Medication history reconciliation by clinical pharmacists in elderly inpatients admitted from home or a nursing home.

BACKGROUND: Accurate medication histories at hospital admission are an important element of medication safety. Discrepancies may have clinically significant consequences, especially in the elderly population. OBJECTIVE: To assess the clinical pharmacist's performance in obtaining patients' medication histories and in reconciling these data with the medical records and medication orders and whether the patients' residential situation prior to hospitalization influences the number of drug discrepancies. METHODS: A prospective observational study was conducted at a 29-bed acute geriatric ward of a Belgian university hospital. Medication histories acquired by clinical pharmacists were compared with those documented in the medical records by the attending physicians. All discrepancies were identified and categorized by an independent pharmacist and were scored for their clinical relevance in consensus by a senior internist and a senior geriatrician. RESULTS: Of the 215 screened geriatric (aged ≥65 years) patients admitted between October 27, 2007, and September 23, 2008, 197 were enrolled in the study. For patients living in the community, as well as those residing in a nursing home prior to hospitalization, clinical pharmacists identified significantly more preadmission drugs compared with physicians, with a median number of 8 correctly identified medications versus 6, respectively (p < 0.001). Extra identified drugs consisted of over-the-counter as well as prescription medications. Furthermore, 117 other medication discrepancies were noted, mainly related to erroneous drug identification and incorrect drug dose. In all, the clinical pharmacists identified 379 (24.2%) medication discrepancies, of which 188 (49.6%) were judged clinically relevant. CONCLUSIONS: Pharmacist-acquired medication histories enhance the medication reconciliation process, both in patients residing at home and in a nursing home prior to hospitalization. A focus should be placed on seamless care procedures that facilitate the transfer of medication histories between primary and secondary care in both of these populations.

Flemish community pharmacists' motivation and views related to continuing education.

OBJECTIVE: IPSA (Institute for Permanent Study for Pharmacists) wanted to assess community pharmacists' opinion on CE-related issues in order to develop more tailored CE programs. METHOD: A survey for self-administration was sent to 1691 community pharmacists. The method of stratified sampling was used to include pharmacists who do not take up CE courses as well. MAIN OUTCOME MEASURES: (1) Preferences for course formats, topics of interest and opinion on different CE providers; (2) Facilitators and barriers for participation in CE courses; (3) Opinion on rewarding and participation, obligation and willingness to pay. RESULTS: A response rate of 62.8% was obtained after three mailings. Lectures remain the most favorite course format. Topics related to pharmaceutical care are the most wanted. The strongest facilitators for attending CE courses are gathering practical knowledge and keeping scientific knowledge up to standard. Social contact with colleagues and receiving a syllabus are perceived as moderately motivating factors. Most frequently mentioned barriers were lack of time, family constraints, distance to the classes and uninteresting subjects. Around 2/3rd of questioned pharmacists are willing to invest more time in CE when participation would be rewarded. When it comes to opinion on mandatory CE, disagreement exists between pharmacists who take up CE courses and those who don't, the latter being less in favor. CONCLUSION: This survey revealed community pharmacists' opinions, wishes and needs concerning CE. This should enable CE providers to develop more tailored CE programs.

Television and adolescent use of over-the-counter analgesic agents.

BACKGROUND: Portrayals of the use of over-the-counter (OTC) analgesics on television may stimulate their use. OBJECTIVE: To explore the association between taking OTC analgesics and television viewing by adolescents. METHODS: A standardized self-administered questionnaire among first-year (mean age 13.16 y) and fourth-year (mean age 16.37 y) secondary students in Flanders, Belgium (n = 2546) was administered in a school setting. The independent variable was television viewing; control variables were school year, gender, drinking alcohol, days off sick, computer gaming, and Internet use. The main outcome variable was monthly use of OTC analgesics. RESULTS: On average, respondents watched 3 hours 18 minutes of television per day (boys more than girls, first-year students more than fourth-year students). Per additional hour of television per day, the odds that respondents were regular users of analgesics were 1.16 times higher (95% CI 1.08 to 1.24). For the 10% heaviest viewers, the odds were 2.30 times higher (95% CI 1.25 to 4.24) compared with the 10% lightest viewers. Odds of OTC analgesic use were higher for students reporting more sick days in the past year (OR 1.38, 95% CI 1.28 to 1.49), regular users of alcohol (OR 1.33, 95% CI 1.17 to 1.50), and girls (OR 1.92, 95% CI 1.35 to 2.73). CONCLUSIONS: A relationship was found between watching television and the use of OTC analgesics, even after controlling for gender and lifestyle measures. More research is needed to establish whether this relationship is causal.

Frequency and trends of interventions of prescriptions in Flemish community pharmacies.

OBJECTIVE: To study the role of the community pharmacist in medication management. METHOD: Participating Flemish pharmacists quantified their interventions during two weeks by use of validated diagrams. The clinical interventions were recorded in detail, while the technical interventions were only registered. RESULTS: 124 pharmacists participated. Intervention was needed in 4.1% of the total number of prescriptions (n = 87.647). On average, 20.2 technical and 8.4 clinical interventions over a period of 2 weeks per pharmacy were needed. The main problem was missing or incorrect data on administering the drug (23%). Missing or incorrect advice (37.8%), dose-related problems (26.1%) and interactions or contra-indications (20.2%) were mentioned as important clinical discrepancies. The pharmacists utilized the patient medication records to solve most of the problems. In one out of five cases, the physician was contacted. CONCLUSION: Interventions by community pharmacists in medication management have been recorded in this study. The results should be translated into a process of integrated pharmaceutical care.

[Introduction to pharmaceutical sciences from the faculty of pharmaceutical science of Leuven: an experience of cohabitation]. / L'introduction de sciences "douces" à la Faculté des Sciences Pharmaceutiques de Leuven: une expérience de cohabitation.

Teaching Pharmacy Practice as an approach to pharmaceutical care started in 1991 at the Katholieke Universiteit Leuven (KUL). Although completely new, none of the courses related to pharmacy practice was compulsory for all students, due to the option system adopted at the Faculty of Pharmaceutical Sciences of the KUL. After 10 years the number of students choosing for the option community and hospital pharmacy (most related to pharmacy practice) is stabilized at about 60% of the total number of students. From the very beginning. It was quite difficult to harmonize the research field of pharmacy practice with the more fundamentally oriented research activities in the different pharmaceutical laboratories. This resulted in a "Living Apart Together" (LAT) relationship with some negative consequences on activity funding. Nevertheless interesting research projects emerged from the Division of Drug and Patient Information. One PhD thesis was achieved. In the near future external partners may play an important role in structural support of research activities. These research is necessary to ensure the presence of pharmaceutical care as a validated discipline in the training of future pharmacists.