Purpose
Computerised prescriber (or physician) order entry (CPOE) implementation is one of the strategies to reduce medication errors. The extent to which CPOE influences the incidence of chemotherapy-related medication errors (CMEs) was not previously collated and systematically reviewed. Hence, this study was designed to collect, collate, and systematically review studies to evaluate the effect of CPOE on the incidence of CMEs.
Methods
A search was performed of four databases from 1 January 1995 until 1 August 2019. English-language studies evaluating the effect of CPOE on CMEs were selected as per inclusion and exclusion criteria. The total CMEs normalised to total prescriptions pre- and post-CPOE were extracted and collated to perform a meta-analysis using the ‘meta’ package in R. The systematic review was registered with PROSPERO CRD42018104220.
Results
The database search identified 1621 studies. After screening, 19 studies were selected for full-text review, of which 11 studies fulfilled the selection criteria. The meta-analysis of eight studies with a random effects model showed a risk ratio of 0.19 (95% confidence interval: 0.08–0.44) favouring CPOE (I2 = 99%).
Conclusion
The studies have shown consistent reduction in CMEs after CPOE implementation, except one study that showed an increase in CMEs. The random effects model in the meta-analysis of eight studies showed that CPOE implementation reduced CMEs by 81%.
Objectives: To assess the arterial stiffness index (ASI) and pulse wave velocity (PWV) in patients with hypertension and to compare with age matched healthy controls; to assess and compare the ASI and PWV in relation to the treatment status. Methods: The study was observational-cross sectional. Group one included chronic hypertensive patients on regular treatment for more than 2 months; group two included newly diagnosed hypertensive patients and group three had age matched healthy controls with normal blood pressure. The hypertensives subjects with other comormid conditions such as renal disease, diabetes were excluded from the study. The study was approved by the Institute Ethics Committee. The subjects were interviewed and explained the purpose of the study. All subjects gave written informed consent. The noninvasive periscope device was used to measure PWV, ASI and pulse pressure. Results: PWV, ASI and pulse pressure were statistically higher in hypertensive patients when compared to controls. Further, carotid-femoral PWV was correlated with mean arterial pressure in hypertensive subjects and was found to be statistically significant. Conclusion: PWV, ASI and pulse pressure are significantly higher in chronic and newly diagnosed non-diabetic hypertensives as compared to controls irrespective of their treatment status. S. Kola et al.
Pediatric cancer treatment has evolved significantly in recent decades. The implementation of risk stratification strategies and the selection of evidence-based chemotherapy combinations have improved survival outcomes. However, there is large interindividual variability in terms of chemotherapy-related toxicities and, sometimes, the response among this population. This variability is partly attributed to the functional variability of drug-metabolizing enzymes (DME) and drug transporters (DTS) involved in the process of absorption, distribution, metabolism and excretion (ADME). The DTS, being ubiquitous, affects drug disposition across membranes and has relevance in determining chemotherapy response in pediatric cancer patients. Among the factors affecting DTS function, ontogeny or maturation is important in the pediatric population. In this narrative review, we describe the role of drug uptake/efflux transporters in defining pediatric chemotherapy-treatment-related toxicities and responses. Developmental differences in DTS and the consequent implications are also briefly discussed for the most commonly used chemotherapeutic drugs in the pediatric population.
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