Journal of Pharmacy Practice and Research最新文献

{"title":"Expansion of the partnered pharmacist medication charting model on admission in the General Medicine Unit — initiation of new medications","authors":"Phuong U. Hua BPharm(Hons),&nbsp;Gail Edwards BPharm, MClinPharm,&nbsp;Eleanor Van Dyk BPharm, MClinPharm,&nbsp;Gary Yip MBBS, FRACP,&nbsp;Biswadev Mitra MBBS, MHSM, PhD, FACEM,&nbsp;Michael J. Dooley BPharm, GradDipHospPharm, PhD, FISOPP, FSHPA, FAAQHC,&nbsp;Erica Y. Tong BPharm(Hons), MClinPharm, PhD","doi":"10.1002/jppr.1842","DOIUrl":"10.1002/jppr.1842","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increasing life expectancy has seen a continual rise in older patients who present to hospital with acute decompensation. Pharmacists are well equipped to make medication recommendations in these settings to meet patient care needs, promote harm minimisation, and improve workflow efficiency. The Partnered Pharmacist Medication Charting (PPMC) model enables pharmacists to chart regular medications for patients admitted to the General Medicine Unit (GMU) in collaboration with treating clinicians. The model was expanded to assess the safety of pharmacists additionally charting newly initiated medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to assess the safety of the expanded PPMC model through the number of medication errors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This prospective observational study was conducted at a tertiary hospital. Patients admitted to the GMU and received PPMC were included. Pharmacists were able to chart any new medications as well as the patients' pre-admission medications. The primary outcome was the number of medication errors charted on admission. Medication errors were defined as medications charted outside of the specific recommendations documented in the medication management plan written by the PPMC pharmacist and co-signed by the admitting medical officer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 8093 medications were charted by a credentialed pharmacist, with 10% (<i>n</i> = 816) planned newly initiated medications. Eight (0.98%) medication charting errors were identified in the PPMC model, which included five planned medications omitted. Of the 811 newly charted medications, 87 (10.7%) were amended within 24 h, with the majority being due to change in diagnosis or driven by changes in clinical status or investigative results becoming available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The expansion of the PPMC model of care to enable pharmacist charting of new medications was found to be safe. The adoption of the model may aid in reducing medication errors, thereby improving patient care and safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42491672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes, and practices of Australian oncology health professionals on complementary medicines","authors":"Martin R. Keene,&nbsp;Ian M. Heslop,&nbsp;Sabe S. Sabesan,&nbsp;Beverley D. Glass","doi":"10.1002/jppr.1838","DOIUrl":"10.1002/jppr.1838","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Approximately half of people with cancer are using complementary and alternative medicine (CAM), presenting safety concerns due to potential interactions with conventional cancer treatment. Oncology staff have a role to play in ensuring the safe use of CAMs and so, this study examined their knowledge, attitudes, and practices regarding CAMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to assess the knowledge, attitudes, and practices of Australian doctors, nurses, and pharmacists regarding CAM use in oncology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Members of three national oncology professional associations took part in an online questionnaire, which determined their knowledge, attitudes, and practices regarding CAM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-nine completed surveys were obtained from nine doctors, 70 nurses, and 20 pharmacists. Most respondents (68.4%) felt that they did not have adequate knowledge of CAMs to respond to patients' questions. Assessment of attitudes found respondents generally believed that CAMs have a complementary role in oncology but indicated their concerns for the safety of patients. Respondents indicated in practice they would discuss CAMs with less than half of patients (40.6%), with a lack of scientific data and guidelines for CAM use presenting significant barriers to these discussions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study suggests that oncology health professionals' knowledge of CAMs potentially leads to a lack of confidence in providing advice to patients and concerns for patient safety. This impacts their discussion of CAMs and lack of disclosure from patients about their use of CAMs. Education on CAMs in oncology would assist in increasing professionals' confidence in discussing these therapies, leading to increased patient disclosure of CAMs and safer treatment decision making for people with cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42715282","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":"Who is asking? Requests for antimicrobial prescribing advice received by hospital pharmacists","authors":"Sarah Wise LLB, MSc, PhD,&nbsp;Eloise Smith BMedSc(Hons),&nbsp;Lilibeth Carlos BPharm,&nbsp;Matthew Coleshill BSc(Hons), PhD,&nbsp;Richard Osborne Day MBBS(Hons), MD, FRACP,&nbsp;Terry Melocco BPharm,&nbsp;Jane Ellen Carland BMedSc(Hons), PhD","doi":"10.1002/jppr.1841","DOIUrl":"10.1002/jppr.1841","url":null,"abstract":"<p>Doctors are perceived as the primary decision makers in antimicrobial therapy, but prescribing decisions are influenced by the multidisciplinary team. Antimicrobial stewardship (AMS) programs formalise interprofessional advice-giving. No studies capture the advice provided by pharmacists. This study aimed to describe the volume and nature of antimicrobial prescribing advice that healthcare professionals seek from hospital pharmacists. A prospective audit of antimicrobial-related advice requests received by pharmacists (<i>n</i> = 18) at an Australian public hospital was undertaken in July 2020. Antimicrobial advice was sought from 11 pharmacists on 300 occasions. Most requests (80%) were received by the AMS pharmacist. A mean (range) of 30 (17–40) requests per day was recorded and the AMS pharmacist received 24 (16–31) requests daily. Most requests came from the intensive care unit (22.1%), pharmacy (21.4%), and infectious diseases (17.1%). The AMS pharmacist was mostly contacted by consultants and pharmacists, and other pharmacists were contacted by registrars and junior medical officers. Despite COVID-19 adaptations, face-to-face interaction was most common. This audit demonstrates the value of an AMS pharmacist, and indicates the importance of face-to-face interactions and the formalisation of pharmacists' role in prescribing decision-making. Pharmacists provided antimicrobial advice daily to other healthcare professionals. Further research is required to provide insights into the barriers and enablers to effective advice-giving interactions.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1841","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46144542","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":"Are our leaders and managers aware of their responsibilities in ensuring culturally safe workplaces for staff?","authors":"Susan Trevillian BPharm, PGradDipPharm, AdvPP(II), MSHP,&nbsp;Aleena Williams MPharm, BPharmSci, GradDiP PharmPrac,&nbsp;Russell Hill BPharm, PGradDipPharm (Dist), GradDipBus, MBA (Dist), FPS","doi":"10.1002/jppr.1837","DOIUrl":"10.1002/jppr.1837","url":null,"abstract":"<p>The <i>United Nations Declaration on the Rights of Indigenous Peoples</i> (UNDRIP) remains the most comprehensive international instrument on the rights of First Nations peoples around the world, setting standards for survival, dignity, and wellbeing. Under the UNDRIP, the Aboriginal and Torres Strait Islander Peoples of Australia “have an equal right to the enjoyment of the highest attainable standard of physical and mental health”.<span>¹</span> In 2017, when the UNDRIP was first adopted by the United Nations General Assembly, Australia was one of four countries who did not vote in support. Whilst Australia and its three counterparts later reversed their positions and now support the UN declaration, this chapter in history illustrates the challenges that face those seeking to address discriminatory attitudes within the Australian community.</p><p>Throughout Australia, freedom from racism at work is protected by legislation, the <i>Fair Work Act 2009</i>.<span>²</span> When bias, discrimination, and racism occur in the workplace “the psychological and cultural safety of staff” is threatened, “feelings of acceptance and respect at work” are weakened, and the burnout of staff may result.<span>³</span> It is important that leaders and managers understand the effects of structural racism on workplace dynamics, and that they identify and act on incidences of racism in the workplace.</p><p>This understanding is crucial, not only to fostering a workplace that is free from racism, but for ensuring all pharmacists have access to training and education to further develop their own cultural capacity, communication skills, and ability to connect with First Nations Peoples. These competencies are described within the <i>National Competency Standards Framework for Pharmacists in Australia</i>,<span>⁴</span> the Pharmacy Council of New Zealand's <i>Competence Standards for the Pharmacy Profession,</i><span>⁵</span> and internationally.</p><p>A pharmacists' development of cultural competency can be accelerated by undertaking cultural responsiveness training and focusing on developing appropriate communication skills that enable the delivery of care to First Nations Peoples in a culturally safe manner. Undergraduate pharmacy programs and pharmacy intern training programs in Australia are including these elements of pharmacy practice within their curriculums, so Australia's newly registered pharmacists are arguably the most culturally responsive we have ever had.</p><p>But what of their leaders and managers?</p><p>Successful leaders can often point to mentors who have guided elements of their career. ‘Mentors’ are defined within the Australian Competency Standards Framework as “those who share their knowledge, expertise and experience on career, technical, professional <i>and</i> cultural issues with another individual”.<span>⁴</span> Amongst those you consider your mentors, is there someone fro","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1837","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47100392","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":"Development and trial of an instrument to evaluate accredited pharmacists' clinical home medicines review reports in Australia","authors":"Marea Patounas PhD, BPharm, MPS, AACPA, SFHEA, AFHEA (Indigenous),&nbsp;Esther T. L. Lau PhD, BPharm (Hons), GCResComm, GradCertAcadPrac, SFHEA, AFHEA (Indigenous), MPS,&nbsp;Deborah Rigby BPharm, GradDipClinPharm, AdvPracPharm, FPS, FSHP, FACP, FASCP FAICD,&nbsp;Vincent Chan PhD, BPharm, MPH, MPS,&nbsp;Lisa M. Nissen PhD, BPharm, AdvPracPharm, FPS, FHKAPh, FSHP","doi":"10.1002/jppr.1829","DOIUrl":"10.1002/jppr.1829","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>In Australia, clinical reports are written by an accredited pharmacist following in-home patient consultations as part of a home medicines review (HMR). These reports communicate clinical findings and recommendations to the patient's general practitioner to optimise medicines and improve patient health. However, it is unknown if clinical HMR reports adhere to practice guidelines. This study aimed to develop an instrument from Australian practice guidelines, and then test the instrument by evaluating a small sample of clinical HMR reports written by accredited pharmacists. An instrument was developed from a consolidation of HMR practice guidelines and then applied to a small sample of de-identified clinical HMR reports provided by accredited pharmacists. The instrument developed contained 30 criteria for clinical HMR report writing, and 20 HMR reports were evaluated from 12 accredited pharmacists. Seven of the 30 criteria were met by all clinical HMR reports evaluated (were consumer-focused, documented a medicines list, medicines strengths, medicines directions, medication-related problems, and included both evidence-based and clinical recommendations for optimising medicines management). However, of the 20 HMR reports evaluated only 30% (<i>n</i> = 6) documented the general practitioner's reason for HMR referral, 60% (<i>n</i> = 12) detailed allergies/adverse drug reactions, 50% (<i>n</i> = 10) documented an adherence statement, and 20% (<i>n</i> = 4) documented vaccination status. Clinical HMR reports evaluated in this small study were aligned with practice guidelines for some criteria. Future research is warranted in a larger study to further investigate clinical HMR report writing adherence to practice guidelines in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1829","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42924128","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":"Hospital-initiated post-discharge medication reviews in Australia: expert opinion on the barriers and enablers to implementation","authors":"Manya Angley BPharm, PhD, AACPA, AdvPracPharm, FSHP, FPS,&nbsp;Deirdre Criddle BPharm, GradDipPharm, AACPA, AdvPracPharm, FPS, MSHP, MRPharmS,&nbsp;Deborah Rigby BPharm, GradDipClinPharm, AdvPracPharm, AACPA, FPS, FSHPA, FACP, FASCP, FAICD,&nbsp;Rohan A. Elliott BPharm, BPharmSc (Hons), MClinPharm, FSHP, PhD,&nbsp;Katie Phillips BPharm (Hons), Grad Cert Pharmacy Practice, AACPA, MSHP,&nbsp;Jonathan Penm BPharm (Hons), PhD, GradCert (Higher Ed), FFIP, FSHP, FHEA,&nbsp;Janet K. Sluggett BPharm (Hons), PhD, GradDipClinEpid, AACPA, FSHP, GAICD,&nbsp;Joy Gailer BPharm, DipHospPharm, BCPS, AdvPracPharm, FPS, MSHP,&nbsp;Horst Thiele DipPharm, MSHP,&nbsp;Amy T. Page PhD, BHealth Sci, BPharm, Grad Dip Biostatistics, Grad Cert Health Prof Ed, Grad Cert Pharm Pract, MClinPharm, AACPA, AdvPracPharm, FPS,&nbsp;Carly Pauw BPharm, MSHP,&nbsp;Sarah Gillespie BPharm, AACPA, MSHP, MPS,&nbsp;Sepehr Shakib MBBS, PhD, FRACP,&nbsp;Jerry Yik BPharm MPubPol","doi":"10.1002/jppr.1832","DOIUrl":"10.1002/jppr.1832","url":null,"abstract":"<p>Medication-related harm can occur during transitions of care. Revised Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) program rules were published in April 2020 which allowed provision for some hospital medical practitioners to refer at-risk patients for medication review. In turn, the Society of Hospital Pharmacists of Australia's (SHPA's) Transitions of Care and Primary Care Leadership Committee developed a framework to support hospitals facilitating Hospital-Initiated Medication Reviews (HIMRs) via three pathways: HMR, RMMR, and Hospital Outreach Medication Review. Following the compilation of draft barriers and enablers to implementation of the SHPA HIMR framework, refinement occurred after broad consultation with hospital- and primary care-based pharmacists with transitions of care experience. The finalised list of barriers and enablers can inform broadscale implementation of the SHPA HIMR framework to reduce medication-related harm when high-risk patients transition from hospital to primary care and aged care.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44798004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing chronic obstructive pulmonary disease in primary care: clinical characteristics of patients receiving inhaled corticosteroids","authors":"Madisyn Strain PharmD, BCPS, BCACP,&nbsp;Kaci Boehmer PharmD, BCACP, CDCES,&nbsp;Justin Usery PharmD, BCPS","doi":"10.1002/jppr.1835","DOIUrl":"10.1002/jppr.1835","url":null,"abstract":"Inhaled corticosteroid (ICS) therapy in patients with chronic obstructive pulmonary disease (COPD) has been associated with a variety of unfavourable effects, including increased risk of pneumonia, and is only recommended if specific characteristics are present to ensure patients derive the most benefit.","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42289094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative medication management for older people","authors":"Samuel Johnson MBBS,&nbsp;Cilla Haywood MBBS, PhD, FRACP","doi":"10.1002/jppr.1834","DOIUrl":"10.1002/jppr.1834","url":null,"abstract":"<p>The average age of surgical candidates is increasing with the ageing population worldwide. Major surgery in older patients is associated with a significant risk of complications due to physiologic changes occurring with ageing and individual patient factors such as frailty, polypharmacy, and multimorbidity. Periodic medication review should be part of the routine management of all older patients, with the perioperative period presenting an opportune time for this review. Regular medications may need short-term modification during the surgical period. Medications implicated in increasing risk of inducing or worsening delirium should be identified and withdrawal considered ahead of time. Perioperative commencement of medication aimed at reducing risk of other complications, including cardiovascular events, should be considered on an individual basis, analysing risks and benefits. Comprehensive medication review and careful planning through the perioperative period may enhance the prospects of recovery and reduce morbidity and mortality for older surgical patients.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1834","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45302932","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":"Response from Authors: a benchmarking scoping review of research output from hospital pharmacy departments in Australia","authors":"Jonathan Penm BPharm (Hons), PhD, GradCert (Higher Ed),&nbsp;Sujita Narayan PhD,&nbsp;Jan-Willem Alffenaar PharmD, PhD,&nbsp;Jacinta L. Johnson BPharm (Hons), PhD, AdvPracPharm,&nbsp;Sanja Mirkov BPharm, PGDipPH,&nbsp;Amy T. Page PhD, MClinPharm, GradDipBiostat, GCertHProfEd, MAACP, GStat, FPS, AdvPracPharm,&nbsp;Lisa G. Pont BSc, BPharm, MSc(Epi), PhD,&nbsp;Asad E. Patanwala PharmD, MPH","doi":"10.1002/jppr.1833","DOIUrl":"10.1002/jppr.1833","url":null,"abstract":"<p>To the Editor,</p><p>We thank Elliott et al.<span>¹</span> and Misko et al.<span>²</span> for their feedback on our recent scoping review.<span>³</span> They both provided valuable feedback for future benchmarking studies. We acknowledge that these limitations may impact state or territory-based benchmarking but reinforce that the national benchmarking offered by our paper appears useful for such sites to compare against.</p><p>Amy Page is an Editorial Board member of the <i>Journal of Pharmacy Practice and Research</i> and a co-author of this article. To minimise bias, she was excluded from all editorial decision-making related to the acceptance of this article for publication.</p><p>All listed authors comply with the <i>Journal's</i> authorship policy.</p><p>No ethics approval was required for this letter to the editor.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48711928","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":"Improving medicine information on discharge summaries through implementation of a reconciliation-based intervention","authors":"Anna Nguyen BPharm (Hons), GradCertPharmPrac,&nbsp;Stephanie Gibson BPharm (Hons), MClinPharm,&nbsp;Paul Wembridge BPharm (Hons), MClinPharm","doi":"10.1002/jppr.1828","DOIUrl":"10.1002/jppr.1828","url":null,"abstract":"<p>The handover of medication-related information at the point of discharge often occurs via the discharge summary (DS), although these frequently contain errors. We aimed to investigate whether an intern pharmacist reviewing the medication details in discharge summaries (DSs), reconciling them with the discharge prescription and pointing out any discrepancies with the medical staff would reduce the rate of medication errors. The intervention was retrospectively reviewed by comparing medication information on the DS with the discharge prescription (considered the ‘source of truth’). Error rates on the DS were compared to a control group of patients discharged over a different 2-week period from the same ward. A modified APINCH (Antimicrobials, Potassium and other electrolytes, Insulin, Narcotics and other sedatives, Chemotherapeutic agents, Heparin and other anticoagulants, Systems) classification system was used to identify high-risk errors. The time taken to perform the intervention was measured and details of any recommendations collected. The study included 22 intervention patients and 31 control patients. Patients who received the intervention were less likely to have one or more medication errors on their DS (any: 4% vs 84%, p &lt; 0.01; high-risk: 0% vs 29%, p &lt; 0.01). The intern pharmacist made a total of 77 recommendations during the intervention. Six recommendations (8%) related to high-risk medications. The median time required to undertake the first review was 4 min, and the second review took 1 min. In conclusion, we found a reconciliation-based intervention involving an intern pharmacist could reduce the rate of medication errors on DSs.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43848719","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}