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Nguyen ATT, Nguyen KHP, Le HB, Pham HT, Nguyen HT, Nguyen NTB, Dong PTX, Dang TND, Pham VTT, Nguyen DT, Benoit A, Bedouch P, Vo HT. Translation and validation of the CLEO tool in Vietnamese to assess the significance of pharmacist interventions. Int J Clin Pharm 2024:10.1007/s11096-024-01813-y. [PMID: 39365523 DOI: 10.1007/s11096-024-01813-y] [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: 05/22/2024] [Accepted: 09/26/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND There is currently no validated tool available for assessing the potential significance of pharmacist interventions in Vietnam. AIM This study aimed to translate the CLEO tool from French into Vietnamese, validate the Vietnamese version, and demonstrate its feasibility in daily practice. METHOD The CLEO tool was translated into Vietnamese (CLEOVN) using a 5-step process by bilingual experts. A total of 100 scenarios were compiled from clinical cases from nine hospitals evaluated by seven clinical pharmacists to determine inter-rater reliability and 30 out of 100 scenarios were re-evaluated one month later to determine test-retest reliability. Reliability was quantified using the intra-class correlation coefficient (ICC). A 20-item questionnaire on a 7-point Likert scale assessed the tool's appropriateness, acceptability, precision, and feasibility. RESULTS Inter-rater reliability was good for clinical dimension (ICCA,1 = 0.71), excellent for economic dimension (ICCA,1 = 0.86), and fair for organizational/operational dimension (ICCA,1 = 0.56). Test-retest reliability scores were excellent for clinical (I̅C̅C̅A,1 = 0.79), excellent for economic (I̅C̅C̅A,1 = 0.84), and fair for organizational/operational (I̅C̅C̅A,1 = 0.56). The tool was rated as appropriate (mean = 5.86; SD = 1.03), acceptable (mean = 5.19; SD = 1.12), precise (mean = 5.71; SD = 1.17), and feasible (mean = 5.05; SD = 1.24). The maximum time required to evaluate an intervention was three minutes. CONCLUSION The CLEOVN tool was successfully translated and validated for reliability, appropriateness, acceptability, precision, and feasibility. It will be suitable to evaluate the value of clinical pharmacy interventions.
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Affiliation(s)
- An Thi-Truong Nguyen
- Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
| | | | - Hai Ba Le
- Faculty of Pharmacology and Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, 100000, Vietnam
| | - Hong Tham Pham
- Department of Pharmacy, Nhan Dan Gia Dinh Hospital, Ho Chi Minh, 70000, Vietnam
- Faculty of Pharmacy, Pham Ngoc Thach University of Medicine, Ho Chi Minh, 70000, Vietnam
| | - Hai Thanh Nguyen
- Faculty of Pharmacology and Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, 100000, Vietnam
| | | | - Phuong Thi-Xuan Dong
- Faculty of Pharmacology and Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, 100000, Vietnam
| | - Trang Nguyen-Doan Dang
- Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
- Department of Pharmacy, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
| | - Van Thi-Thuy Pham
- Faculty of Pharmacology and Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, 100000, Vietnam
- Department of Pharmacy, Friendship Hospital, Hanoi, 100000, Vietnam
| | - Dung Tuan Nguyen
- Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, 70000, Vietnam
| | - Allenet Benoit
- TIMC, CNRS UMR5525; UFR de Pharmacie, University Grenoble-Alpes, Saint Martin d'Hères, 38400, France
- UF Pharmacie clinique, Pole Pharmacie, CHU Grenoble-Alpes, 38043, Grenoble, France
| | - Pierrick Bedouch
- TIMC, CNRS UMR5525; UFR de Pharmacie, University Grenoble-Alpes, Saint Martin d'Hères, 38400, France
- UF Pharmacie clinique, Pole Pharmacie, CHU Grenoble-Alpes, 38043, Grenoble, France
| | - Ha Thi Vo
- Faculty of Pharmacy, Pham Ngoc Thach University of Medicine, Ho Chi Minh, 70000, Vietnam.
- Department of Pharmacy, Nguyen Tri Phuong Hospital, Ho Chi Minh City, 70000, Vietnam.
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Novais T, Reallon E, Martin J, Barral M, Krolak-Salmon P, Coste MH, Zenagui H, Garnier-Crussard A, Hoegy D, Mouchoux C. Clinical impact of an individualised clinical pharmacy programme into the memory care pathway of older people: an observational study. Int J Clin Pharm 2024; 46:889-898. [PMID: 38642248 DOI: 10.1007/s11096-024-01723-z] [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: 06/12/2023] [Accepted: 03/08/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND In older patients, medication exposure [i.e. polypharmacy, potentially inappropriate medications (PIMs), medications with anticholinergic and/or sedative properties] is a modifiable risk factor associated with cognitive iatrogenic risk and dementia. AIM To assess the potential clinical impact of the implementation of an individualised clinical pharmacy programme at the initiation of the Memory care pathway in older patients with a cognitive complaint. METHOD This prospective observational study included older patients with high-risk of adverse drug event (HR) admitted in a French geriatric university hospital to explore the cognitive complaint or the cognitive disorder between January and November 2021. Drug-related problems (DRPs) were identified during a medication review performed in HR patients, and pharmaceutical interventions (PIs) notified in the patient's hospitalisation report were collected. The clinical impact of PIs was assessed by an expert panel (geriatricians and clinical pharmacists) using the Clinical, Economic, and Organisational (CLEO) tool. RESULTS Overall, 326 patients were eligible and 207 (63.5%) were considered as HR patients. Among HR patients, 88.9% (n = 184) were treated using at least 5 medications (polypharmacy), and 36.7% (n = 76) received at least one PIM with cognitive iatrogenic risk. During the medication review, 490 PIs were provided and their clinical impact was rated as minor for 57.3% (n = 281), moderate for 26.7% (n = 131), and major for 2.5% (n = 12). CONCLUSION The integration of clinical pharmacist secured the Memory care pathway of older patients with a cognitive complaint by identifying an important number of DRPs and PIMs with potential cognitive iatrogenic risk.
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Affiliation(s)
- Teddy Novais
- Pharmaceutical Unit, Lyon Institute for Aging, Charpennes Hospital, University Hospital of Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France.
- Research on Healthcare Performance (RESHAPE), INSERM U1290, University Lyon 1, Lyon, France.
| | - Elsa Reallon
- Pharmaceutical Unit, Lyon Institute for Aging, Charpennes Hospital, University Hospital of Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France
| | | | | | - Pierre Krolak-Salmon
- Day-Care Unit, Lyon Institute for Aging, Charpennes Hospital, University Hospital of Lyon, Lyon, France
- Clinical and Research Memory Center of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, France
- Eduwell Team, Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, UCBL1, Lyon, France
| | - Marie-Hélène Coste
- Day-Care Unit, Lyon Institute for Aging, Charpennes Hospital, University Hospital of Lyon, Lyon, France
- Clinical and Research Memory Center of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, France
| | - Hanane Zenagui
- Day-Care Unit, Lyon Institute for Aging, Charpennes Hospital, University Hospital of Lyon, Lyon, France
| | - Antoine Garnier-Crussard
- Day-Care Unit, Lyon Institute for Aging, Charpennes Hospital, University Hospital of Lyon, Lyon, France
- Clinical and Research Memory Center of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, France
- Eduwell Team, Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, UCBL1, Lyon, France
| | - Delphine Hoegy
- Pharmaceutical Unit, Groupement Hospitalier Est, University Hospital of Lyon, Lyon, France
- Health, Systemic, Process (P2S), Research Unit 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Christelle Mouchoux
- Pharmaceutical Unit, Lyon Institute for Aging, Charpennes Hospital, University Hospital of Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, University Lyon 1, Lyon, France
- Eduwell Team, Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, UCBL1, Lyon, France
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3
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Bailly R, Wuyts S, Toelen L, Mets T, Van Hauwermeiren C, Scheerlinck T, Cortoos PJ, Lieten S. Introducing a pharmacist-led transmural care program to reduce drug-related problems in orthogeriatric patients: a prospective interventional study. BMC Geriatr 2024; 24:47. [PMID: 38212699 PMCID: PMC10782737 DOI: 10.1186/s12877-023-04591-w] [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: 07/11/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Orthogeriatric patients have an increased risk for complications due to underlying comorbidities, chronic drug therapy and frequent treatment changes during hospitalization. The clinical pharmacist (CP) plays a key role in transmural communication concerning polypharmacy to improve continuity of care by the general practitioner (GP) after discharge. In this study, a pharmacist-led transmural care program, tailored to orthogeriatric patients, was evaluated to reduce drug related problems (DRPs) after discharge. METHODS An interventional study was performed (pre-period: 1/10/2021-31/12/2021; post-period: 1/01/2022-31/03/2022). Patients (≥ 65 years) from the orthopedic department were included. The pre-group received usual care, the post-group received the pharmacist-led transmural care program. The DRP reduction rate one month after discharge was calculated. Associated factors for the DRP reduction rate were determined in a multiple linear regression analysis. The GP acceptance rate was determined for the proposed interventions, as well as their clinical impact using the Clinical, Economic and Organizational (CLEO) tool. Readmissions one month after discharge were evaluated. RESULTS Overall, 127 patients were included (control n = 61, intervention n = 66). The DRP reduction rate was statistically significantly higher in the intervention group compared to the control group (p < 0.001). The pharmacist's intervention was associated with an increased DRP reduction rate (+ 1.750, 95% confidence interval 1.222-2.278). In total, 141 interventions were suggested by the CP, of which 71% were accepted one month after discharge. In both periods, four patients were readmitted one month after discharge. 58% of the interventions had a clinical impact (≥ 2 C level using the CLEO-tool) according to the geriatrician and for the CP it was 45%, indicating that they had the potential to avoid patient harm. CONCLUSIONS The pharmacist-led transmural care program significantly reduced DRPs in geriatric patients from the orthopedic department one month after discharge. The transmural communication with GPs resulted in a high acceptance rate of the proposed interventions.
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Affiliation(s)
- Rachel Bailly
- Departement of Pharmacy, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
| | - Stephanie Wuyts
- Departement of Pharmacy, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Research Group Clinical Pharmacology and Clinical Pharmacy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Loic Toelen
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tony Mets
- Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | | | - Thierry Scheerlinck
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Orthopedics and Traumatology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Pieter-Jan Cortoos
- Departement of Pharmacy, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Siddhartha Lieten
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
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Baptista R, Williams M, Price J. Improving the impact of pharmacy interventions in hospitals. BMJ Open Qual 2023; 12:e002276. [PMID: 37940333 PMCID: PMC10632884 DOI: 10.1136/bmjoq-2023-002276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
The clinical and pharmaceutical interventions of pharmacy professionals are considered impactful inputs towards optimised patient care and safety, by rationalising prescriptions, enhancing therapeutic choices and reducing and preventing medication errors and adverse effects. Pharmacy interventions (PIs), related to the identification, prevention and resolution of drug-related problems, should be recorded for optimal clinical governance and potential health outcomes.Between October 2020 and October 2021, the community hospitals at Powys Teaching Health Board recorded 158 PIs, corresponding to 0.4 interventions per staff per week. Only two members of the team were recording these PIs. Poor indicative PIs can result in lost opportunities for medication optimisation and prescribing rationalisation, increased costs and unidentified training potential.The aims of this project were (1) to record 180 interventions between 22 November 2021 and 8 April 2022 (20 weeks), corresponding to an average threefold increase, compared to the interventions recorded between October 2020 and October 2021 (52 weeks); (2) to have all hospital pharmacy staff recording at least one intervention during the same period.The number of interventions recorded and the number of pharmacy staff recording each intervention were two process measures. The project was completed through two Plan-Do-Study-Act cycles and applied theory on managing change in healthcare.The most successful intervention influencing positively the process measures was the implementation of a new Pharmacy Intervention Record Tool (xPIRT) toolkit that included an online recording tool (xPIRT) and an interactive panel with up-to-date results from all interventions recorded (xPIRT Dashboard). Motivating change was proven to be one of the best determinants of user satisfaction and engagement that contributed to meet the project's targets. xPIRT Dashboard provided staff the capacity to act on possible personal motivators and the possibility to improving care with medicines on their wards. The implementation of xPIRT toolkit was able to increase the representativity and significance of PIs recorded by the hospital pharmacy team, and it is expected to be used for personal professional development, demonstrating team activity and impact, service planning, prescribing practice optimisation and to identify education/training needs. This toolkit can be easily applied and adapted to other health organisations, settings and services.
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Affiliation(s)
- Rafael Baptista
- Medicines Management, Powys Teaching Health Board, Bronllys, Powys, UK
| | - Mary Williams
- School of Pharmacy & Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Jayne Price
- Medicines Management, Powys Teaching Health Board, Bronllys, Powys, UK
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Raymond J, Parrein P, Barat E, Chenailler C, Decreau-Gaillon G, Varin R, Joly LM. Pharmacist tracking and correction of medication errors: An improvement project in the observation ward of the emergency department. ANNALES PHARMACEUTIQUES FRANÇAISES 2023; 81:1007-1017. [PMID: 37356662 DOI: 10.1016/j.pharma.2023.06.004] [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: 07/12/2022] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE The risk of medication errors is high in emergency departments. Implementation of medication reconciliation activity complemented by pharmaceutical analysis of prescription is an effective way to reduce drug related problems. This study aimed to assess the potential clinical impact of these activities to prevent medication errors for the observation ward patients. The secondary objective was to assess these activities' cost-avoidance and benefit-to-cost ratio. MATERIAL AND METHODS This study was conducted in a 16-bed unit, over a 5-month period. The patients' demographic and treatment details, and data from pharmaceutical activities were collected and analyzed by a pharmacist. Two pharmacists and an emergency physician assessed the potential clinical impact of medication errors. RESULTS Medication reconciliation for 250 patients (15.7% of 1589 admitted patients) and pharmaceutical analysis of prescription for 302 patients (19%) were performed by the pharmacist. Medication reconciliation detected 752 errors in 197 patients; 19% were related to high-risk medications and 14% had a potential clinical impact assessed as major, critical or fatal. Pharmaceutical analysis of prescription revealed 159 drug related problems in 118 patients; of which 26% involved high-risk medications and 24% had a potential clinical impact assessed "at least major". In total, 16% of pharmacist interventions had a potential clinical impact assessed "at least major" in 33% of patients: this represents 1.8 pharmacist interventions formulated per day. CONCLUSION The presence of a pharmacist in the observation ward of the emergency department is useful in detecting iatrogenic drug related problems and reducing their medical impact. The benefit-to-cost ratio is favorable for the hospital.
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Affiliation(s)
- Johanna Raymond
- Pharmacy Department, CHU Rouen, Rouen, France; Observation ward, Adult Emergency Department, CHU Rouen, 76000 Rouen, France.
| | | | - Eric Barat
- Pharmacy Department, CHU Rouen, Rouen, France
| | | | | | - Rémi Varin
- Pharmacy Department, CHU Rouen, Rouen, France
| | - Luc-Marie Joly
- Observation ward, Adult Emergency Department, CHU Rouen, 76000 Rouen, France
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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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Costa E Silva T, Dias P, Alves E Cunha C, Feio J, Lavrador M, Oliveira J, Figueiredo IV, Rocha MJ, Castel-Branco M. [Medication Reconciliation During Admission to an Internal Medicine Department: A Pilot Study]. ACTA MEDICA PORT 2022; 35:798-806. [PMID: 35245429 DOI: 10.20344/amp.16892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The purpose of medication reconciliation is to promote patient safety by reducing medication errors and adverse events due to medication discrepancies in transition of care. The aim of this pilot study of medication reconciliation at the time of hospital admission was to identify the necessary resources for its implementation in clinical practice. MATERIAL AND METHODS Pilot study with 100 patients admitted to an Internal Medicine department between October and December 2019, aged 18 and over, and chronically taking at least one medicine. The best possible medication history was obtained systematically, with subsequent identification, classification and resolution of the discrepancies. RESULTS The study sample, in general characterized by polypharmacy and by having multiple long-term conditions, presented a mean age of 77.04 ± 13.74 years, being 67.0% male. Overall, 791 discrepancies were identified. Intentional discrepancies were 95.7% and 50.9% of them were documented. The difficulties encountered were mainly related with the access and quality of therapeutic information and communication problems between different healthcare professionals. The key priority resources that were identified were related with the process, tools, and personnel categories. CONCLUSION The data revealed weaknesses in the clinical records available at the primary/hospital care interface. Optimization of data sources, standardization and informatization of the process, multidisciplinary approach and definition of priority groups were identified as opportunities for optimization.
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Affiliation(s)
- Thaís Costa E Silva
- Laboratório de Farmacologia e Cuidados Farmacêuticos. Faculdade de Farmácia. Universidade de Coimbra. Coimbra.Portugal
| | - Patrícia Dias
- Serviço de Medicina Interna. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Catarina Alves E Cunha
- Unidade de Farmacologia Clínica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - José Feio
- Serviços Farmacêuticos. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Marta Lavrador
- Laboratório de Farmacologia e Cuidados Farmacêuticos. Faculdade de Farmácia. Universidade de Coimbra. Coimbra. Instituto de Investigação Clínica e Biomédica de Coimbra. Coimbra. Portugal
| | - Joelizy Oliveira
- Laboratório de Farmacologia e Cuidados Farmacêuticos. Faculdade de Farmácia. Universidade de Coimbra. Coimbra. Fundação Capes. Ministério da Educação. Brasília. Brasil. Centro de Documentação e Informação em Educação Superior. Ministério da Educação Superior e Pesquisa do Governo do Grão-Ducado de Luxemburgo. Luxemburgo
| | - Isabel Vitória Figueiredo
- Laboratório de Farmacologia e Cuidados Farmacêuticos. Faculdade de Farmácia. Universidade de Coimbra. Coimbra. Instituto de Investigação Clínica e Biomédica de Coimbra. Coimbra. Portugal
| | - Marília João Rocha
- Serviços Farmacêuticos. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Margarida Castel-Branco
- Laboratório de Farmacologia e Cuidados Farmacêuticos. Faculdade de Farmácia. Universidade de Coimbra. Coimbra. Instituto de Investigação Clínica e Biomédica de Coimbra. Coimbra. Portugal
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Vallecillo T, Slimano F, Moussouni M, Ohl X, Bonnet M, Mensa C, Hettler D, Kanagaratnam L, Mongaret C. Development and validation of a ready-to-use score to prioritise medication reconciliation at patient admission in an orthopaedic and trauma department. Eur J Hosp Pharm 2022; 29:264-270. [PMID: 33293282 PMCID: PMC9660597 DOI: 10.1136/ejhpharm-2020-002283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 10/14/2020] [Accepted: 11/17/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Medication reconciliation (MR) is recognised as an important tool in preventing medication errors such as unintentional discrepancies (UDs). The aim of this study was to identify independent predictive factors of UDs during MR at patient admission to an orthopaedic and trauma department. The secondary objective was to build and validate a ready-to-use score to prioritise patients. METHOD A retrospective study was performed on 3.5 years of pharmacist-led MR in the orthopaedic and trauma department of a large university teaching hospital. Independent predictors of UD were identified by multivariable logistic regression. A priority score to identify patients at risk of at least one UD was constructed from the odds ratios of the risk factors, and validated in a separate cohort. Performance was assessed with sensitivity, specificity, C-statistic and Hosmer-Lemeshow goodness-of-fit. RESULTS In total, 888 patients were included and 387 UDs were identified, mainly drug omissions (65.1%). Five independent predictors of UD were identified: age >75 years (OR 2.05, 95% CI 1.41 to 3.00; p<0.001), admission during school holidays (OR 1.69, 95% CI 1.17 to 2.44; p=0.005), female gender (OR 2.20, 95% CI 1.53 to 3.16; p<0.001), emergency hospitalisation (OR 2.05, 95% CI 1.45 to 2.92; p<0.001), and ≥5 medications on the best possible medication history (BPMH) (OR 3.29, 95% CI 2.20 to 4.94; p<0.001). Based on these predictors, a priority score ranging from 0 to 10 was built and internally and externally validated (C statistic 0.72, 95% CI 0.67 to 0.76). CONCLUSIONS This study confirms the high prevalence of UD in patients admitted to orthopaedic and trauma surgery departments. Five independent predictive factors of UD during MR were identified (female gender, emergency hospitalisation, hospitalisation during school holidays, age ≥75 years, and ≥5 medicines on the BPMH). The developed risk score will help to prioritise MR among patients at risk of medication error and is ready-to-use in other orthopaedic and trauma departments.
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Affiliation(s)
| | - Florian Slimano
- Pharmacy, CHU Reims, Reims, France
- MEDyC UMR CNRS/URCA n°7369, Reims Champagne-Ardenne University Faculty of Pharmacy, Reims, France
| | | | - Xavier Ohl
- Orthopaedic Surgery, CHU Reims Pôle Locomoteur, Reims, France
- EA 4691, Reims Champagne-Ardenne University Faculty of Pharmacy, Reims, France
| | | | | | | | | | - Céline Mongaret
- Pharmacy, CHU Reims, Reims, France
- EA 4691, Reims Champagne-Ardenne University Faculty of Pharmacy, Reims, France
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Alghamdi A, Alhulaylah F, Al-Qahtani F, Alsallal D, Alshabanat N, Alanazi H, Alshehri G. Evaluation of Pharmacy Intern-led Transition of Care Service at an Academic Hospital in Saudi Arabia: A Prospective Pilot Study. Saudi Pharm J 2022; 30:629-634. [PMID: 35693446 PMCID: PMC9177444 DOI: 10.1016/j.jsps.2022.02.007] [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: 10/13/2021] [Accepted: 02/10/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives The transition of patients from one setting to another increases the risk of medication errors (MEs). This study aims to assess the implementation of pharmacy intern-led transition of care (TOC) service and to demonstrate its impact on the quality of patient care. Method A prospective interventional pilot study was carried out from August 2020 to April 2021 at an academic hospital in Saudi Arabia. The TOC team consisted of three pharmacy interns and one pharmacist-in-charge. Daily activities included medication reconciliation, discharge counseling, and follow-up call after 3 days of discharge. The identified discrepancies were categorized according to the National Coordinating Council for Medication Error Reporting Program. Key findings A total of 182 patients were included in the analysis. During medication reconciliation, 102 discrepancies were detected, with an average of 0.7 discrepancy per patient. The most common discrepancy at admission and discharge was omission (41.7% and 70%, respectively). Category B was the most frequent and accounted for 46% at admission and 93% at discharge. Around 39% of TOC beneficiaries received a follow-up call, and all reported a high level of satisfaction with the service. Conclusion Involving the pharmacy team in TOC activities was effective in identifying discrepancies and resolving MEs.
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10
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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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11
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Chappe M, Corvaisier M, Brangier A, Annweiler C, Spiesser-Robelet L. Impact of the COVID-19 pandemic on drug-related problems and pharmacist interventions in geriatric acute care units. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 80:669-677. [PMID: 34968479 PMCID: PMC8711174 DOI: 10.1016/j.pharma.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 11/18/2022]
Abstract
Objectives To assess and compare the pharmaceutical analysis on drug management in a geriatric acute care unit prior to and during the COVID-19 pandemic. Methods This was a single-centre, retrospective, and comparative cohort study. All Pharmacist Interventions (PIs) carried out in the unit between 27 January 2020 and 30 April 2020 were distinguished according to whether they were conducted prior to or during the first wave of COVID-19. The main outcome measure was the rate of PIs per patient and per prescription lines analysed. Other data collected were the drug class managed by the PI, the Drug Related Problems (DRP) identified, the nature of the advice given, and the acceptance rate by geriatricians. Results A total of 355 patients were analysed, with PIs generated for 21.7% of the patients prior to COVID-19, and for 53.4% of the patients during the first wave (p < 0.001). Among the 4402 prescription lines analysed, 54 PIs were carried out for prescriptions prior to COVID-19, and 177 during the first wave (p = 0.002). DRPs were mostly related to anti-infectious drugs during the pandemic (20.3%, p = 0.038), and laxatives prior to the pandemic (13.0%, p = 0.023). The clinical impact of the PIs was mainly moderate (43.7%). The acceptance rate was 59.3%. Conclusions A greater amount of DRPs were detected and more therapeutic advice was proposed during the first wave of COVID-19, with a focus on drugs used for the management of COVID-19 rather than geriatric routine treatments. The needs for clinical pharmacists were strengthened during the pandemic.
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Affiliation(s)
- M Chappe
- Department of Pharmacy, Angers University Hospital, Angers, France; Department of Geriatric Medicine, Research Center on Autonomy and Longevity, Angers University Hospital, Angers, France; Department of Pharmacy, Haut Anjou Hospital, Chateau-Gontier, France.
| | - M Corvaisier
- Department of Pharmacy, Angers University Hospital, Angers, France; Department of Geriatric Medicine, Research Center on Autonomy and Longevity, Angers University Hospital, Angers, France; UPRES EA 4638, University of Angers, Angers, France
| | - A Brangier
- Department of Geriatric Medicine, Research Center on Autonomy and Longevity, Angers University Hospital, Angers, France
| | - C Annweiler
- Department of Geriatric Medicine, Research Center on Autonomy and Longevity, Angers University Hospital, Angers, France; UPRES EA 4638, University of Angers, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada
| | - L Spiesser-Robelet
- Department of Pharmacy, Angers University Hospital, Angers, France; Health Education and Practices Laboratory-LEPS (EA 3412), Paris13-Sorbonne Paris Cité University, Bobigny, France
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12
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Farhat A, Abou-Karroum R, Panchaud A, Csajka C, Al-Hajje A. Impact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool. Curr Ther Res Clin Exp 2021; 95:100650. [PMID: 34824649 PMCID: PMC8604771 DOI: 10.1016/j.curtheres.2021.100650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background It has been well recognized that pharmaceutical interventions (PIs) can prevent patient harm related to prescribing errors. Various tools have been developed to facilitate the detection and the reduction of inappropriate prescriptions and some have shown benefit on clinical outcomes. Objective The objective of this study was to evaluate the clinical, economical, and organizational impact of interventions generated by clinical pharmacists in hospitalized patients, and to evaluate the performance of an explicit tool, the Potentially Inappropriate Medication Checklist for Patients in Internal Medicine (PIM-Check), in detecting each pharmacist's intervention. Methods A cohort retrospective study was conducted on hospitalized patients. The impact of PIs based on pharmacists’ standard examination was evaluated using the Clinical, Economic, and Organizational (CLEO) tool. The performance of PIM-Check in detecting each intervention was assessed by conducting a retrospective medication review based on available information collected from patients’ records. A qualitative analysis was also conducted to identify the types of PIs that PIM-Check failed to detect. Results The study was performed on 162 patients with a median age of 68 years (interquartile range = 46–77 years) and a median hospital stay of 5 days (interquartile range = 4–7 days). The pharmacists generated 1.9 PIs per patient (n = 304) of which 31% were detected by PIM-Check. The acceptance rate of the interventions by physicians was 84% (n = 255). Among the accepted interventions, 53% (n = 136) had a clinical impact graded CL ≥ 2C (moderate or major), whereas the majority of them were not detected by PIM-Check (63%; 86 out of 136). In addition, 46% of accepted interventions (n = 117) were associated with a cost decrease, among which 62% were not detected by PIM-Check (73 out of 117). The qualitative analysis shows that PIM-Check mostly failed to detect PIs related to dose adjustment, overprescribing, and therapy monitoring. Conclusions According to the CLEO tool evaluation of PIs, our results show that clinical pharmacists’ interventions are associated with improved clinical outcomes. In comparison with pharmacists’ interventions, PIM-Check failed in detecting the majority of interventions associated with a moderate or major impact.
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Affiliation(s)
- Akram Farhat
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Rime Abou-Karroum
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,Department of Pharmacy, Clemenceau Medical Center, Beirut, Lebanon
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital, Lausanne, Switzerland
| | - Chantal Csajka
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Amal Al-Hajje
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
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13
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Role of pharmacist during COVID-19 pandemic: A retrospective study focused on critically ill COVID-19 patients. Saudi Pharm J 2021; 29:1050-1055. [PMID: 34305425 PMCID: PMC8282452 DOI: 10.1016/j.jsps.2021.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 01/14/2023] Open
Abstract
Background and aim During the Coronavirus 2019 (COVID-19) crisis, there has been a huge demand for medications and unprecedented utilization of intensive care unit (ICU) services that subsequently and profoundly impacted the quality of medical care provided to COVID-19 patients. This study aimed to shed light on the role of pharmacists on the health care provided to critically ill COVID-19 patients. Methods A retrospective study, was conducted in Diriyah hospital in Riyadh, Saudi Arabia on all COVID-19 patients admitted to the ICU between June 27th and August 15th, 2020 until patients were transferred to the medical ward, discharged, or deceased. All medication related interventions performed by pharmacists have been documented electronically, collected and subsequently categorized and analyzed. Results The mean age of patients was 58.8 years (±12.98 SD), with age of >64 years in approximately 37%. Four hundred and seventy interventions (470) were made by pharmacists of which 32%, 11.7%, 4%, 2.6%, 2.1% were due to error in dosing regimens, drug duplication, missing drug information, drugs requiring prior authorization, and missing critical information, respectively; while 40.6% were due to medication shortage of which 40.3% were substituted with alternative medications. Based on the analysis of drugs involved in interventions, medication groups that were mainly associated with interventions included antibiotics (16.8%), electrolytes/minerals (11.7%) and vitamins (9.4%). Conclusion During health crises such as COVID-19 pandemic, the role of pharmacists in the ICU services becomes extremely crucial for providing better patients’ outcomes. Further studies should be conducted to follow up these findings in the context of COVID-19 pandemic.
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14
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Vo HT, Charpiat B, Chanoine S, Juste M, Roubille R, Rose FX, Conort O, Allenet B, Bedouch P. CLEO: a multidimensional tool to assess clinical, economic and organisational impacts of pharmacists' interventions. Eur J Hosp Pharm 2021; 28:193-200. [PMID: 33883205 DOI: 10.1136/ejhpharm-2020-002642] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/05/2021] [Accepted: 03/22/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Clinical pharmacists' interventions (PIs) are an important element in ensuring good pharmaceutical care. We aimed to develop and validate a comprehensive multidimensional tool for assessing the potential impact of PIs for daily practice of medication review. METHODS Experts of the French Society of Clinical Pharmacy (SFPC) developed the CLinical, Economic and Organisational (CLEO) tool, consisting of three independent dimensions concerning clinical, economic and organisational impact. They were asked to analyse 30 scenarios of PIs, and re-rated 10 PIs with a washout of 1 month (internal validation). Then, seven external experts not involved in the development of the tool rated 60 scenarios collected when using the CLEO in daily practice. Inter- and intra-rater reliabilities were determined by calculation of the intra-class correlation (ICCA,1). Users' satisfaction and acceptability of the tool were assessed on a 7-level Likert scale with a 17-item questionnaire. RESULTS For internal reliability, the inter-rater reliability for the CLEO tool was good for clinical dimensions (ICCA,1=0.693), excellent for economic dimensions (ICCA,1=0.815) and fair for organisational dimensions (ICCA,1=0.421); and the intra-rater reliability was good for clinical dimensions (ICCA,1=0.822), excellent for economic dimensions (ICCA,1=0.918) and good for organisational dimensions (ICCA,1=0.738). For external reliability, the inter-rater reliability was good for clinical dimensions (ICCA,1=0.649), excellent for economic dimensions (ICCA,1=0.814) and fair for organisational dimensions (ICCA,1=0.500). CLEO was viewed as relevant (mean±SD 4.93±1.27), acceptable (4.81±1.78), practicable (5.56±1.45) and precise (5.38±1.47). CONCLUSIONS CLEO is a comprehensive tool assessing clinical, economic and organisational impacts of PIs which has been developed, validated and was reliable and feasible for use in routine clinical practice.
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Affiliation(s)
- Ha Thi Vo
- Faculty of Pharmacy, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam .,ThEMAS (Techniques for Evaluation and Modeling of Health Actions) TIMC-IMAG (Techniques for Biomedical Engineering and Complexity Management - Informatics, Mathematics and Applications) UMR CNRS (National Institute of Sciences of the Universe - Research Unit 5525), Grenoble Alpes University, Grenoble, France
| | - Bruno Charpiat
- ThEMAS (Techniques for Evaluation and Modeling of Health Actions) TIMC-IMAG (Techniques for Biomedical Engineering and Complexity Management - Informatics, Mathematics and Applications) UMR CNRS (National Institute of Sciences of the Universe - Research Unit 5525), Grenoble Alpes University, Grenoble, France.,Pharmacy Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Sebastien Chanoine
- Grenoble School of Pharmacy, Univ Grenoble Alpes, Grenoble, France.,Pharmacy Department, Grenoble University Hospital, Grenoble, France
| | - Michel Juste
- Centre Hospitalier Auban-Moët, Pharmacie, Epernay, France
| | | | | | - Ornella Conort
- Pharmacy hôpital Cochin, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Benoît Allenet
- ThEMAS (Techniques for Evaluation and Modeling of Health Actions) TIMC-IMAG (Techniques for Biomedical Engineering and Complexity Management - Informatics, Mathematics and Applications) UMR CNRS (National Institute of Sciences of the Universe - Research Unit 5525), Grenoble Alpes University, Grenoble, France.,Grenoble School of Pharmacy, Univ Grenoble Alpes, Grenoble, France.,Pharmacy Department, Grenoble University Hospital, Grenoble, France
| | - Pierrick Bedouch
- ThEMAS (Techniques for Evaluation and Modeling of Health Actions) TIMC-IMAG (Techniques for Biomedical Engineering and Complexity Management - Informatics, Mathematics and Applications) UMR CNRS (National Institute of Sciences of the Universe - Research Unit 5525), Grenoble Alpes University, Grenoble, France.,Grenoble School of Pharmacy, Univ Grenoble Alpes, Grenoble, France.,Pharmacy Department, Grenoble University Hospital, Grenoble, France
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15
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Pouget AM, Civade E, Cestac P, Rouzaud-Laborde C. From hospitalisation to primary care: integrative model of clinical pharmacy with patients implanted with a PICC line-research protocol for a prospective before-after study. BMJ Open 2021; 11:e039490. [PMID: 33827827 PMCID: PMC8031034 DOI: 10.1136/bmjopen-2020-039490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Clinical pharmacy improves patient safety and secures drug management using information, education and good clinical practices. However, medical device management is still unexplored, and proof of effectiveness is needed. A PICC line (peripherally inserted central catheter) is a medical device for infusion. It accesses the central venous system after being implanted in a peripheral vein. However, complications after implantation often interfere with smooth execution of the treatment. We hypothesise that clinical pharmacy for medical devices could be as effective as clinical pharmacy for medications. The main objective is to assess the effectiveness of clinical pharmacy activities on the complication rate after PICC line implantation. METHODS AND ANALYSIS This is a before-after prospective study. The study will begin with an observational period without clinical pharmacy activities, followed by an interventional period where pharmacists will intervene on drug and medical device management and provide personalised follow-up and advice. Sixty-nine adult patients will be recruited in each 6-month period from all traditional care units. The main inclusion criteria will be the implantation of a PICC line. The primary outcome is the decrease in the number of complications per patient and per month. Secondary outcomes are the consultation and hospital readmission rates, the acceptance rate of pharmaceutical interventions, the patients' quality of life, the direct hospital induced or avoided costs and the participants' satisfaction. Data will be collected using case report forms during hospitalisation and telephone follow-up after discharge. The analysis will compare these criteria during the two periods. ETHICS AND DISSEMINATION The study has received the approval of our Ethics Committee (Clermont-Ferrand Southeast VI, France, number AU1586). Results will be made available to the patients or their caregivers, the sponsor and other researchers when asked, as described in the consent form. TRIAL REGISTRATION NUMBER NCT04359056.
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Affiliation(s)
- Alix Marie Pouget
- Department of Pharmacy, University Hospital Centre Toulouse, Toulouse, Occitanie, France
- INSERM unit 1048, I2MC, Toulouse, Occitanie, France
| | - Elodie Civade
- Department of Pharmacy, University Hospital Centre Toulouse, Toulouse, Occitanie, France
| | - Philippe Cestac
- Department of Pharmacy, University Hospital Centre Toulouse, Toulouse, Occitanie, France
| | - Charlotte Rouzaud-Laborde
- Department of Pharmacy, University Hospital Centre Toulouse, Toulouse, Occitanie, France
- INSERM unit 1048, I2MC, Toulouse, Occitanie, France
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16
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Oh AL, Tan AGHK, Chieng IYY. Detection of Medication Errors Through Medication History Assessment During Admission at General Medical Wards. J Pharm Pract 2021; 35:407-412. [PMID: 33433248 DOI: 10.1177/0897190020987127] [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: 11/17/2022]
Abstract
INTRODUCTION Medication history assessment during hospital admissions is an important element in the medication reconciliation process. It ensures continuity of care and reduces medication errors. OBJECTIVES This study aimed to determine the incidence of unintentional discrepancies (medication errors), types of medication errors with its potential severity of patient harm and acceptance rate of pharmaceutical care interventions. METHODS A four-month cross-sectional study was conducted in the general medical wards of a tertiary hospital. All newly admitted patients with at least one prescription medication were recruited via purposive sampling. Medication history assessments were done by clinical pharmacists within 24 hours or as soon as possible after admission. Pharmacist-acquired medication histories were then compared with in-patient medication charts to detect discrepancies. Verification of the discrepancies, interventions, and assessment of the potential severity of patient harm resulting from medication errors were collaboratively carried out with the treating doctors. RESULTS There were 990 medication discrepancies detected among 390 patients recruited in this study. One hundred and thirty-five (13.6%) medication errors were detected in 93 (23.8%) patients (1.45 errors per patient). These were mostly contributed by medication omissions (79.3%), followed by dosing errors (9.6%). Among these errors, 88.2% were considered "significant" or "serious" but none were "life-threatening." Most (83%) of the pharmaceutical interventions were accepted by the doctors. CONCLUSION Medication history assessment by pharmacists proved vital in detecting medication errors, mostly medication omissions. Majority of the errors intervened by pharmacists were accepted by the doctors which prevented potential significant or serious patient harm.
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Affiliation(s)
- Ai Ling Oh
- Department of Pharmacy, 58986Sarawak General Hospital, Ministry of Health, Sarawak, Malaysia
| | | | - Irene Yee Yew Chieng
- Department of Pharmacy, 58986Sarawak General Hospital, Ministry of Health, Sarawak, Malaysia
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17
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Heffner C, Dillaman M, Hill J. Pharmacist-driven medication reconciliation reduces oral oncolytic medication errors during transitions of care. Am J Health Syst Pharm 2020; 77:S100-S104. [PMID: 32725142 DOI: 10.1093/ajhp/zxaa168] [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: 11/14/2022] Open
Abstract
PURPOSE The purpose of this study was to characterize medication errors associated with oral oncolytics as patients with cancer were admitted to the inpatient setting and identify contributing factors that lead to errors. METHODS A review of patients prescribed a cyclic oral oncolytic who were then admitted to the inpatient setting at a large, academic medical center from July 1, 2013, to June 30, 2018, was conducted. RESULTS Eighty-one patients were included in the analysis. Thirty-five errors (43%) related to transcription of the oral oncolytic regimen from the outpatient to the inpatient setting were identified. Categorization of errors revealed that 46% were due to delays in treatment. Within this error subset, 75% of the delays were related to unavailability of nonformulary oral oncolytics. There was a significant decrease in error for patients who received medication reconciliation by a pharmacist (P = 0.032) after admission. There were no other significant differences observed among variables that may have led to increased error rates. Three percent of errors were reported to the internal medication safety reporting system at our institution. CONCLUSION The inability to fully confirm patients' home regimen via chart review poses great risk to accurate medication ordering upon hospital admission. Completion of medication reconciliations by pharmacists serves to decrease rates of errors that may occur during hospital admission in cancer patients undergoing treatment with oral oncolytic therapies.
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Affiliation(s)
| | | | - Jordan Hill
- Department of Pharmacy, WVU Medicine, Morgantown, WV
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18
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Opportunities for broadening the application of cell wall lytic enzymes. Appl Microbiol Biotechnol 2020; 104:9019-9040. [DOI: 10.1007/s00253-020-10862-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/14/2020] [Accepted: 08/26/2020] [Indexed: 01/21/2023]
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19
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Faqeer N, Mustafa N, Abd Al-Jalil N, Qur'an T. Impact of clinical pharmacists in an inpatient medical oncology service: A prospective study at a comprehensive cancer center in Jordan. J Oncol Pharm Pract 2020; 27:897-901. [PMID: 32703083 DOI: 10.1177/1078155220943277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Clinical pharmacy is considered an integral discipline in the health care system for optimizing therapy and reducing drug-related problems. The objective of this study was to evaluate the impact of clinical pharmacists in optimizing management in a medical oncology service. METHODS A prospective study was conducted at King Hussein Cancer Center between July 2019 and September 2019 of patients admitted to the medical oncology service. The impact of clinical pharmacists was measured by evaluating their interventions, defined as actions that were expected to result in a change in patient management. Data were collected daily by routine review of patients' profiles and by recording clinical pharmacists' interventions. The data collected were baseline characteristics of patients, numbers and types of clinical pharmacists' interventions, their significance, medications involved, and rate of acceptance of clinical pharmacists' interventions by physicians. The significance of each intervention was assessed by two clinical pharmacists on a Hatoum scale. Physicians' acceptance was assessed by whether the recommendations were implemented. RESULTS During the study period, 748 patients were included, of whom 605 required a total of 1683 clinical interventions. The mean age was 56.3 years (±15.5 SD). Of the interventions, 39% resulted in initiation of a drug and 25% in drug discontinuations. The drug group most commonly associated with clinical pharmacists' interventions was antibiotics (26.5%). Physicians accepted 98% of the clinical pharmacists' interventions, and 92.4% of the interventions brought care to a more appropriate level and were considered significant. CONCLUSION Most patients in the medical oncology service required clinical pharmacists' interventions, as demonstrated by the high number of significant clinical pharmacists' interventions. Studies should be conducted to follow up these findings with respect to patient outcomes and cost savings.
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Affiliation(s)
- Nour Faqeer
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Nour Mustafa
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | | | - Tasnim Qur'an
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
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20
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de Grégori J, Pistre P, Boutet M, Porcher L, Devaux M, Pernot C, L Chrétien M, Rossi C, Manfredi S, Dalac S, Gueneau P, Boulin M. Clinical and economic impact of pharmacist interventions in an ambulatory hematology–oncology department. J Oncol Pharm Pract 2020; 26:1172-1179. [DOI: 10.1177/1078155220915763] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives To evaluate clinical and financial impact of pharmacist interventions in an ambulatory adult hematology–oncology department. Methods All cancer patients receiving a first injectable immuno- and/or chemotherapy regimen were included in this prospective study over a one-year period. The clinical impact of pharmacist interventions made by two clinical pharmacists was rated using the Clinical Economic and Organizational tool. Financial impact was calculated through cost savings and cost avoidance. Main results: Five hundred and fifty-eight patients were included. A total of 1970 pharmacist interventions were performed corresponding to a mean number of 3.5 pharmacist interventions/patient. The clinical impact of pharmacist interventions was classified as negative, null, minor, moderate, major and lethal in 0, 84 (4%), 1353 (68%), 385 (20%), 148 (8%) and 0 cases, respectively. The overall cost savings were €175,563. One hundred and nine (6%) of all pharmacist interventions concerned immuno- or chemotherapy regimen for cost savings of €148,032 (84% of the total amount of cost savings). The cost avoidance was €390,480. Cost avoidance results were robust to sensitivity analyses with cost of preventable adverse drug event as main driver of the model. When the cost of employing a pharmacist was subtracted from the average yearly cost savings plus cost avoidance per pharmacist, this yielded a net benefit of €223,021. The cost–benefit ratio of the clinical pharmacist was €3.7 for every €1 invested. Principal conclusions: To have two full-time clinical pharmacists in a 55-bed ambulatory adult hematology–oncology department is both clinically and financially beneficial.
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Affiliation(s)
| | - Pauline Pistre
- Department of Pharmacy, University Hospital, Dijon, France
| | | | - Laura Porcher
- Department of Pharmacy, University Hospital, Dijon, France
| | | | - Corinne Pernot
- Department of Pharmacy, University Hospital, Dijon, France
| | - Marie L Chrétien
- Department of Clinical Hematology, University Hospital and SAPHIIR-UMR 1231, University of Burgundy & Franche Comte, Dijon, France
| | - Cédric Rossi
- Department of Clinical Hematology, University Hospital and SAPHIIR-UMR 1231, University of Burgundy & Franche Comte, Dijon, France
| | - Sylvain Manfredi
- Department of Hepatogastroenterology and Digestive Oncology, University Hospital and EPICAD LNC UMR 1231, University of Burgundy & Franche Comte, Dijon, France
| | - Sophie Dalac
- Department of Dermatology, University Hospital, Dijon, France
| | | | - Mathieu Boulin
- Department of Pharmacy, University Hospital and EPICAD LNC UMR 1231, University of Burgundy & Franche Comte, Dijon, France
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21
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Guo Q, Guo H, Song J, Yin D, Song Y, Wang S, Li X, Duan J. The role of clinical pharmacist trainees in medication reconciliation process at hospital admission. Int J Clin Pharm 2020; 42:796-804. [PMID: 32221824 DOI: 10.1007/s11096-020-01015-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 03/14/2020] [Indexed: 12/01/2022]
Abstract
Background Medication discrepancies are a common occurrence following hospital admission and carry the potential for causing harm. However, little is known about the prevalence and potential risk factors involved in medication discrepancies in China. Objective To determine the frequency of medication discrepancies and the associated risk factors and evaluate the potential harmsof errors prevented by pharmacist trainees performing medication reconciliation process. Setting A tertiary hospital in Shanxi, China. Method Medication reconciliation was conducted at admission to four clinical departments including cardiology, nephrology, endocrinology and pneumology department between 2019 Feb 1st and 2019 Aug 31st by clinical pharmacist trainees. All unintentional medication discrepancies were presented to the expert panel to evaluate. Associations between unintentional medication discrepancies and various factors were examined. Main outcome measure The primary outcome was the prevalence of unintentional medication discrepancies as well as the associated risk factors. Results Overall, 331 patients were included (mean age 59.7 ± 15.2 years; 176 men). The reconciliation process identified 511 drug discrepancies, 98 of which were unintentional medication discrepancies; these occurred in 74 patients. The most common unintentional medication discrepancies type was omission (40.8%), followed by incorrect dose (25.5%), and 73.5% could have caused patients moderate to significant harm and complications. 5 or more drugs and 2 or more chronic diseases at admission associated with unintentional medication discrepancies in a logistic regression analysis. Conclusion Medication reconciliation performed by pharmacist trainees upon admission can reduce unintentional medication discrepancies. Patients taking 5 or more drugs and experiencing more than two chronic diseases were found to be particularly at risk.
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Affiliation(s)
- Qian Guo
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No.382, Wuyi Road, Taiyuan, Shanxi, China
| | - Hui Guo
- Department of Pharmacy, Shanxi Cardiovascular Disease Hospital, Taiyuan, China
| | - Junli Song
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No.382, Wuyi Road, Taiyuan, Shanxi, China
| | - Donghong Yin
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No.382, Wuyi Road, Taiyuan, Shanxi, China
| | - Yan Song
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No.382, Wuyi Road, Taiyuan, Shanxi, China
| | - Shuyun Wang
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No.382, Wuyi Road, Taiyuan, Shanxi, China
| | - Xiaoxia Li
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No.382, Wuyi Road, Taiyuan, Shanxi, China
| | - Jinju Duan
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No.382, Wuyi Road, Taiyuan, Shanxi, China.
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22
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Zecchini C, Vo TH, Chanoine S, Lepelley M, Laramas M, Lemoigne A, Allenet B, Federspiel I, Bedouch P. Clinical, economic and organizational impact of pharmacist interventions on injectable antineoplastic prescriptions: a prospective observational study. BMC Health Serv Res 2020; 20:113. [PMID: 32050957 PMCID: PMC7017539 DOI: 10.1186/s12913-020-4963-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 02/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background Pharmacists play a key role in ensuring the safe use of injectable antineoplastics, which are considered as high-alert medications. Pharmaceutical analysis of injectable antineoplastic prescriptions aims to detect and prevent drug related problems by proposing pharmacist interventions (PI). The impact of this activity for patients, healthcare facilities and other health professionals is not completely known. This study aimed at describing the clinical, economic, and organizational impacts of PIs performed by pharmacists in a chemotherapy preparation unit. Methods A prospective 10-week study was conducted on PIs involving injectable antineoplastic prescriptions. Each PI was assessed by one of the four multidisciplinary expert committees using a multidimensional tool with three independent dimensions: clinical, economic and organizational. An ancillary quantitative evaluation of drug cost savings was conducted. Results Overall, 185 patients were included (mean age: 63.5 ± 13.7 years; 54.1% were male) and 237 PIs concerning 10.1% prescriptions were recorded. Twenty one PIs (8.9%) had major clinical impact (ie: prevented hospitalization or permanent disability), 49 PIs (20.7%) had moderate clinical impact (ie: prevented harm that would have required further monitoring/treatment), 62 PIs (26.2%) had minor clinical impact, 95 PIs (40.0%) had no clinical impact, and 9 PIs (3.8%) had a negative clinical impact. For one PI (0.4%) the clinical impact was not determined due to insufficient information. Regarding organizational impact, 67.5% PIs had a positive impact on patient management from the healthcare providers’ perspective. A positive economic impact was observed for 105 PIs (44.3%), leading to a saving in direct drug costs of 15,096 €; 38 PIs (16.0%) had a negative economic impact, increasing the direct drug cost by 11,878 €. Overall cost saving was 3218€. Conclusions PIs are associated with positive clinical, economic and organizational impacts. This study confirms the benefit of pharmacist analysis of injectable antineoplastic prescriptions for patient safety with an overall benefit to the healthcare system.
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Affiliation(s)
- Céline Zecchini
- Centre Hospitalo-Universitaire Grenoble Alpes, Pôle Pharmacie, F-38000, Grenoble, France.
| | - Thi-Ha Vo
- Centre Hospitalo-Universitaire Grenoble Alpes, Pôle Pharmacie, F-38000, Grenoble, France.,CNRS, TIMC-IMAG, UMR5525, F-38000, Grenoble, France.,Pham Ngoc Thạch University of Medicine, Hochiminh, V-70000, Vietnam
| | - Sébastien Chanoine
- Centre Hospitalo-Universitaire Grenoble Alpes, Pôle Pharmacie, F-38000, Grenoble, France.,CNRS, TIMC-IMAG, UMR5525, F-38000, Grenoble, France.,University Grenoble Alpes, F-38000, Grenoble, France
| | - Marion Lepelley
- Centre Régional de Pharmacovigilance, F-38000, Grenoble, France
| | - Mathieu Laramas
- Centre Hospitalo-Universitaire Grenoble Alpes, Pôle Cancer et maladies du sang, F-38000, Grenoble, France
| | - Aude Lemoigne
- Centre Hospitalo-Universitaire Grenoble Alpes, Pôle Pharmacie, F-38000, Grenoble, France
| | - Benoît Allenet
- Centre Hospitalo-Universitaire Grenoble Alpes, Pôle Pharmacie, F-38000, Grenoble, France.,CNRS, TIMC-IMAG, UMR5525, F-38000, Grenoble, France.,University Grenoble Alpes, F-38000, Grenoble, France
| | - Isabelle Federspiel
- Centre Hospitalo-Universitaire Grenoble Alpes, Pôle Pharmacie, F-38000, Grenoble, France
| | - Pierrick Bedouch
- Centre Hospitalo-Universitaire Grenoble Alpes, Pôle Pharmacie, F-38000, Grenoble, France.,CNRS, TIMC-IMAG, UMR5525, F-38000, Grenoble, France.,University Grenoble Alpes, F-38000, Grenoble, France
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23
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Karaoui LR, Chamoun N, Fakhir J, Abi Ghanem W, Droubi S, Diab Marzouk AR, Droubi N, Masri H, Ramia E. Impact of pharmacy-led medication reconciliation on admission to internal medicine service: experience in two tertiary care teaching hospitals. BMC Health Serv Res 2019; 19:493. [PMID: 31311537 PMCID: PMC6636006 DOI: 10.1186/s12913-019-4323-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 07/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Institute for Healthcare Improvement identifies medication reconciliation as the shared responsibility of nurses, pharmacists, and physicians, where each has a defined role. The study aims to assess the clinical impact of pharmacy-led medication reconciliation performed on day one of hospital admission to the internal medicine service. METHODS This is a pilot prospective study conducted at two tertiary care teaching hospitals in Lebanon. Student pharmacists who were properly trained and closely supervised, collected the medication history, and pharmacists at the corresponding sites performed the reconciliation process. Interventions related to the unintended discrepancies were relayed to the medical team. The main outcome was the number of unintended discrepancies identified. The time needed for medication history, and the information sources used to complete the Best Possible Medication History were also assessed. The unintended discrepancies were classified by medication class and route of medication administration, by potential severity, and by proximal cause leading to the discrepancy. For the bivariate and multivariable analysis, the dependent variable was the incidence of unintended discrepancies. The "total number of unintended discrepancies" was dichotomized into yes (≥ 1 unintended discrepancy) or no (0 unintended discrepancies). Independent variables tested for their association with the dependent variable consisted of the following: gender, age, creatinine clearance, number of home medications, allergies, previous adverse drug reactions, and number of information sources used to obtain the BPMH. Results were assumed to be significant when p was < 0.05. RESULTS During the study period, 204 patients were included, and 195 unintended discrepancies were identified. The most common discrepancies consisted of medication omission (71.8%), and the most common agents involved were dietary supplements (27.7%). Around 36% of the unintended discrepancies were judged as clinically significant, and only 1% were judged as serious. The most common interventions included the addition of a medication (71.8%) and the adjustment of a dose (12.8%). The number of home medications was significantly associated with the occurrence of unintended discrepancies (ORa = 1.11 (1.03-1.19) p = 0.007). CONCLUSIONS Pharmacy-led medication reconciliation upon admission, along with student pharmacist involvement and physician communication can reduce unintended discrepancies and improve medication safety and patient outcomes.
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Affiliation(s)
- Lamis R. Karaoui
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O. Box S-23, Byblos, Lebanon
| | - Nibal Chamoun
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O. Box S-23, Byblos, Lebanon
| | - Jessica Fakhir
- Saint George Hospital – University Medical Center, Pharmacy Department, Beirut, Lebanon
| | - Wael Abi Ghanem
- Saint George Hospital – University Medical Center, Pharmacy Department, Beirut, Lebanon
| | - Sarah Droubi
- Makassed General Hospital, Pharmacy Department, Beirut, Lebanon
| | | | - Nabila Droubi
- Makassed General Hospital, Pharmacy Department, Beirut, Lebanon
| | - Hiba Masri
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O. Box S-23, Byblos, Lebanon
| | - Elsy Ramia
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O. Box S-23, Byblos, Lebanon
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24
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Gillibert A, Griffon N, Schuers M, Hardy K, Elmerini A, Letord C, Staccini P, Darmoni SJ, Benichou J. Impact on medical practice of accessing pharmaceutical records. Int J Med Inform 2019; 121:58-63. [DOI: 10.1016/j.ijmedinf.2018.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/24/2018] [Accepted: 09/09/2018] [Indexed: 10/28/2022]
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25
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Stämpfli D, Baumgartner P, Boeni F, Bedouch P, Lampert ML, Hersberger KE. Translation and validation of a tool to assess the impact of clinical pharmacists' interventions. Int J Clin Pharm 2018; 41:56-64. [PMID: 30478493 DOI: 10.1007/s11096-018-0755-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/13/2018] [Indexed: 11/26/2022]
Abstract
Background The tool CLEO in French language is designed for estimating the potential relevance of pharmacists' interventions (PIs) in three independent dimensions with regard to process-related, clinical, economic, and humanistic impact. Objective We aimed to translate CLEO into German (CLEOde), to demonstrate its feasibility in daily practice, and to validate the German version. Setting Convenience sample of three Swiss hospitals with established clinical pharmacy services. Method We translated CLEO according to the ISPOR Principles of Good Practice. The potential relevance of PIs performed within a 13-day period of routine clinical pharmacy services was then estimated with CLEOde. Ten clinical pharmacists experienced with CLEOde subsequently completed a 19-item questionnaire to assess user's agreement on appropriateness, acceptability, feasibility, and precision of the tool. Additionally, each pharmacist evaluated 10 model cases with CLEOde. Main outcome measure User satisfaction; interrater reliability and test-retest reliability. Results CLEOde was used to estimate the potential relevance of 324 PIs. The reported time needed to complete a single estimation was less than 1 min. The use of CLEOde was seen as appropriate, acceptable, feasible, and precise. Interrater reliability was good for the clinical and economic dimensions and was poor for the organisational dimension; test-retest correlation was strong for all three dimensions with excellent to fair reliability. Conclusion We present CLEOde as a validated tool in German language suitable to estimate the potential relevance of PIs. After further refinement of the organisational dimension, CLEOde could provide a qualitative value to quantitative information on PIs.
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Affiliation(s)
- Dominik Stämpfli
- Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland.
| | - Pascal Baumgartner
- Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland
| | - Fabienne Boeni
- Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland
- Clinical Pharmacy, Solothurner Spitaeler AG, Olten, Switzerland
| | - Pierrick Bedouch
- Department of Clinical Pharmacy, Faculty of Pharmacy TIMC-IMAG/CNRS (UMR5525), University Grenoble Alpes, Grenoble, France
| | - Markus L Lampert
- Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland
- Clinical Pharmacy, Solothurner Spitaeler AG, Olten, Switzerland
| | - Kurt E Hersberger
- Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland
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