International journal of clinical pharmacy
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Multicenter Study
The role of clinical pharmacist to improve medication administration through enteral feeding tubes by nurses.
As a common practice, medications are given in addition to nutrients through enteral catheters especially in critically ill patients. Nurses are primarily responsible to administer medications in this manner. The correct drug delivery via enteral tubes requires special skills. ⋯ This study showed that nurses did not have sufficient baseline knowledge about rules of drug administration via enteral feeding tubes; however, integrated educational program by clinical pharmacists that focus on promoting correct administration of drugs via enteral feeding catheters significantly improved knowledge and practice of nurses. A theory-practice gap was found in this study that may be related to the authority of physicians not nurses in ordering rules for medication administration through enteral catheters.
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Foreign-language (FL) patients are at increased risk for adverse drug events. Evidence regarding communication barriers and the safety of pharmaceutical care of FL patients in European countries is scarce despite large migrant populations. ⋯ Communication barriers with FL patients are frequent in Swiss pharmacies and pharmacists perceive FL patients to be at increased risk for adverse drug events. Development and dissemination of communication tools are needed to support pharmacists in counselling of a diverse migrant population.
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Performing bedside clinical recommendations is important for the prevention of adverse drug events. From an economic perspective, the economic value of adverse drug event avoidance needs to be weighed against the labour costs of pharmacists. ⋯ Clinically important pharmacy interventions are not automatically cost beneficial. Interventions that prevent digoxin and valproic acid toxicity were cost effective in this setting. The routine advice to switch the antibiotic class for every reported penicillin allergy is unlikely to avoid adverse drug events and challenges the cost value of this intervention. Interventions with methotrexate are relevant because they can be lifesaving. However, due to their low incidence, effective detection of these errors is crucial for reducing harm.
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Simvastatin 10 mg was reclassified in 2004 to over-the-counter (OTC) status in the UK, indicated for the prevention of a first major coronary event in individuals at moderate risk of the event. The primary reason behind the reclassification was to reduce the burden of disease management in general practice. Community pharmacists' adoption of OTC simvastatin into practice immediately post reclassification was reported to below but there has been no systematic update on current practice. ⋯ Community Pharmacists' views of reclassified simvastatin supply 5 years post reclassification, as compared to the time it was newly reclassified, suggest low uptake. This lack of progress over time suggests that, against policy initiatives, OTC availability is unlikely to have impacted on the level of general practice led management of patients at risk of coronary events.
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Multicenter Study
Evaluation of potentially inappropriate medications among older residents of Malaysian nursing homes.
There is an increasing evidence of medicines related issues such as inappropriate prescribing among older people. Inappropriate prescribing is an important risk factor for adverse drug reactions and hospitalizations in the older people. ⋯ Potentially inappropriate medications are highly prevalent among older residents living in the nursing homes and are associated with number of medications and longer nursing home stay. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.