Neonatal mythbusters: evaluating the evidence for and against pharmacologic and nonpharmacologic management of gastroesophageal reflux.

Gastroesophageal reflux (GER) is a challenging clinical entity that has often been associated with a number of negative clinical outcomes. The treatment of this condition lacks evidence and is often based on anecdotal beliefs and myths. This article will define GER and review the recommendations for the diagnosis of GER as well as review the evidence for both pharmacologic and nonpharmacologic treatment of GER.

Implementation of a Meds to Beds Medication Use Program and Parent Experience at the Time of Transition From a Neonatal Intensive Care Unit to Home.

OBJECTIVE: This study aims to describe the overall experience of the neonatal intensive care unit (NICU) parent at time of transition home related to discharge medication use, following implementation of a Meds to Beds program. METHODS: A descriptive, qualitative study was used to explore parent experiences around medication use during transition home. Eleven parents whose infants required medications at the time of transition home from the NICU participated in a semi-structured telephone interview post-discharge. The data were coded and analyzed for themes. RESULTS: Major themes nested within the key stages of medication use in preparation for transition home from the NICU were identified: in-hospital preparation (practice early and often, Meds to Beds, and relationship with clinical pharmacist), transition home (schedule and routine, strategies for medication administration) and post-discharge (refills and long-term medication management). Strategies based on parent experiences to improve the process and ameliorate anxiety are presented. CONCLUSIONS: Parents expressed how effective the Meds to Beds program was on the transition home by increasing parental confidence and knowledge around medications and reducing stress around the acquisition of medications for home. They also reported comfort in having a relationship with the NICU clinical pharmacist, providing a tailored approach to coordinating care both in hospital and during the transition home. Regardless of implementation of a Meds to Beds program, great opportunities remain to refine the transition home. Implementing the suggested improvement strategies could provide significant positive effects with respect to patient care and parental stress during the transition home.