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"medication reconciliation"

Rebecca Rottman-Sagebiel, Nicole Cupples, Chen Pin Wang, Seth Cope, Stephanie Pastewait, Hanna Braden, Daniel MacCarthy, Alicia Conde, Melody Moris, Eneida-Yvette Gonzalez, Sara Espinoza
Medication reconciliation and patient education during admission and after discharge helped older patients remain independent at home.
December 2018: Federal Practitioner: for the Health Care Professionals of the VA, DoD, and PHS
Mirjam Simoons, Henricus G Ruhé, Eric N van Roon, Robert A Schoevers, Richard Bruggeman, Daniëlle C Cath, Diny Muis, Johan Arends, Bennard Doornbos, Hans Mulder
BACKGROUND: At many outpatient departments for psychiatry worldwide, standardized monitoring of the safety of prescribed psychotropic drugs is not routinely performed in daily clinical practice. Therefore it is unclear to which extent the drugs used by psychiatric outpatients are prescribed effectively and safely. These issues warrant structured monitoring of medication use, (pre-existing) co-morbidities, effectiveness and side effects during psychiatric outpatient treatment. Improvement of monitoring practices provides an opportunity to ensure that somatic complications and adverse drug effects are detected and dealt with in a timely manner...
February 14, 2019: BMC Health Services Research
Jaclyn M Stoffel, Regan A Baum, Adam J Dugan, Abby M Bailey
Purpose: The purpose of this survey-based research project is to identify factors, including prior training, institution demographics, and pharmacist prioritization of services that may impact variability in practice among emergency medicine (EM) pharmacists. Methods: An electronic survey was available for 6 weeks. Participants were contacted through professional membership directories. Survey questions addressed EM pharmacist training and institution demographics...
February 8, 2019: American Journal of Health-system Pharmacy: AJHP
Kristie McDonald, Douglas Arndt, Lonn Myronuk
Island Health Authority ordering providers and staff continue to experience challenges related to electronic medication reconciliation. A Think Tank was created to seek a deeper understanding of the reasons why end users were experiencing challenges with documenting home medications, managing conversion failures, and writing prescriptions. Strategies to improve configuration, education, and process are underway.
2019: Studies in Health Technology and Informatics
Bita A Kash, Juha Baek, Ohbet Cheon, Joanna-Grace Mayo Manzano, Stephen L Jones, Jaya Paranilam, Robert A Phillips
Although various interventions targeted at reducing hospital readmissions have been identified in the literature, little is known about actual operationalization of such evidence-based interventions. This study conducted a systematic review and a survey of key informants in 2 leading hospitals, Houston Methodist (HM) and MD Anderson Cancer Center (MDACC), to compare and contrast the most cited evidence-based interventions in the current literature with interventions reported by those hospitals. The authors found that both hospitals followed evidence-based practices reported as successful in the literature...
February 4, 2019: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Kelly C Rogers, Daniel W Neu, Melanie C Jaeger, Rahman Shah, Shannon W Finks
A poorly understood significant drug-drug interaction compounded by ineffective communication among providers at times of care transition most likely contributed to multiple thromboembolic events in an 81-year-old patient. Increased awareness of drug interactions with direct oral anticoagulants (DOACs), as well as improved communication among inpatient and outpatient providers at the time of discharge is essential in maximizing efficacy and safety outcomes in patients requiring chronic anticoagulation. When rifampin is coadministered with apixaban, a reduction in apixaban exposure results in decreased efficacy and increased risk for thromboembolic events...
February 2019: Southern Medical Journal
Ashley N Rubin, Eduardo D Espiridion, Mohamad Kattan, Elizabeth C Desmarais
The incidence of serotonin syndrome in the United States is rising yearly. Providers should be aware of the useful diagnostic criteria and have a low threshold for utilizing such criteria to prevent increased morbidity and mortality. In this case, a 64-year-old female with a complex past medical history presented to the emergency department with an altered mental status after being found poorly responsive by her husband. Many of her symptoms aligned with the commonly used criteria for serotonin syndrome; yet, her complex past medical history and uncommonly elevated sodium levels veered her providers from arriving at this diagnosis earlier...
November 19, 2018: Curēus
M Duwez, A Valette, L Foroni, B Allenet
OBJECTIVES: Medication reconciliation is widely promoted by international health authorities. Its expansion requires human resources, which are limited and unequally distributed among health care facilities. Recent international studies support the involvement of pharmacy technician in the medication reconciliation process but his role remains unstructured in France. We aimed to assess pharmacy technicians' opinions and willingness to be involved in the medication reconciliation process expansion and to identify the levers and barriers of the project...
January 21, 2019: Annales Pharmaceutiques Françaises
João Paulo Vilela Rodrigues, Fabiana Angelo Marques, Ana Maria Rosa Freato Gonçalves, Marília Silveira de Almeida Campos, Tiago Marques Dos Reis, Manuela Roque Siani Morelo, Andrea Fontoura, Beatriz Maria Pereira Girolineto, Helen Palmira Miranda de Camargo Souza, Maurílio de Souza Cazarim, Lauro César da Silva Maduro, Leonardo Régis Leira Pereira
It is estimated that around five to 10.0% of hospital admissions occur due to clinical conditions resulting from pharmacotherapy. Clinical pharmacist's activity can enhance drug therapy's effectiveness and safety through pharmacotherapy interventions (PIs), thus minimizing drug-related problems (DRPs) and optimizing the allocation of financial resources associated with health care. This study aimed to estimate the DRPs prevalence, evaluate PI which were performed by clinical pharmacists in the Neurology Unit of a Brazilian tertiary teaching hospital and to identify factors associated with the occurrence of PI-related DRP...
2019: PloS One
Cécile Chung, Victoria Gauthier, Filomena Marques-Tavares, Patrick Hindlet, Ariel Cohen, Christine Fernandez, Marie Antignac
BACKGROUND: Medication reconciliation is a powerful formal process to decrease medication errors, but it has proved to be complex and time consuming. AIMS: To describe the frequency and types of medication discrepancies (between previous treatment and medication order at admission), and to identify predictors of unintentional medication discrepancies (UMDs). METHODS: This interventional study was carried out in the cardiology department of a French teaching hospital...
January 10, 2019: Archives of Cardiovascular Diseases
Charlotte D Van Der Luit, Iris R De Jong, Marieke M Ebbens, Sjoerd Euser, Sjoerd L Verweij, Patricia M Van Den Bemt, Hanneke M Luttikhuis, Matthijs L Becker
Background: Medication discrepancies are a common occurrence following hospital admission and carry the potential for causing harm. However, little is known about the potential risk factors involved in medication discrepancies. Objective: The objective of this study was to determine how frequently medication discrepancies occur and their associated risk factors, in patients hospitalized via the emergency department of the Spaarne Gasthuis Hospital, located in The Netherlands...
October 2018: Pharmacy Practice
Marcia Y Shade, Matthew Witry, Katie Robinson, Kevin Kupzyk
AIMS AND OBJECTIVES: The purpose of this analysis is to describe and explore characteristics associated with oral dietary supplement use and identify potential interactions with prescription medications in a sample of rural community-dwelling older adults. BACKGROUND: Older adults use polypharmacy to help manage chronic diseases. Due to health care access disparities rural older adults may consider dietary supplement use as an alternative approach to maintain health and manage disease...
December 27, 2018: Journal of Clinical Nursing
Kristen Johnson, Gregory S Burkett, Daniel Nelson, Allen R Chen, Carol Matlin, Cathy Garger, Steven McMahan, Helen Hughes, Marlene Miller, Julia M Kim
Introduction: Medication reconciliation can reduce medication discrepancies, errors, and patient harm. After a large academic hospital introduced a medication reconciliation software program, there was low compliance with electronic health record documentation of home medication reconciliation. This quality improvement project aimed to improve medication reconciliation on admission in 4 pediatric inpatient units by 50% over 3 months. Methods: We used Lean Sigma methodology to observe medication reconciliation processes; interview residents, nurses, pharmacists, and families; and perform swim lane process mapping and Ishikawa Cause and Effect analysis...
September 2018: Pediatric Quality & Safety
Jessica Saunders, Shahram Ahmadzadeh, Margaret Bush, Robin Wright, Bradi Granger
BACKGROUND: The commonly employed medication reconciliation process leaves room for mismanagement of medications in the complex end-stage renal disease patient population. PURPOSE: The purpose of this quality improvement project was to implement and evaluate a multidisciplinary education and feedback intervention designed to improve self-management for adults with end-stage renal disease. METHODS: A pre-post, same subject repeated measures design was used to evaluate the intervention...
December 12, 2018: Journal of Nursing Care Quality
Rana Abu Farha, Khawla Abu Hammour, Sayida Al-Jamei, Raja AlQudah, Mohammed Zawiah
BACKGROUND: Medication discrepancies are seen frequently in hospital setting upon admission or discharge. Medication Reconciliation service is a practice designed to ensure that patients' medications are ordered in a correct manner upon hospital admission, thus reducing the risk of having medication discrepancies. This study aimed to determine the prevalence of medication discrepancies and their clinical seriousness in pediatric patients at the time of hospital admission. METHODS: A prevalence cross-sectional study was conducted at the pediatric departement at the Jordan University hospital between March-May 2018...
December 14, 2018: BMC Health Services Research
Joseph Carson, Stephanie Gottheil, Sherri Lawson, Tim Rice
BACKGROUND: Long-term care (LTC) homes expressed concern that patients had experienced medication incidents after hospital discharge as a result of poor coordination of care. OBJECTIVE: The London Transfer Project aimed to reduce LTC medication incidents by 50% within 48 hours of discharge from general medicine units at the London Health Sciences Centre. DESIGN: This quality improvement study involved 2 hospitals and 5 LTC homes in London, Ontario, Canada...
December 4, 2018: Journal of the American Medical Directors Association
Sheila Jala, Elizabeth O'Brien
Treatment options for anticoagulated patients presenting with ischemic stroke are limited. Off-label use of idarucizumab to rapidly reverse the anticoagulant effect of dabigatran may ensure eligibility for thrombolytic therapy with alteplase. This case describes a 77-year-old white male who presented to the hospital 89 minutes after sudden onset of right-sided hemiparesis, dysarthria, and facial palsy. Significant history included atrial fibrillation and previous right-sided cortical stroke. Medication reconciliation revealed he was taking dabigatran 150 mg twice a day, with the last dose being 179 minutes before presentation...
February 2019: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Zhi Yang Neo, Yi Ting Low, Kheng Yong Ong, Joy Boon Ka Chong, Kiat Wee Lim, Max Wei Chan, Anson Zong Neng Lim, Kaysar Mamun, Li Li Chen
OBJECTIVE: To evaluate the effectiveness of a pilot model engaging community pharmacists in the collaborative care of patients from a tertiary hospital, in terms of identification and resolution of drug-related problems (DRPs), and patients' acceptance and satisfaction with the program. METHODS: A prospective case series was conducted. Eligible patients were recruited from the tertiary hospital and referred to their preferred community pharmacy for medication reconciliation, review, and counseling...
November 29, 2018: International Journal of Health Planning and Management
Lori A Herbst, Sanyukta Desai, Dan Benscoter, Karen Jerardi, Katie A Meier, Angela M Statile, Christine M White
Transition of care from the intensive care unit (ICU) to the ward is usually an indication of the patient's improving clinical status, but is also a time when patients are particularly vulnerable. The transition between care teams poses a higher risk of medical error, which can be mitigated by safe and complete patient handoff and medication reconciliation. ICU readmissions are associated with increased mortality as well as ICU and hospital length of stay (LOS); however tools to accurately predict ICU readmission risk are limited...
October 2018: Translational Pediatrics
Jamilah Alsaidan, Jane Portlock, Hisham Saad Aljadhey, Nada Atef Shebl, Bryony Dean Franklin
Background: Errors in medication use are a patient safety concern globally, with different regions reporting differing error rates, causes of errors and proposed solutions. The objectives of this review were to identify, summarise, review and evaluate published studies on medication errors, drug related problems and adverse drug events in the Gulf Cooperation Council (GCC) countries. Methods: A systematic review was carried out using six databases, searching for literature published between January 1990 and August 2016...
November 2018: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
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