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BACKGROUND: Medication errors can often occur due to the patient's inability to comprehend written or verbal medication orders. This study aimed to develop pictograms of selected medication orders and to validate the comprehension of prescription orders index and compare the comprehension scores with and without pictograms. In addition to determine the predictors that could be associated with a better or worse comprehension of prescription orders with pictograms versus that of their written counterparts. METHODS: A cross-sectional study was conducted using a snowball sampling technique. Six pictograms were developed to depict specific medication orders. The comprehension of prescription orders index was constructed and validated. The study then compared the comprehension scores of prescription orders with and without pictograms, and identified the predicting factors score difference. RESULTS: A total of 1848 participants were included in the study. The structure of the comprehension of prescription orders index was validated over a solution of four factors, with an adequate Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy of 0.711 and a significant Bartlett's test of sphericity (P < 0.001). The construct validity of the index was further confirmed by highly significant correlations between each item and the full index (P < 0.001). The study also found a significant association between the difference in comprehension scores for prescription orders with and without pictograms and several factors, including age, level of education, area of residence, number of children, and smoking status with the difference of comprehension scores (P < 0.001). CONCLUSION: Pictogram-based instructions of medication orders were better understood by the Lebanese population than written instructions, making the incorporation of pictograms in pharmacy practice paramount to optimize medication use by the patient and thus yielding better health outcomes.
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Comprensión , Países en Desarrollo , Niño , Humanos , Estudios Transversales , Prescripciones , EscolaridadRESUMEN
OBJECTIVE:To provide reference for rational drug use in the clinic. METHODS:Irrational medication orders eval-uated by the Affiliated Cancer Hospital of Zhengzhou University during Oct. 2014 to Sep. 2015 were arrangemented,summarized and analyzed. RESULTS:A total of 515 inpatient medical records were reviewed and analyzed,among which there were 165 unrea-sonable medical records and 185 irrational medication orders. Irrational medical records of general surgery department were the most(38 items,accounting for 23.03%). Irrational drug use mainly included irrational usage and dosage(80.00%),drug use with-out indications or not suit indications (7.57%),inappropriate solvent selection (4.86%). Including 66.22% of single overdose, 18.92% of longer medication duration. CONCLUSIONS:There are many irrational medical orders which should be standardized in our hospital,especially overdose and longer medication duration,which increase financial burden of patient. Pharmacists should strengthen communication with clinicians,and hold rational drug use trainings regularly base on the types of the irrationality. These can help to improve rational drug use and guarantee the safety of drug use.
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PURPOSE: To synthesize pharmacists' interventions made in the department of internal medicine and hypertension of university hospital of Toulouse and assess the impact on medication orders. METHODS: This is a single-center, prospective study using pharmacists' interventions recorded between September 2013 and March 2014 on the Act-IP(©) website of the French Society of Clinical Pharmacy. The clinical pharmacist is present everyday in the unit to establish the medication reconciliation of new patients (the process of comparing a patient's medication orders to all of the medications that the patient has been taking), and analysis of medication orders. When a risk of iatrogenic drug is identified, a therapeutic change is proposed to the prescriber. RESULTS: A total of 2491 medication orders were analyzed for 7 months, leading to 39 pharmacists' interventions (1.6 pharmacists' interventions per 100 medication orders). The most commonly identified drug-related problems were improper administration (33%, n=13), not prescribed drug (21%, n=8), non-conformity to guidelines (18%, n=7), supratherapeutic dose (15%, n=6), and 13% (n=5) targeted prescribed treatment not administered, underdosing, incorrect administration or drug interaction. The most relevant molecules were atorvastatin (10%), bromazepam (8%) and levothyroxine (8%) and only 2 interventions targeted antihypertensive drugs. The rate of physicians' acceptance was 92%. CONCLUSION: Pharmacists' interventions mainly concern the co-prescriptions of antihypertensive drugs and very few antihypertensive drugs. The clinical pharmacist contributes to preventing iatrogenic in patients with hypertension with a very good acceptance by the clinician.
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Antihipertensivos/uso terapéutico , Prescripciones de Medicamentos/estadística & datos numéricos , Hipertensión/tratamiento farmacológico , Servicio de Farmacia en Hospital/estadística & datos numéricos , Anciano , Femenino , Humanos , Masculino , Estudios ProspectivosRESUMEN
OBJECTIVE:To strengthen the clinical rational use of drug and to ensure safety of drug use.METHODS:The irrational medication orders of PIVAS in our hospital from Mar.to Aug.in 2009 were analyzed statistically.RESULTS:Of total 859 339 medication orders,771 irrational medication orders accounted for 0.94‰,including excessive dosage,irrational compatibility and improper solvent selection,etc.CONCLUSIONS:Pharmacists can correct irrational medication order to improve rational use of drug by PIVAS.Moreover,PIVAS plays an important role in training clinical pharmacists.
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OBJECTIVE:To evaluate the role of clinical pharmacists in intervening irrational medication during the clinical therapy process. METHODS:334 pieces of medication orders in medicine and surgery medical records from Feb. to Apr 2009 were analyzed. The severity and variety of irrational medication orders were evaluated with irrational medication classification criteria. RESULTS:334 copies of medical records included 1 781 pieces of medication orders. 419 pieces of surgery medication orders contained 119 copies of irrational ones and the mean proportion of irrational drug use was 28.4% vs. 272 copies of the irrational ones and 20.0% of proportion for 1 362 copies of medicine medication orders. CONCLUSION:The status quo of irrational medication in our hospital is severe. Clinical pharmacists' intervention on clinical rational medication is of great importance. The severity of irrational medication and the extent of deviating from standard treatment can be evaluated by the irrational medication classification criteria with clear content and practical property,which can be a way for evaluating clinical pharmacists' behavior and the efficacy of clinical pharmacy care.