Liability Associated With Prescribing Medications

Edersheim, Judith G.; Stern, Theodore A.

doi:10.4088/pcc.08r00717

Cited by 20 publications

(14 citation statements)

References 6 publications

(4 reference statements)

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“…General practitioners (GPs) have the responsibility for patients’ health and safety, including their PD [13]. Their responsibility regarding DS is less clear [4].…”

Section: Introductionmentioning

confidence: 99%

Pharmacy employees’ involvement in safeguarding persons with dementia who use dietary supplements: Results from a survey of Norwegian pharmacies

Risvoll

Halvorsen

Giverhaug

et al. 2019

BMC Complement Altern Med

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Background Community-dwelling persons with dementia commonly use dietary supplements (DS), often without receiving help with the administration. Patient safety is a concern, as DS-drug interactions and adverse events are potential complications. Since many persons with dementia buy their DS in pharmacies, we investigated Norwegian pharmacy employees’ attitudes and professional practice behaviors related to DS. Methods We conducted a survey in eight Norwegian municipalities of pharmacy employees involved in the sale of DS. The questionnaire covered demographics and investigated attitudes toward DS, professional practice behaviors related to the sale of DS, experiences with customers with dementia, and perceived and attributed responsibilities with regard to patient safety. Results One hundred and five employees responded (response rate: 52%). Most employees regarded general practitioners (GPs) as primarily responsible for safeguarding the use of DS by persons with dementia and rated themselves less responsible. Thirty-seven percent of the employees reported personal use of DS (past or current use). Nine percent considered some of the DS to have symptomatic or prophylactic effects against dementia. Forty-eight percent confirmed that they informed customers about potential adverse events; 42% indicated that they did this sometimes. Sixteen percent checked regularly for DS-drug interactions, and two-thirds checked depending on the customers’ health, the type of drug or the type of DS. One-quarter regularly asked about the co-use of prescription drugs (PD) when selling DS, while only 2% asked about the co-use of DS when dispensing PD. Only 25% reported access to independent scientific information on all or most DS sold in their pharmacy. Eight percent had experienced unsafe use of DS by persons with dementia. Six percent had been taught about counselling persons with dementia. Education level influenced professional practice behavior to some extent. Conclusion Pharmacy employees do not see themselves as primarily responsible for the safe use of DS by persons with dementia. Moreover, they have limited experience with the unsafe use of DS by these persons. There is potential for improvement regarding tools and educational interventions for pharmacy employees to provide sufficient help to persons with dementia who use DS. Electronic supplementary material The online version of this article (10.1186/s12906-019-2587-4) contains supplementary material, which is available to authorized users.

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“…General practitioners (GPs) have the responsibility for patients’ health and safety, including their PD [13]. Their responsibility regarding DS is less clear [4].…”

Section: Introductionmentioning

confidence: 99%

Pharmacy employees’ involvement in safeguarding persons with dementia who use dietary supplements: Results from a survey of Norwegian pharmacies

Risvoll

Halvorsen

Giverhaug

et al. 2019

BMC Complement Altern Med

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“…When a new medicine is released, the benefit‐risk ratio based on randomized trials conducted before release will change due to the wider prescription. At first, physicians follow the authorized treatment recommendations (the label), possibly supplemented by guidance from scientific societies and governmental bodies . Incentives for physicians for off‐label treatment can also be obtained from scientific publications, or they could be communicated through colleagues via their professional network .…”

Section: Introductionmentioning

confidence: 99%

Identifying Off‐Label Prescriptions Through Data Mining in Danish Community Pharmacy Servers: An Exploratory Study on Desmopressin, Diclofenac, Fucidin, Mirtazapine and Quetiapine

Andrulyte

Bjerrum

2018

Basic Clin Pharma Tox

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The term off-label use describes the prescription and administration of medicines outside of the terms for which it officially has been approved, including age, dose and indication. Off-label data can be generated from the Danish National Prescription Registry through combinations with diagnoses; however, the community pharmacy servers provide equal, local, albeit less data through a faster and less constrained collection process. The data collection for this exploratory study took place at five community pharmacies in Denmark. Five drugs were chosen for the investigation and collection of prescription data across a 2-year period. Off-label use by age was observed to be 1.9% for diclofenac, 1.7% for desmopressin and 2.3% for quetiapine. The percentages were based on total number of 3881, 925, 2712 prescriptions, respectively. Off-label monitored by dosage appeared to be 75% for quetiapine; by box label text analysis, off-label indication was found to be 10-15% and 15-23% for quetiapine and mirtazapine (from a total number of 3178 prescriptions), respectively. By route of administration where fucidin ointment was applied to the nose in 60 patients, 83% were prescribed off-label (non-dermatological). This exploratory study revealed that pharmacy servers represent a reliable and up-to-date source to collect a substantial amount of raw prescription data. The method gives straightforward and simple access to analysis of off-label use by age and dose, whereas it is possible but difficult to interpret off-label indications and route of administration from the box label text.

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“…Thus, the majority of the LAMA consent documentation was incomplete in this sense as it cannot demonstrate that the patient/patient's nearest kin has understood the possible risks and courts look for pieces of evidence that the discussion was discussed with the person in question. 7 This can be related to the fact that many medical professionals do not know, that the failure to obtain and document high-quality informed consent or informed treatment refusals can give rise to a claim of professional negligence. 7 The code of ethics and professional conduct published in 2017 by NMC states that a mentally sound patient has the right to refuse to consent to treatment, provided that he can exercise his judgment freely and is taken from the patient unless he or she is minor or less than 16 years of age or is mentally unsound or ill to give the decision and this is when the nearest kin who knows the patient as a person who can decide by placing the interest of patients before them.…”

Section: Discussionmentioning

confidence: 99%

Cases of Left Against Medical Advice from the Emergency Department of a Tertiary Care Hospital in Kathmandu: A Descriptive Cross-Sectional Study

Pant

Jha²,

Shrestha³

2020

J Nepal Med Assoc

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Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Left against medical advice do not provide the health professionals with legal impunity. A well-informed consent should be present with surety that they are well understood by the patient before they leave. The study was undertaken to study the prevalence of patients that leave against medical advice. Methods: This is a descriptive cross-sectional study done in the emergency department of a tertiary care hospital from 1st February 2020 to 31 July 2020. Ethical approval was taken from the Institutional Review Committee (ref. no. 130120205). The sample size was calculated and the convenient sampling method was used. Data were analyzed in the Statistical Package of the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 5834 visits, 332 (5.96%) (4.70-7.22 at 95% Confidence Interval) patients left against medical advice. The mean age was 36.48 years (3 days-91 years) and males 173 (52.3%) were prone to leave than females. Only 50 (15.1%) cases had well-informed consent with complications documented. Hundred (30.5%) patients had wanted to come on follow up the next day in the out-patient department while 41 (12.4%) had to leave because of financial reasons. Only seven (2.9%) of well-oriented patients gave their consent and the remaining 233 (97.1%) were by the kin present. Only 76 (23%) patients were sent home with a well-documented medicine prescription. Conclusions: The proportion of patients who left against medical advice was more than the studies done in a similar setting.

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Liability Associated With Prescribing Medications

Cited by 20 publications

References 6 publications

Pharmacy employees’ involvement in safeguarding persons with dementia who use dietary supplements: Results from a survey of Norwegian pharmacies

Pharmacy employees’ involvement in safeguarding persons with dementia who use dietary supplements: Results from a survey of Norwegian pharmacies

Identifying Off‐Label Prescriptions Through Data Mining in Danish Community Pharmacy Servers: An Exploratory Study on Desmopressin, Diclofenac, Fucidin, Mirtazapine and Quetiapine

Cases of Left Against Medical Advice from the Emergency Department of a Tertiary Care Hospital in Kathmandu: A Descriptive Cross-Sectional Study

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