Background:In most health care facilities, problems related to delays in STAT medication order processing time are of common concern.Objective:The purpose of this study was to evaluate processing time for STAT orders at Kimball Medical Center.Methods:All STAT orders were reviewed to determine processing time; order processing time was also stratified by physician order entry (physician entered (PE) orders vs. non-physician entered (NPE) orders). Collected data included medication ordered, indication, time ordered, time verified by pharmacist, time sent from pharmacy, and time charted as given to the patient.Results:A total of 502 STAT orders were reviewed and 389 orders were included for analysis. Overall, median time was 29 minutes, IQR 16–63; p<0.0001.). The time needed to process NPE orders was significantly less than that needed for PE orders (median 27 vs. 34 minutes; p=0.026). In terms of NPE orders, the median total time required to process STAT orders for medications available in the Automated Dispensing Devices (ADM) was within 30 minutes, while that required to process orders for medications not available in the ADM was significantly greater than 30 minutes. For PE orders, the median total time required to process orders for medications available in the ADM (i.e., not requiring pharmacy involvement) was significantly greater than 30 minutes. [Median time = 34 minutes (p<0.001)].Conclusion:We conclude that STAT order processing time may be improved by increasing the availability of medications in ADM, and pharmacy involvement in the verification process.
Background The presence of a clinical pharmacist in a hospital's Emergency Department (ED) is important to decrease the potential for medication errors. To our knowledge, no previous studies have been conducted to evaluate the impact of implementing clinical pharmacy services in the ED in Qatar. Objective To characterize the contributions of clinical pharmacists in a short stay unit of ED in order to implement and scale-up the service to all ED areas in the future. Methods A retrospective study conducted for 7 months in the ED of Hamad General Hospital, Qatar. The intervention recommendations were made by clinical pharmacists to the physician in charge during medical rounds. Results A total of 824 documented pharmacist recommendations were analyzed. The interventions included the following: Providing information to the physician (24.4 %) and recommending medication discontinuation (22.0 %), dose adjustment (19.3 %), medication addition (16.0 %), changes in frequency of medications (7.6 %), medication resumption (5.7 %), and patient education (5.0 %). Conclusion Clinical pharmacists in the ED studied play an important role in patient care.
The effectiveness of dapagliflozin in the management of type-2 diabetes mellitus (T2-DM) is an essential issue for establishing a basis for prescribing dapagliflozin. This study aimed to assess the effectiveness of dapagliflozin in combination with other hypoglycemic agents (OHAs) in reducing glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) at 3, 6, 9 and 12 months. This retrospective observational study included all patients who visited the endocrine clinics at Hamad Medical Corporation (HMC) and were treated with dapagliflozin. Demographics and laboratory data were obtained retrospectively from computerized patient medical profiles (eMR-viewer). The main outcome measures were the differences in HbA1c and FBG from baseline at different months. Eighty-one Qatari patients were found to have received dapagliflozin during the study period; 72% of them (n = 58) were males, with a mean age of 57.0 ± 9.0 years and a mean baseline HbA1c of 9.0 ± 1.4%. Administration of dapagliflozin as an add-on therapy was found to decrease HbA1c significantly by 0.8 percentage point after 6 months (P = 0.006) and by 1.5 percentage point after 12 months (P = 0.062). FBG was significantly reduced at 6 months and 9 months (P = 0.001 and P = 0.03, respectively). Dapagliflozin effectively reduced the HbA1c level and FBG when used in combination with other OHAs or insulin within 6 to 12 months.
The question of what to do in such a situation is addressed. The possible causes of the erythema are discussed, as well as its management, and the literature is reviewed.
Background: Co-trimoxazole is a broad-spectrum antibiotic associated with hyperkalemia. Objective: To determine the incidence of hyperkalemia and its risk factors in patients receiving co-trimoxazole. Materials and Methods: A retrospective observational study involving all patients who received co-trimoxazole between 1 January 2012 and 1 January 2013 was conducted. Subjects were identified through a list generated from a computerized pharmacy system. The patients' demographic and clinical characteristics were retrieved from electronic medical records. Data were analyzed using univariate and multivariate logistic regression. Results: One hundred sixty-one patients fulfilled the eligibility criteria. Of these, 46 (28.6%) experienced hyperkalemia. Around 35 (76%) of the patients who experienced hyperkalemia received co-administered medications that might induce hyperkalemia. The coadministration of co-trimoxazole with other medications that may induce hyperkalemia was found to be associated with higher incidence of hyperkalemia when compared to cotrimoxazole administration alone [adjusted OR 3.2, 95% CI (1.4-7.3), p=0.005]. Additionally, age > 60 years was associated with an increased risk of hyperkalemia when compared to younger age group 18-39 years [adjusted OR 6.5, 95% CI (2.1-19.7); p=0.001]. Conclusion: Co-trimoxazole use is associated with high incidence of hyperkalemia, especially among older patients and those receiving it in combination with other medications that might contribute to hyperkalemia development such as calcineurin inhibitors and β-blockers.
While there is some evidence that migration to Western countries increases metabolic syndrome (MetS) risk, there is a lack of data pertaining to migration to the Middle East. This study aimed to investigate the relationship between migration and MetS incidence following 24-months of residency in Qatar and identify possible MetS determinants. Migrants to Qatar employed at Hamad Medical Corporation (the national health service) aged 18–65 years were invited to participate. Baseline and follow-up screening for MetS included HbA1c, triglycerides, HDL-cholesterol, blood pressure, and waist circumference. MetS-free migrants were rescreened 24-months post-migration, and the World Health Organization STEPwise questionnaire was administered, assessing changes in lifestyle from baseline. Of 1095 migrants contacted, 472 consented to participate, 205 of whom had normal metabolic parameters at baseline; 160 completed follow-up screening. Most participants were males (74.6%, n = 153) and Asian (81.0%, n = 166/205), and two thirds (66.3%, n = 136/205) were nurses. The incidence of new-onset MetS was 17.0% (n = 27/160, 95%CI; 11.0–23.0%), with 81.0% (n = 129/160, 95%CI; 73.8–86.0%) having at least one MetS element 24-months post-residency in Qatar. Male gender was a risk factor for MetS (adjusted odds ratio (AOR) = 3, p = 0.116), as was consuming medication that could induce MetS (AOR = 6.3, p < 0.001). There is merit in further research targeting these groups.
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