

Direct oral anticoagulant-related medication incidents and pharmacists’ interventions in hospital in-patients: evaluation using reason’s accident causation theory

Background: Single elements of the Closed Loop Medication Management process (CLMM), including electronic prescribing, involvement of clinical pharmacists (CPs), patient individual logistics and digital administration/documentation, have shown to improve medication safety and patient health outcomes. The impact of the complete CLMM on patient safety, as reflected in pharmacists’ interventions (PIs), is largely unknown. Aim: To evaluate the extent and characterization of routine PIs performed by hospital-wide CPs at a university hospital with an implemented CLMM. Methods: This single-center study included all interventions documented by CPs on five self-chosen working days within 1 month using the validated online-database DokuPIK (Documentation of Pharmacists’ Interventions in the Hospital). Based on different workflows, two groups of CPs were compared. One group operated as a part of the CLMM, the “Closed Loop Clinical Pharmacists” (CL-CPs), while the other group worked less dependent of the CLMM, the “Process Detached Clinical Pharmacists” (PD-CPs). The professional experience and the number of medication reviews were entered in an online survey. Combined pseudonymized datasets were analyzed descriptively after anonymization. Results: A total of 1,329 PIs were documented by nine CPs. Overall CPs intervened in every fifth medication review. The acceptance rate of PIs was 91.9%. The most common reasons were the categories “drugs” (e.g., indication, choice of formulation/drug and documentation/transcription) with 42.7%, followed by “dose” with 29.6%. One-quarter of PIs referred to the therapeutic subgroup “J01 antibacterials for systemic use.” Of the 1,329 underlying PIs, 1,295 were classified as medication errors (MEs) and their vast majority (81.5%) was rated as “error, no harm” (NCC MERP categories B-D). Among PIs performed by CL-CPs (n = 1,125), the highest proportion of errors was categorized as B (56.5%), while in the group of PIs from PD-CPs (n = 170) errors categorized as C (68.2%) dominated (p < 0.001). Conclusion: Our study shows that a structured CLMM enables CPs to perform a high number of medication reviews while detecting and solving MEs at an early stage before they can cause harm to the patient. Based on key quality indicators for medication safety, the complete CLMM provides a suitable framework for the efficient medication management of inpatients.

/pdf/the-impact-of-pharmacists-interventions-within-the-closed-35h3fjsk.pdf

The impact of pharmacists’ interventions within the Closed Loop Medication Management process on medication safety: An analysis in a German university hospital

https://www.mdpi.com/2227-9032/10/12/2450/pdf?version=1670224352

Using xPIRT to Record Pharmacy Interventions: An Observational, Cross-Sectional and Retrospective Study

Objective The aim of this study is to describe and categorise pharmacist interventions (PIs) in a central hospital and report acceptance rates by physicians. Methods A retrospective study was carried out in a 350-bed central hospital between January and June 2013. Eleven pharmacists screened the pharmacotherapy charts for drug-related problems leading to PIs. The recommendations resulting from this analysis were entered in the electronic prescribing system. All the PIs registered on the electronic medical record system during the study period were eligible for inclusion. Interventions were quantified and characterised. Computer records were consulted to assess acceptance rate by physicians. Results A total of 1249 PIs were made by 11 pharmacists, and covered 147 drugs, with the most common being antibacterial (25%) and for the central nervous system (24%) and cardiovascular system (18%). Of the 1249 PIs, 18% concerned acetaminophen, 13% enoxaparin and 10% amoxicillin/clavulanic acid. The PIs were classified into three main categories: drug, dosage and administration related. When we analysed the most relevant PI type (n>20), the highest acceptance rate was for dosage adjustment according to therapeutic indication (58.1%) and renal function (57.4%). The global rate of acceptance was 53%. Conclusions Pharmacists’ recommendations entered in the electronic prescribing system with a short explanation, as well as the pharmacotherapy recommendation, are immediately available to the doctor; however, the relatively low acceptance rate suggests that a further study also evaluating verbal interventions is needed, since the most urgent recommendations are made verbally, and this would likely increase the acceptance rate.

https://ejhp.bmj.com/content/ejhpharm/early/2014/10/28/ejhpharm-2014-000491.full.pdf

Hospital pharmacist interventions in a central hospital

Objective: The objective of this study was to conduct a study on the characterization and maintenance of equipment in a hospital environment and apply it in the case study conducted as part of an internship at the Instituto de Medicina Molecular João Lobo Antunes (iMM), with a duration of eleven months. This work contributed to the identiﬁcation of improvements to be applied in the Safety and Compliance Department, in the maintenance, calibration, and monitoring of medical-hospital equipment (MHE), to improve their reliability and efﬁciency, the reduction of costs and downtime, and the probability risk to the patient, engineer, or user associated with the equipment. Materials and Methods: This is an MHE study of the iMM, also monitoring the maintenance and calibration of different equipment by technicians and engineers responsible internally and externally. Discussion and Practical Results: A maintenance software for the iMM was chosen to help the institute to have all the equipment information in a more organized way. Monitoring of some iMM equipment was conducted. Conclusion: It was found that the safety of patients, engineers, or users who manage MHE is an extremely principal factor. For this factor not to be harmed, constant monitoring, maintenance, and calibration of the equipment are necessary, ensuring the safety of the user and their proper functioning.

Characterization and Maintenance of Hospital Equipment: A Case Study on the Institute of Molecular Medicine Jo˜ao Lobo Antunes

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Sofia Santos

Author Tools

Chat about Author

Papers

Hospital pharmacist interventions in a central hospital

Characterization and Maintenance of Hospital Equipment: A Case Study on the Institute of Molecular Medicine Jo˜ao Lobo Antunes