International journal of clinical pharmacy
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Review Meta Analysis
Risk factors for QTc-prolongation: systematic review of the evidence.
Background QTc-interval prolongation has been associated with serious adverse events, such as Torsade de Pointes and sudden cardiac death. In the prevention of QTc-prolongation, special attention should go to high-risk patients. Aim of the review The aim of this review is to summarize and assess the evidence for different risk factors for QTc-prolongation (demographic factors, comorbidities, electrolytes, QTc-prolonging medication). ⋯ Very strong evidence was found for hypokalemia, use of diuretics, antiarrhythmic drugs and QTc-prolonging drugs of list 1 of CredibleMeds. Little or no evidence was found for hyperlipidemia, the use of digoxin or statins, neurological disorders, diabetes, renal failure, depression, alcohol abuse, heart rate, pulmonary disorders, hormone replacement therapy, hypomagnesemia, history of a prolonged QTc-interval/Torsade de Pointes, familial history of cardiovascular disease, and the use of only QTc-prolonging drugs of list 2 or 3 of CredibleMeds. Conclusion This systematic review gives a clear overview of the available evidence for a broad range of risk factors for QTc-prolongation.
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Background The UK's Department of Health has recommended that formal communication channels between hospital and community pharmacy should be established so that post discharge Medicines Use Reviews (dMUR) become an integral part of the medicines pathway. Objective To investigate the perspective of community pharmacists on the usefulness of dMUR referrals from hospital, the suitability of patients referred and overall views on the service. Method Self-completed survey distributed to 21 community pharmacists who had received referrals from the hospital during a 9-month randomized controlled feasibility study. ⋯ Community pharmacists held positive opinions on the dMUR service and could see the benefit to patients. Pharmacists wanted more referrals but reported performing few dMURs outside this study. Conclusion This study highlights the need to improve communication between hospital and community pharmacies and to overcome barriers to performing dMURs outside the pharmacy premises in this patient group.
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Background Patients in the Neonatal Intensive Care Unit (NICU) are at an increased risk for medication errors. Objective The objective of this study is to describe the nature and setting of medication errors occurring in patients admitted to an NICU in Qatar based on a standard electronic system reported by pharmacists. Setting Neonatal intensive care unit, Doha, Qatar. ⋯ Conclusion Medication errors reported by pharmacists occur most frequently in the prescribing phase of the medication process. Our data suggest that error reporting systems need to be specific to the population involved. Special attention should be paid to frequently used medications in the NICU as these were responsible for the greatest numbers of medication errors.