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Yailian AL, Biry L, Fontana A, Vignot E, Estublier C, Confavreux C, Pivot C, Chapurlat R, de Freminville H, Janoly-Dumenil A. Implementation and effectiveness of pharmacist-led interviews at patient hospital admission in a rheumatology department. Eur J Hosp Pharm 2023; 30:273-278. [PMID: 34649963 PMCID: PMC10447965 DOI: 10.1136/ejhpharm-2021-002786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/28/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Medication reconciliation is time-consuming and its complete deployment can be difficult. The implementation of a simplified process, such as patient interviews at admission without full reconciliation, may contribute to improve patient care. The objective of the present study was to describe the feasibility and assess the potential effectiveness of implementing pharmacist-led interviews at patient admission to a rheumatology department. METHODS This is a prospective observational study of pharmacist-led interviews at patient admission conducted between April 2015 and May 2017 in the 34-bed rheumatology department of Edouard Herriot Hospital, a French university hospital. These interviews were structured to explore patient medication management at home. The main outcome was the number of medication errors at admission. Other outcomes were the total number of interviews, the number of interviews with at least one new item of information provided by the patient, the number of interviews with at least one medication error detected, and the number of interviews leading to a modification of the hospital medication order. RESULTS A total of 247 interviews were carried out; there was an increase in the number of interviews over the study period (n=54 in 2015, n=98 in 2016, and n=95 for the first 5 months of 2017). Among the interviews conducted, 135 (55%) provided new information concerning patient medication management and 117 medication errors were identified in hospital orders (0.47/patient). There were 76 interviews (31%) with at least one medication error; all led to a medication order modification. CONCLUSIONS The study found that pharmacist-led interviews at patient admission were effective in detecting medication errors. They could be an alternative to a full medication reconciliation process in targeted situations. When the patient interview does not provide sufficiently robust information, full medication reconciliation may be performed.
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Affiliation(s)
- Anne-Laure Yailian
- Department of Pharmacy, Hospices Civils de Lyon, Lyon, France
- EA 4129 Parcours Santé Systémique, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Laura Biry
- Department of Pharmacy, Hospices Civils de Lyon, Lyon, France
| | - Aurélie Fontana
- Department of Rheumatology, Hospices Civils de Lyon, Lyon, France
- INSERM UMR 1033, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Emmanuelle Vignot
- Department of Rheumatology, Hospices Civils de Lyon, Lyon, France
- INSERM UMR 1033, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Charline Estublier
- INSERM UMR 1033, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
- Department of Rheumatology, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Cyrille Confavreux
- INSERM UMR 1033, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
- Department of Rheumatology, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Christine Pivot
- Department of Pharmacy, Hospices Civils de Lyon, Lyon, France
| | - Roland Chapurlat
- Department of Rheumatology, Hospices Civils de Lyon, Lyon, France
- INSERM UMR 1033, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Humbert de Freminville
- EA 4129 Parcours Santé Systémique, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
- Department of General Medicine, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Audrey Janoly-Dumenil
- Department of Pharmacy, Hospices Civils de Lyon, Lyon, France
- EA 4129 Parcours Santé Systémique, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
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ENVER C, ERTÜRK ŞENGEL B, SANCAR M, KORTEN V, OKUYAN B. Medication Reconciliation Service in Hospitalized Patients with Infectious Diseases During Coronavirus Disease-2019 Pandemic: An Observational Study. Turk J Pharm Sci 2023; 20:210-217. [PMID: 37605897 PMCID: PMC10445224 DOI: 10.4274/tjps.galenos.2022.08455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
Objectives To determine the prevalence and type of medication discrepancies and factors associated with unintentional discrepancies and identify the rate of hospital readmission and emergency service visit within 30 days after discharge among hospitalized patients with infectious diseases and receiving clinical pharmacist-led medication reconciliation during the coronavirus disease-2019 (COVID-19) pandemic. Materials and Methods This observational study was conducted in the internal medicine and infectious diseases wards of a tertiary university hospital between July 2020 and February 2021 among hospitalized adult patients with infectious diseases. Medication reconciliation service (including patient counseling) was provided in person or by telephone. The number and type of medication discrepancies detected during the medication reconciliation services, the acceptance rate of pharmacists' recommendation, and factors associated with having at least one unintentional medication discrepancy at admission were evaluated. At follow-up, hospital readmission and emergency service visit within 30 days after discharge were assessed by telephone. Results Among 146 patients, 84 (57.5%) had at least one unintentional discrepancy at admission. Only three unintentional discrepancies were determined in three patients at hospital discharge. All the pharmacists' recommendations for medication discrepancies were accepted by the physicians. Having COVID-19 [odds ratio (OR): 2.25, 95% confidence interval (CI): 1.15-4.40; p<0.05], being at a high risk for medication error (OR: 2.01, 95% CI: 1.03-3.92; p<0.05), and higher number of medications used at home (OR: 1.41, 95% CI: 1.23-1.61; p<0.001) were associated with having at least one unintentional discrepancy at admission. The rates of 30 day hospital readmission and admission to the emergency medical service were 12.3% and 15.8%, respectively. Conclusion Medication reconciliation service provided by in-person or by telephone was useful for detecting and solving unintentional medication discrepancies during the COVID-19 pandemic.
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Affiliation(s)
- Cüneyd ENVER
- Marmara University, Faculty of Pharmacy, Department of Clinical Pharmacy, İstanbul, Türkiye
| | - Buket ERTÜRK ŞENGEL
- Marmara University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Mesut SANCAR
- Marmara University, Faculty of Pharmacy, Department of Clinical Pharmacy, İstanbul, Türkiye
| | - Volkan KORTEN
- Marmara University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Betül OKUYAN
- Marmara University, Faculty of Pharmacy, Department of Clinical Pharmacy, İstanbul, Türkiye
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Huang PP, Poon SYK, Chang SH, Kuo CW, Chien MW, Chen CC, Chiang SC. Improving the Efficiency of Medication Reconciliation in Two Taiwanese Hospitals by Using the Taiwan National Health Insurance PharmaCloud Medication System. Int J Gen Med 2023; 16:211-220. [PMID: 36699342 PMCID: PMC9869693 DOI: 10.2147/ijgm.s389683] [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: 09/15/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023] Open
Abstract
Purpose Medication reconciliation (MedRec) is a process to ensure complete and accurate communication of patient medication information throughout care transitions to prevent medication errors. Hospitals in Taiwan have stride to implement a universal protocol for MedRec. To establish a feasible protocol indigenously, the World Health Organization (WHO) protocol was incorporated with the Taiwan National Health Insurance (NHI) PharmaCloud patient medication profile. The efficiency and error detection capability of this modified protocol was evaluated in two hospitals. Methods A prospective, non-randomized, unblinded, multicenter cohort study was conducted. Subjects were recruited among patients admitted for colorectal or orthopedic surgery with at least 4 or more chronic drugs. To obtain the best possible medication history (BPMH), the control group was conducted according to the WHO protocol, and the experimental group used the modified WHO protocol with the medication data from the PharmaCloud system. The time spent on the two protocols was recorded. Admission and discharge orders were reconciled against the BPMH to identify any discrepancies. Discrepancies were evaluated by appropriateness, prescribing intentions, and types of inappropriateness. The levels of potential harm were classified for inappropriate discrepancies. Results The mean time to obtain BPMH in the control group was 34.3±10.8 minutes and in the experimental group 27.5±11.5 minutes (P = 0.01). The experimental group had more subjects with discrepancies (87.9%) than the control (58.3%) (p < 0.001). The discrepancies in both admission and discharge orders for the experimental group (84.5 and 67.2%) were higher than those of the control (47.9 and 37.5%). Many inappropriate discrepancies were classified as the potential harm of level 2 (77.8%). Conclusion Through the establishment of BPMH with the medication data from the Taiwan NHI PharmaCloud, MedRec could be achieved with greater efficiency and error detection capability in both the admission and discharge order validation processes.
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Affiliation(s)
- Pei-Pei Huang
- Division of Outpatient Pharmacy, Department of Pharmacy, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Samantha Yun-Kai Poon
- Department of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University (Yang Ming Campus), Taipei, Taiwan
| | - Shao-Hsuan Chang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Chien-Wen Kuo
- Department of Pharmacy, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Ming-Wen Chien
- Division of Outpatient Pharmacy, Department of Pharmacy, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Chien-Chih Chen
- Division of Colorectal Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Shao-Chin Chiang
- Department of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University (Yang Ming Campus), Taipei, Taiwan,Department of Pharmacy, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan,Correspondence: Shao-Chin Chiang, Department of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University (Yang Ming Campus), Taipei, Taiwan, Tel +886-983641216, Email ;
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Abu Hammour K, Abu Farha R, Ya’acoub R, Salman Z, Basheti I. Impact of Pharmacist-Directed Medication Reconciliation in Reducing Medication Discrepancies: A Randomized Controlled Trial. Can J Hosp Pharm 2022; 75:169-177. [PMID: 35847464 PMCID: PMC9245405 DOI: 10.4212/cjhp.3143] [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: 01/07/2023]
Abstract
Background In hospital surgical wards, patients are at higher risk for medication errors, in part because physicians may not consider themselves sufficiently trained to prescribe medications. Hence, collaborative teamwork involving the pharmacist is needed. Objectives To assess the impact of medication reconciliation directed by pharmacists on decreasing medication discrepancies after discharge from the surgical ward. Methods Patients admitted to the surgical unit at a tertiary teaching hospital in Amman, Jordan, between July 2017 and July 2018 were selected and randomly assigned to either the control or the intervention group. Upon admission, the number and kinds of unintentional medication discrepancies were determined for both groups. Medication reconciliation was then provided to patients in the intervention group. The number of unintentional discrepancies was re-evaluated upon discharge for both groups. To assess differences between the control and intervention groups, the χ2 or Fisher exact test was used for categorical variables and an independent-sample t test for continuous data. A paired t test was conducted to determine whether the number of medication discrepancies was reduced as a result of pharmacists' recommendations. Results A total of 123 patients met the inclusion criteria, 61 in the intervention group and 62 in the control group. Discrepancies of omission and wrong dose constituted 41 (77%) of the 53 discrepancies in the intervention group and 25 (76%) of the 33 discrepancies in the control group. The number of unintentional discrepancies was significantly reduced from admission to discharge in both the intervention group (p = 0.002) and the control group (p = 0.007). Of 53 recommendations made by pharmacists, 20 (38%) were accepted by the treating physician, and all of these discrepancies were resolved. Conclusions This study sheds light on the existence of unintentional medication discrepancies upon admission for surgical patients, which may expose the patients to potential harm upon discharge from hospital. Additional studies with a larger sample size are needed to gain further insights on pharmacists' role in implementing medication reconciliation for surgical patients.
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Rababa'h A, Mardini A, Ababneh M, Rababa M, Hayajneh M. Medication errors in Jordan: A systematic review. Int J Crit Illn Inj Sci 2022; 12:106-114. [PMID: 35845119 PMCID: PMC9285130 DOI: 10.4103/ijciis.ijciis_72_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/14/2021] [Accepted: 10/23/2021] [Indexed: 11/04/2022] Open
Abstract
Medication errors (MEs) present a significant issue in health care area, as they pose a threat to patient safety and could occur at any stage of the medication use process. The objective of this systematic review was to review studies reporting the rates, prevalence, and/or incidence of various MEs in different health care clinical settings in Jordan. We searched PubMed, HINARI, Google, and SCOPUS for relevant published studies. We included observational, cross-sectional or cohort studies on MEs targeting adults in different health-care settings in Jordan. A total of 411 records were identified through searching different databases. Following the removal of duplicates, screening of title, abstract and full-text screening, 24 papers were included for the final review step. Prescribing errors was the most common error reported in the included studies, where it was reported in 15 studies. The prevalence of prescribing errors ranged from 0.1% to 96%. Two studies reported unintentional discrepancies and documentation errors as other types of MEs, where the prevalence of unintentional discrepancies ranged from 47% to 67.9%, and the prevalence of documentation errors ranged from 33.7% to 65%. In conclusion, a wide variation was found between the reviewed studies in the error prevalence rates. This variation may be due to the variation in the clinical settings, targeted populations, methodologies employed. There is an imperative need for addressing the issue of MEs and improving drug therapy practice among health-care professionals by introducing education and training.
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Magalhães GF, Rosa MB, Noblat LACB. Patients’ medication reconciliation in a university hospital. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e19832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Abu Farha R, Yousef A, Gharaibeh L, Alkhalaileh W, Mukattash T, Alefishat E. Medication discrepancies among hospitalized patients with hypertension: assessment of prevalence and risk factors. BMC Health Serv Res 2021; 21:1338. [PMID: 34903221 PMCID: PMC8670213 DOI: 10.1186/s12913-021-07349-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 11/15/2021] [Indexed: 12/02/2022] Open
Abstract
Background Medication errors remained among the top 10 leading causes of death worldwide. Furthermore, a high percentage of medication errors are classified as medication discrepancies. This study aimed to identify and quantify the different types of unintentional medication discrepancies among hospitalized hypertensive patients; it also explored the predictors of unintentional medication discrepancies among this cohort of patients. Methods This was a prospective observational study undertaken in a large teaching hospital. A convenience sample of adult patients, taking ≥4 regular medications, with a prior history of treated hypertension admitted to a medical or surgical ward were recruited. The best possible medication histories were obtained by hospital pharmacists using at least two information sources. These histories were compared to the admission medication orders to identify any possible unintentional discrepancies. These discrepancies were classified based on their severity. Finally, the different predictors affecting unintentional discrepancies occurrence were recognized. Results A high rate of unintentional medication discrepancies has been found, with approximately 46.7% of the patients had at least one unintentional discrepancy. Regression analysis showed that for every one year of increased age, the number of unintentional discrepancies per patient increased by 0.172 (P = 0.007), and for every additional medication taken prior to hospital admission, the number of discrepancies increased by 0.258 (P= 0.003). While for every additional medication at hospital admission, the number of discrepancies decreased by 0.288 (P < 0.001). Cardiovascular medications, such as diuretics and beta-blockers, were associated with the highest rates of unintentional discrepancies in our study. Medication omission was the most common type of the identified discrepancies, with approximately 46.1% of the identified discrepancies were related to omission. Regarding the clinical significance of the identified discrepancies, around two-third of them were of moderate to high significance (n= 124, 64.2%), which had the potential to cause moderate or severe worsening of the patient´s medical condition. Conclusions Unintentional medication discrepancies are highly prevalent among hypertensive patients. Medication omission was the most commonly encountered discrepancy type. Health institutions should implement appropriate and effective tools and strategies to reduce these medication discrepancies and enhance patient safety at different care transitions. Further studies are needed to assess whether such discrepancies might affect blood pressure control in hypertensive patients.
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Affiliation(s)
- Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Alaa Yousef
- Faculty of Medicine, Al Balqa' Applied University, Salt, Jordan
| | - Lobna Gharaibeh
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Waed Alkhalaileh
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Tareq Mukattash
- Department of Clinical Pharmacy, Faculty of pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Eman Alefishat
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan. .,Department of Pharmacology, College of Medicine and Health Science, Khalifa University of Science and Technology, P O Box 127788, Abu Dhabi, United Arab Emirates. .,Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.
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Yousef AM, Abu-Farha RK, Abu-Hammour KM. Detection of medication administration errors at a tertiary hospital using a direct observation approach. J Taibah Univ Med Sci 2021; 17:433-440. [PMID: 35722230 PMCID: PMC9170789 DOI: 10.1016/j.jtumed.2021.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives Medication administration errors (MAEs) are the most common and significant type of medication errors worldwide. This study aims to assess the prevalence, types, and severity of MAEs. Furthermore, this study attempts to determine the factors associated with the occurrence of MAEs. Method This cross-sectional study was conducted over a three-month interval in the internal medicine ward of a tertiary teaching hospital in Jordan. During the study period, 13 nurses were observed while they were preparing and administering medications using a direct disguised observation method. All the recorded observations about the preparation and administration were compared with the physician's orders in the medications' records to identify any possible MAEs. Results Having observed a total of 1,012 opportunities for errors, 910 MAEs were identified. Among these 910 errors, adherence errors were found to be the most frequent type (n = 364, 35.9%), followed by incorrect drug preparation (n = 247, 24.4%). None of the MAEs revealed any serious harm to patients or contributed to prolonged hospitalization. Antimicrobial drugs (n = 210, 23.0%) was the most common class associated with MAEs, followed by the class of cardiovascular (n = 157, 17.2%) medicines. Results have shown that the occurrence of MAEs was significantly higher in the non-intravenous medications in comparison to the intravenous medications (p-value < 0.001). Conclusion While this study revealed a high rate of MAEs, all the identified errors did not cause harm to the patients. Continuous awareness and education campaigns targeting the nurses about the importance of proper and safe drug administration are highly recommended.
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Affiliation(s)
- Alaa M. Yousef
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Rana K. Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- Corresponding address: Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University. Amman 11931 Jordan.
| | - Khawla M. Abu-Hammour
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
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Gebre M, Addisu N, Getahun A, Workye J, Gamachu B, Fekadu G, Tekle T, Wakuma B, Fetensa G, Mosisa B, Bayisa G. Medication Errors Among Hospitalized Adults in Medical Wards of Nekemte Specialized Hospital, West Ethiopia: A Prospective Observational Study. Drug Healthc Patient Saf 2021; 13:221-228. [PMID: 34795534 PMCID: PMC8593339 DOI: 10.2147/dhps.s328824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Mohammed Gebre
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Mohammed Gebre Email
| | - Nigatu Addisu
- Department of Pharmacy, College of Health and Medical Sciences, Dilla University, Dilla, Ethiopia
| | - Ayantu Getahun
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Jenber Workye
- Department of Pharmacy, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Busha Gamachu
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tesfa Tekle
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Bizuneh Wakuma
- Department of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- Department of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Balisa Mosisa
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getu Bayisa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Abdul Halim Zaki I, Razali RM, Gnanasan S, Alias R, Karuppannan M. Medication discrepancies among elderly patients discharged from a tertiary hospital: prevalence and risk factors. Singapore Med J 2021; 62:362-365. [PMID: 34409484 DOI: 10.11622/smedj.2021093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Izzati Abdul Halim Zaki
- Pharmacy Department, Hospital Queen Elizabeth II, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.,Faculty of Pharmacy, Puncak Alam Campus, Universiti Teknologi MARA, Selangor, Malaysia
| | | | - Shubashini Gnanasan
- Faculty of Pharmacy, Puncak Alam Campus, Universiti Teknologi MARA, Selangor, Malaysia
| | - Rosmaliah Alias
- Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Mahmathi Karuppannan
- Faculty of Pharmacy, Puncak Alam Campus, Universiti Teknologi MARA, Selangor, Malaysia
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Aidah S, Gillani SW, Alderazi A, Abdulazeez F. Medication error trends in Middle Eastern countries: A systematic review on healthcare services. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:227. [PMID: 34395664 PMCID: PMC8318177 DOI: 10.4103/jehp.jehp_1549_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/18/2020] [Indexed: 05/14/2023]
Abstract
Medication errors (MEs) are a critical worldwide concern and can cause genuine clinical ramifications for patients. Studies concerning such errors have not been undertaken as much in the Middle Eastern region. The aim of this study was to systematically review and identify studies done in the Middle Eastern nations to recognize the principle contributory factors included and to estimate the prevalence in the region. A review of the retrospective, prospective, cohort, and case-control studies based on MEs in the Middle Eastern nations was directed in January 2020 utilizing the accompanying databases: Embase, Medline, PubMed, Ebsco, Cochrane, Scopus, and Prospero. The search methodology incorporated all ages and in English only dating back to 2010. The search methodology included articles about MEs in the Middle East with errors in people of all ages, articles in English, and articles dating back to 2010. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses appraisal instrument was used to assess the quality of the included articles. Individual data extraction, pooled analysis, and the accompanying databases were used for data analysis of the MEs in eligible studies. Fifteen of the 18 articles reviewed from four Middle Eastern countries had low risk of bias, while three out of 18 had medium risk of bias. A total of 58,221 reported people were studied, with a total of 34,730.9 reported MEs. The pooled analysis showed that numbers of errors were mainly prescribing errors (n = 22,715.25), general prescription errors (n = 8097.16), and commission errors (n = 158.2). Iran had the highest rate amid the reported administration errors, at 25.07% (599.11/2388.9). Measuring a patient's clinical laboratory values was another less common type of prescription ME. Lebanon reported to have the highest monitoring errors, with a rate of 13.13% (277.91/2117). A negative trend was shown in the amount of MEs in the vast majority of the nations under the examination. The under-reporting or uncertain information recommended that significan changes are needed in the healthcare sector. There is solid need of literature on healthcare services in the region to completely understand and address the MEs and issues.
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Affiliation(s)
- Saba Aidah
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE
| | - Syed Wasif Gillani
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE
- Address for correspondence: Prof. Syed Wasif Gillani, Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE. E-mail:
| | - Afifa Alderazi
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE
| | - Fawaz Abdulazeez
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE
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Yousif ME, Elamin M, Ahmed K, Saeed O. Impact of clinical pharmacist-led medication reconciliation on therapeutic process. SAUDI JOURNAL FOR HEALTH SCIENCES 2021. [DOI: 10.4103/sjhs.sjhs_6_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Oñatibia-Astibia A, Malet-Larrea A, Mendizabal A, Valverde E, Larrañaga B, Gastelurrutia MÁ, Ezcurra M, Arbillaga L, Calvo B, Goyenechea E. The medication discrepancy detection service: A cost-effective multidisciplinary clinical approach. Aten Primaria 2020; 53:43-50. [PMID: 32994060 PMCID: PMC7752972 DOI: 10.1016/j.aprim.2020.04.008] [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: 10/10/2019] [Revised: 02/14/2020] [Accepted: 04/15/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To estimate the effectiveness of a Medication Discrepancy Detection Service (MDDS), a collaborative service between the community pharmacy and Primary Care. DESIGN Non-controlled before-and-after study. SETTING Bidasoa Integrated Healthcare Organisation, Gipuzkoa, Spain. PARTICIPANTS The service was provided by a multidisciplinary group of community pharmacists (CPs), general practitioners (GPs), and primary care pharmacists, to patients with discrepancies between their active medical charts and medicines that they were actually taking. OUTCOMES The primary outcomes were the number of medicines, the type of discrepancy, and GPs' decisions. Secondary outcomes were time spent by CPs, emergency department (ED) visits, hospital admissions, and costs. RESULTS The MDDS was provided to 143 patients, and GPs resolved discrepancies for 126 patients. CPs identified 259 discrepancies, among which the main one was patients not taking medicines listed on their active medical charts (66.7%, n=152). The main GPs' decision was to withdraw the treatment (54.8%, n=125), which meant that the number of medicines per patient was reduced by 0.92 (9.12±3.82 vs. 8.20±3.81; p<.0001). The number of ED visits and hospital admissions per patient were reduced by 0.10 (0.61±.13 vs 0.52±0.91; p=.405 and 0.17 (0.33±0.66 vs. 0.16±0.42; p=.007), respectively. The cost per patient was reduced by €444.9 (€1003.3±2165.3 vs. €558.4±1273.0; p=.018). CONCLUSION The MDDS resulted in a reduction in the number of medicines per patients and number of hospital admissions, and the service was associated with affordable, cost-effective ratios.
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Affiliation(s)
- Ainhoa Oñatibia-Astibia
- Official Pharmacist Association of Gipuzkoa, Prim 2, 20006 Donostia/San Sebastian, Spain; Pharmaceutical Technology Department, Faculty of Pharmacy, University of the Basque Country, UPV/EHU, P. Universidad 7, 01006 Vitoria, Spain.
| | - Amaia Malet-Larrea
- Official Pharmacist Association of Gipuzkoa, Prim 2, 20006 Donostia/San Sebastian, Spain
| | - Amaia Mendizabal
- Primary Care Pharmacy, Bidasoa Integrated Healthcare Organisation (Osakidetza), Spain
| | - Elena Valverde
- Primary Care Pharmacy, Bidasoa Integrated Healthcare Organisation (Osakidetza), Spain
| | - Belen Larrañaga
- Official Pharmacist Association of Gipuzkoa, Prim 2, 20006 Donostia/San Sebastian, Spain
| | - Miguel Ángel Gastelurrutia
- Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, 18071 Granada, Spain
| | - Martín Ezcurra
- Martin Ezcurra Fernandez Pharmacy, Harmugarrieta 2, 20305 Irun, Spain
| | - Leire Arbillaga
- Official Pharmacist Association of Gipuzkoa, Prim 2, 20006 Donostia/San Sebastian, Spain
| | - Begoña Calvo
- Pharmaceutical Technology Department, Faculty of Pharmacy, University of the Basque Country, UPV/EHU, P. Universidad 7, 01006 Vitoria, Spain
| | - Estibaliz Goyenechea
- Official Pharmacist Association of Gipuzkoa, Prim 2, 20006 Donostia/San Sebastian, Spain
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Moghli MA, Farha RA, Hammour KA. Medication discrepancies in hospitalized cancer patients: Do we need medication reconciliation? J Oncol Pharm Pract 2020; 27:1139-1146. [PMID: 32741239 DOI: 10.1177/1078155220946388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aimed to identify and point out the number and types of medication discrepancies among cancer patients admitted to Jordan University Hospital. METHOD This is a cross-sectional observational study that was conducted on cancer patients in the internal medicine department at Jordan University Hospital, Amman, Jordan. During a period of six months, a convenience sample of cancer patients was recruited, and their medical records were reviewed to collect information regarding their demographics, clinical, and medication information. Also, patients' Best Possible Medication History (BPMH) was collected using different methods, and a comparison between patients' BPMH and their current medications was conducted where discrepancies were recognized. RESULTS Seventy-eight medical records were reviewed, with a total of 166 discrepancies identified. Of these, 110 discrepancies (66.3%) were unintentional. Exactly 67.9% of the study participants (n = 53) were found to have at least one unintentional discrepancy, with the most common type being omissions (n = 71, 65.1%,) and the second most common type being additions (n = 16, 14.7%). Most of the discrepancies ranged between low to moderate in severity. Fifty-six (33.7%) intentional undocumented discrepancies (documentation errors) were also identified. CONCLUSION This study revealed a high rate of medication discrepancies among hospitalized cancer patients, most commonly unintentional omissions. Nevertheless, undocumented intentional discrepancies can equally harm this critically ill population. So, do we need medication reconciliation in cancer patients? Yes. Cancer patients are critically ill, and therefore more effort should be paid towards implementing medication reconciliation services in their treatment plan.
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Affiliation(s)
- Maram Abu Moghli
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Khawla Abu Hammour
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
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15
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Ramadanov N, Klein R, Schumann U, Aguilar ADV, Behringer W. Factors, influencing medication errors in prehospital care: A retrospective observational study. Medicine (Baltimore) 2019; 98:e18200. [PMID: 31804342 PMCID: PMC6919435 DOI: 10.1097/md.0000000000018200] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine the frequency of medication errors in prehospital care and to investigate the influencing factors - diagnostic agreement (DA), the medical educational status, the specialty, the approval for emergency medicine of the prehospital emergency physician, the patient age and sex and the time of deployment.We retrospectively reviewed 708 patients from 2013 to 2015, treated by the prehospital emergency physicians of the emergency medical service center Bad Belzig, Germany. The medication appropriateness was determined by a systematic comparison of the administered medication in prehospital deployments with the discharge diagnosis, according to current guidelines. The influencing factors were examined by univariate analysis of medication appropriateness (MA), using the χ, the Mann-Whtiney U and the Welch tests. We calculated a cut-off value with the Youden index to predict absent MA, according to patients age. The significance level was P = .05.MA was absent in 220 of 708 patients (31.1%). In the case of present DA, MA was absent in 103 of 491 patients (20.9%). In the case of absent DA, MA was absent in 117 of 217 patients (53.9%) (P = .01). MA was absent in 82 of 227 patients (36.1%), treated by specialist and in 138 of 481 patients (28.7%), treated by resident physicians (P = .04). The calculated cut-off value to predict absent MA was 75.5 years. MA was absent in 100 of 375 patients (26.7%) of the younger patient age group (≤75.5 years), MA was absent 120 of 333 patients (36.0%) of the older patient age group (>75.5 years) (P = .01). Absent MA showed peak values (46.7%-60%) at night from 3 to 6 AM (P = .01) The other investigated factors had no influence on MA.The correctness of medication as a quality feature in prehospital care shows a necessity for improvement with a proportion of 31.1% medication errors. The correct diagnosis by the prehospital emergency physician and his rapid accumulation of experience had an impact on the correctness of medication in prehospital care. Elderly patients (75+ years) and nighttime prehospital deployments (3-6 AM) were identified as high risk for medication errors by the emergency physicians.
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Affiliation(s)
- Nikolai Ramadanov
- Center for Emergency Medicine, University Hospital Jena, Friedrich Schiller
| | | | - Urs Schumann
- Center for Internal Medicine, Clinic for Endocrinology and Diabetology Niemegker Str. Bad Belzig, Germany
| | | | - Wilhelm Behringer
- Center for Emergency Medicine, University Hospital Jena, Friedrich Schiller
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Rungvivatjarus T, Kuelbs CL, Miller L, Perham J, Sanderson K, Billman G, Rhee KE, Fisher ES. Medication Reconciliation Improvement Utilizing Process Redesign and Clinical Decision Support. Jt Comm J Qual Patient Saf 2019; 46:27-36. [PMID: 31653526 DOI: 10.1016/j.jcjq.2019.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 09/02/2019] [Accepted: 09/04/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite years of attention, hospitals continue to struggle to implement successful medication reconciliation. This study aimed to increase the percentage of hospital admission medication reconciliation (AdmMedRec) completion to ≥ 95% in 12 months at a large academic children's hospital. METHODS A quality improvement (QI) project was initiated in April 2017 by an interdisciplinary team of physicians, nurses, pharmacists, and analysts, co-led by a pediatric hospitalist and chief medical information officer. Interventions were implemented through sequential Plan-Do-Study-Act cycles. Process maps, fishbone diagrams, and failure mode and effects analysis were used to identify AdmMedRec failures. Baseline data from 12,481 admission encounters July 2016-April 2017 were analyzed. Interventions included electronic health record (EHR) workflow redesign, clarification of clinicians' responsibilities, targeted training, Best Practice Advisory alert, and weekly reporting of specialty- and physician-specific performance data. Data from 13,082 postintervention period admission encounters were examined. Reconciliation by therapeutic drug classes was calculated as a proxy for quality. RESULTS AdmMedRec completion rate increased from a baseline of 73% to 95% within 7 months from the start of this project and was sustained at 94% during the postintervention period. Psychiatry and hospital medicine demonstrated the largest improvements, with rates increasing from 17% to 88% and 76% to 98%, respectively. Percentages of reconciled medications in all 13 therapeutic classes, including high-risk drugs, improved significantly (p < 0.05). CONCLUSIONS Using an interdisciplinary team and interventions focused on process and culture changes, this QI initiative was successful at increasing AdmMedRec rates and reducing omission errors across all therapeutic drug classes.
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Ramadanov N, Klein R, Aguilar Valdez AD, Behringer W. Medication Appropriateness in Prehospital Care. Emerg Med Int 2019; 2019:6947698. [PMID: 31565440 PMCID: PMC6745092 DOI: 10.1155/2019/6947698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The aim of the present study was to determine the medication appropriateness (MA) in prehospital emergency physician deployments according to the hospital discharge diagnosis and to investigate the factors influencing the MA. METHODS The MA was determined by a systematic comparison of the administered medication in prehospital emergency physician deployments with the discharge diagnosis in a period of 24 months at the emergency medical services in Bad Belzig. Categorial variables for the specialty, medical educational status, and approval for emergency medicine of prehospital emergency physicians were examined univariate for relations with the MA, using the χ2 test with the significance level of p=0.05. RESULTS The MA was present in 69% (n = 488) cases. The MA was present in 64% of cases by specialists and in 71% by resident physicians (p=0.04). The specialty and the approval for emergency medicine of the prehospital emergency physician did not show significant results. MA was present in 46% (n = 100) of cases with incorrect diagnoses, and it was present in 79% (n = 388) of cases with correct diagnoses by the prehospital emergency physician (p=0.01). In cases of missing MA, 224 drugs and 23 different drugs were administered by the prehospital emergency physician. CONCLUSIONS The MA in prehospital emergency physician deployments shows a necessity for improvement with 31% medication errors. Incorrect diagnoses by the prehospital emergency physician seem to lead to medication errors in prehospital emergency physician deployments. The necessary standards and guidelines for administration of drugs should be taken into account in educational courses. The wide-ranging emergency medical training and the rapid accumulation of operational experience seem to play a crucial role for correct administration of medication in the prehospital emergency physician deployments.
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Affiliation(s)
- Nikolai Ramadanov
- Center for Emergency Medicine, University Hospital Jena, Friedrich Schiller University, Am Klinikum 1, 07747 Jena, Germany
| | - Roman Klein
- Orthopaedics, Trauma Surgery and Sports Traumatology, Marienhaus Hospital Hetzelstift, Stiftstr. 10, 67434 Neustadt, Germany
| | - Abner Daniel Aguilar Valdez
- Center for Internal Medicine, Clinic for Endocrinology and Diabetology, Ernst von Bergmann Hospital Bad Belzig, Niemegker Str. 45, 14806 Bad Belzig, Germany
| | - Wilhelm Behringer
- Center for Emergency Medicine, University Hospital Jena, Friedrich Schiller University, Am Klinikum 1, 07747 Jena, Germany
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18
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Abu Farha R, Abu Hammour K, Al-Jamei S, AlQudah R, Zawiah M. The prevalence and clinical seriousness of medication discrepancies identified upon hospital admission of pediatric patients. BMC Health Serv Res 2018; 18:966. [PMID: 30547782 PMCID: PMC6295069 DOI: 10.1186/s12913-018-3795-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 12/05/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Medication discrepancies are seen frequently in hospital setting upon admission or discharge. Medication Reconciliation service is a practice designed to ensure that patients' medications are ordered in a correct manner upon hospital admission, thus reducing the risk of having medication discrepancies. This study aimed to determine the prevalence of medication discrepancies and their clinical seriousness in pediatric patients at the time of hospital admission. METHODS A prevalence cross-sectional study was conducted at the pediatric departement at the Jordan University hospital between March-May 2018. During the study period, 100 pediatric patients were enrolled using a convenience sampling method. Patients' medical records were reviewed by two clinical pharmacist-reserachers to obtain patients' demographic, medical, and admission medication information. All parents were interviewed to obtain information regarding their children's Best Possible Medication History (BPMH). Following data collection, differences between patient's current admission medications and the BPMH were identified as medication discrepancies, and then they were classified into either undocumented intentional or unintentional discrepancies. RESULTS Among the 100 medication records reviewed, 13.0% (13 out of 100) contained at least one unintentional discrepancy, with the majority (n = 11, 84.6%) being classified to be associated with mild potential harm to patients. Of those discrepancies, 8 were omission of medications (61.5%) and 5 were addition of unnecessary medication (38.5%). On the other hand, 35.0% (35 out of 100) of medication records contained at least one intentional undocumented discrepancy. CONCLUSIONS This study revealed that unintentional medication discrepancies exist at the time of hospital admission for pediatric patients but with low proportion. The low proportion of medication discrepancies might be explained by the recent implementation of medication reconciliation service at the studied hospital. Also, intentional undocumented discrepancies were common, which may carry a potential harm to such vulnerable population at discharge. These data may inform the need for a strict policies to regulate medication documentation, thus decreasing the possibilities of medication errors.
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Affiliation(s)
- Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Khawla Abu Hammour
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Sayida Al-Jamei
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Raja AlQudah
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Mohammed Zawiah
- Department of Pharmacy Practice, Faculty of Clinical Pharmacy, Al-Hodeida University, Al-Hodeida, Yemen
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Li Z, Fu J, Zhou R, Wang D. Effects of phenolic acids from ginseng rhizosphere on soil fungi structure, richness and diversity in consecutive monoculturing of ginseng. Saudi J Biol Sci 2018; 25:1788-1794. [PMID: 30591801 PMCID: PMC6303186 DOI: 10.1016/j.sjbs.2018.07.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/13/2018] [Accepted: 07/15/2018] [Indexed: 12/05/2022] Open
Abstract
Ginseng yield and quality are seriously compromised by consecutive monoculturing in northeastern China. The imbalance of soil fungi communities and autotoxicity of ginseng are the major factors in consecutive monoculturing ginseng crops. Soil fungal communities were identified using Illumina MiSeq sequencing, applied to soils that consecutively cultured ginseng (CCG) for six years and new forest soil (NFS), or receiving application of phenolic acids (PAs). The CCG field received five treatments with five different phenolic acids, including gallic acid (GA), salicylic acid (SA), 3-phenylpropionic acid (3-PA), benzoic acid (BA) and cinnamic acid (CA), which were detected from ginseng rhizosphere in consecutive cropping soil. Fungal richness, fungi diversity, community composition, relative taxon abundances, root rot disease, and growth rate were compared among the different treatments. 579 fungal operational taxonomic units at 97% ITS sequence identity were found among 201,617 sequence reads derived from 18 separate soil samples. Members of the phylum Ascomycota dominated the soil fungal communities, and putative pathogens, such as Fusarium, Gibberella and Nectriaceae_unclassified which may include the abundant sexual morph of Cylindrocarpon destructans, showed higher relative abundances in the CCG fields. Compared to the CCG and NFS fields, PAs (except CA) enhanced the fungi richness and decreased fungi diversity. Cluster analysis indicated that the PAs (except CA) changed the fungi structure in a uniform way. PAs stimulate root rot disease and enhance disease severity, restricting plant growth. The results suggest that the PAs (except CA) may enhance the fungi richness, decrease the fungi diversity and changed the fungi structure to increase fungal pathogen loads, which could explain the declined yield and quality of ginseng in consecutively monocultured ginseng crops.
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Affiliation(s)
| | - Junfan Fu
- Department of Plant Protection, Shenyang Agricultural University, Shenyang 110866, China
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Salameh LK, Abu Farha RK, Abu Hammour KM, Basheti IA. Impact of pharmacist's directed medication reconciliation on reducing medication discrepancies during transition of care in hospital setting. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2018. [DOI: 10.1111/jphs.12261] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Objectives
To evaluate the effect of pharmacist's directed services (reconciliation plus counselling) on reducing medication discrepancies and improving patient's outcomes at discharge from hospital.
Methods
During the 3-month study period, 200 patients were randomly selected from internal medicine department from Jordan University Hospital (JUH) and allocated into two groups (intervention and control groups). The number and types of medication discrepancies were identified at admission. Then, pharmacist implemented medication reconciliation and medication counselling services to the intervention group patients. At discharge, the number of unintentional discrepancies was evaluated for both groups. Patients were assessed at 1 month following their discharge for any subsequent hospital readmissions, emergency department visits or side effects of medication therapy.
Key findings
The total number of identified unintentional discrepancies was 84 for the intervention group compared with 60 discrepancies for the control group. Omission and addition represented the most common types of discrepancies for both groups. Of the 84 recommendations submitted by pharmacists, clinicians accepted 78 cases (92.8%), and implemented only 46 recommendations (54.7%). At discharge, a significant reduction in the number of unintentional discrepancies was achieved for the intervention group, P-value (0.014), while no significant change was found for the control group, P-value = 0.508. One month postdischarge, a significantly higher number of patients in the control group reported experiencing side effects compared with the intervention group, P-value = 0.020.
Conclusion
The presence of clinical pharmacists in hospital wards had a promising effect on decreasing the number of medication errors and improving health outcomes.
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Affiliation(s)
- Lana K. Salameh
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Rana K. Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Khawla M. Abu Hammour
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Iman A. Basheti
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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