Assessment of drug administration via feeding tube and the knowledge of health-care professionals in a university hospital

Demirkan, Kutay; Bayraktar-Ekincioglu, Aygin; Gulhan-Halil, M.; Abbasoğlu, Osman

doi:10.1038/ejcn.2016.147

Cited by 21 publications

(17 citation statements)

References 10 publications

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“…9,10 Several studies have found that pharmacists provide added value in resolving and preventing DRPs in settings such as outpatient clinics, acute care in inpatients, nursing homes, and palliative care. 5,[11][12][13][14][15][16][17][18] Studies from inpatient settings have also shown that including a pharmacist as a member of the interdisciplinary health care team may improve outcomes and decrease drug-related readmissions and mortality in geriatric patients. 2,17,[19][20][21] As team members, pharmacists offer an additional perspective in the application of medication reviews, resulting in an increase in detection of DRPs and a reduction of polypharmacy in elderly inpatients.…”

Section: Introductionmentioning

confidence: 99%

<p>Evaluation of pharmacist interventions and commonly used medications in the geriatric ward of a teaching hospital in Turkey: a retrospective study</p>

Ertuna

Arun

et al. 2019

CIA

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Aging increases the prevalence of diseases. The elderly population is consequently often exposed to complex medication regimens. Increased drug use is one of the main reasons for drug-related problems (DRPs). The primary objective of this study was to define and classify DRPs, pharmacist interventions, and frequently prescribed medications in relation to possible DRPs in patients admitted to the geriatric ward of a teaching hospital in Turkey. Patients and methods: Pharmacist medication review reports for 200 orders of 91 patients (mean age: 80.33±0.46) were analyzed retrospectively. Results: A total of 1,632 medications were assessed and 329 interventions were proposed for possible DRPs in 156 orders. A total of 87.5% of the patients used five or more drugs (mean: 8.17±0.23). The number of DRPs per order was higher when polypharmacy was present (1.04±0.15 vs 1.66±0.11, P,0.05). In 71.31% of the cases, adverse drug events were recognized as the problem. The principal cause of possible DRPs was determined as drug interactions (40.12%). Only 22 potentially inappropriate medications were prescribed. The most common interventions included monitoring drug therapy (31.0%), stopping the drug (20.06%), and changing dosage (13.98%). The acceptance rate of pharmacist interventions by treating geriatrician was 85.41%. The most frequently prescribed drugs were for the nervous system, alimentary tract and metabolism, and cardiovascular system (n=358, 314, and 304, respectively). The pharmaceutical forms of 23 drugs were deemed inappropriate by pharmacists. Conclusion: Clinical pharmacy services are still not properly implemented in Turkey. The study highlights ways in which clinical pharmacy services can be instrumental in a geriatric ward. The high acceptance rates of pharmacist recommendations concerning a wide variety of DRPs and different classes of drugs indicate that advanced collaboration among geriatricians and pharmacists is possible in interdisciplinary geriatric assessment teams in Turkey.

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Section: Introductionmentioning

confidence: 99%

<p>Evaluation of pharmacist interventions and commonly used medications in the geriatric ward of a teaching hospital in Turkey: a retrospective study</p>

Ertuna

Arun

et al. 2019

CIA

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“…2 Another study carried out in Turkey pointed out that 40.5% of the medications administered via enteral feeding tubes were conducted incorrectly and that 17% of the nurses and 24% of the physicians knew that formulations with enteral coating cannot be crushed. 16 A case report published by Iranian authors identified lack of professional knowledge about the prescription and, consequently, of drug administration through this route, causing harms to the patients. 17 These research studies reflect the knowledge shortage of the professionals involved in health care and indicate the importance of adequate training to prevent errors.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of prescription containing medication via enteral feeding tubes in an adult emergency unit

Spezia¹,

Matheus²

2020

Rev Bras Farm Hosp Serv Saude

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Objective: This study aims to evaluate medication prescriptions to be used by a feeding tube in an emergency unit, identify and classify the problems with the prescriptions and suggest interventions, done by a pharmacist, when necessary. Also aims to develop a guide with information about administering medication through the feeding tube in order to help the health care team. Methods: the study is characterized as a quantitative cross-sectional study, with data collected during March to September of 2019 at an adult emergency unit, a total of 47 prescriptions were analyzed by a pharmacist and 138 drugs were prescripted to be administered through a feeding tube. Results: A total of 18.8% of those medications presented some restriction to be administered by the feeding tube. The most common problems observed were the loss or reduction of therapeutic effect present in 61,6% of the cases, followed by drug-food interactions with 30.8%. About the pharmaceutical intervention more performed was requesting to change the pharmaceutical form (36%), followed by orientation about stop the enteral feeding (30.2%). To the elaboration of the guide for the health care team, 181 medications standardized at the hospital were analyzed, of that 33.1% presented some restriction to administer by feeding tube and only 35% presented another pharmaceutical form for substitution. Conclusion: it was possible to note the importance of pharmaceutical evaluation of prescriptions to identify errors and prevent future problems assuring the patient’s safety. The guide elaboration sought to assist and optimize the process of medication administration by feeding tube guaranteeing the safety and effectiveness of pharmacotherapy.

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“…The potential for inadvertent exposure of healthcare professionals and patients to some immunosuppressive drugs is a severe hazard that is often neglected or unknown . The absence of an appropriate technique for the conversion of the dosage form may cause obstruction of the feeding tube, toxicity, drug interactions and other problems …”

Section: What Is Known and Objectivementioning

confidence: 99%

Immunosuppressives and enteral feeding tubes: An integrative review

et al. 2019

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What is known and objective: Immunosuppression is the main goal in the treatment of autoimmune diseases, chronic inflammatory diseases, and solid organ and tissue transplantation. However, due to a lack of liquid-form medications, it is challenging to achieve adequate immunosuppression when the patient is using enteral feeding tubes. It is necessary to transform solid oral medications into other forms for administration. Besides that, the occupational risk should be considered, and safetyhandling measures should be taken. This review aimed to investigate the available evidence regarding the use of immunosuppressive drugs through enteral feeding tubes, focusing on the administration technique, efficacy and treatment safety. Methods:We performed an integrative review using the databases PubMed, LILACS, SciELO, Cochrane and Google Scholar, including papers published between 1997 and 2017 in Portuguese, English and Spanish. We excluded editorials, theoretical reflections, abstracts presented at events, dissertations, theses, monographs and studies with extemporaneous formulations administered only by the oral route. In addition, we investigated the references of the included papers, as well as pharmaceutical guides, books and package inserts of selected drugs for additional evidence.Information and recommendations found were analysed and classified according to the GRADE system. Results and discussion:Fifty papers were identified, and 14 met the selection criteria. Among the assessed immunosuppressive drugs, we observed that tacrolimus, mycophenolic acid derivatives and azathioprine were the most studied, and they have more guided recommendations regarding their use through enteral feeding tubes.We noted the need for personal protective equipment for the conversion of the solid oral dosage forms, along with special caution during administration, due to occupational hazard. Other important factors identified were the position of the tube and interactions with the enteral nutrition, because they may compromise absorption, bioavailability and serum blood levels of immunosuppressive agents. However, the studies found have methodological limitations and poor quality, and this was taken into consideration during the classification of the evidence. | 409 e SILVA et AL.

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Assessment of drug administration via feeding tube and the knowledge of health-care professionals in a university hospital

Cited by 21 publications

References 10 publications

<p>Evaluation of pharmacist interventions and commonly used medications in the geriatric ward of a teaching hospital in Turkey: a retrospective study</p>

<p>Evaluation of pharmacist interventions and commonly used medications in the geriatric ward of a teaching hospital in Turkey: a retrospective study</p>

Evaluation of prescription containing medication via enteral feeding tubes in an adult emergency unit

Immunosuppressives and enteral feeding tubes: An integrative review

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