Pharmacology, Toxicology and Pharmaceutics › Pharmacology

Pharmacy and Medical Practices

Works Count: 46068

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Description

This cluster of papers covers a wide range of topics related to pharmaceutical care and clinical pharmacy practice, including medication management, patient education, drug information, adverse drug reactions, community pharmacy services, pharmacist roles, healthcare communication, and pharmacy training. The papers discuss various aspects of pharmaceutical interventions, evaluation of training programs, patient satisfaction, and the role of pharmacists in optimizing medication therapy and ensuring patient safety.

Keywords

Pharmaceutical Care; Clinical Pharmacy; Medication Management; Patient Education; Drug Information; Pharmacy Training; Adverse Drug Reactions; Community Pharmacy; Pharmacist Role; Healthcare Communication

Patients' evaluation of shape, size and colour of solid dosage forms.

2001-01-01

Anne-Julie Overgaard , Jørn Møller Sonnergaard , Lona Louring Christrup +2 more

A floating controlled-release drug delivery system: in vitro-in vivo evaluation.

1993-01-01

Subhash Desai , Sanford Bolton

CONVENIENT PROCEDURES FOR THE PREPARATION OF ANTIHEMORRHAGIC COMPOUNDS

1940-04-01

Louis Fieser

Handbook on anaerobic fermentations

1989-05-01

Larry E. Erickson , Daniel Yee-Chak Fung

Psychiatric Comorbidity and Length of Stay in the General Hospital

1994-05-01

Stephen M. Saravay , Michael R. Lavin

Do continuous infusions of omeprazole and ranitidine retain their effect with prolonged dosing?

1994-01-01

H. S. Merki , Clive H. Wilder‐Smith

Enhancement of the systemic and CNS specific delivery of L-dopa by the nasal administration of its water soluble prodrugs.

2000-01-01

Huaihung Danny Kao , Ashraf Traboulsi , Soichi Itoh +2 more

Japanese Lesson Study in Mathematics

2007-02-01

Masami Isoda , Max Stephens , Yutaka Ohara +1 more

Japanese Lesson Study in Mathematics Methods and Types of Study Lessons Trends of Research Topics in Japan Society of Mathematical Education Diversity and Variety of Lesson Study International Cooperative Projects. Japanese Lesson Study in Mathematics Methods and Types of Study Lessons Trends of Research Topics in Japan Society of Mathematical Education Diversity and Variety of Lesson Study International Cooperative Projects.

Recall Accuracy for Prescription Medications: Self-report Compared with Database Information

1995-11-15

Suzanne L. West , David A. Savitz , Gary G. Koch +3 more

A methodological study was performed in 1992 to evaluate the accuracy of self-reported use of nonsteroidal antiinflammatory drugs (NSAIDs) and noncontraceptive estrogens that had been dispensed during the previous 12 … A methodological study was performed in 1992 to evaluate the accuracy of self-reported use of nonsteroidal antiinflammatory drugs (NSAIDs) and noncontraceptive estrogens that had been dispensed during the previous 12 years. A sample of 560 individuals dispensed NSAIDs or estrogens, and 140 individuals without NSAID/estrogen dispensations were selected from the Group Health Cooperative pharmacy database. Demographic, behavioral, and drug information was ascertained by telephone interview for 356 persons with and 98 persons without NSAID/estrogen dispensations. Of those with only a single NSAID dispensation, 41% (95% confidence interval (CI) 32-50%) were able to recall any NSAID use compared with 85% (95% CI 76-94%) for those with multiple NSAID dispensations. Thirty percent (95% CI 24-36%) recalled the NSAID name, and 15% (95% CI 10-20%) recalled both the name and dose. For estrogens, 78% (95% CI 70-86%) recalled the name, but only 26% (95% CI 17-34%) recalled the name and dose. Age, but not sex, appeared to influence recall accuracy: Persons 50-65 years of age recalled the NSAID name more accurately than those aged 66-80 (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.0-3.4). A similar advantage was noted for 50- to 65-year-old women in recalling the estrogen name (OR = 1.5, 95% CI 0.6-3.9). Drug name was recalled more frequently for exposures stopped 2-3 years prior to interview than for those stopped 7-11 years prior (OR = 3.0, 95% CI 1.6-5.7, and OR = 2.4, 95% CI 0.9-6.7, for NSAIDs and estrogens, respectively). Specificity was consistently high, ranging from 92% to 100%. This study suggests significant underascertainment of self-reported prescription drug exposure but little evidence that exposures are overreported.

Hospital Admissions Caused by Iatrogenic Disease

1986-10-01

Mark Lakshmanan

Complications of medical therapy requiring hospitalization affect the costs and quality of medical care. We studied all admissions to the medical services of a public teaching hospital to characterize current … Complications of medical therapy requiring hospitalization affect the costs and quality of medical care. We studied all admissions to the medical services of a public teaching hospital to characterize current incidence and cause of iatrogenic admissions. We studied 834 admissions resulting in 47 distinct iatrogenic events and 45 iatrogenic admissions (5.4%). Thirty-five cases were caused by medications, nine by procedures, one by radiotherapy, one by transfusional therapy, and one by nosocomial infection. Almost 50% of these admissions were avoidable. Though the incidence of iatrogenic admissions in this study is similar to that in previous reports, the profile of the responsible agents is different. We did not find relationships with age, number or type of diagnoses, or number of medications on admission. Study of other patient and physician characteristics may be more rewarding in reducing the number of iatrogenic complications.

Blended learning on medication administration for new nurses: Integration of e-learning and face-to-face instruction in the classroom

2008-07-03

Young Hee Sung , In Gak Kwon , Eunjung Ryu

A Dyadic Remediation Program for Care Recipients with Dementia

1995-05-01

Mary P. Quayhagen , Margaret Quayhagen , Robert R. Corbeil +2 more

A cognitive remediation intervention was tested for its effect on functional outcomes of older care recipients with the diagnosis of dementia of the Alzheimer's type. The 78 community-dwelling care recipients … A cognitive remediation intervention was tested for its effect on functional outcomes of older care recipients with the diagnosis of dementia of the Alzheimer's type. The 78 community-dwelling care recipients were assessed on cognitive and behavioral functioning and randomly assigned to one of three conditions. Care recipients were expected to benefit most from active cognitive stimulation training as compared to placebo (passive) activity or wait-list control conditions. Following each weekly instruction session, the intervention was executed in the home by the family caregiver. Care recipients in the experimental group improved in cognitive and behavioral performance with treatment, but returned to former level of functioning by the 9th month. In contrast, the control group declined, while the placebo group remained static on these variables. These findings support the viability of remediation interventions in dementia despite the trajectory of cognitive decline.

Prediction of pharmacist intention to provide Medicare medication therapy management services using the theory of planned behavior

2006-09-01

Kathleen E. Herbert , Julie M. Urmie , Brand A. Newland +1 more

The Effect of Increased Prescription Drug Cost-Sharing on Medical Care Utilization and Expenses of Elderly Health Maintenance Organization Members

1997-11-01

Richard E. Johnson , Michael J. Goodman , Mark C. Hornbrook +1 more

OBJECTIVES. The nature and extent of prescription drug benefits for the elderly are a continuing concern for health-care managers and policy makers. This study examined the impact of increased prescription … OBJECTIVES. The nature and extent of prescription drug benefits for the elderly are a continuing concern for health-care managers and policy makers. This study examined the impact of increased prescription drug cost-sharing on the drug and medical care utilization and expenses of the elderly. METHODS. Two groups of well-insured Medicare risk-based members of a large health maintenance organization (HMO) had their copayments increased in different years during a 3-year period. Four 2-year analysis periods were established for comparing these elderly groups. During one analysis period, copayments did not change in either group. RESULTS. Moderate increases of from $1 to $3, from $3 to $5 per copayment, and from 50% per dispensing to 70% per dispensing with a maximum payment per dispensing resulted in lower annual per capita prescription drug use and expenses. No consistent annual changes were observed in either medical care utilization (office visits, emergency room visits, home health-care visits, hospitalizations) or total medical care expenses across analysis periods. CONCLUSIONS. No consistent relationships were observed between increased copayments per dispensing and medical care utilization and expense. Future research needs to address the impact on the classes of medications received and related health status, and the impact of larger increases in copayments per dispensing on medical care and health-related factors.

The Effect of Clinical Pharmacy Services on Patients with Essential Hypertension

1973-11-01

James M. McKenney , Judith M. Slining , H. Henderson +2 more

The effect of clinical services provided by a pharmacist to 25 study patients with essential hypertension was evaluated and compared to the course followed by 25 control hypertensive patients not … The effect of clinical services provided by a pharmacist to 25 study patients with essential hypertension was evaluated and compared to the course followed by 25 control hypertensive patients not receiving these services. Results show a significant improvement ( P < 0.001) in the study patients' knowledge of hypertension and its treatment, a significant increase ( P < 0.001) in the number of study patients who complied with prescribed therapy, and a significant increase ( P < 0.001) in the number of study patients whose blood pressures were kept within the normal range during the study period. Most of these study patients had been hypertensive and noncompliant before, and they reverted to this status after the study period. The 25 control patients were hypertensive and noncompliant before, during, and after the study period. Fifty-nine incidents of suspected adverse reactions to antihypertensive drugs were identified in the study patients, occurring more frequently in those patients who were noncompliant, hypertensive, or taking progressively larger numbers of antihypertensive drugs. Patients were receptive to this service and kept appointments with the pharmacist investigator 92% of the time. The services provided which may have contributed to the success of treatment are discussed. It is concluded that pharmacy clinical services are beneficial and that pharmacists should become more involved in the long term care given hypertensive patients.

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An analysis of GSR conditioning.

1961-01-01

Moira Stewart , John A. Stern , George Winokur +1 more

Health Education for Hypertensive Patients

1979-04-20

David M. Levine , Lawrence W. Green , Sigrid G. Deeds +3 more

Three educational interventions for the control of essential hypertension in ambulatory patients were based on analyses of the educational needs of patients and providers. The educational program increased reported compliance … Three educational interventions for the control of essential hypertension in ambulatory patients were based on analyses of the educational needs of patients and providers. The educational program increased reported compliance with medication, improved the proportion of patients losing weight, and improved appointment keeping. Most important, there was a favorable effect on blood pressure (BP) control. The proportion of patients with BP under control in the group assigned to all three interventions increased by 28% (from 38% to 66%), while the proportion in the control group receiving standard medical therapy with no educational interventions remained unchanged at 42%.

A study of the causes of non-compliance by patients prescribed eyedrops.

1990-08-01

A.J. Winfield , D. Jessiman , Andrew M. Williams +1 more

An investigation into the causes of non-compliance by patients using eyedrops has been undertaken by questionnaire, ability tests, and by tests on eyedrop bottles. The results indicate a high prevalence … An investigation into the causes of non-compliance by patients using eyedrops has been undertaken by questionnaire, ability tests, and by tests on eyedrop bottles. The results indicate a high prevalence of non-compliance, compounded by an inability adequately to instill a drop into the eye. About half the patients had difficulty aiming the drop, and other problems including squeezing the bottle, blinking, and seeing the tip of the bottle. Ability tests included a measurement of the grip strength of patients to complement measurement of the force required to expel a drop from a bottle. Some patients, particularly those with arthritis, could not generate enough force to squeeze a bottle. These same patients also had difficulty with the other movements required to administer drops. While some attempts have been made to produce devices to assist with eyedrops which can improve the aim of the patient, none give assistance in expelling a drop. An additional problem found was the reluctance of patients to admit to medical staff that they experienced any difficulty with their drops.

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Preparation and Evaluation of Tablets Rapidly Disintegrating in Saliva Containing Bitter-Taste-Masked Granules by the Compression Method.

1999-01-01

Tatsuya Ishikawa , Yoshiteru Watanabe , Naoki Utoguchi +1 more

The aim of this study was to prepare, using taste-masked granules, tablets which can rapidly disintegrate in saliva (rapidly disintegrating tablet), of drugs with bitter taste (pirenzepine HCl or oxybutynin … The aim of this study was to prepare, using taste-masked granules, tablets which can rapidly disintegrate in saliva (rapidly disintegrating tablet), of drugs with bitter taste (pirenzepine HCl or oxybutynin HCl). The taste-masked granules were prepared using aminoalkyl methacrylate copolymers (Eudragit E-100) by the extrusion method. None of the drugs dissolved from the granules (% of dissolved, < 5%) even at 480 min at pH 6.8 in the dissolution test. However, the drugs dissolved rapidly in the medium at pH 1.2 in the dissolution test. Rapidly disintegrating tablets were prepared using the prepared taste-masked granules, and a mixture of excipients consisting of crystalline cellulose (Avicel PH-102) and low-substituted hydroxypropylcellulose (L-HPC, LH-11). The granules and excipients were mixed well (mixing ratio by weight, crystalline cellulose: L-HPC = 8:2) with 1% magnesium stearate, and subsequently compressed at 500-1500 kgf in a single-punch tableting machine. The prepared tablets (compressed at 500 kgf) containing the taste-masked granules have sufficient strength (the crushing strength: oxybutynin tablet, 3.5 kg; pirenzepine tablet, 2.2 kg), and a rapid disintegration time (within 20 s) was observed in the saliva of healthy volunteers. None of the volunteers felt any bitter taste after the disintegration of the tablet which contained the taste-masked granules. We confirmed that the rapidly disintegrating tablets can be prepared using these taste-masked granules and excipients which are commonly used in tablet preparation.

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Probabilities Associated with the Referral to Placement Process

1982-07-01

Bob Algozzine , Sandra L. Christenson , James E. Ysseldyke

Normative Data on the Boston Naming Test and Two Equivalent 30-Item Short Forms

2000-11-01

Judith Saxton , Graham Ratcliff , Cynthia A. Munro +4 more

Abstract Because of the significance of the Boston Naming Test (BNT) in the differential diagnosis of the dementias, especially Alzheimer's disease, adequate norms from community-dwelling elderly individuals are essential. The … Abstract Because of the significance of the Boston Naming Test (BNT) in the differential diagnosis of the dementias, especially Alzheimer's disease, adequate norms from community-dwelling elderly individuals are essential. The present study describes the development of two new empirically derived equivalent short forms (30 items each) of the test. Normative data for the total BNT and the two equivalent 30-item halves based on item difficulty are presented using the performance of 314 community-dwelling individuals aged 65 and over. Age and education norms are presented using an overlapping midpoint interval strategy.

Pharmacists’ Attitudes Toward Worklife: Results From a National Survey of Pharmacists

2004-05-01

David A. Mott , William R. Doucette , Caroline A. Gaither +2 more

An Emergency Room??s Patients: Their Characteristics and Utilization of Hospital Services

1975-12-01

Ralph Ullman , James A. Block , William C. Stratmann

Utilization of the emergency room at an urban community hospital is studied in a format designed to accomplish three complementary objectives: 1) to characterize a sample of individual patients, rather … Utilization of the emergency room at an urban community hospital is studied in a format designed to accomplish three complementary objectives: 1) to characterize a sample of individual patients, rather than an unweighted sample of visits, 2) to estimate the number of individuals served during a specified period and the magnitude of the relationship between these patients and the utilization of other hospital services, and 3) to introduce the patient's "frequency-of-visit" as an important variable in the analysis of emergency room utilization. Some specific findings are: 1) the vast majority of patients who used the emergency room did so very infrequently; 46,527 visits were made in one year by an estimated 34,286 different patients; 2) an estimated 2,586 patients made three or more visits during the year; a disproportionately large number of these "high-frequency" users were black, low-income, and from inner-city areas; a relatively small percentage of their visits were for accidental injury, 3) approximately 53 per cent of the hospital's inpatient admissions and 68 per cent of the inpatient days were generated by patients who also made at least one emergency room visit during the year studied.

A Rank Sum Test for Comparing All Pairs of Treatments

1960-05-01

R. G. D. Steel

Abstract A multiple comparison rank sum test, for the simultaneous comparison of all pairs of treatments in a one-way classification with equal numbers of observations, is presented. An example is … Abstract A multiple comparison rank sum test, for the simultaneous comparison of all pairs of treatments in a one-way classification with equal numbers of observations, is presented. An example is worked and tables of critical values are given. Computation of probabilities for the general case of unequal numbers of observations is considered and means, variances, and covariances are given for this case.

Outcomes of pharmacist-managed diabetes care services in a community health center

2006-10-20

David Scott , Steven T. Boyd , Michelle Stephan +2 more

Journal Article Outcomes of pharmacist-managed diabetes care services in a community health center Get access David M. Scott, M.P.H., Ph.D., David M. Scott, M.P.H., Ph.D. Associate Professor Department of Pharmacy … Journal Article Outcomes of pharmacist-managed diabetes care services in a community health center Get access David M. Scott, M.P.H., Ph.D., David M. Scott, M.P.H., Ph.D. Associate Professor Department of Pharmacy Practice, College of Pharmacy, North Dakota State University, Fargo; at the time of this study he was Associate Professor, Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center (UNMC), Omaha Address correspondence to Dr. Scott at the College of Pharmacy, North Dakota State University, 118K Sudro Hall, Fargo, ND 58105 ([email protected]). Search for other works by this author on: Oxford Academic Google Scholar Steven T. Boyd, Pharm.D., BCPS, CDE, CDM, Steven T. Boyd, Pharm.D., BCPS, CDE, CDM Clinical Pharmacist and Clinical Assistant Professor UNMC; at the time of this study he was Instructor, Department of Pharmacy Practice, College of Pharmacy, UNMC, and Clinical Pharmacist, Siouxland Community Health Center (SCHC), Sioux City, IA Search for other works by this author on: Oxford Academic Google Scholar Michelle Stephan, R.N., CEO, Michelle Stephan, R.N., CEO Quality Coordinator SCHC Search for other works by this author on: Oxford Academic Google Scholar Sam C. Augustine, Pharm.D., Sam C. Augustine, Pharm.D. Associate Professor Department of Pharmacy Practice, School of Pharmacy and Health Professions, Creighton University, Omaha; at the time of this study he was Associate Professor, Department of Pharmacy Practice, College of Pharmacy, UNMC Search for other works by this author on: Oxford Academic Google Scholar Thomas P. Reardon, M.A. Thomas P. Reardon, M.A. Senior Programming Analyst Academic Computing, Information Technology Services, UNMC Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, Volume 63, Issue 21, 1 November 2006, Pages 2116–2122, https://doi.org/10.2146/ajhp060040 Published: 01 November 2006

Factors associated with medication-related problems in ambulatory hemodialysis patients

2003-01-27

Harold J. Manley , Marcy L. McClaran , Debra K. Overbay +6 more

A STUDY OF TREATMENT COMPLIANCE FOLLOWING KIDNEY TRANSPLANTATION

1993-01-01

Deborah J. Kiley , Chow S. Lam , Raymond Pollak

Kidney transplantation is a successful treatment for end-stage renal disease. We studied demographic and psychosocial variables that relate to compliance behaviors following renal transplant. One hundred and five renal allograft … Kidney transplantation is a successful treatment for end-stage renal disease. We studied demographic and psychosocial variables that relate to compliance behaviors following renal transplant. One hundred and five renal allograft recipients, with a minimum of 18 months follow-up, were studied. A biographical questionnaire, the Center for Epidemiologic Studies Depression Scale, the Multidimensional Health Locus of Control Scale, and the Social Support Appraisals Questionnaire were used as measuring instruments. Specifically for this study, we designed a Health Belief Model Questionnaire, a Patient and Provider Relationship Questionnaire, a Compliance Self-Report Questionnaire, and a Self-Efficacy Questionnaire. Compliance was determined by cyclosporine whole blood levels >30 ng/ml, maintenance of ideal body weight (<20% gain), and percentage of missed clinic visits (<20%). Data was analyzed using discriminant analysis, Pearson's correlation, and chi-square. Four groups were identified, i.e., overall compliant (n=25), noncompliant with diet (n=29), noncompliant with medication (n=27), and overall noncompliant (n=29). No patient missed >20% of clinic visits. Discriminant function analysis distinguished patients who were compliant from those who were not. Males were more likely to be noncompliant with medication, whereas females were more likely to be noncompliant with diet. Noncompliance was also associated with increased numbers of prescribed medications, depression, black race, locus of control attributed to powerful others, unemployment, as well as the perceived amount of social and family support. Patients with failed grafts (n=14) were more depressed (P<0.05), perceived less benefit from the treatment regimen (P<0.01), and had less confidence in their care providers (P<0.05) than those recipients of successful grafts (n=91). In conclusion, this study identifies a number of psychosocial and demographic variables that impact on patient compliance behaviors after renal transplant. Interventional strategies to obviate noncompliance will need to consider these heterogeneous variables in order to maximize long-term renal allograft survival.

Characteristics of Hospitals Receiving Penalties Under the Hospital Readmissions Reduction Program

2013-01-23

Karen E. Joynt , Ashish Kumar Jha

A Bedside Decision Instrument To Elicit a Patient's Preference Concerning Adjuvant Chemotherapy for Breast Cancer

1992-07-01

Mark N. Levine , Amiram Gafni , B Markham +1 more

▪ The objective of this study was to develop an instrument to help clinicians inform patients with breast cancer of risks and benefits of adjuvant chemotherapy as derived from clinical … ▪ The objective of this study was to develop an instrument to help clinicians inform patients with breast cancer of risks and benefits of adjuvant chemotherapy as derived from clinical trials and to help the informed patient decide whether she prefers treatment or no treatment. The instrument consists of a visual aid (called the decision board) and written material. It provides detailed information on a patient's choices (chemotherapy or no chemotherapy), outcomes (recurrence or not), probabilities of outcomes and their meaning, and quality of life associated with treatment choice and outcome. The validity and reliability of the instrument were evaluated in 30 healthy female volunteers. It was first administered using standard estimates of recurrence for node-negative breast cancer (15% risk of recurrence without treatment, which is reduced to 10% with chemotherapy). A preference for treatment (or no treatment) was then elicited. The validity was evaluated by changing the information provided on risks and benefits and determining whether the preference changed in a predictable manner. To test for reliability, the instrument was administered 2 weeks later. Seventeen women chose chemotherapy and 13 chose no chemotherapy. In the former group, 14 women (82%) switched preference when the magnitude of benefit was reduced, and 16 (94%) switched when the toxicity of treatment was increased. For those women who chose not to receive chemotherapy, 12 (92%) switched when the benefit was increased and 100% switched when toxicity was eliminated. The reliability was excellent (κ = 0.86). The instrument has been used to elicit treatment preferences in 37 newly presenting patients with high-risk, node-negative breast cancer and has been found to be acceptable and helpful to the patient.

Current Concepts of "Normal Values," "Reference Values," and "Discrimination Values" in Clinical Chemistry

1975-12-01

F. William Sunderman

The term "normal values" is seriously afflicted by sylleptic ambiguities and conceptual problems, and it is gradually being discarded from the lexicon of clinical chemistry. The neutral term "reference values" … The term "normal values" is seriously afflicted by sylleptic ambiguities and conceptual problems, and it is gradually being discarded from the lexicon of clinical chemistry. The neutral term "reference values" preferable on semantic and scientific grounds, and its use in clinical chemistry is rapidly gaining acceptance. The term "discrimination value" has been added to the lexicon of clinical chemistry. Use of the "discrimination value" for the results of a laboratory test in a specified clinical situation provides the optimal discrimination between the "healthy" and the "diseased," or between "those who need not be investigated further" and "those who do."

Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

2006-01-11

Satoko Niwata , Yukari Yamada , Naoki Ikegami

Abstract Background The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data … Abstract Background The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan. Methods We conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC) facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria. Results The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1%) of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%). There were 300 (18.0%) patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511), medication cost of per day (OR = 1.173), number of medications (OR = 1.140), and age (OR = 0.981) as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries.

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Effects of a pharmacist's medication review in nursing homes

2000-06-01

Lee Furniss , Alistair Burns , Sarah Craig +3 more

Older people in nursing and residential homes often have complex disabilities and behavioural disturbances. Recent publicity has highlighted the dangers of medication in this group, and controls over prescribing have … Older people in nursing and residential homes often have complex disabilities and behavioural disturbances. Recent publicity has highlighted the dangers of medication in this group, and controls over prescribing have been suggested.To investigate the effect of a review of medication by a pharmacist.An 8-month prospective trial of an active medication review by a pharmacist was carried out on 330 residents in nursing homes in Manchester.The intervention group experienced greater deterioration in cognitive function and behavioural disturbance than the control group, but the changes in depression and quality of life were similar for both groups. The number of drugs prescribed fell in the intervention group, but not in the control group, with a corresponding saving in drug costs. The number of deaths was significantly smaller in the intervention homes during the intervention period (4 v. 14) but not overall during the study period as a whole (26 v. 28).This clinical intervention reduced the number of medicines prescribed to elderly people in nursing homes, with minimal impact on their morbidity and mortality.

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Drug information handbook

1983-08-15

Richard I. Ogilvie

DEVELOPING A PROTOTYPE FOR EVALUATING ALCOHOL TREATMENT EFFECTIVENESS

1980-01-01

Mark B. Sobell , Ashley M. Cooper , Stephen A. Maisto +3 more

Estimating the Validity of the Korean Version of Expanded Clinical Dementia Rating (CDR) Scale

2001-11-01

Seong Hye Choi , Duk L. Na , Byung Hwa Lee +6 more

The European Pharmacopoeia

2018-01-01

Roland Barret

A Study of Queues and Appointment Systems in Hospital Out-Patient Departments, with Special Reference to Waiting-Times

1952-07-01

Norman T. J. Bailey

Summary An investigation, based on the use of random numbers, has been made into the kind of queueing process occurring in hospital out-patient departments. Special attention has been paid to … Summary An investigation, based on the use of random numbers, has been made into the kind of queueing process occurring in hospital out-patient departments. Special attention has been paid to the patients’ waiting time and also to the time which a consultant may waste waiting for the next patient. As compared with many appointment systems at present in use, it is concluded that by suitable choice of the system to be adopted a substantial amount of the patients’ waiting time may be eliminated without appreciably affecting the consultant. A recommended procedure is to give patients appointments at regular intervals, each equal to the average consultation time; the consultant commencing work when the second patient arrives. The effect of variations in the appointment interval, the number of patients attending the clinics, and the distribution of queue-size are discussed. The precision of the results obtained is also considered.

The Equation of the Characteristic Curve of Activated Charcoal

1947-01-01

M. M. Dubinin

Unobtrusive reference testing: the 55 percent rule

1986-01-01

Peter Hernon , Charles R. McClure

Evaluation des taux de reponses exactes fournies par les bureaux de renseignements des bibliotheques aux utilisateurs cherchant a acceder aux publications officielles Evaluation des taux de reponses exactes fournies par les bureaux de renseignements des bibliotheques aux utilisateurs cherchant a acceder aux publications officielles

Assignment to Treatment Group on the Basis of a Covariate

1977-01-01

Donald B. Rubin

Ultilization of clinical chemistry services by medical house staff. An analysis

1974-12-01

R. H. Dixon

The purpose of this study was to analyze the utilization of clinical chemistry services by a medical house staff. The percentage of laboratory data that is actually used in diagnosis … The purpose of this study was to analyze the utilization of clinical chemistry services by a medical house staff. The percentage of laboratory data that is actually used in diagnosis and treatment of patients is low (5%). This percentage can be significantly increased when greater selectivity is required prior to ordering blood chemistry tests. A close relationship existed between the percentage of abnormal test results and the number of test results significant to patient care. This relationship should be useful in assessing the effectiveness with which a house officer uses the chemistry laboratory. We suggest that greater teaching emphasis should be placed on the patient care-laboratory interface of house staff training.

A Multiple Comparison Procedure for Comparing Several Treatments with a Control

1955-12-01

Charles W. Dunnett

ASHP Statement on Pharmaceutical Care

1993-08-01

Journal Article ASHP Statement on Pharmaceutical Care Get access American Journal of Hospital Pharmacy, Volume 50, Issue 8, 1 August 1993, Pages 1720–1723, https://doi.org/10.1093/ajhp/50.8.1720 Published: 01 August 1993 Journal Article ASHP Statement on Pharmaceutical Care Get access American Journal of Hospital Pharmacy, Volume 50, Issue 8, 1 August 1993, Pages 1720–1723, https://doi.org/10.1093/ajhp/50.8.1720 Published: 01 August 1993

Temporal Trends in Patient Characteristics and Treatment With Intravenous Thrombolysis Among Acute Ischemic Stroke Patients at Get With the Guidelines-Stroke Hospitals

2013-09-01

Lee H. Schwamm , S. F. Ali , Mathew J. Reeves +7 more

Substantial efforts over the past decade have increased rates of intravenous tissue plasminogen activator (tPA) use in the United States. We sought to determine changes in patient characteristics and rates … Substantial efforts over the past decade have increased rates of intravenous tissue plasminogen activator (tPA) use in the United States. We sought to determine changes in patient characteristics and rates of tPA use over time among hospitalized acute ischemic stroke (AIS) patients.We analyzed all AIS patients (n=1 093 895) and those arriving ≤ 2 hours and treated with tPA ≤ 3 hours after onset (n=50 798) from 2003 to 2011 in the American Heart Association's Get with the Guideline-Stroke (GWTG-Stroke). Categorical data were analyzed by Pearson χ(2) and continuous data by Wilcoxon test. Intravenous tPA use ≤ 3 hours after onset increased from 4.0% to 7.0% in all AIS admissions and 42.6% to 77.0% in AIS patients arriving ≤ 2 hours and fully eligible for tPA (P<0.001). In univariate analysis, tPA use increased over time, especially in those aged >85 years, nonwhite, and with milder strokes (National Institutes of Health Stroke Scale 0-4). Door-to-image time (median 24 versus 20 minutes) and door-to-tPA time (median 81 versus 72 minutes) also improved, with ≈65% of tPA-treated patients getting brain imaging ≤ 25 minutes after arrival. Multivariable analysis showed that with each additional calendar year, the odds that an eligible patient would receive tPA increased by 1.37-fold, adjusting for other covariates.The frequency of IV tPA use among all AIS patients, regardless of contraindications, nearly doubled from 2003 to 2011. Treatment with tPA has expanded to include more patients with mild deficits, nonwhite race/ethnicity, and oldest old age.

The effect of prescribed daily dose frequency on patient medication compliance

1990-09-01

Seth A. Eisen

Understanding and Utilizing Claim Data from the Korean National Health Insurance Service (NHIS) and Health Insurance Review & Assessment (HIRA) Database for Research

2022-01-01

Dae‐Sung Kyoung , Hun‐Sung Kim

Almost every Korean (97%) is enrolled in the National Health Insurance program, and most receive medical treatment at least once a year. Data are collected by the Health Insurance Review … Almost every Korean (97%) is enrolled in the National Health Insurance program, and most receive medical treatment at least once a year. Data are collected by the Health Insurance Review and Assessment Service (HIRA), and the results of the review are sent to the National Health Insurance Service (NHIS). The data handled by NHIS and HIRA cover almost the entire population and can be used for various research purposes. NHIS and HIRA support research by making these data available to researchers. The greatest advantage of these data is that they are the only data which include virtually the entire population. Both HIRA and NHIS data are provided in the form of sample data and all (customized) data. NHIS and HIRA data are similar but exhibit minor differences. HIRA data consists of five tables, including general specification details, in-hospital treatment details, disease details, out-of-hospital prescription details, and nursing institution information. NHIS data include death records (including cause of death), some medical examination records, and the socio-economic variables of the subject, such as income, in addition to all the HIRA data. Clinical results of treatments are not recorded in NHIS or HIRA. However, because public data are used for billing purposes, actual research has thus far been limited. Therefore, researchers must develop a study design that can minimize the errors or bias occurring during the course of the study. Therefore, it is necessary to clearly understand the structure and characteristics of NHIS and HIRA data when initiating research.

A Test for Differences between Treatment Means When Several Dose Levels are Compared with a Zero Dose Control

1971-03-01

D. A. Williams

A Revised Tolerance Table

1949-03-01

F. S. Baker

Pharmacy-Based Immunization Delivery Certificate Training Program for Enhancing the Pharmacy Profession in Public Health

2025-06-25

Sandy Jeong Rhie | Korean Journal of Clinical Pharmacy

Factors Influencing Customer Transaction Behavior in Pharmacies: A Comparative Analysis of Chain-affiliated and Independent Pharmacies in South Korea

2025-06-25

Su Yeon Kang , H Kim , Hee Yeon Kay | Korean Journal of Clinical Pharmacy

Development and Application of a Clinical Pharmacy-based General Education Curriculum for Non-pharmacy Undergraduate Students

2025-06-25

Seeun Choi , Seunghwan Jung , Kiyon Rhew | Korean Journal of Clinical Pharmacy

Community pharmacists’ perceptions of dispensing long-term prescriptions exceeding 90 days – A survey of pharmacists from a single pharmacy chain

2025-06-25

Youngran Kim , Eunjin Hong , Hyekyung Park | Korean Journal of Clinical Pharmacy

Impact of Pharmacist Telehealth Comanagement for Heart Failure

2025-06-25

Debra Fox , Nadine Zawadski , Kimberly A. Buss +3 more | JACC Advances

Community Pharmacists’ Awareness and Perceptions on the Role of Pharmacists in the Treatment and Management of Rare Disease Patients in Korea

2025-06-25

Jeongeun Kim , Sung Cil Lim | Korean Journal of Clinical Pharmacy

Predicting the Relative Risk of Pharmacotherapy Based on a Mathematical Model of Age-Related Decline in Homeostasis in Elderly and Senile Patients

2025-06-24

R. D. Syubaev , Г. Н. Енгалычева | Safety and Risk of Pharmacotherapy

INTRODUCTION. The natural morpho-functional involution of the ageing body is accompanied by an age-related decline in homeostasis, which leads to changes in the pharmacodynamics, pharmacokinetics, and toxicity of medicines. Mathematical … INTRODUCTION. The natural morpho-functional involution of the ageing body is accompanied by an age-related decline in homeostasis, which leads to changes in the pharmacodynamics, pharmacokinetics, and toxicity of medicines. Mathematical prediction models (MPMs) are a promising tool for predicting age-associated pharmacotherapy risks in elderly and senile patients. AIM. This study aimed to develop a simple linear mathematical model for predicting age-related changes in the relative risk of pharmacotherapy. MATERIALS AND METHODS. A basic statistical hypothesis for the MPM was formulated using generally accepted approaches and methods adapted to the original physiological concept of age-related decline in homeostasis. The prediction hypothesis has theoretical and clinical prerequisites. Statistically, the proposed MPM is a single-factor linear regression model. The main parameters and key criteria of the model include age (predictor), life expectancy, and the rates of population and physiological age-related decline in homeostasis. RESULTS. The algorithm developed for predicting the relative risk of pharmacotherapy based on the concept of age-related decline in homeostasis includes the following steps: 1) establishing the rate of population-based decline relative to the linear trend of hypothetical physiological decline; 2) determining the probability limits for critical age-related decline in homeostasis; 3) extrapolating the relative risk (RR) and the odds ratio (OR) of age-related decline in homeostasis to the corresponding pharmacotherapy parameters; and 4) using the available data on the risk of pharmacotherapy in young and middle-aged patients to convert predictions into quantitative characteristics of adverse drug reactions. The predictions based on the data obtained are in good agreement with clinical observations that indicate a 2–7-fold increase in the risk of developing adverse drug reactions during pharmacotherapy in elderly and senile patients. The physiological homeostatic decline rate in centenarians within the linear model corresponds to the age-related decline in human pharmacokinetic clearance parameters. The physiological homeostatic decline parameters allow researchers to assess the impact of population risk factors on age-related decline in homeostasis. CONCLUSIONS. The MPM developed in this study provides a means to predict the relative risk of pharmacotherapy in elderly and senile patients based on the concept of age-related decline in homeostasis. The results support further evaluation of the predictive effectiveness of the model.

Clerkship Assessment Reliability Based on Assessor Type and Assessor-Student Contact Frequency: A Generalizability Theory Analysis

2025-06-23

Christopher Mattson , Celia Laird O’Brien , Yoon Soo Park +3 more | Academic Medicine

Workplace-based assessments (WBAs), such as clinical performance assessments (CPAs), often comprise a significant portion of clerkship assessment systems. This study explores the reliability of CPAs in clerkships based on assessor … Workplace-based assessments (WBAs), such as clinical performance assessments (CPAs), often comprise a significant portion of clerkship assessment systems. This study explores the reliability of CPAs in clerkships based on assessor characteristics, including assessor type and assessor-student contact frequency. The CPAs of third-year medical students at Northwestern University Feinberg School of Medicine completed during 5 clerkships in academic year 2021 to 2022 were compiled. Analyses compared clerkship assessments per student and breakdown of assessor characteristics by clerkship. Generalizability analysis divided assessments by clerkship, assessor type (resident vs attending), and assessor-student contact frequency (daily vs not daily). Decision studies examined the number of assessments needed per student to achieve reliability of 0.7 (D0.7). A total of 4,062 CPAs completed by 734 assessors on 179 students were analyzed. The number of attending versus resident assessors and daily versus not daily assessors varied by clerkship. Assessments completed by residents were more reliable than assessments completed by attendings (resident φ coefficient = 0.62; student variance, 8.5%; D0.7 = 19; attending φ coefficient = 0.48; student variance, 5.6%; D0.7 = 34). Assessments completed by assessors with daily contact were more reliable than assessments completed by assessors with not daily contact (daily contact φ coefficient of = 0.63; student variance, 7.6%; D0.7 = 22; not daily contact φ coefficient = 0.31; student variance, 5.7%; D0.7 = 34). Residents with daily contact were most reliable (φ coefficient = 0.38, D0.7 = 16). Differences in assessor type and assessor-student contact frequency may explain between-clerkship differences in assessment reliability. These findings provide an opportunity to consider assessor characteristics in the design of assessment systems, thus improving assessment reliability and working toward systems that can be trusted by all stakeholders.

STUDY OF PHARMACISTS’ AWARENESS OF PHARMACOTHERAPY PRINCIPLES, PATIENT COUNSELING, AND PREFERENCES OF CUSTOMERS WITH DIABETES

2025-06-16

Nikitin R.O. , Irina Y. Filina , Varenykh G.V. | Medical & pharmaceutical journal Pulse

Type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic conditions, requiring continuous monitoring and pharmacological support. However, the level of awareness among pharmacy staff regarding T2DM and … Type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic conditions, requiring continuous monitoring and pharmacological support. However, the level of awareness among pharmacy staff regarding T2DM and their readiness to provide counseling may vary significantly. The aim of the study was to assess the knowledge and informational needs of pharmacists in the Belgorod region concerning the counseling of T2DM patients, as well as to analyze the needs of diabetic patients. The study involved 155 pharmaceutical specialists from the Belgorod region. The analysis revealed that 54.2% of respondents considered their knowledge of T2DM to be comprehensive, 31.6% rated it as superficial, and 14.2% as unsatisfactory. Assessment of factual knowledge showed that only 72.2% correctly identified the primary symptoms of T2DM, while 61.9% recognized its complications. At the same time, a quarter of respondents reported difficulties in counseling diabetic patients. The main sources of information for pharmacy staff were webinars (65.8%) and medical reference materials (58.7%). The overwhelming majority of professionals (92.3%) expressed a need for additional training. In the patient-focused segment of the study, 396 individuals participated. Satisfaction with medical care was relatively high: 77.8% of patients were content with their physician consultations, and 72.2% positively evaluated the clarity and completeness of prescribed treatment information. However, 55.6% of respondents believed that pharmacy staff lacked sufficient competence in counseling on medication selection, usage, and dispensing. The demand for pharmaceutical information among patients was exceptionally high: 94.4% wanted details about drug synonyms and alternatives, 66.7% were interested in drug interactions, 55.6% sought information on diabetes prevention and risk reduction strategies, and half of the patients desired guidance on indications, administration rules, and medication costs. 50% of respondents preferred domestically produced medications, while 61.1% felt that the current pharmaceutical market offerings were insufficient for effective diabetes management. Additionally, 61.1% reported having to purchase diabetes medications and supplies at their own expense. The findings of this study can be utilized to enhance continuing education programs for pharmacists, optimize counseling services for diabetic patients, and improve the overall quality of pharmaceutical care for individuals with diabetes.

РОЛЬ КОМПЛЕКСНОГО УПРАВЛІННЯ ЯКІСТЮ МЕДИЧНИХ ПОСЛУГ У СИСТЕМІ ОХОРОНИ ЗДОРОВ’Я

2025-06-16

N. Ya. Panchyshyn , І. О. ДМИТРУК , Н. О. Теренда +3 more | Вісник соціальної гігієни та організації охорони здоров я України

Мета: вивчення ролі комплексного управління якістю медичних послуг у підвищенні якості закладів у системі охорони здоров’я. Матеріали та методи. Як підхід до аналізу даних було використано метод контент-аналізу з метою … Мета: вивчення ролі комплексного управління якістю медичних послуг у підвищенні якості закладів у системі охорони здоров’я. Матеріали та методи. Як підхід до аналізу даних було використано метод контент-аналізу з метою систематичного опрацювання, оцінювання та інтерпретації форми та змісту інформаційних джерел. Результати. Досягнення постійного поліпшення якості є фундаментальною основою підходів комплексного управління якістю (КУЯ) і безперервного поліпшення якості в системі охорони здоров’я. Мета КУЯ полягає в тому, щоб залучити та мотивувати всі рівні робочої сили закладу охорони здоров’я взяти на себе відповідальність за успіх організації. Важливо, щоб усі в організації працювали разом, щоб постійно вдосконалювати цільове рішення, а саме якість медичної допомоги, що надається пацієнтам, щоб задовольнити їхні потреби та очікування. Ключовим інструментом забезпечення та покращення якості медичних послуг є клінічний аудит, який дозволяє оцінювати відповідність надання медичної допомоги стандартам, виявляти недоліки та впроваджувати коригувальні заходи. Впровадження КУЯ в організаційний процес незмінно призводить до покращення рівня продуктивності цієї організації. Доведено, що це є статистично значущим результатом. Методологія КУЯ наголошує на задоволеності пацієнтів, виявленні загальноорганізаційних проблем, розвитку та просуванні відкритого прийняття рішень і серед співробітників, і серед пацієнтів. Висновки. Управління якістю передбачає підвищення безпеки пацієнтів, мінімізацію помилок та оптимізацію результатів надання медичної допомоги з використанням сучасних методологій, зокрема КУЯ, та безперервного поліпшення якості. КУЯ має вирішальне значення для надання високоякісних медичних послуг, досягнення задовільних результатів у галузі охорони здоров’я та виконання головної мети охорони здоров’я ‒ підвищення рівня задоволеності пацієнтів.

A systematic review and meta-analysis of health-related quality of life values derived from EQ-5D-5L in psoriatic patients

2025-06-15

Hoàng Văn Minh , Ngan Pham , Hải Trần +2 more | Ministry of Science and Technology Vietnam

Retrospective Analysis of Notification Cards about Adverse Events of Anti-tuberculosis Medicines

2025-06-15

N. Toktonalieva , I. Toktonaliev | Bulletin of Science and Practice

This study is devoted to the analysis of adverse events (AE) associated with the use of anti-tuberculosis medicines in the Kyrgyz Republic for 2023–2024, based on notification cards received by … This study is devoted to the analysis of adverse events (AE) associated with the use of anti-tuberculosis medicines in the Kyrgyz Republic for 2023–2024, based on notification cards received by the pharmacovigilance and advertising department of the Department of Medicines and Medical Devices of the Ministry of Health of the Kyrgyz Republic. A total of 1152 notification cards were analyzed. AEs were recorded almost equally in men (49%) and women (51%), the average age of patients was 37,6 years. The most common AEs were hepatotoxic reactions (22,5%), especially with the combination drug Protube 4 (isoniazid, rifampicin, pyrazinamide, ethambutol). Other common AEs were gastrointestinal disorders (20,9%), allergic reactions (11,6%), myelosuppression (12,2%), arthralgia (9,3%), and CNS disorders (7,8%). Cases of QT prolongation (2.6%) and fatal cardiotoxicity (0.5%) have been reported with the combination of bedaquiline and fluoroquinolones. Peripheral neuropathies, optic nerve damage, hypokalemia, and dyspnea have also been reported. The analysis highlights the high importance of systematic pharmacovigilance, especially in the context of polypharmacy and the use of regimens with potentially unidirectional toxic effects. The obtained data allow us to predict the development of AE and adjust pharmacotherapy, providing an individualized approach to the treatment of tuberculosis, minimizing the risks of multiple organ failure and increasing patient safety.

263-OR: Impact of Pharmacist-Led Digital Education Program on Diabetes Medication Adherence—A Large-Scale Retrospective Cohort Study in Japan

2025-06-13

MASAYA SAKAMOTO , TOMOYA SAIKA , SHOTA SHIMAYOSHI +3 more | Diabetes

Introduction and Objective: Medication adherence is critical for glycemic control in diabetes, but is limited by provider workload. This study evaluated the impact of pharmacist-delivered digital education on medication adherence. … Introduction and Objective: Medication adherence is critical for glycemic control in diabetes, but is limited by provider workload. This study evaluated the impact of pharmacist-delivered digital education on medication adherence. Methods: A retrospective cohort study using data from Japanese pharmacies (July-December 2023) via the electronic medication history system Musubi (KAKEHASHI Inc.) for diabetes patients. Medication counseling included optional Health Advice (HA), digital content based on the Health Belief Model displayed on digital device via Musubi. Patients were divided into HA and non-HA groups. Propensity score matching was used to adjust for background differences. Primary outcome was the proportion of days covered (PDC) over 180 days as medication adherence, analyzed using multilevel logistic regression analysis for PDC ≥ 80%. Results: Of 399,022 patients, 45,721 were matched in each group, confirming similar backgrounds by standardized mean differences. HA was a significant independent factor for PDC ≥ 80% (OR 1.98 [95% CI 1.88-2.08]) (Figure). Antihypertensive and antihyperlipidemic medications were also significant factors. Conclusion: Pharmacist-led counseling using digital content may improve medication adherence in diabetes, supporting standardization and broader implementation. Disclosure M. Sakamoto: None. T. Saika: Employee; KAKEHASHI Inc. S. Shimayoshi: Employee; KAKEHASHI Inc. M. Yamazaki: Employee; KAKEHASHI Inc. T. Takebe: Employee; KAKEHASHI Inc. S. Ikeda: None.

Exploring the Perspectives of Health and Social Care Workers on the Influence of CQC-Regulated Services on Providers in the Health and Social Care Sector

2025-06-13

Chijioke Paul Igwe , Ejikeme Peter Igwe , Fimbaya Chua Ephraim | Asian Journal of Advanced Research and Reports

Within the United Kingdom, particularly England, this work is an exploration of the health and social care employees’ perspective on the impacts of Care Quality Commission (CQC)-regulated services. The CQC … Within the United Kingdom, particularly England, this work is an exploration of the health and social care employees’ perspective on the impacts of Care Quality Commission (CQC)-regulated services. The CQC plays a paramount role in sustaining, maintaining, and improving the quality of service delivery, being the primary regulator. Nonetheless, these roles have practical implications for health and social care frontliners. The CQC regulations influence the quality of service delivery in England. Based on the foregoing, the present study examines the impact assessment of CQC-regulated activities through the health and social care personnel perspective, covering areas like roles, practices, outcomes, and quality of care. This study uses a quantitative research method as well as a survey method to gather data from various healthcare providers by administering a well-structured Google Form (survey questionnaire) to about 250 persons. About 143 participating individuals within the health and social care sector responded. Data was analysed through the lens of descriptive statistics and correlation analysis. Findings reveal a structural disconnect between the approach to inspection and the health and social care service realities. It is, however, compounded by genuine concerns about accuracy, fairness, frontline engagement, and lack of flexibility in implementation—with 64.3% suggesting that CQC is a reflection of true standards; other results, as also shown in RQ2, indicate that CQC ratings are also influenced by internal strategies and external perceptions. 58.1% and 49% viewed CQC as impactful; meanwhile, 12.6% and 11.9% reflect the gaps in capturing staff needs and the daily operational struggles. Critical gaps in regulatory methodologies and potentially biased approaches are voiced out in the analysis and pinpointed by 10.5% and 12.6% of respondents, respectively. The findings further highlighted the challenges and the positive aspects of CQC regulation. Moreover, the research provides substantial input to the ongoing discussion in both academic and health settings regarding regulation in care settings. It also offers service enhancement and insight to regulatory bodies, policymakers, and health providers.

A Study on Incidence of Minimal Hepatic Encephalopathy in Chronic Liver Disease Patients by Psychometric Methods

2025-06-13

Arshiya Mubin S P , Sandeep Kumar Reddy G , Annareddy Tejeswara Reddy | International Journal of Science and Research (IJSR)

1126-P: Pharmacist Intervention to Improve OB Provider Confidence in CGMS Interpretation and Billing

2025-06-13

Jay D. Mitchell , Jessica Odom , Amy Robinson +1 more | Diabetes

Introduction and Objective: Pregnant individuals with diabetes face increased risks of complications for mother and fetus. CGMS use has been shown to improve outcomes in type 1 diabetes with ongoing … Introduction and Objective: Pregnant individuals with diabetes face increased risks of complications for mother and fetus. CGMS use has been shown to improve outcomes in type 1 diabetes with ongoing research in type 2 and gestational diabetes. A unique education module was produced for OB providers to address hesitation to adopt the technology due to time constraints and technological challenges. This study evaluates an educational intervention for OB providers to enhance their knowledge and confidence in CGMS use and billing practices. Methods: A single-center quasi-experimental study assessed the impact of a 30-min live learning module on CGMS report interpretation and billing for OB providers. Pre and post module surveys evaluated knowledge and confidence with statistical significance determined by the Wilcoxon signed-rank test. A retrospective review of billing data from Dec 2023 to Feb 2024 was conducted. Results: Twenty-one OB providers participated in the learning module, pre- and immediate-post assessment. Eleven of 21 (52%) OB providers participated in the 3-month post assessment. Knowledge and confidence scores were significantly higher immediately after the educational session than prior to completion, (knowledge score mean difference: 5.38; p &lt; 0.001, confidence score mean difference: 6.76; p &lt; 0.001) and at the 3-month post assessment compared to the preassessment, (knowledge score mean difference: 3.33; p = 0.004, confidence score mean difference: 7.67; p = 0.004). The providers successfully billed 70% of CGMS opportunities from Dec 2023 through Feb 2024, with a decline over the 3 months measured, Dec 2023 (90%), Jan 2024 (72%), Feb 2024 (35%). Conclusion: The educational intervention increased OB providers knowledge and confidence in CGMS interpretation and billing immediately after the intervention and 3 months later. Providers could successfully bill for CGMS interpretation following the intervention. However, there is opportunity to bill more consistently. Disclosure J. Mitchell: None. J. Odom: None. A. Robinson: None. M.M. Schellinger: None.

518-P: Enhancing CGM Utilization in Primary Care—Outcomes of a Comprehensive Education and Training Program in an Academic Institution

2025-06-13

Ina C. Flores Shih , RAFAEL CELEDON-GARCIA , K. Walkiria Zamudio-Coronado +5 more | Diabetes

Introduction and Objective: Despite the proven benefits of continuous glucose monitoring (CGM) in improving diabetes management, its adoption remains limited, particularly in primary care (PC) settings. This underutilization represents a … Introduction and Objective: Despite the proven benefits of continuous glucose monitoring (CGM) in improving diabetes management, its adoption remains limited, particularly in primary care (PC) settings. This underutilization represents a critical gap in healthcare delivery. Methods: A CGM implementation program was launched within a large academic network to educate, train, and support primary care professionals—including residents, faculty, nursing staff, and ancillary personnel—on using CGM for insulin-treated patients with type 1 and type 2 diabetes. Spanning over 25 PC clinics between February 2023 and December 2024, the program combined live and virtual conferences and hands-on clinic-based education sessions covering CGM placement, ordering, data interpretation, and workflow integration. After training, participants completed an anonymous, retrospective pre-post survey with a 4-point Likert scale and free-response questions Results: A total of 650 healthcare professionals participated in the training program, comprising 42.9% providers and 57.1% support staff. Of them, 67.1% attended live conferences, and 32.9% participated in clinic-based face-to-face sessions. Level of comfort and expertise after training increased on CGM placement (67% to 92%), understanding benefits (68% to 93%), sensor-device ordering (53% to 77%), sensor-device connectivity (72% to 91%), and linking patients to the clinic’s data management platforms (53% to 74%); all p &lt; 0.0001. All providers expressed interest, with 93% demonstrating strong interest for implementing CGM into their practice. Participants cited insurance challenges (29%), time constraints (18%), and insufficient training (16%) as the most significant barriers. Conclusion: Primary care professionals are eager to implement CGM but face several challenges when prescribing it. This study reinforces the need for improved clinician education on CGM technology, improving care for patients with diabetes. Disclosure I.C. Flores Shih: None. R. Celedon-Garcia: None. K. Zamudio-Coronado: None. B. Marshall: None. I.A. Castro-Revoredo: None. S. Kantipudi: None. A. Isaacs: None. G. Umpierrez: Research Support; Abbott, Dexcom, Inc., Bayer Pharmaceuticals, Inc, Corcept Therapeutics. Advisory Panel; Dexcom, Inc., GlyCare Health.

1115-P: Examining Facilitators and Barriers of CGM and Technology Use among Patients with Type 2 Diabetes Mellitus in Community Health Centers

2025-06-13

Marc Wolter , Emily Lam , Andrew Boutsicaris +7 more | Diabetes

Introduction and Objective: Continuous glucose monitoring (CGM) improves outcomes but is rarely used in community health centers (CHCs). This study aimed to assess CGM use in CHCs in the context … Introduction and Objective: Continuous glucose monitoring (CGM) improves outcomes but is rarely used in community health centers (CHCs). This study aimed to assess CGM use in CHCs in the context of in-person and remote (e.g., telehealth) delivery. Methods: Participants with T2DM were recruited from two Midwest-based CHC systems that care for underserved communities. CGM users and non-users completed a survey and virtual semi-structured interviews with a trained facilitator. Interviews were recorded and transcribed, and themes were identified among CGM non-users and non-users. Results: Twenty-five participants (18 CGM users, 7 non-users, age 48 +13 yrs) were diverse in racial and gender identity (15 black, 6 white, 4 other, 15 female, 8 male, 1 non-binary, 1 transgender) with primarily public insurance (22 Medicare/Medicaid) and 14 unemployed and/or disabled. They reported using internet and cellphones for health information (88%), had apps on phone (88%), and described varying social needs related to transportation (n=14), food (n=10), and housing (n=3). Most utilized EHR portals (n=17), but fewer (n=12) used telemedicine. For CGM non-users, barriers included insurance coverage and lack of device-specific knowledge. CGM users weighed a variety of factors (e.g., reduced need for fingerstick, pain) before deciding; concerns also stemmed from lack of information or prior experience with CGM. Both users and non-users believed that CGM is helpful for diabetes care. Both groups reported learning about CGM outside the clinic through channels such as social media, including specifically YouTube. Conclusion: Advancements in information sharing and health education, along with understanding of social networks, are needed to improve uptake and utilization of CGM among patients with T2DM at CHCs. Disclosure M.E. Wolter: None. E.L. Lam: None. A.S. Boutsicaris: None. J. Gacki-Smith: None. S.E. DeLacey: None. A. Pack: Consultant; Gilead Sciences, Inc. S. Agarwal: Research Support; Dexcom, Inc. A. Berry: None. M.J. O'Brien: None. A. Wallia: Research Support; UnitedHealth Group. Funding NIH NIDDK (5 P30DK020541-4751) and the Chicago Center for Diabetes Translation Research (P30 DK092949)

1012-P: Codesigning Solutions for CGM Use in Community Health Centers

2025-06-13

Emily Lam , MELANIE E. WOLTER , ALLISON PACK +7 more | Diabetes

Introduction and Objective: Co-design is a research method to help develop solutions for complex healthcare problems. Continuous glucose monitoring (CGM) helps optimize diabetes mellitus (DM) care, yet uptake in community … Introduction and Objective: Co-design is a research method to help develop solutions for complex healthcare problems. Continuous glucose monitoring (CGM) helps optimize diabetes mellitus (DM) care, yet uptake in community health centers (CHCs) is low. This study aimed to identify barriers to CGM use and propose user-centered solutions to increase CGM use in CHCs. Methods: DM team members involved in implementation or delivery of DM care in CHCs in the US were recruited to participate in 1-2 sessions via videoconferencing, which were audio recorded and transcribed. Session 1 elicited barriers and facilitators, guided by the Consolidated Framework for Implementation Research (CFIR) and System Engineering Initiative for Patient Safety (SEIPS) model. Session 2 (design) focused on ideating, categorizing, and prioritizing solutions. Transcripts were coded deductively using these constructs, and inductive codes were generated from data. A code matrix was used to organize coded data and develop themes. Solutions were categorized at the individual, clinic, or external level. Results: Twenty-two participants spanning roles (quality, clinical), across 5 states, participated. Analyses identified barriers, facilitators, and solutions to CGM initiation and data monitoring. CGM initiation was hindered by insurance requirements, inadequate staffing, and low confidence in managing patients with CGM. Remote monitoring of CGM data was limited by a perceived lack of patient access to necessary technologies (cell phones, internet) and limited integration of data into the EHR and workflows. Facilitators (dedicated expertise in CGM, utilization of CGM samples) and solutions were largely focused on initiation. Solutions were at the individual (trainings), clinic (partnerships with CGM companies, utilization of diabetes prevention program infrastructure), and external levels (broader coverage, receiver redesign). Conclusion: Multilevel solutions are needed to ensure that healthcare teams and patients benefit from DM technologies. Disclosure E.L. Lam: None. M.E. Wolter: None. A. Pack: Consultant; Gilead Sciences, Inc. J. Gacki-Smith: None. S.E. DeLacey: None. S. Agarwal: Research Support; Dexcom, Inc. B. Ankenman: None. D.W. Gatchell: None. A. Berry: None. C.T. Schaefer: None. M.J. O'Brien: None. A. Wallia: Research Support; UnitedHealth Group. Funding NIH NIDDK (P30DK020541-4751); Chicago Center for Diabetes Translation Research (P30 DK092949)

Differentiation Between Early and Severe Stages of Dementia in Claims Data Based on Diagnosis, Prescription, and Utilization Patterns

2025-06-12

Moritz Platen , Maresa Buchholz , Anika Rädke +5 more | Neurology and Therapy

Documentation of Quality Management System for Higher Education Institution

2025-06-05

| Ergodesign

The article examines an approach to documenting the quality management system (QMS) of a higher education institution (HEI), following the principles outlined in ENQA and ISO 9000 series based on … The article examines an approach to documenting the quality management system (QMS) of a higher education institution (HEI), following the principles outlined in ENQA and ISO 9000 series based on integrating into the considered model of the standards GOST R ISO 10013-2024 and GOST R 7.0.97-2016. The work analyses challenges and associated discrepancies in forming registers and forms of QMS documentation at HEIs caused by two factors. Firstly, the lack of specificity regarding development and control of documented information in the current family of international ISO 9000 standards (version 2015); secondly, the release only in December 2025 of the anticipated new version of ISO 9000:2025 standards, which raises hopes among the scientific community for resolving these issues. The authors justify the relevance of applying specific approaches, particularly for identifying the register of documented QMS information using GOST R ISO 10013-2024 and standardizing document formats according to GOST R 7.0.97-2016. The work discusses testing the proposed methodology by developing and formatting the form of this key QMS document of the higher school, which is the policy statement on quality. Finally, one substantiates the prospective value of adopting an approach to enhancing documented information based on integrating the standards GOST R ISO 10013-2024 and GOST R 7.0.97-2016 into the quality model. This allows for improving the quality of the higher education institution’s QMS documentation and reducing uncertainty in verifying its conformity in certification authorities.

Organized Case Management System for Homeopathy Practitioners

2025-06-05

| IJARCCE

A Review on Interprofessional Collaboration in Poisoning and Overdose Management

2025-06-05

Vivian Ukamaka Nwokedi , Olukunle O. Akanbi | Journal of Pharma Insights and Research.

The global burden of poisoning and overdose cases continues to rise, presenting significant challenges to healthcare systems worldwide. Effective management of these cases requires coordinated efforts across multiple healthcare disciplines. … The global burden of poisoning and overdose cases continues to rise, presenting significant challenges to healthcare systems worldwide. Effective management of these cases requires coordinated efforts across multiple healthcare disciplines. This review provides information about interprofessional collaboration in poisoning and overdose management, highlighting the inter-relationship between various healthcare professionals and their roles in patient care. The classification of poisoning types, common substances involved, and clinical manifestations, followed by detailed protocols for immediate response and treatment methods were also discussed. The roles of emergency medical technicians, nurses, physicians, pharmacists, laboratory technicians, toxicologists, and public health officials are elaborated, showing their unique contributions to patient care. Several barriers impede optimal care delivery, including limited access to antidotes, inadequate training, poor data collection systems, and communication gaps between healthcare professionals. Solutions for successful management includes integration of technology, standardized treatment protocols, and enhanced educational initiatives. Recent trends such as telemedicine platforms, mobile decision support tools, and digital health records show promise in improving collaborative care. The implementation of these solutions, combined with structured interprofessional education and clear communication channels, can significantly enhance patient outcomes in poisoning and overdose cases. Success in managing these cases depends on effective collaboration among healthcare professionals, supported by appropriate technologies and standardized protocols

An assessment of e-liquid label accuracy in Aotearoa New Zealand

2025-06-04

Renee Hosking , Jude Ball , Calvin Cochran +1 more | New Zealand medical journal

Gap analysis: Patient Safety Curriculum for undergraduate nursing students against WHO guidelines at bachelor’s degree

2025-06-03

Noha Mohamed Rashed , Wafaa Abdelazeem Elhosany Dawood , Kawther Abdel Ghafar Ali | Research Square (Research Square)

<title>Abstract</title> Background Integrating patient safety into nursing curricula is essential to ensure that students are equipped with the skills needed to safely deliver clinical practice. This study aimed to assess … <title>Abstract</title> Background Integrating patient safety into nursing curricula is essential to ensure that students are equipped with the skills needed to safely deliver clinical practice. This study aimed to assess the extent to which the undergraduate nursing curriculum was aligned with World Health Organization (WHO) patient safety guidelines. Methods Descriptive Comparative research design. This cross-sectional study was conducted at a Nursing College of a private university in Egypt. The protagonists in this story are the 48 faculty members teaching second—to fourth-year nursing students. Data were collected using the WHO Patient Safety Curriculum Guide and a faculty questionnaire. Descriptive statistics and chi-square tests were used to collect data. Results There were major deficits in faculty knowledge of patient safety, teaching methods used to teach patient safety and curriculum structure. Key findings showed a predominance of traditional lecture-based instruction, infrequent training of faculty in patient safety, and inadequate curriculum coverage in areas such as quality improvement and clinical risk management. Conclusions Addressing critical gaps in the patient safety curriculum for undergraduate nursing students requires targeted faculty training, educational enhancements, and curriculum restructuring. These measures aim to equip nursing graduates with essential skills to improve patient safety in clinical settings, thereby enhancing healthcare outcomes.

ABS1151 CLINICAL CHARACTERISTICS ASSOCIATED WITH ACHIEVEMENT OF SUSTAINABLE DRUG-FREE REMISSION IN RHEUMATOID ARTHRITIS PATIENTS

2025-06-01

Kaja E Kjørholt , Siri Lillegraven , J. Sexton +5 more | Annals of the Rheumatic Diseases

[Enhancing Dietary Awareness Accuracy in Hematology Patients Using Visualization and Game-Based Learning].

2025-06-01

Yun Seong Kang , Chia-Wen Lin , Wai Chee Annie Kung

During cancer treatment, hematology patients often experience treatment interruptions, reduced tolerance, and increased morbidity due to improper or insufficient dietary intake, which negatively impact their quality of life and, in … During cancer treatment, hematology patients often experience treatment interruptions, reduced tolerance, and increased morbidity due to improper or insufficient dietary intake, which negatively impact their quality of life and, in severe cases, increase mortality rates. A situational analysis revealed the accuracy rate of dietary knowledge among hematology patients in our hospital to be only 66.3%. The factors affecting this low rate of accuracy were identified as: nursing staff underestimating the importance of dietary education, inconsistent and poorly implemented dietary education, and the absence of dietary knowledge assessments and appropriate educational tools necessary to reinforce patient understanding. Moreover, the hospital lacked a standardized educational process and audit system. Furthermore, due to case selection criteria, dietitians were unable to provide nutritional counseling to every patient. A project was developed and implemented to increase the correct dietary knowledge rate among hematology patients from 66.3% to above 87.9%, and to raise the completion rate of dietary education by nursing staff for hematology patients from 58.3% to above 85%. The project utilized cloud technology with QR codes combined with educational posters and leaflets, game-based teaching tools (such as the fruit traffic light and nutrition-matching games), patient sharing sessions, group health education, and on-the-job training. The accuracy rate for dietary knowledge among the hematology patients increased from 66.3% to 91.2%, and the completion rate for dietary education by nursing staff increased from 58.3% to 90%, achieving the objectives of this project. This project effectively improved the overall rate of dietary knowledge accuracy among hematology patients, demonstrating positive outcomes. Based on this success, the program will be incorporated into the unit's group health education activities and conducted every three months. In addition to benefiting patient dietary choices, the program should reduce the time nurses spend on dietary education in clinical settings significantly.

Re-Audit of Preadmission Handover Meeting on a Medium Secure Rehabilitation Ward

2025-06-01

Neeti Sud , Yousra Ghandour , Melissa Harris +1 more | BJPsych Open

Aims: Patients are admitted to our medium secure rehabilitation ward from high secure hospitals or other medium secure wards from within and outside our trust. We have a waiting list. … Aims: Patients are admitted to our medium secure rehabilitation ward from high secure hospitals or other medium secure wards from within and outside our trust. We have a waiting list. There is extensive documentation and updates shared prior to any transfer over months. For patients within our trust, we share the same electronic records system. The legal status of most patients requires mandatory information sharing prior to any transfer for example via Ministry of Justice applications. We examined our process of preadmission handover meetings for all five admissions in 2023–2024. We identified a lack of structured approach to preparing for the preadmission meeting. We concluded that a structured checklist may help. At the time of the re-audit in January 2025, we had two vacant beds and therefore two planned admissions from our waiting list were imminent in the coming weeks. Methods: We used the following broad national, forensic and trust standards. NICE NG53: “1.2.7 During admission planning, record a full history or update that covers the person’s cognitive, physical and mental health needs, includes details of their current medication, identifies the services involved in their care.” Trust Policy: “Lead professional should make contact with service that covers the area the service user is to move to/from and arrange a formal hand over.” QNFMHS: “When patients are transferred between services there is a handover which ensures that the new team have an up to date care plan and risk assessment.” We re-audited our service using a preadmission checklist based on last year’s audit to review what information has already been handed over and what needs to be specifically requested prior to admission. We then compared the preadmission meeting minutes of the last five admissions of 2023–2024 with the first two admissions of 2025 to reflect on our learning. Results: There was no difference in terms of overall information sought by our team both pre- and post-audit. Updates were needed regarding physical and mental health and third party safeguarding information in the meeting. Conclusion: Going through the preadmission list in preparation for the formal transfer meeting in a structured manner ensured any information gaps were identified prior to the preadmission meeting and timely requests made. There were reflections on the relational aspect of the information sharing process.

Characteristics of nurses' gaze compared to nursing students and nurses' intentions in obtaining drug information

2025-06-01

Ayami Tateishi , K. Matsuo , Nobuko Hashiguchi | Teaching and learning in nursing

Integration of extended reality (XR) for oncology pharmacist training in chemotherapeutic compounding and risk mitigation

2025-06-01

Salvation Ifechukwude Atalor , Joy Onma Enyejo | International Medical Science Research Journal

The increasing complexity of oncology pharmacotherapy, particularly in the safe handling and compounding of chemotherapeutic agents, necessitates advanced training methodologies that ensure both efficacy and risk reduction. This review explores … The increasing complexity of oncology pharmacotherapy, particularly in the safe handling and compounding of chemotherapeutic agents, necessitates advanced training methodologies that ensure both efficacy and risk reduction. This review explores the integration of Extended Reality (XR)—encompassing Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR)—into the educational frameworks for oncology pharmacists. XR technologies present a transformative opportunity to simulate high-risk clinical environments, enabling immersive, interactive, and replicable training scenarios that are otherwise impractical or hazardous in real-life settings. The paper critically evaluates current XR-based training programs and their efficacy in enhancing cognitive retention, procedural accuracy, and hazard recognition during chemotherapeutic compounding. Furthermore, it discusses the role of XR in improving adherence to safety protocols, reducing contamination risks, and mitigating occupational exposure to hazardous drugs. Emphasis is placed on empirical evidence from recent studies demonstrating improved learner outcomes and behavioral competence among pharmacists trained with XR modules compared to traditional didactic and observational methods. Additionally, the paper highlights implementation challenges, including technological costs, content standardization, and regulatory considerations. Finally, the review outlines strategic recommendations for integrating XR into pharmacy curricula and continuing professional development programs, ultimately aiming to elevate safety standards and patient care quality in oncology settings. Keywords: Extended Reality (XR), Oncology Pharmacist Training, Chemotherapeutic Compounding, Risk Mitigation, Immersive Simulation.

Systematic review and meta-analysis protocol of impact of Pharmacist-Led Antibiotic Stewardship Audit-Feedback Intervention

2025-05-31

Duaa Salem Jawhar , Amer Hayat Khan , Khurshid Alam | MethodsX