Investigating the Frequency and Nature of Medication-Related Problems in the Women’s Health Unit of an Australian Tertiary Teaching Hospital

Thompson, Rebecca; Whennan, Lisa D; Liang, Jasmine; Alderman, Chris; Grzeskowiak, Luke E.

doi:10.1177/1060028015581009

Cited by 16 publications

(52 citation statements)

References 27 publications

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“…In addition, studies in non-pregnant patients have shown the effectiveness of pharmacists' counselling on medication adherence, persistence, clinical management and therapeutic outcomes [16][17][18][19][20][21][22]. This is important since two recent studies have shown medication-related problems (MRP) frequently occur among pregnant women [23,24]. These MRP were largely resolved by pharmacists correcting misperceptions, providing information, and empowering the women to make safe decisions about medication use [23].…”

Section: Introductionmentioning

confidence: 99%

Women’s Beliefs About Medicines and Adherence to Pharmacotherapy in Pregnancy: Opportunities for Community Pharmacists

Ceulemans

Lupattelli

Nordeng

et al. 2019

CPD

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BackgroundDuring pregnancy women might weigh benefits of treatment against potential risks to the unborn child. However, non-adherence to necessary treatment can adversely affect both mother and child. To optimize pregnant women's beliefs and medication adherence, community pharmacists are ideally positioned to play an important role in primary care. ObjectiveThis narrative review aimed to summarize the evidence on 1) pregnant women's beliefs, 2) medication adherence in pregnancy, and 3) community pharmacists' counselling during pregnancy. MethodThree search strategies were used in Medline and Embase to find original studies evaluating women's beliefs, medication adherence and community pharmacists' counselling during pregnancy. All original descriptive and analytic epidemiological studies performed in Europe, North America and Australia, written in English and published from 2000 onwards were included. ResultsWe included 14 studies reporting on women's beliefs, 11 studies on medication adherence and 9 on community pharmacists' counselling during pregnancy. Women are more reluctant to use medicines during pregnancy and tend to overestimate the teratogenic risk of medicines. Risk perception varies with type of medicine, level of health literacy, education level and occupation. Furthermore, low medication adherence during pregnancy is common. Finally, limited evidence showed current community pharmacists' counselling is insufficient. Barriers hindering pharmacists are insufficient knowledge and limited access to reliable information. ConclusionConcerns about medication use and non-adherence are widespread among pregnant women. Community pharmacists' counselling during pregnancy is insufficient. Further education, training and research are required to support community pharmacists in fulfilling all the opportunities they have when counselling pregnant women.

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Section: Introductionmentioning

confidence: 99%

Women’s Beliefs About Medicines and Adherence to Pharmacotherapy in Pregnancy: Opportunities for Community Pharmacists

Ceulemans

Lupattelli

Nordeng

et al. 2019

CPD

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“…MRPs were classi ed into eight categories: need for additional drug therapy, unnecessary drug therapy, dose too low, dose too high, ineffective drug, adverse drug reactions, noncompliance [1], and other, subdivided into need for additional laboratory test and/or incomplete drug order (Additional le 1) [3].…”

Section: Mrp Identi Cation and Assessmentmentioning

confidence: 99%

“…A panel of experts comprised of senior clinical pharmacists and experienced obstetricians/gynaecologists identi ed MRPs and classi ed them into categories as recommended by Cipolle et al [22]. The panel of experts further re ned the MRP identi cation and classi cation method for the study setting in accordance with Ethiopian standard treatment guidelines and literature reviews (Additional le 1) [3,[23][24][25][26].…”

Section: Mrp Identi Cation and Assessmentmentioning

confidence: 99%

“…The clinical signi cance of each MRP was classi ed as low (level 1) or moderate/severe (level 2) [3].…”

Section: Mrp Identi Cation and Assessmentmentioning

confidence: 99%

“…A medication-related problem (MRP) is de ned as an unwanted event or circumstance involving medication therapy that actually or potentially interferes with desired health outcomes [1,2]. Studies have shown that the prevalence of MRPs among hospitalized pregnant patients varies from 42-83% [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Medication-related problems among hospitalized pregnant women in a tertiary teaching hospital in Ethiopia: A prospective observational study

AHMED

Sundby

Aragaw

et al. 2020

Preprint

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Background Studies on medication-related problems (MRPs) among pregnant women are scarce, despite the potential consequences for both mother and child. This study aimed to describe the prevalence, clinical significance, and risk factors for MRPs among hospitalized pregnant or postpartum women at Jimma University Medical Centre (JUMC) in Ethiopia. Methods A prospective follow-up and clinical audit of 1,117 hospitalized pregnant or postpartum women in the maternity and gynaecology wards at JUMC was carried out between February and June 2017. Patients were followed throughout their stay in the hospital to assess the presence and development of MRPs. Pre-tested data extraction form and an interview-guided structured questionnaire were used to collect data. Descriptive statistics were used to describe MRPs. Logistic regression analysis was used to identify factors associated with MRPs. Results One or more MRPs occurred among 323 (28.9%) study participants, mostly in relation to lack of iron supplementation. A total of 278 (70.6%) of all MRPs were considered to be of moderate to high clinical significance. Nulliparous women were more likely to experience MRPs than their counterparts (adjusted OR 1.82; 95% CI 1.23, 2.69). When excluding MRPs due to iron from the analysis, nulliparous women (adjusted OR 1.99; 95% CI 1.22, 3.24) and previous medication use were significantly associated with experiencing an MRP (adjusted OR 2.38; 95% CI 1.24, 4.56). Conclusions Nearly 3 out of 10 hospitalized pregnant women at JUMC had one or more MRPs. The need for additional iron therapy was by far the most common type of MRP. Improved adherence to guidelines on iron supplementation are required. Multidisciplinary approaches including physicians, nurses, and clinical pharmacists in the maternity and gynaecology wards could possibly prevent MRPs and promote patient safety for women and children.

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Analysis of clinical intervention records by pharmacists in an Australian principal referral and specialist women's and newborns' hospital

Teoh

Hattingh

Lebedevs

et al. 2017

Pharmacy Practice and Res

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Aim: The objectives of this study were to evaluate clinical interventions recorded by pharmacists in an Australian principal referral and specialist women's and newborns' hospital, as well as to identify common medications involved in each specialty area (neonatology, obstetrics and gynaecology), to assess the risks of medication-related problems (MRPs) likely to have been prevented, and to obtain institution-specific MRPs for future staff education. Methods: This retrospective, observational study involved an analysis of all interventions documented by pharmacists from January 2005 to December 2014. The interventions recorded were collated according to ward, medication involved, description of the intervention and the risk classification. Results: There were a total of 14 085 interventions documented over 10 years; 60.33% made in obstetric patients, 28.71% in gynaecology patients and 10.96% in neonates. The three main intervention types were: (i) dose/frequency/time incorrect (25.70%, n = 3260); (ii) prescribing clarification (21.77%, n = 3066); and (iii) medicine omission (15.21%, n = 2143). An average of 12.02% of the interventions were regarded as high-risk and 0.85% as extreme-risk. Of the MRPs documented within each specialty, the prevalence of extreme risk interventions was higher in the neonatal ward. Discussion: The most common intervention was identifying incorrect medication dose/frequency/time. Common medications involved in the MRPs included: opioids and antihypertensives in gynaecology; parenteral nutrition and gentamicin in neonatology; and opioids and non-steroidal anti-inflammatory drugs (NSAIDs) in obstetrics. The medications involved in high and extreme risk MRPs included gentamicin, opioids and NSAIDs. Conclusion: This study demonstrates that hospital pharmacists contribute to the reduction of MRPs, including some potentially fatal adverse medicine events. These findings also enable targeted, site-specific education, which is valuable in improving patient safety. Analysis of pharmacists interventions ina women's and newborns' hospital 1 (1.8) Antiviral 1 (1.8) GORD = gastro-oesophageal reflux disease; NSAIDs = nonsteroidal anti-inflammatory drugs. Only the ten most common medications are reported for each specialty each year. Analysis of pharmacists interventions in a women's and newborns' hospital 141 (86.57) 894 (72.1) 1848 (70.53) NSAIDs = nonsteroidal anti-inflammatory drugs.

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Investigating the Frequency and Nature of Medication-Related Problems in the Women’s Health Unit of an Australian Tertiary Teaching Hospital

Abstract: The widespread nature of identified MRPs in this setting suggests that various approaches to minimizing these problems and mitigating the associated burden on the health care system are warranted.

Cited by 16 publications

References 27 publications

Women’s Beliefs About Medicines and Adherence to Pharmacotherapy in Pregnancy: Opportunities for Community Pharmacists

Women’s Beliefs About Medicines and Adherence to Pharmacotherapy in Pregnancy: Opportunities for Community Pharmacists

Medication-related problems among hospitalized pregnant women in a tertiary teaching hospital in Ethiopia: A prospective observational study

Analysis of clinical intervention records by pharmacists in an Australian principal referral and specialist women's and newborns' hospital

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