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Grimes TC, Guinan EM. Interprofessional education focused on medication safety: a systematic review. J Interprof Care 2023; 37:131-149. [PMID: 35050843 DOI: 10.1080/13561820.2021.2015301] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Safe medication use necessitates interprofessional working, with calls to enhance interprofessional education (IPE) focusing on medication safety (MS) in healthcare professional (HCP) curricula. Little is known about the design, delivery or evaluation of such activities. This systematic literature review describes MS-focused IPE activities in pre-qualification HCP programmes. MedLine, EMBASE, CINAHL and ERIC were searched, relevant studies identified and data extracted. The McGill Mixed Methods Appraisal Tool was employed. The 3P (presage-process-product) theory structured deductive analysis. Thirty-one studies were included, reporting on 30 activities, mostly undertaken in North America or United Kingdom. Presage/Design: Most reported activities involved pharmacy, nursing, medical or physician assistant students learning with one or more other HCP group. Few studies matched student groups' skills or experiences. Few studies reported theoretical underpinnings. Process/Delivery: Multiple pedagogical approaches were employed, mostly social construction, and low- and high-fidelity simulation-based learning. Few studies reported learning outcomes or summative assessment, more reported formative assessment. Product/evaluation: Outcomes measured were learners' opinions, satisfaction or attitudes toward interprofessional working and findings were generally positive. Few studies reported on student development or outcomes specific to medication safety. Lack of integration of qualitative/quantitative components of mixed methods studies and limited outcome measurements' validity or reliability weakened study quality. MS-focused IPE for pre-qualification HCPs is well received by students. Design of future activities could be enhanced by employing theory and ensuring matching of students' and groups' skills, professional identity and learner attributes to enhance learning in an interprofessional setting. Future delivery should embed MS-focused IPE into the standard curricula to optimize constructive alignment, learner engagement, quality and drive development. The required skillset in pre-qualification HCP programmes to facilitate future safe medication practice, together with the associated learning outcomes and assessment approaches, should be defined. The quality of scholarly studies examining these activities needs improvement.
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Affiliation(s)
- T C Grimes
- School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin, Dublin 2, Ireland
| | - E M Guinan
- School of Medicine, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
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Aziz AA, Rogers S, Hassanien O, Shalaby L, Nagy M. Knowledge, attitudes and practice regarding pharmacovigilance and adverse drug reaction reporting among physicians and pharmacists in Egypt: a step toward personalized medicine implementation. Per Med 2022; 19:495-507. [PMID: 36239598 DOI: 10.2217/pme-2022-0030] [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: 11/21/2022]
Abstract
Aim: To assess the knowledge, attitudes, and practices of the healthcare professionals working at Children's Cancer Hospital Egypt regarding pharmacovigilance (PV) and adverse drug reaction (ADR) reporting, in addition to the ADR reporting barriers. Materials & methods: A cross-sectional study was conducted at Children's Cancer Hospital Egypt from July to September 2021 using a validated questionnaire. Results: About 37 physicians (20.3%) and 145 pharmacists (79.7%) responded to the survey. Overall, the knowledge (median: 40%) and practice (median: 50%) of PV and the reporting of ADRs were low; however, attitudes were mostly positive. The main barrier to reporting ADRs was The difficulty of determining whether or not ADRs occurred (42.3%). Conclusion: Understanding of PV and ADR reporting could improve the huge gap between ADRs experienced and ADRs reported. In order to be able to assess the impact of personalized medicine implementation, adequate ADR reporting should be well established.
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Affiliation(s)
- Alaa Abdel Aziz
- Department of Pharmaceutical Services, Children's Cancer Hospital Egypt, Cairo, 57357, Egypt.,Department of Pharmacy, Ain Shams University Hospitals, Cairo, Egypt
| | - Sara Rogers
- American Society of Pharmacovigilance, Houston, TX 77225, USA.,Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville, TX 78363, USA.,Department of Translational Medical Sciences, College of Medicine, Texas A&M Health Science Center, Bryan, TX 77807, USA
| | - Omneya Hassanien
- Department of Epidemiology & Clinical Research, Children's Cancer Hospital Egypt, Cairo, 57357, Egypt
| | - Lobna Shalaby
- Infectious Disease Unit, Children's Cancer Hospital Egypt, Cairo, 57357, Egypt.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mohamed Nagy
- Department of Pharmaceutical Services, Children's Cancer Hospital Egypt, Cairo, 57357, Egypt.,Personalized Medication Management Unit, Children's Cancer Hospital Egypt, Cairo, 57357, Egypt
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Aung AK, Walker S, Khu YL, Tang MJ, Lee JI, Graudins LV. Adverse drug reaction management in hospital settings: review on practice variations, quality indicators and education focus. Eur J Clin Pharmacol 2022; 78:781-791. [PMID: 35171316 PMCID: PMC9005418 DOI: 10.1007/s00228-022-03287-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/31/2022] [Indexed: 11/28/2022]
Abstract
Purpose Adverse drug reactions (ADRs) contribute significantly to healthcare burden. However, they are largely preventable through appropriate management processes. This narrative review aims to identify the quality indicators that should be considered for routine monitoring of processes within hospital ADR management systems. It also examines the potential reasons behind variation in ADR management practices amongst HCPs, and explores possible solutions, focusing on targeted education programmes, to improve both the quality and quantity indicators of ADR management processes. Methods A comprehensive literature review was conducted to explore relevant themes and topics concerning ADR management, quality indicators and educational interventions. Results Substantial variability exists in ADR management amongst healthcare professionals (HCPs) with regard to reporting rates, characteristics of ADRs reported, quality of assessment, completeness of reports and, most importantly, risk communication practices. These variable practices not only threaten patient safety but also undermine pharmacovigilance processes. To date, quality indicators to monitor ADR management practices within hospital settings remain ill-defined. Furthermore, evidence behind effective interventions, especially in the form of targeted education strategies, to improve the quality of ADR management remains limited. Conclusions The focus of ADR management in hospitals should be to promote patient safety through comprehensive assessment, risk communication and safe prescribing. There is a need to develop a system to define, measure and monitor the quality of ADR management. Educational strategies may help improve the quality of ADR management processes.
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Affiliation(s)
- Ar Kar Aung
- Department of General Medicine, Alfred Hospital, Melbourne, Australia. .,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Steven Walker
- Department of Pharmacy, Alfred Hospital, Melbourne, Australia
| | - Yin Li Khu
- Department of General Medicine, Alfred Hospital, Melbourne, Australia
| | - Mei Jie Tang
- Department of General Medicine, Alfred Hospital, Melbourne, Australia
| | - Jennifer I Lee
- Department of Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, USA.,Quality Improvement Academy, Weill Cornell Medicine, New York, USA
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Howarth SD, Fielden SA, O'Hara JK. How do we educate medical students interprofessionally about patient safety? A scoping review. J Interprof Care 2021; 36:259-267. [PMID: 33944657 DOI: 10.1080/13561820.2021.1878116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Medical education has an important role in developing attitudes, behaviors and cultures that support safe care. Increasingly, however, research has argued for a more interprofessional approach to be taken. This scoping review examines the design and impact of interprofessional education interventions involving medical students that focus on patient safety. We systematically searched PubMed, EMBASE, PsycINFO and CINAHL between January 2000 and November 2019. Studies were eligible if they included medical students and at least one other profession, interactive learning, a strong emphasis on patient safety in the learning objectives, and an empirical method of evaluation. Forty-three studies met these criteria and the diverse range of approaches to intervention design and method of evaluation are detailed in this review. We found that interprofessional patient safety education interventions are generally well received by students with knowledge and skill gain documented; several also reported changes in student behaviour. However, the lack of empirically driven study designs, combined with the lack of rigour when reporting, makes it difficult to draw clear comparisons. Future research should address this, and in particular, report how and why the intervention has been designed to be delivered interprofessionally.
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Affiliation(s)
- Sarah D Howarth
- Leeds Institute of Medical Education, School of Medicine, University of Leeds, Leeds, UK
| | - Shelley A Fielden
- Leeds Institute of Medical Education, School of Medicine, University of Leeds, Leeds, UK
| | - Jane K O'Hara
- School of Healthcare, University of Leeds, Leeds; Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Omer U, Danopoulos E, Veysey M, Crampton P, Finn G. A Rapid Review of Prescribing Education Interventions. MEDICAL SCIENCE EDUCATOR 2021; 31:273-289. [PMID: 34457882 PMCID: PMC8368780 DOI: 10.1007/s40670-020-01131-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/15/2020] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Many studies conducted on the causes and nature of prescribing errors have highlighted the inadequacy of teaching and training of prescribers. Subsequently, a rapid review was undertaken to update on the nature and effectiveness of educational interventions aimed at improving the prescribing skills and competencies. METHODS Twenty-two studies taking place between 2009 and 2019 were identified across nine databases. RESULTS AND DISCUSSION This review reinforced the importance of the WHO Guide to Good Prescribing to prescribing curriculum design as well as the effectiveness of small group teaching. However, it also highlighted the lack of innovation in prescribing education and lack of longitudinal follow-up regarding the effectiveness of prescribing education interventions.
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Affiliation(s)
- Usmaan Omer
- Health Professions Education Unit, Hull York Medical School, University of York, York, YO10 5DD UK
| | - Evangelos Danopoulos
- Health Professions Education Unit, Hull York Medical School, University of York, York, YO10 5DD UK
| | - Martin Veysey
- Health Professions Education Unit, Hull York Medical School, University of York, York, YO10 5DD UK
| | - Paul Crampton
- Health Professions Education Unit, Hull York Medical School, University of York, York, YO10 5DD UK
| | - Gabrielle Finn
- Health Professions Education Unit, Hull York Medical School, University of York, York, YO10 5DD UK
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Designing and Evaluating a Virtual Patient Simulation—The Journey from Uniprofessional to Interprofessional Learning. INFORMATION 2019. [DOI: 10.3390/info10010028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
“Ready to Practice?”(R2P) is a virtual patient simulation designed for undergraduate medical and pharmacy students. After initial prototyping, R2P developed into a screen-based virtual patient (VP) simulation with an intuitive interface using photorealistic images of people and places with speech bubbles and decision menus. We describe the design of the VP, findings from student experiences with the software, and the potential of VPs for interprofessional learning. We used a mixed methods study to assess students’ perceptions of the VP as a learning tool. Qualitative data were gathered using semi-structured interviews and observations, and quantitative data through the Readiness for Interprofessional Learning Scale (RIPLS) and an evaluation questionnaire. Overall, participants showed significantly improved RIPLS scores after participation in the simulation (78.78 to 82.25, p < 0.0001), including in the Positive Professional Identify domain (p < 0.001). Students also showed significant improvement in RIPLS scores in the Teamwork and Collaboration domain when pharmacy and medical students were working together in interprofessional pairs (40.75 to 43.00, p < 0.006) but not when working alone (n.s.). Five themes emerged from interviews where participants identified specific interprofessional insights into each other’s roles and skills. Students found the VP engaging and valuable for their learning and their understanding of teamwork.
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van Eekeren R, Rolfes L, Koster AS, Magro L, Parthasarathi G, Al Ramimmy H, Schutte T, Tanaka D, van Puijenbroek E, Härmark L. What Future Healthcare Professionals Need to Know About Pharmacovigilance: Introduction of the WHO PV Core Curriculum for University Teaching with Focus on Clinical Aspects. Drug Saf 2018; 41:1003-1011. [PMID: 29949100 PMCID: PMC6182454 DOI: 10.1007/s40264-018-0681-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Adverse drug reactions (ADRs) can cause serious health problems, as shown in studies about drug-related hospitalizations. To build knowledge of and raise awareness about ADRs among healthcare professionals, more education in the field of ADRs and pharmacovigilance (PV) is needed. No standard exists for teaching PV at universities for medical, pharmacy, dentistry and nursing students, so a core curriculum needs to be developed to teach important aspects of PV to students. In September 2016, a stakeholders' meeting was initiated on behalf of the World Health Organization (WHO) and organized by the Netherlands Pharmacovigilance Centre Lareb. This meeting addressed and agreed on the PV competencies students need to develop and what key aspects of the subject should be taught. Five key aspects were identified: understanding the importance of PV in the context of pharmacotherapy, and preventing, recognizing, managing and reporting ADRs. Since time and resources for PV education are limited, elements of the WHO PV core curriculum for university teaching were designed to be integrated into existing courses but can be used as a stand-alone programme. The basis of and outline for the WHO PV core curriculum for university teaching are addressed in this paper. It is expected that PV competencies for students are vital for their contribution to safe use of medicines in the future. In addition, this article aims to stimulate discussion on this subject and promote collaboration between universities, national PV centres and other stakeholders to integrate key aspects of PV in their educational programmes.
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Affiliation(s)
- Rike van Eekeren
- Netherlands Pharmacovigilance Centre Lareb, WHO Collaborating Centre For Pharmacovigilance in Education and Patient Reporting, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands.
- University of Groningen, Groningen Research Institute of Pharmacy, PharmacoTherapy, -Epidemiology and -Economics, PO Box 196, Groningen, 9700 AD, The Netherlands.
| | - Leàn Rolfes
- Netherlands Pharmacovigilance Centre Lareb, WHO Collaborating Centre For Pharmacovigilance in Education and Patient Reporting, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
- University of Groningen, Groningen Research Institute of Pharmacy, PharmacoTherapy, -Epidemiology and -Economics, PO Box 196, Groningen, 9700 AD, The Netherlands
| | - Andries S Koster
- Department of Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands
| | - Lara Magro
- Department of Diagnostics and Public Health, Section of Pharmacology, University of Verona, Verona, Italy
| | | | - Hussain Al Ramimmy
- Department of Pharmacovigilance and Drug Information, Directorate General of Pharmaceutical Affairs and Drug Control, Ministry of Health, Muscat, Sultanate of Oman
| | - Tim Schutte
- Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
- RECIPE (Research and Expertise Center in Pharmacotherapy Education), Amsterdam, The Netherlands
| | | | - Eugène van Puijenbroek
- Netherlands Pharmacovigilance Centre Lareb, WHO Collaborating Centre For Pharmacovigilance in Education and Patient Reporting, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
- University of Groningen, Groningen Research Institute of Pharmacy, PharmacoTherapy, -Epidemiology and -Economics, PO Box 196, Groningen, 9700 AD, The Netherlands
| | - Linda Härmark
- Netherlands Pharmacovigilance Centre Lareb, WHO Collaborating Centre For Pharmacovigilance in Education and Patient Reporting, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
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Reeves S, Clark E, Lawton S, Ream M, Ross F. Examining the nature of interprofessional interventions designed to promote patient safety: a narrative review. Int J Qual Health Care 2017; 29:144-150. [DOI: 10.1093/intqhc/mzx008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 02/01/2017] [Indexed: 11/13/2022] Open
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