BackgroundAudits of the drug prescribing process in hospitals can help to identify problematic fields in relation to drug treatment. This can increase patient safety by preventing potential medicines errors.PurposeTo quantify the frequency of drug-related problems (DRPs) and assess consequent interventions in hospitalised patients.Material and methodsThe study took place in the vascular and general surgery ward over a 6-week period in 2014. Medicines recorded on patient charts were reviewed by a pharmacy resident in order to identify DRPs. DRPs of chronic medicines and those newly prescribed during the stay in hospital were assessed. Interventions were also recorded. The number of chronic medicines (i.e. including polypharmacy status: taking ≥6 medicines) in relation to DRPs were analysed (SPSS, T-test).ResultsMedicines of 171 patients (vascular surgery: 105, general surgery: 66) were assessed. Overall 123 DRPs were identified from 89 patients. Majority (68%, 84 cases) of DRPs were related to newly prescribed medicines while the rest (32%, 39 cases) were related to chronic medicines. In case of chronic medicines the most frequent type of error (71%) was inaccuracy of product strength or recording of dosing regimen. In newly prescribed drugs the lack of daily update on patient charts was the most frequent DRP (60%). The most frequent types of intervention were clarification of dosage/dosing regimen (60 cases) and clarification of the necessity for daily dosing (50 cases). Association was found between the number of medicines and DRPs: firstly, patients with polypharmacy had significantly higher chances of DRPs (OR: 2.45, 95% CI: 1.14–5.26; p = 0.020), secondly, in the vascular surgical ward, the average number of chronic medicines per patient was significantly higher when DRPs were found (7.1 ± 4.5 vs. 8.9 ± 3.5, p = 0.03).ConclusionWe identified drug-related problems (DRPs) in every second patient. Pharmacists are able to detect and solve DRPs and prevent potential medicines errors.ReferencePCNE Classification of DRP V 6.2No conflict of interest.
BackgroundAnaemia is a common, multifactorial condition among elderly patients and associated with harmful consequences regarding hospitalisation, morbidity and mortality.PurposeThe aim of the study was to assess the prevalence of anaemia among elderly, hospitalised patients, and to compare the anaemic and non-anaemic patient group to determine which possible factors are associated with the development of this condition.Material and methodsPatients (≥65 years) admitted and operated with low energy, osteoporotic hip fractures from January 2011 to December 2012 were included. Anaemia was detected according to WHO criteria (haemoglobin level below 130 g/L in males and below 120 g/L in females). A retrospective analysis was performed on data recorded from the patient charts and documentation, including the following information: baseline patient characteristics, blood count outcome before surgery, chronic medications and 3 month mortality.ResultsFour hundred and twenty-one patients met the inclusion criteria (100 males, 321 females; mean age: 81.97±7.28 years). Two hundred and eleven patients (50.12%) were anaemic at admission and 20.9% of the patients had moderate or severe anaemia. The prevalence of anaemia was significantly higher among males, than females (62% vs. 46.42%; p=0.009). Among the anaemic group female patients more often suffered from moderate or severe anaemia than male patients. The presence of anaemia was increasing with age. The prevalence of polypharmacy was 80.09% and anaemic patients were taking significantly more chronic medications than non-anaemic patients (7.71 vs. 6.58; p=0.002). Proton pump inhibitor use was significantly higher among anaemic patients (36.49% vs. 26.19%; p=0.029). 65.4% of the anaemic patients and 30.95% of the non-anaemic patients received blood transfusion during the hospital stay. Thirty-six patients (8.55%) died within 3 months after hospital admission and there was no difference between anaemic and non-anaemic groups.ConclusionThe prevalence of preoperative anaemia was high among the studied patients. Although hip fracture itself may slightly contribute to anaemia, there can be numerous factors and underlying causes of anaemia. It is important to reveal the causes of anaemia and treat it accordingly.No conflict of interest
BackgroundOral anticoagulants (OAC) play a crucial role in preventing thromboembolic diseases. However, these medications may carry numerous problems and risks while applied. Patients taking oral anticoagulants may have a higher risk of bleeding during a surgical intervention.PurposeOur aim was to analyse the risks that patients on oral anticoagulant therapy may have during their hospitalisation and surgical procedure.Material and methodsPatients were recruited from the traumatology department, admitted with osteoporotic hip fractures. A retrospective analysis was performed for the period between January 2011 and August 2012. Data were recorded from the patient charts and documentation. Data comparison was made regarding the risks of patients on OAC and of patients not taking oral anticoagulants (control group).Results510 patients were enrolled in this study (133 males, 377 females), mean age 79.68 ± 9.81 years (mean ± SD). On admission, 49 patients were taking OAC (14 males, 35 females, mean age 80.88 ± 10.04 years), which was acenocumarol. 119 men and 342 women (mean age 79.56 ± 7.22 years) were included in the control group. In the OAC group, more time elapsed between the admission date and the surgical procedure: 3.43 days (±2.30 days) versus 1.74 days (±2.21 days) in the control group (p ≤ 0.001). At the same time, there was no substantial difference in the length of operation between the two groups: 1 h 54 min versus 1 h 50 min. Following the surgical intervention, the mean length of hospital stay did not differ significantly between the two groups (11.24 days). Complications during the surgical procedure and/or hospital stay occurred in 57.1% in the OAC group and in 51.8% of controls. During the hospital stay, 53.1% of the OAC group received blood transfusion compared with 45.3% of the control group. Mortality rate was 8.16% in OAC patients versus 3.14% in the control group. Autopsy confirmed cause of mortality was not available.ConclusionAlthough the overall hospital stay did not differ significantly, considerable differences were seen regarding length of time elapsed until surgery, complication rate and mortality rate between the OAC and control groups. The higher mortality rate highlights the frailty of patients receiving oral anticoagulant therapy.No conflict of interest.
Background The Septic Ward treats patients with bone-, jointand prosthetic-joint infections. The treatment of these infections requires complex, long-term antibiotic therapies. Clinical pharmacy services were introduced in 2015. This included
CASP checklists. The success characteristics were extracted from the eligible articles. Results: The search returned with 1833 articles with 944 excluded for duplicates, non-relevance, study design and endpoints, and publication types after initial review. Preliminary result showed that diabetes, cardiology and obesity were the most common target disease areas for digital technology implementation. The most used digital technology were mobile applications, wearables, and web-based intervention, with artificial intelligence is increasingly studied. Publications on industry-sponsored trials, digital technology in clinical trials and as specific treatment companion are limited. The endpoints for outcome measurement and result of digital technology in improving patients' quality of care vary. The success factors for digital technology implementation are quality of care achievement (effective, efficient, accessible/ coverage, and standardized) and positive user experience (usability, acceptability, non-interference and reliability). Conclusions: Digital technology is increasingly used in healthcare settings and showed promising benefits to measure and improve patient outcome. Patients' insights, system standardization and validation are crucial for the success of digital solution. A standardized and robust study design is required to demonstrate the impact of digital technology on patients' quality of care.
vancomycin/metronidazol), days and regimen of treatment, recurrence or death at 8 weeks. Risk factors evaluated: age >65 years, use of antibiotics in the previous 3 months, ICD in the last 6 months, severe disease (oncological patient, immunosuppressed, renal failure). Tapered dosage of fidaxomicin oral was defined as 200 mg/12 hours (5 days) and 200 mg/48 hours (D7-D25).Data were obtained from the pharmacy dispensation program and the patients' digital clinical records. Results Forty-one patients were included, 25 women (61%), mean age 69 (21-99) years, 73.2% (n=30) were older than 65 years. 95.1% (n=39) had received antibiotics in the previous 3 months, 51.2% (n=21) had suffered CDI in the last 6 months, 60.9% (n=26) had severe baseline disease and 21.9% (n=9) were immunosuppressed. As first line, 41.4% (n=17) received vancomycin and metronidazole, 44% (n=18) received vancomycin and 14.6% (n=6) received fidaxomicin. 63.4% (n=26) received fidaxomicin 200 mg/12 hours (10 days), in 14.6% (n=9) the extended regimen was used and 22% (n=6) received 200 mg/12 hours for longer. 82.9% (n=34) of fidaxomicin-treated patients had no CDI recurrence at 8 weeks. 22% (n=9) of the patients died. Nine fidaxomicin-treated patients were administered bezlotuxumab and none subsequently developed CDI. All were older than 65 years and 66.6% (n=6) were oncology patients. Conclusion and relevanceThe CDI treatment was mostly adjusted to the recommendedations in the therapeutic guidelines, with vancomycin/metronidazole as first-line and fidaxomicin in recurrences. The use of bexlotuxumab was adapted to the considerations of the Therapeutic Positioning Index and was used in patients with a higher risk of recurrence.Although in the pivotal studies the recurrence rate with bexlotuxumab was 16.5%, in our study there were no recurrences. In the case of fidaxomicin, the recurrence rate was 17.1%, which was higher than the published studies.Limitations: small sample size and the impact of the joint use of bexlotuxumab and fidaxomicin has not been measured.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.