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Li BX, Guo SM, Wang YP, Zhong KX, Wei YH. Identification and resolution of drug-related problems in the cardiovascular surgery unit of a tertiary hospital in China: a retrospective study. J Cardiothorac Surg 2025; 20:8. [PMID: 39755659 DOI: 10.1186/s13019-024-03237-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 12/24/2024] [Indexed: 01/06/2025] Open
Abstract
OBJECTIVE The prevalence and characteristics of drug-related problems (DRPs) in the cardiovascular surgery unit have not been adequately explored, leaving a gap in our understanding of this critical issue. This study aimed to address this gap by determining the prevalence, characteristics of DRPs and identifying factors associated with their occurrence. METHODS During a non-consecutive 48-month study period, a retrospective analysis was conducted to investigate DRPs and the interventions carried out by pharmacists for patients undergoing cardiovascular surgery. The study collected data on patient demographics, clinical characteristics, and pharmacist interventions. RESULTS A comprehensive data analysis revealed 671 DRPs among the 623 hospitalized patients, averaging 1.08 DRPs per patient. The most prevalent type of DRPs observed was "Unnecessary drug-treatment P3.2", accounting for 56.18% (377/671). The primary cause of DRPs was drug selection (C1), followed by dose selection (C3). Pharmacists proposed 1,628 interventions, averaging 2.43 interventions per DRP and 2.61 interventions per patient. Most interventions were accepted and fully implemented by physicians or patients, resulting in 537 (80.03%) of the total DRPs resolved. Furthermore, binary logistic regression analysis demonstrated that the frequency of DRPs was correlated with age, the length of hospitalization, diagnosis of valvular disease, presence of infectious desease and the number of different types of drugs used by the patients. CONCLUSIONS DRPs are a prevalent issue within the cardiovascular surgery unit, mainly due to drug selection. Clinical pharmacists' presence has proven effective in mitigating and preventing DRPs, thus optimizing medication therapy.
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Affiliation(s)
- Bo-Xia Li
- Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou, Gansu Province, 730000, China
| | - Si-Ming Guo
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi Province, 710061, China
| | - Yan-Ping Wang
- Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou, Gansu Province, 730000, China
| | - Ke-Xin Zhong
- Clinical College of Chinese Medicine, Gansu University Of Chinese Medicine, Lanzhou, Gansu Province, 730000, China
| | - Yu-Hui Wei
- Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou, Gansu Province, 730000, China.
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Borges M, Vilela Rodrigues JP, Freato Gonçalves AM, Silveira Almeida Campos M, Rossi Varallo F, Barbosa Zanetti MO, Regis Leira Pereira L. An Analysis of Drug-Related Problems in the Neurology Ward of a Tertiary Teaching Hospital: A Cross-Sectional Study. Cureus 2024; 16:e63829. [PMID: 39099928 PMCID: PMC11297551 DOI: 10.7759/cureus.63829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2024] [Indexed: 08/06/2024] Open
Abstract
Background and objective Drugs that act on the central nervous system have a high potential to cause drug-related problems (DRPs). A clinical pharmacist aided by collaborative efforts within an interdisciplinary healthcare team can prevent, detect, and resolve DRPs, thereby contributing to the promotion of medication safety and improving the quality of life of individuals under care. This study aimed to assess DRPs identified in the neurology ward of a tertiary hospital from February 2016 to November 2019. Methods This was a descriptive study with a cross-sectional and retrospective design involving secondary data collected from pharmaceutical care (PC) records. Student's t-tests, Pearson correlation coefficients, Poisson models, and logistic regression models were used to analyze the associations between age, number and type of medications, duration of hospitalization, and the occurrence of DRPs. Results A total of 130 patients were included in the study, and a total of 266 DRPs were detected, with 93 patients experiencing more than one DRP and 37 not presenting any DRPs. Necessity-related DRPs were the most prevalent (46.6%) type, followed by safety-related DRPs (28.6%). The prevalence of safety-related DRPs was higher in individuals older than 60 years (p<0.001). Conclusions Of note, 84.6% of the interventions suggested by pharmacists to resolve DRPs were accepted by the healthcare team. The high number of DRPs found underscores the importance of the clinical role of the pharmacist and interprofessional collaboration in the care of neurological patients, especially in the pharmaceutical follow-up of elderly individuals.
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Affiliation(s)
- Milena Borges
- Department of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, BRA
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Jimmy N, Upadhya M, Jaison JM, Sidheque S, Sundaramurthy H, Nemichandra S, Paneyala S, Ramesh M, Sri Harsha C, Syed J, Pal N. A Clinical Pharmacist-led Approach on Reducing Drug Related Problems Among Patients with Neurological Disorders: An Interventional Study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 11:100302. [PMID: 37538991 PMCID: PMC10393785 DOI: 10.1016/j.rcsop.2023.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/16/2023] [Accepted: 07/07/2023] [Indexed: 08/05/2023] Open
Abstract
Background Neurological disorders are common in the general population and the majority of patients have other chronic diseases, necessitating the use of multiple medications, which increases the incidence of drug-related problems (DRPs). Studies from different countries discovered an average of 0.29-1.45 DRPs per patient admitted into the neurology unit. Objectives To identify common DRPs and to evaluate the impact of clinical pharmacist's interventions in resolving the identified DRPs in patients with neurological disorders. Methods A prospective interventional study was conducted in the Department of Neurology in a tertiary care teaching hospital in Southern India, for a period of six months. Patients aged ≥18 years and had been hospitalized for >24 h, were intensively monitored until discharge for the occurrence of any DRPs and pharmacist interventions were provided. The identified DRPs were classified according to Hepler and Strand's Classification. Results A total of 310 prescriptions were reviewed, of which 174 patients (mean age 45.93 ± 2.49 years) experienced at least one DRP during their hospital stay. The average DRP per patient was found to be 1.75, with drug-drug interactions [254 (83%)] being the predominant DRPs, followed by adverse drug reactions [13 (4%)], and drug duplications [9 (3%)]. Most of the drug-drug interactions were pharmacokinetic [144 (56.69%)]. Hyponatremia [2 (15%)]; and nausea and vomiting [2 (15%)] were most commonly reported ADRs. All 306 DRPs involved active clinical pharmacist intervention, of which [275 (89.87%)] of pharmacists' interventions were accepted, which led to modification of the therapy. Conclusion Monitoring the use of drugs allowed the clinical pharmacist to detect DRPs and to suggest interventions that promote rational drug prescribing, therapy optimization and enhanced patient safety.
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Affiliation(s)
- Nivya Jimmy
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
| | - Meghana Upadhya
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
| | - Jesslyn Maria Jaison
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
| | - Shahal Sidheque
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
| | - Harsha Sundaramurthy
- Department of Neurology, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - S.C. Nemichandra
- Department of Neurology, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - Shasthara Paneyala
- Department of Neurology, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - Madhan Ramesh
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
| | - Chalasani Sri Harsha
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
| | - Jehath Syed
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
| | - Nikita Pal
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
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Zanetti MOB, Rodrigues JPV, Varallo FR, Cunha RLG, Simões BP, Pereira LRL. Impact of the insertion of the clinical pharmacist in the Allogeneic Hematopoietic Stem Cells Transplantation team. J Oncol Pharm Pract 2023; 29:375-385. [PMID: 35037789 DOI: 10.1177/10781552211073797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Allogeneic Hematopoietic Stem Cells Transplantation (allo-HSCT) is capable of curing patients with neoplastic or non-neoplastic hematologic disorders or of prolonging their survival. This study assessed if the insertion of the clinical pharmacist in the allo-HSCT team modified the outcomes: transplantation-related mortality, grafting failure, incidence of Graft versus Host Disease, hospitalization time, time for grafting, number of readmissions, number of drug-related problems (DRPs), adherence and knowledge about pharmacotherapy. METHODS Interventional study with historical control carried out in an allo-HSCT unit, in which the intervention group (IG) included 33 individuals who received pharmacotherapy follow-up. Control Group (CG) consisted of 28 individuals. RESULTS A total of 250 DRPs were identified, 59 team's doubts were clarified, and 309 interventions were conducted in the IG. The DRPs mainly arose from safety (51.60%) and effectiveness (38.40%) problems. A mean of 9.36 (SD = 6.97) interventions per patient was obtained, mainly including dose reductions (19.09%), adjustments in administration time (18.12%), educational activities (15.21%) and drug removal (10.68%). Clinical significance of the interventions was considered high (75.7% extremely significant, very significant or significant), as well as their acceptability (89.7% accepted). Each patient attended a mean of 4.68 pharmaceutical consultations (SD = 1.91) after hospital discharge, presenting increase in knowledge (p = 0.0001) and in adherence (p = 0.0115). There was no evidence of differences between the groups in the other outcomes analyzed. CONCLUSIONS The pharmacotherapy follow-up allowed detecting several DRPs and performing interventions of high clinical relevance and acceptability, in addition to improving adherence and individualizing the pharmacotherapy.
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Affiliation(s)
| | - João Paulo Vilela Rodrigues
- School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Fabiana Rossi Varallo
- School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | | | - Belinda Pinto Simões
- Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
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Intercepting Medication Errors in Pediatric In-patients Using a Prescription Pre-audit Intelligent Decision System: A Single-center Study. Paediatr Drugs 2022; 24:555-562. [PMID: 35906499 DOI: 10.1007/s40272-022-00521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Medication errors can happen at any phase of the medication process at health care settings. The objective of this study is to identify the characteristics of severe prescribing errors at a pediatric hospital in the inpatient setting and to provide recommendations to improve medication safety and rational drug use. METHODS This descriptive retrospective study was conducted at a tertiary pediatric hospital using data collected from Jan. 1st, 2019 to Dec. 31st, 2020. During this period, the Prescription Pre-audit Intelligent Decision System was implemented. Medication orders with potential severe errors would trigger a Level 7 alert and would be intercepted before it reached the pharmacy. Trained pharmacists maintained the system and facilitated decision making when necessary. For each order intercepted by the system the following patient details were recorded and analyzed: patient age, patient's department, drug classification, dosage forms, route of administration, and the type of error. RESULTS A total of 2176 Level 7 medication orders were intercepted. The most common errors were associated with drug dosage, administration route, and dose frequency, accounting for 35.2%, 32.8% and 13.2%, respectively. Of all the intercepted oerrors. 53.6% occurred in infants aged < 1 year. Administration routes involved were mainly intravenous, oral and external use drugs. Most alerts came from the neonatology department and constituted 40.5% of the total alerts, followed by the nephrology department 15.9% and pediatric intensive care unit (PICU) 11.3%. As to dosage forms, injections accounted for 50.4% of alerts, with 21.3% attributable to topical solutions, 9.1% to tablets, and 5.7% to inhalation. Anti-infective agents were the most common therapeutic drugs prescribed with errors. CONCLUSIONS The Prescription Pre-audit Intelligent Decision System, with the supervision of trained pharmacists can validate prescriptions, increase prescription accuracy, and improve drug safety for hospitalized children. It is a medical service model worthy of consideration.
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Carneiro LG, Paz KD, Ribeiro E. Economic impact of pharmaceutical interventions in a medium complexity Brazilian university hospital. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e201198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
| | | | - Eliane Ribeiro
- Universidade de São Paulo, Brazil; Universidade de São Paulo, Brazil
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Liu P, Li G, Han M, Zhang C. Identification and solution of drug-related problems in the neurology unit of a tertiary hospital in China. BMC Pharmacol Toxicol 2021; 22:65. [PMID: 34702348 PMCID: PMC8547903 DOI: 10.1186/s40360-021-00530-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence and characteristics of drug-related problems (DRPs) and factors associated with the occurrence of DRPs in the neurology unit in China remain unknown. This study aimed to determine the prevalence, characteristics and severity ratings of DRPs and identify factors associated with the occurrence of DRPs in the neurology unit of a tertiary care and academic teaching hospital in China. METHODS A retrospective study of DRPs and pharmacists' interventions for neurology patients was performed during a non-consecutive 24-month study period. Patient demographics and clinical characteristics, and pharmacist's intervention records were collected. The characteristics and severity ratings of DRPs were categorized using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.00 and the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification respectively. RESULTS A total of 242 DRPs were detected for 974 admitted patients, an average of 0.25 DRPs per patient. Treatment safety was the major type of DRPs (106;43.8%) followed by treatment effectiveness (78;32.2%). The primary causes of DRPs were drug selection (124;44.1%) and dose selection (92;32.7%). Clinical pharmacists provided 525 interventions, and most interventions occurred at the prescriber level (241;45.9%). A total of 91.4% of these interventions were accepted, contributing to solving 93.0% of the identified problems. The majority of DRPs (210;86.8%) were rated at severity categories B to D (causing no patient harm). Multiple logistic regression showed that creatinine clearance, number of medications used, nasogastric feeding, diabetes, and infectious diseases were associated with more frequent DRPs (p < 0.05). CONCLUSIONS DRPs are relatively common in the neurology unit in China, with primary causes of drug and dose selection, and clinical pharmacists can effectively reduce and prevent DRPs to optimize medication therapy.
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Affiliation(s)
- Pengpeng Liu
- Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Guangyao Li
- Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Mei Han
- Evidence-Based Medicine Center, Beijing University of Chinese Medicine, Beijing, China
| | - Chao Zhang
- Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
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Martin AW, Isaac J, Furbish A. Implementation of a pharmacist‐managed population health monitoring tool for disease modifying therapies in treatment of patients with multiple sclerosis in a veterans affairs medical center. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Alison W. Martin
- Ralph H. Johnson Veterans Affairs Medical Center Charleston South Carolina USA
| | - Julianne Isaac
- Ralph H. Johnson Veterans Affairs Medical Center Charleston South Carolina USA
| | - Amelia Furbish
- Ralph H. Johnson Veterans Affairs Medical Center Charleston South Carolina USA
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Saldanha V, de Araújo IB, Lima SIVC, Martins RR, Oliveira AG. Risk factors for drug-related problems in a general hospital: A large prospective cohort. PLoS One 2020; 15:e0230215. [PMID: 32369489 PMCID: PMC7199929 DOI: 10.1371/journal.pone.0230215] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/24/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To identify risk factors for potential Drug-Related Problems (DRP) at admission in hospitalized patients. METHODOLOGY Prospective cohort study conducted in adults patients hospitalized (May 2016 to May 2018) in a general tertiary care hospital in Brazil. Potential DRP were detected by daily review of 100% of electronic medication orders by hospital pharmacists and classified by the Pharmaceutical Care Network Europe classification system (PCNE version 6.2). For the identification of risk factors of potential DRP, backward stepwise logistic regression was used to identify the set of independent predictors among over 120 variables collected in the initial 48 hours after admission in a training set consisting of 2/3 of the study population. The model was validated in the remaining sample. RESULTS The study population consisted of 1686 patients aged 52.0+/- 18.3 years-old, 51.4% females, with a median length of stay of 3.24 days, and 4.5% in-hospital mortality. The cumulative incidence of potential DRP was 14.5%. Admission for elective surgery and main diagnosis of disease of the circulatory system were associated with reduced risk of DRP (OR 0.41 and 0.57, respectively, p<0.05). The independent risk factors of DRP are heart rate ≥ 80 bpm (OR 1.41, p = 0.05), prescription of more than seven drugs in day 2 (OR 1.63, p = 0.05), prescription in day 1 of drugs of the Anatomical Therapeutic Chemical Code (ATC) class A (alimentary tract and metabolism, OR 2.24, p = 0.003), prescription in day 2 of two or more ATC class A drugs (OR = 3.52, p<0.001), and in day 1 of ATC class J drugs (antiinfectives for systemic use, OR 1.97, p = 0.001). In the validation set, the c-statistic of the predictive model was 0.65, the sensitivity was 56.1% and the specificity was 65.2%. CONCLUSION This study identified seven independent risk factors of potential DRP in patients hospitalized in a general hospital that have fair predictive performance for utilization in clinical practice.
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Affiliation(s)
- Valdjane Saldanha
- Graduate Program in Pharmaceutical Sciences, Centro de Ciências da Saúde, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ivonete Batista de Araújo
- Pharmacy Department, Centro de Ciências da Saúde, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Sara Iasmin Vieira Cunha Lima
- Graduate Program in Pharmaceutical Sciences, Centro de Ciências da Saúde, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Rand Randall Martins
- Pharmacy Department, Centro de Ciências da Saúde, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Antonio Gouveia Oliveira
- Graduate Program in Pharmaceutical Sciences, Centro de Ciências da Saúde, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Pharmacy Department, Centro de Ciências da Saúde, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Saldanha V, Randall Martins R, Lima SIVC, Batista de Araujo I, Gouveia Oliveira A. Incidence, types and acceptability of pharmaceutical interventions about drug related problems in a general hospital: an open prospective cohort. BMJ Open 2020; 10:e035848. [PMID: 32332007 PMCID: PMC7204863 DOI: 10.1136/bmjopen-2019-035848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To evaluate the incidence and types of drug-related problems (DRP) in a general teaching hospital and to evaluate the acceptability of pharmaceutical interventions by the medical team. DESIGN Prospective cohort study during 2 years. SETTING Conducted in a Brazilian University Hospital. PARTICIPANTS The patient cohort consisted of 9303 patients with a total of 12 286 hospitalisation episodes. PRIMARY OUTCOME MEASURES DRP detected by pharmacists' review of 100% medication orders using Pharmaceutical Care Network Europe 6.2 classification. RESULTS Patients with a mean age of 52.6±17.7 years and 50.9% females. A total of 3373 DRP in 1903 hospital episodes were identified, corresponding to a cumulative incidence of 15.5%. 'Treatment ineffectiveness' (11.5%) and 'Treatment costs' (5.90%) were the most common DRP and 'Drug use process' (18.4%) and 'Treatment duration' (31.0%) the main causes of DRP. The medicines involved most often involved in DRP were anti-infectives (36.0%), mainly cephalosporins (20.2%), antiulcer (38.6%), analgesics/antipyretics (61.2%), propulsives (51.2%), opioids (38.5%) and antiemetics (57.4%). From 1939 pharmaceutical interventions, at least, 21.4% were not approved by the medical team. CONCLUSION DRP detected by 100% medication order review by hospital pharmacists occur in a significant proportion of hospital episodes, the most frequent being related to treatment effectiveness and treatment costs. The medications mostly involved were cephalosporins, penicillins, antidyspeptics, analgesics, antipyretics, opioids and antiemetics. Pharmaceutical interventions had low acceptability by the medical staff.
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Affiliation(s)
- Valdjane Saldanha
- Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Rand Randall Martins
- Department of Pharmacy, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sara Iasmin Vieira Cunha Lima
- Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ivonete Batista de Araujo
- Department of Pharmacy, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Antonio Gouveia Oliveira
- Department of Pharmacy, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Shawahna R. Development of key performance indicators to capture in measuring the impact of pharmacists in caring for patients with epilepsy in primary healthcare: A Delphi consensual study. Epilepsy Behav 2019; 98:129-138. [PMID: 31374468 DOI: 10.1016/j.yebeh.2019.07.034] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study was conducted to develop and achieve formal consensus on a core set of key performance indicators (KPIs) that can be captured in measuring the impact of pharmacists in caring for patients with epilepsy (PWE) visiting epilepsy clinics as outpatients in primary healthcare practice. METHODS In this study, a comprehensive literature search and review was conducted to extract candidate KPIs. Interviews with key contacts (6 pharmacists, 2 neurologists, 3 nurses, and 3 PWE) were also conducted to supplement the inventory set of KPI candidates. A three-round Delphi technique was followed among a panel of 40 members to achieve formal consensus on a core list of KPIs. Consensual KPIs were ranked by the ratings of the panelists. RESULTS The final consensual core set contained 8 KPIs in the thematic activity areas of pharmaceutical care, medication reconciliation and best possible medication history, patient education/counseling, interprofessional patient care, competence, and performance efficiency/patient satisfaction. The KPIs related to therapy problems identified and resolved by pharmacist and provision of proactive comprehensive direct patient care by a pharmacist received significantly higher (p-value: 0.0001) scores compared to the KPI related to complaints about pharmacists received. CONCLUSION Eight consensual KPIs to capture in measuring the impact of pharmacists in caring for PWE visiting epilepsy clinics as outpatients in primary healthcare practice were developed using the Delphi technique. If successfully adopted, implemented, captured, and analyzed, these consensual KPIs might help advance pharmaceutical care of PWE in primary healthcare practice.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
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