Hospital Pharmacy最新文献

{"title":"Impact of a Medication Reconciliation Improvement Package on Adherence to Medication Reconciliation Among Internal Medicine Physicians: A Quality Improvement Project in a Lower-Middle Income Country.","authors":"Saad Bin Zafar Mahmood, Fazal Rehman, Aisha Jamal, Naureen Ali Meghani, Madiha Iqbal, Ambreen Amirali, Aysha Almas","doi":"10.1177/00185787241253442","DOIUrl":"https://doi.org/10.1177/00185787241253442","url":null,"abstract":"<p><p><b>Background:</b> Medication reconciliation is one of the best measures to prevent medication-related errors at the time of admission and discharge of patients. We conducted a quasi-experimental study to evaluate the impact of a Medication reconciliation improvement package (intervention) on adherence to medication reconciliation at the time of admission in Department of Internal Medicine. The study included all adult patients admitted to internal medicine from August 2019 to December 2020. Pre-intervention data on adherence to medication reconciliation was less than 50%. The study involved creation of a quality improvement team to conduct a root-cause analysis which identified the need to target physician related issues and hence drafted a medication reconciliation improvement package which included meetings with physicians on the internal medicine floor, dedicated WhatsApp groups for repeated reminders, and appreciation messages for timely adherence. We used the Chi Square test to check the association between adherence to medication reconciliation and physicians and acuity level. <b>Findings:</b> We included 7914 records of patients, in which 4471 participants (56.4%) were from pre-intervention phase and 3443 (43.5%) were from intervention groups. The overall adherence to medication reconciliation was 54.3% (4297/7914). Adherence of medication reconciliation increased from 44.4% (1983/4471) in the pre-intervention phase to 67.2% (2314/3443) in the intervention phase (<i>P</i> < .001). Improvement was observed in adherence of medication reconciliation done by residents and in low acuity areas (<i>P</i> < .005). <b>Conclusion:</b> The Medical reconciliation improvement package is a simple low-cost intervention that resulted in improvement in adherence to medication reconciliation but needs further studies to assess its sustainability. However, it awaits to be seen if the same improvement can also be replicated to qualitative medication errors and clinical outcomes respectively.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"59 6","pages":"624-630"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of <i>TBXA2R</i> Gene Variants on the Risk of Aspirin-Induced Upper Gastrointestinal Bleeding: A Case-Control Study.","authors":"Marcela Forgerini, Ana Luísa Rodriguez Gini, Isabele Held Lemos, Ana Caroline Silva Santos, Maria Paula Bessa, Sandro Roberto Valentini, Patrícia de Carvalho Mastroianni","doi":"10.1177/00185787241269111","DOIUrl":"10.1177/00185787241269111","url":null,"abstract":"<p><p><b>Objective:</b> Upper gastrointestinal bleeding (UGIB) has been identified as a potential adverse drug reaction associated with the use of low-dose aspirin (LDA). This study aimed to investigate the relationship between variants in the <i>TBXA2R</i> gene, which is involved in platelet aggregation, and the risk of UGIB in patients with cardiovascular diseases treated with LDA. <b>Methods:</b> A case-control study was conducted at a Brazilian hospital complex. Three groups were defined: (1) case group (n = 50): patients with cardiovascular disease who used LDA and were diagnosed with UGIB of non-variceal etiology, (2) LDA control group (n = 50): patients with cardiovascular disease who used LDA without developing UGIB, and (3) healthy control group (n = 189). Data were collected through face-to-face interviews, and blood samples were collected for the analysis of <i>Helicobacter pylori</i> infection and genotyping of 3 genetic variants [rs2238631 (C > T), rs4807491 (A > G), and rs1131882 (A > G)]. <b>Results:</b> The case group had a significantly higher frequency of carriers of the rs4807491.G allele compared to the control group of LDA users (<i>P</i>-value = .004). No significant difference was observed in the proportion of carriers of the rs2238631.T and 1131882.G variants between the studied groups. Carriers of rs2238631.T (OR: 4.515, 95% CI: 1.37-14.89) and rs4807491.G allele (OR: 3.232, 95% CI: 1.12-9.37) exhibited a higher risk of UGIB. <b>Conclusion:</b> These findings suggest that the presence of the rs2238631 and rs4807491 variant alleles is associates with a 3- to 4-fold increased risk of UGIB in patients with cardiovascular diseases treated with LDA. Future studies with larger sample sizes should confirm these results and to better identify individuals who may benefit from chronic LDA use.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"59 6","pages":"666-676"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phytonadione Utilization and the Risk of Bleeding in Chronic Liver Disease.","authors":"Joanna He, Tessa R Cox, Brian W Gilbert","doi":"10.1177/00185787241269114","DOIUrl":"10.1177/00185787241269114","url":null,"abstract":"<p><p><b>Purpose:</b> To determine the safety and efficacy of phytonadione in patients with an elevated international normalized ratio (INR) secondary to chronic liver disease without active bleeding. <b>Methods:</b> This retrospective chart review compared hospitalized patients from 2015 to 2022 with a diagnosis of chronic liver disease, a baseline INR of 1.2 to 1.9, and without active bleeding who did or did not receive phytonadione. The primary outcome was the incidence of new bleeding. The incidence of thrombosis and change in INR were also evaluated. <b>Results:</b> A total of 133 patients were included, of which 46 received phytonadione (mean 2.46 doses and mean dose 7.95 mg, 72.74% intravenously). Child-Pugh scores were higher in phytonadione patients (8.7 vs 9.93, <i>P</i> = .0003). There was no difference in the incidences of new bleeding (9.20 vs 13.04%, <i>P</i> = .492) or thrombosis (3.45 vs 0%, <i>P</i> = .203) between the control and phytonadione groups. After phytonadione administration, there was no change in INR, while INR increased by 0.24 in the control group (<i>P</i> = .025). <b>Conclusion:</b> In chronic liver disease patients who were not bleeding, phytonadione did not reduce INR or the incidence of new bleeding.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"59 6","pages":"660-665"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cefepime/Enmetazobactam.","authors":"Andrew R Staten, Danial E Baker","doi":"10.1177/00185787241269112","DOIUrl":"10.1177/00185787241269112","url":null,"abstract":"<p><p>Each month, subscribers to <i>The Formulary Monograph Service</i> receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of <i>The Formulary, Hospital Pharmacy</i> publishes selected reviews in this column. For more information about <i>The Formulary Monograph Service</i>, contact Wolters Kluwer customer service at 866-397-3433.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"59 6","pages":"606-613"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11504107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Study on the Continuation of Buprenorphine in the Perioperative Setting.","authors":"Morgan Lynn Dermody, Sandra Lemon, Lisa Kingdon, Laura Ruekert","doi":"10.1177/00185787241301348","DOIUrl":"https://doi.org/10.1177/00185787241301348","url":null,"abstract":"<p><p><b>Background and Aims:</b> The purpose of this study is to review the 2020 Substance Abuse and Mental Health Services Administration Guideline for Opioid Use Disorder recommendations to continue buprenorphine perioperatively by evaluating the total morphine milligram equivalents (MME) requirements in the first 24 hours postoperatively of patients who continued their buprenorphine therapy to those who discontinued their buprenorphine therapy perioperatively. <b>Methods:</b> This IRB approved study is a multicenter retrospective chart review of 80 surgical inpatients on buprenorphine prior to admission at participating sites from January 2015 to October 2022. The primary outcome is MME administered 24 hours postoperatively in patients who continued buprenorphine perioperatively versus those who discontinued buprenorphine perioperatively. Secondary efficacy outcomes included MME administered 48 and 72 hours postoperatively and daily average pain scores. Safety outcomes included rate of respiratory depression and mortality. <b>Findings:</b> Patients who continued buprenorphine perioperatively required significantly less MME in the first 24 hours postoperatively compared to those who discontinued buprenorphine perioperatively (median [IQR]; 23.25 [6-74.35] vs 93.38 [49.8-156.26]; <i>P</i> < .001). Secondary outcomes of MME administered at 48 hours (10.4 [0-40.5] vs 66.15 [27.94-143.5], <i>P</i> < .001) and 72 hours (0 [0-31.13] vs 66 [22.5-144], <i>P</i> < .001) postoperatively were also significantly less in those whose buprenorphine was continued versus those whose buprenorphine was discontinued perioperatively. Patients whose buprenorphine was continued perioperatively experienced significantly lower average pain scores at 48 (median [IQR]; 4.74 [2.9-7.08] vs 6 [4.93-7.4], <i>P</i> = .028) and 72 hours (3.78 [1.78-5.85] vs 5.75 [4.15-7.45], <i>P</i> = .002) postoperatively. <b>Conclusion:</b> Continuation of buprenorphine in the perioperative setting results in significantly lower utilization of MME in patients whose buprenorphine is continued compared to those whose buprenorphine is discontinued perioperatively.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241301348"},"PeriodicalIF":0.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital Outcomes Associated With Initial Fibrinolysis Versus Primary Percutaneous Coronary Intervention Among Patients Residing in Rural Areas Presenting With ST-Segment Elevation Myocardial Infarction.","authors":"Whitney B Sussman, Conner E Johnson, Erin R Weeda","doi":"10.1177/00185787241303485","DOIUrl":"https://doi.org/10.1177/00185787241303485","url":null,"abstract":"<p><p><b>Background:</b> Fibrinolysis is more commonly used to manage ST-segment elevation myocardial infarction (STEMI) in rural versus urban areas. However, little is known about the outcomes associated with this treatment strategy in rural individuals. We sought to compare in-hospital outcomes associated with the use of fibrinolysis versus primary percutaneous coronary intervention (PCI) among patients residing in rural areas presenting with STEMI. <b>Methods:</b> We identified adult patients with STEMI between 2016 and 2021 using the United States National Inpatient Sample. The cohort was restricted to individuals residing in rural areas. Patients were divided into 2 cohorts based on the receipt of initial fibrinolysis versus primary PCI. In-hospital outcomes were compared between cohorts, with in-hospital mortality serving as the primary outcome and length of stay (LOS) serving as a secondary outcome. <b>Results:</b> We identified 13 475 rural STEMI encounters receiving either initial fibrinolytic therapy (n = 1095) or primary PCI (n = 12 380). The average age and number of comorbidities were similar between cohorts. In-hospital mortality occurred in 5.2% of patients, and mean LOS for initial fibrinolysis and primary PCI patients was 3.73 ± 3.739 days and 3.45 ± 3.974 days, respectively. After adjusting for covariates, initial fibrinolysis was not associated with higher in-hospital mortality (odds ratio [OR] = 0.913; 95% confidence interval [CI] = 0.679-1.228). Initial fibrinolysis was associated with a small increase in LOS compared to primary PCI (Mean difference = 0.079 days; 95%CI = 0.035-0.123). <b>Conclusions:</b> In this analysis of approximately 13 000 STEMI encounters among rural individuals, patient characteristics between those treated with initial fibrinolysis versus primary PCI were similar. Observed outcomes were not meaningfully different between cohorts. Fibrinolytic therapy should not be an overlooked treatment strategy in rural STEMI patients facing delays in receipt of primary PCI.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241303485"},"PeriodicalIF":0.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Predictive Value of the SAMe-TT2R2 Score for Poor Anticoagulation Control in a Diverse Ethnic Population.","authors":"Sahimi Mohamed, Nik Najibah Nik Abdul Rahman, Jun Yuan Tan, Tarani Selvam, Hanis Hanum Zulkifly","doi":"10.1177/00185787241300293","DOIUrl":"https://doi.org/10.1177/00185787241300293","url":null,"abstract":"<p><p><b>Introduction:</b> In Asian countries, warfarin is still widely used for stroke prevention in non-valvular atrial fibrillation compared to non-vitamin K antagonist oral anticoagulants (NOACs) due to its affordability. A tool such as the SAMe-TT₂R₂ is needed to determine the probability of achieving and maintaining good anticoagulation control with warfarin therapy. However, it requires validation in the Malaysian cohort. Therefore, the objective of our study is to validate the SAMe-TT₂R₂ score in predicting poor anticoagulation control in Malaysia. A time in therapeutic range (TTR) < 65% was used to determine poor anticoagulation control. <b>Method:</b> This retrospective cohort study was conducted from July 2022 to July 2023. Patients were enrolled in 2020 from 49 facilities located across Malaysia resulting in a total of 957 included patients. TTR was calculated using Roseendaal's method. <b>Results:</b> The mean (SD) TTR and SAMe-TT₂R₂ score in the overall cohort is 65.2% (±24) and 5.5 (±0.9) respectively. Almost half of the population (43.7%) has the SAMe-TT₂R₂ score of 5. Having diabetes, ischemic heart disease, and increasing HAS-BLED and SAMe-TT₂R₂ score affects anticoagulation control on univariate analysis. However, after adjusting for demographics and clinical variables on multivariate analysis, only the SAMe-TT₂R₂ score as a continuous variable persists in predicting poor anticoagulation control. A SAMe-TT₂R₂ score cut-off point of >5 best predicts poor anticoagulation control with a sensitivity of 0.49 and a specificity value of 0.68. <b>Conclusion:</b> The SAMe-TT₂R₂ score, especially when exceeding 5, was associated with a higher likelihood of poor anticoagulation control, emphasizing its relevance in clinical assessment. However, its limited predictive capability, reflected by a C-statistic of 0.548, suggests the need for cautious interpretation and consideration of additional factors in anticoagulation management decisions. Continuous monitoring and personalized strategies are crucial for optimizing outcomes in this population.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241300293"},"PeriodicalIF":0.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Inpatient Care for Patients With Parkinson Disease.","authors":"Joyce Generali","doi":"10.1177/00185787241299964","DOIUrl":"10.1177/00185787241299964","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241299964"},"PeriodicalIF":0.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience With the Use of Paromomycin Via Nasogastric Tube as Treatment for Cryptosporidium Infection: A Case Report.","authors":"Iván Cores Rodríguez, Eduardo Tejedor Tejada, Daniel Ortiz Del Olmo, Marta Bernárdez Domínguez, Maria Teresa Criado Illana","doi":"10.1177/00185787241299621","DOIUrl":"https://doi.org/10.1177/00185787241299621","url":null,"abstract":"<p><p>Cryptosporidiosis is an infectious disease caused by the Cryptosporidium parasite, primarily affecting the gastrointestinal tract of both humans and animals. Transmission occurs via fecal-oral route, mainly through ingestion of water or food contaminated with oocysts, the parasite's infectious form. Immunocompromised individuals are particularly susceptible to severe and prolonged symptoms. Current treatment strategies involve supportive measures and antiparasitic medications such as nitazoxanide and paromomycin, although patients with predisposing factors have an elevated risk of recurrence. There is currently no evidence supporting the use of paromomycin via nasogastric tube. Therefore, we present our experience with the use of an extemporaneous paromomycin solution and its clinical impact.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241299621"},"PeriodicalIF":0.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on Reliability in Healthcare Training and Critical Evaluation of ChatGPT AI Performance: Simulation of the Admission Test for the Hospital Pharmacy Specialization School in Turin, Italy.","authors":"Eleonora Castellana","doi":"10.1177/00185787241299039","DOIUrl":"10.1177/00185787241299039","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241299039"},"PeriodicalIF":0.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}