Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a collaborative deprescribing intervention by a pharmacist and a physician to multimorbid patients in a SMOC. A randomized controlled pilot study was conducted, with phone follow-up at 30 and 365+ days. A senior pharmacist performed a systematic deprescribing intervention using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, the Danish deprescribing list, and patient interviews. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 medication where deprescribing status was sustained 30 days after inclusion. Out of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% male; mean age 73 years; mean number of 10 prescribed medications). Nineteen patients (56%) in the intervention group and four (12%) in the control group had ≥1 medication where deprescribing status was sustained 30 days after inclusion (p = 0.015). In total, 37 medications were deprescribed in the intervention group and five in the control group. At 365+ days after inclusion, 97% and 100% of the deprescribed medications were sustained in the intervention and control groups, respectively. The three most frequently deprescribed medication groups were analgesics, cardiovascular, and gastrointestinal medications. In conclusion, a collaborative deprescribing intervention for multimorbid patients was feasible and resulted in sustainable deprescribing of medication in a SMOC.
(1) Objective: To assess hospital medication costs and staff time between One-Stop Dispensing (OSD) and the Traditional Medication System (TMS), and to evaluate patient perspectives on OSD. (2) Methods: The study was conducted at Hvidovre Hospital, University of Copenhagen, Denmark in an elective gastric surgery and acute orthopedic surgery department. This study consists of three sub-studies including adult patients able to self-manage medication. In Sub-study 1, staff time used to dispense and administer medication in TMS was assessed. Medication cost and OSD staff time were collected in Sub-study 2, while patient perspectives were assessed in Sub-study 3. Medication costs with two days of discharge medication were compared between measured OSD cost and simulated TMS cost for the same patients. Measured staff time in OSD was compared to simulated staff time in TMS for the same patients. Patient satisfaction related to OSD was evaluated by a questionnaire based on a five-point Likert scale (‘very poor’ (1) to ‘very good’ (5)). (3) Results: In total, 78 elective and 70 acute OSD patients were included. Overall, there was no significant difference between OSD and TMS in medication cost per patient ($2.03 [95% CI −0.57–4.63]) (p = 0.131). Compared with TMS, OSD significantly reduced staff time by an average of 12 min (p ≤ 0.001) per patient per hospitalization. The patients’ satisfaction for OSD was high with an average score of 4.5 ± 0.7. (4) Conclusion: There were no differences in medication costs, but staff time was significantly lower in OSD and patients were overall satisfied with OSD.
Background and importance Recent results showed that most European citizens want the European Union (EU) to provide more financial support to overcome the impact of the pandemic. Public health tops the priority list followed by economic recovery. Findings revealed that more than 75% of Europeans on average have heard about the measures taken by the EU against COVID-19 and a rising number of respondents are now satisfied with these measures. Simultaneously, a majority is nevertheless still not satisfied with the solidarity shown among EU member states during the crisis. What is the opinion of a non-EU country? Aim and objectives To explore and evaluate the national perception of a non-member state about the EU response to the COVID-19 pandemic, EU competences and budget, satisfaction with EU measures, solidarity among member and non-member states and personal circumstances and financial consequences of COVID-19. A survey was conducted (August-September 2020) in 164 randomly selected participants, aged 18-64 years. Material and methods The questionnaire consisted of eight adapted questions from the European Parliament specific survey 'Public opinion in the EU in time of coronavirus crisis 2'. The interviews were conducted by telephone. Results Around 63% of respondents had heard that the EU proposed various measures to fight the consequences of the COVID-19 pandemic, but more than half (57%) did not know what they were. Of those who were familiar with them, 40% reported satisfaction. Most respondents (72%) were not satisfied with the solidarity among EU and non-EU member states. Asked about the policy fields where this enlarged budget should be spent, public health was a priority (65%), followed by economic recovery and new opportunities for businesses (53%), and employment and social affairs (41%). A clear majority (79%) supported a larger budget to fight COVID-19. 75% of respondents reported experiencing personal financial difficulties. The feelings that best described their current emotional state were uncertainty (63%), helplessness (32%), fear (23%), hope (43%) and confidence (28%). Conclusion and relevance Public opinion in the time of COVID-19 did not differ significantly from the opinion of European citizens. However, most respondents were not satisfied with the solidarity among EU and non-EU member states. Personal financial difficulties remain significant.
SummaryThe development of the drug information services within the hospital area is described from its origin in America. The services currently available in the NHS are outlined and a description of the type of enquiries handled is given.
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