Search

AIM: To determine which types of clinical pharmacy interventions are needed at a small rural 360-bed hospital in Austria, and to assess the physicians' acceptance rate of the pharmacists' suggestions. METHODS: Data on interventions made by one clinical pharmacist were collected over a six-month period and rated on a six-point clinical significance scale. A subset of 30 interventions was rated for clinical significance by four independent consultants to determine inter-rater reliability. RESULTS: During the six-month period, 255 clinical pharmacy interventions were made. In a subset of 159 patients, 95 met the criteria for medication review which resulted in 140 interventions being made. Clinical pharmacy input was needed by 59.8% (98/159) of patients, requiring on average 1.5 interventions per patient. Acceptance rate was 59.6% (152/255), a change was considered by the physician involved, but not immediately followed through with in 40.0% (102/255). Average score for clinical significance intervention rating was 2.18. Inter-rater reliability (IRR) agreement was 'good' between the four consultants, and the four consultants with the pharmacist, respectively. CONCLUSION: Clinical pharmacy services (CPS) are needed and well accepted in Austrian hospitals. The clinical pharmacist is a missing member of the multidisciplinary ward team, a key player in reducing adverse drug reactions and improving patient safety, enabling treatment to become more holistic and patient-centred. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the reasons why medicines-related harm remains an issue • To refresh your knowledge of the aims of medicines optimisation • To identify potential strategies that you could use in your area of practice to reduce the risk of medicines-related harm Effective medicines optimisation involves the use of medicines to control disease while ensuring that adverse effects are kept to a minimum. However, medicines-related harm and symptom mismanagement represent significant risks to patients, particularly those with long-term conditions. These risks are accentuated by inadequate patient monitoring, with some nurses and other healthcare professionals being unaware of their responsibility to monitor patients and avoid medicines-related harm. This article explores strategies that will enable nurses to take an increasingly active role in medicines optimisation. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To be aware of the risks and adverse events that can occur at various points of patient transfer • To understand the importance of ensuring continuity of care for patients with diabetes mellitus • To ensure effective practice and patient care throughout the healthcare pathway Diabetes mellitus is a common long-term condition that requires careful monitoring and management. Patients with long-term conditions are often transferred between healthcare settings, for example: during admission to hospital from the community; transfer between hospital wards or inpatient departments; discharge from hospital into the community; and possible readmission to hospital. During the healthcare pathway of a patient with diabetes, there are frequent opportunities for treatment errors or miscommunication to occur, particularly related to medicines such as insulin. Therefore, it is important for nurses to develop effective communication skills to provide continuity of care as patients with diabetes navigate the healthcare pathway. This article examines the potential transfer points in the patient's healthcare pathway and discusses how effective diabetes care can be maintained throughout these transitions. [ABSTRACT FROM AUTHOR]

Communication breakdowns among health care providers, a lack of patient education, and medication reconciliation errors are a few examples.3 Medication therapy management (MTM) can help improve patient outcomes involving TOC.3 Because documentation of medication lists is a key component of MTM, pharmacists are well positioned to incorporate this into TOC. Patients moving from one health care provider or setting to a different one, which can increase the risk of adverse events related to communication about issues such as discharge medications.1 Approximately 1 in 5 patients receiving Medicare who are discharged from the hospital are readmitted within 30 days.1 Pharmacists can play a key role in TOC to improve patient health outcomes (Figure1-5). [Extracted from the article]

Pharmacist involvement in managing patients with HCV andHIV has resulted in improved medication adherence and follow-upthrough multidisciplinary care.2 Medication reconciliation is another significant role that pharmacistscan fulfill as drug experts. MTM Consult | MEDICATION THERAPY MANAGEMENT TODAY® IMMUNIZATION FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) focus on providingservices at outpatient clinics, typically for underserved patientpopulations.1 Examples of FQHCs include community health centers, healthcare at centers for unhoused individuals, migrant health centers, andpublic housing primary-care centers. [Extracted from the article]

If a patient's medication list is inaccurate, the patient may receive an incorrect medication or dose, receive a medication too soon or too late if the time of their last dose is inaccurate, receive inappropriate or duplicate therapies, or not receive a critical medication. A fter documenting themedication list in the EHR, ensure the medication and doses are the correct therapy for that patient, given the patient's current state ofhealth, or seek clarification. [Extracted from the article]

Nursing students, nurses and other healthcare professionals involved in prescribing, dispensing, administration and monitoring of medicines should be able to navigate and use the British National Formulary (BNF) effectively. Recent changes to the structure of the BNF have resulted in new symbols, additional sections in drug and drug-class monographs, and a reduction in the amount of cross-referencing between chapters. This article explores how healthcare professionals can access the information in the BNF to ensure that medicines use is optimised, therapeutic effects are maximised, and adverse drug reactions and drug interactions are minimised. [ABSTRACT FROM AUTHOR]

This article discusses case studies of U.S. hospitals and a physician network that explore different ways to enhance clinical integration in order to improve the quality of patient care and, in the process, reduce unnecessary costs. The hospitals mentioned in the case studies include Abington Memorial Hospital in Pennsylvania, the Michigan health care system Spectrum Health, and Coast Healthcare Management in California. Mentioned also are the lessons they learned on clinical integration.

The author shares his theory to explain the differences in burnout between ophthalmologists and primary care physicians. He believes that primary care physicians experience more burnout because they spend most of their time performing various administrative tasks, while ophthalmologists spend almost the entire day with their patients. The need to restructure medical training programs is suggested.

In email interviews, Ahzam Afzal, PharmD, CEO ofFrontizo, an outpatient care coordination companyin Bingham Farms, Michigan, and Nicole Elharar,PharmD, BCPS, BCPP, a clinical pharmacy specialistat the West Palm Beach Veterans Affairs HealthcareSystem in Florida, discussed the pharmacist's role inParkinson disease (PD) management. Pharmacists interested in starting PD clinicsshould consider offering a variety of ways to performconsults, including telehealth services andvideo appointments, Elharar advised. Changing psychotropic medications that areexacerbating PD symptoms or interacting withPD medications are the most common clinicalinterventions she performs. [Extracted from the article]

The article discusses a study by Tavish Nanda of Columbia University that investigated the rate of intra-ocular pressure (IOP) medication noncompliance among aging glaucoma patients. The study found that glaucoma treatment incurs a high rate of medication noncompliance in the elderly that occurs mostly during transition of care from hospital to nursing home or assisted living facilities. It suggest that emphasis on appropriate medical reconciliation will improve rates of noncompliance.

In the article, the author offers tips on how to ensure that medicines are not wasted or over-ordered by patients and their families. He claims that the current practice in the National Health Service (NHS) in Great Britain is buying a 28-day supply of medicine. He also cites some reasons why medicines are wasted like changing prescription from branded to generic drugs. Also cited is the importance of regular medication reviews to determine if patients are satisfied with their medicine.

The article focuses on the importance of medication reconciliation in care transition process and role of pharmacists in the reconciliation process. Topics discussed include definition of medical reconciliation developed by American Pharmacists Association and the American Society of Health-System Pharmacists; need to promote engagement of community pharmacists in reconciliation; and community pharmacists interacting directly with patients through medication therapy management (MTM).

A letter to the editor is presented in response to the article "A Hybrid Approach to Avoiding Readmissions" by Steven Counsell in the April 9, 2015 issue.

The article presents updates related to the safe use of medicines. The Health Survey for England report indicates that half of women and 43% of men in the country regularly take prescription drugs, with statins, antidepressants, and analgesics. The National Institute for Health and Care Excellence (NICE) has published guidance on the use of medicines, which include systems for identifying and reporting medicines-related patient safety incidents, self-management plans, and medication reviews.

A CPD article improved Clio Badenhorst's approach to collaborative care of patients in the later stages of dementia. [ABSTRACT FROM AUTHOR]

The article presents information on medication reconciliation, a form of brown bagging and medication therapy management (MTM). Medication reconciliation can help hospital pharmacists avoid error when a patient's medications include prescription and over-the-counter (OTC) drugs, herbals and dietary supplements. It is noted that the objective of a brown bag session is the discovery of discrepancies which will allow pharmacists to make suggestions.

The article discusses the various types of medication therapy management (MTM), a medical service by a certified pharmacist to ensure that one gets the full benefits of ones' medications. MTM certified pharmacists are said to be a patient's advocate for improving his lifestyle. This type of MTM is said to be comprehensive, documented and involves following-up with patients. Other types of MTM are target MTM and medication reconciliation.

The article discusses a survey conducted by the Institute for Safe Medication Practices that identified barriers that prevent community pharmacies and emergency department (ED) from conducting medication reconciliation. The survey assessed the awareness of medication reconciliation and determined the degree of communication between community pharmacies and EDs.