Electronic Medication Reconciliation Tools Aimed at Healthcare Professionals to Support Medication Reconciliation: a Systematic Review.

The development of health information technology available and accessible to professionals is increasing in the last few years. However, a low number of electronic health tools included some kind of information about medication reconciliation. To identify all the electronic medication reconciliation tools aimed at healthcare professionals and summarize their main features, availability, and clinical impact on patient safety. A systematic review of studies that included a description of an electronic medication reconciliation tool (web-based or mobile app) aimed at healthcare professionals was conducted. The review protocol was registered with PROSPERO: registration number CRD42022366662, and followed PRISMA guidelines. The literature search was performed using four healthcare databases: PubMed, EMBASE, Cochrane Library, and Scopus with no language or publication date restrictions. We identified a total of 1227 articles, of which only 12 met the inclusion criteria.Through these articles,12 electronic tools were detected. Viewing and comparing different medication lists and grouping medications into multiple categories were some of the more recurring features of the tools. With respect to the clinical impact on patient safety, a reduction in adverse drug events or medication discrepancies was detected in up to four tools, but no significant differences in emergency room visits or hospital readmissions were found. 12 e-MedRec tools aimed at health professionals have been developed to date but none was designed as a mobile app. The main features that healthcare professionals requested to be included in e-MedRec tools were interoperability, "user-friendly" information, and integration with the ordering process.

Model-Informed Precision Dosing Software Tools for Dosage Regimen Individualization: A Scoping Review.

BACKGROUND: Pharmacokinetic nomograms, equations, and software are considered the main tools available for Therapeutic Drug Monitoring (TDM). Model-informed precision dosing (MIPD) is an advanced discipline of TDM that allows dose individualization, and requires a software for knowledge integration and statistical calculations. Due to its precision and extensive applicability, the use of these software is widespread in clinical practice. However, the currently available evidence on these tools remains scarce. OBJECTIVES: To review and summarize the available evidence on MIPD software tools to facilitate its identification, evaluation, and selection by users. METHODS: An electronic literature search was conducted in MEDLINE, EMBASE, OpenAIRE, and BASE before July 2022. The PRISMA-ScR was applied. The main inclusion criteria were studies focused on developing software for use in clinical practice, research, or modelling. RESULTS: Twenty-eight software were classified as MIPD software. Ten are currently unavailable. The remaining 18 software were described in depth. It is noteworthy that all MIPD software used Bayesian statistical methods to estimate drug exposure and all provided a population model by default, except NONMEN. CONCLUSIONS: Pharmacokinetic software have become relevant tools for TDM. MIPD software have been compared, facilitating its selection for use in clinical practice. However, it would be interesting to standardize the quality and validate the software tools.

Stability of Antimicrobials in Elastomeric Pumps: A Systematic Review.

Outpatient parenteral antimicrobial therapy (OPAThttp) programs have become an important healthcare tool around the world. Portable elastomeric infusion pumps are functional devices for ambulatory delivery of antimicrobial drugs, and their stability is an essential point to guarantee an appropriate infusion administration. We conducted a systematic review to provide a synthesis and a critical evaluation of the current evidence regarding antimicrobial stability in elastomeric pumps. Data sources were PubMed, EMBASE, and Web of Sciences. The review protocol was registered on the Center for Open Science, and it was carried out following the PRISMA guidelines. Studies were eligible if the aim was the evaluation of the physicochemical stability of an antimicrobial agent stored in an elastomeric device. Of the 613 papers identified, 33 met the inclusion criteria. The most studied group of antimicrobials was penicillins, followed by cephalosporins and carbapenems. In general, the stability results of the antimicrobials that have been studied in more than one article agree with each other, with the exception of ampicillin, flucloxacillin, and ceftazidime. The antibiotics that displayed a longer stability were glycopeptides and clindamycin. Regarding the stability of antifungals and antivirals, only caspofungin, voriconazole, and ganciclovir have been investigated. The information provided in this article should be considered in patient treatments within the OPAT setting. Further stability studies are needed to confirm the appropriate use of the antimicrobials included in this program to ensure optimal patient outcomes.

Pharmacokinetic software for therapeutic drug monitoring: A scoping review protocol.

OBJECTIVE: Nomograms, equations and pharmacokinetic software are considered the main tools available for therapeutic drug monitoring. Due to  its great applicability to various groups of drugs, the use of software is widely extended in clinical practice. The main goals of the studies using this  type of software do not normally include the description of its features, therefore, the information about its characteristic is scarce. Moreover,  no review of the literature has been published that brings together  all the information available about these software. The present study aimed to synthesize the available evidence regarding software applied to therapeutic drug monitoring to facilitate its identification, evaluation and  election by users. METHOD: This article describe a scoping review protocol, developed following  the PRISMA-P and PRISMA-ScR guidelines. An electronic literature search was  performed in MEDLINE, EMBASE, OpenAire and BASE (Bielefeld Academic  Search Engine) databases. Only those software for which the following  information was available were included: name of the software,  developer/marketer, type of pharmacokinetic analysis allowed, and drugs  included in the analysis. Results: In this study we will synthesized the most relevant characteristics for  the clinical practice of the pharmacokinetic software available. A critical  ppraisal of the sources if information will be included. Also, if it is possible, a  comparison of the available tools will be carried out  in order to facilitate the  evaluation and selection of pharmacokinetic software. CONCLUSIONS: Pharmacokinetic software has become a relevant tool for  therapeutic drugs monitoring. Currently available evidence on such tools is  scarce, which precludes a rapid and effective comparative analysis between the  different options available. An analysis of the main characteristics and a  comparison between different pharmacokinetic software will be useful to the  users, leading to a greater integration of these tools in healthcare practice.

OBJETIVO: Los nomogramas, ecuaciones y software de contenido  armacocinético se consideran las principales herramientas disponibles para la  monitorización farmacocinética clínica. Debido a su gran aplicabilidad en  numerosos grupos de fármacos, el empleo de software se encuentra  ampliamente extendido en la práctica clínica. Generalmente, el objetivo  principal de los estudios que incluyen el uso de estos software no es la  descripción de los mismos, por lo que la información disponible es escasa y,  además, no se dispone de una revisión que aúne toda la información disponible  referente a este tipo de software El objetivo de este estudio será  sintetizar la evidencia disponible sobre los distintos software de aplicación en la  monitorización farmacocinética para facilitar a los usuarios su identificación,  evaluación y selección.Método: Se realizará una revisión exploratoria de la literatura cuyo protocolo se describe en este artículo, de acuerdo con las recomendaciones PRISMA para la elaboración de revisiones exploratorias y  publicación de protocolos. Se realizará una búsqueda bibliográfica en las bases  de datos Medline, Embase, OpenAire y Bielefeld Academic Search Engine. Se  incluirán en el estudio aquellos software detectados de los que se disponga de  la siguiente información: nombre del software, desarrollador/ comercializador,  tipo de análisis farmacocinético y fármacos incluidos. Resultados: En este  estudio se espera realizar una síntesis de las características más relevantes en  la práctica clínica de los software de contenido farmacocinético disponibles en  el mercado. Se realizará una síntesis narrativa crítica de las fuentes de  información utilizadas. Además, se llevará a cabo, si es posible, una  comparación de los mismos para facilitar la evaluación y selección por parte de  los usuarios. CONCLUSIONES: Los software de contenido farmacocinético se han convertido en un recurso fundamental en la práctica de la monitorización  terapéutica de fármacos. La evidencia disponible en la actualidad es escasa y  no permite a los usuarios realizar de forma rápida y eficiente un análisis comparativo entre los distintos software disponibles. El análisis sobre  las características principales y comparación entre los distintos software de  plicación farmacocinética será de gran utilidad a sus usuarios para una mayor  integración de estas herramientas en la práctica asistencial.

Software de contenido farmacocinético para la monitorización terapéutica de fármacos: Protocolo de revisión exploratoria / Pharmacokinetic software for therapeutic drug monitoring: A scoping review protoco

Objetivo: Los nomogramas, ecuaciones y software de contenido farmacocinético se consideran las principales herramientas disponibles para la monitorización farmacocinética clínica. Debido a su gran aplicabilidad en numerososgrupos de fármacos, el empleo de software se encuentra ampliamente extendido en la práctica clínica. Generalmente, el objetivo principal de los estudiosque incluyen el uso de estos software no es la descripción de los mismos, porlo que la información disponible es escasa y, además, no se dispone de unarevisión que aúne toda la información disponible referente a este tipo de softwareEl objetivo de este estudio será sintetizar la evidencia disponible sobre losdistintos software de aplicación en la monitorización farmacocinética parafacilitar a los usuarios su identificación, evaluación y selección.Método: Se realizará una revisión exploratoria de la literatura cuyo protocolo se describe en este artículo, de acuerdo con las recomendacionesPRISMA para la elaboración de revisiones exploratorias y publicaciónde protocolos. Se realizará una búsqueda bibliográfica en las bases dedatos Medline, Embase, OpenAire y Bielefeld Academic Search Engine.Se incluirán en el estudio aquellos software detectados de los que se disponga de la siguiente información: nombre del software, desarrollador/comercializador, tipo de análisis farmacocinético y fármacos incluidos.Resultados: En este estudio se espera realizar una síntesis de lascaracterísticas más relevantes en la práctica clínica de los software decontenido farmacocinético disponibles en el mercado. Se realizará una síntesis narrativa crítica de las fuentes de información utilizadas. Además,se llevará a cabo, si es posible, una comparación de los mismos parafacilitar la evaluación y selección por parte de los usuarios. (AU)

Objective: Nomograms, equations and pharmacokinetic software areconsidered the main tools available for therapeutic drug monitoring. Dueto its great applicability to various groups of drugs, the use of software iswidely extended in clinical practice. The main goals of the studies usingthis type of software do not normally include the description of its features,therefore, the information about its characteristic is scarce. Moreover, noreview of the literature has been published that brings together all theinformation available about these software. The present study aimed tosynthesize the available evidence regarding software applied to therapeutic drug monitoring to facilitate its identification, evaluation and selectionby users.Method: This article describe a scoping review protocol, developedfollowing the PRISMA-P and PRISMA-ScR guidelines. An electronic literature search was performed in MEDLINE, EMBASE, OpenAire and BASE(Bielefeld Academic Search Engine) databases. Only those software forwhich the following information was available were included: name of thesoftware, developer/marketer, type of pharmacokinetic analysis allowed,and drugs included in the analysis.Results: In this study we will synthesized the most relevant characteristics for the clinical practice of the pharmacokinetic software available.A critical appraisal of the sources if information will be included. Also,if it is possible, a comparison of the available tools will be carried out in order to facilitate the evaluation and selection of pharmacokineticsoftware. (AU)