Background: Inappropriate prescribing may lead to medication errors among older adults. Pharmacists can curb the occurrences of these errors by conducting medication reviews. Screening Tool of Older Person’s Prescriptions (STOPP) or Screening Tool to Alert doctors to Right Treatments (START) may curb the incidence of adverse drug reactions and improve medication appropriateness by providing guides about when particular types of medications should be started or stopped. Objective: This study aimed to evaluate the use of STOPP/START to improve the Adapted Medication Appropriateness Index (MAI), to reduce the risk of ADRs (GerontoNet score), and length of stay (LOS). Setting: Geriatric Inpatient Ward, Sanglah General Hospital, Bali, Indonesia. Method: A non-randomized controlled trial was conducted in older adults (>60 years) who were selected consecutively from inpatient units in a tertiary hospital in Bali, Indonesia. The intervention group received medication reviews by pharmacists in collaboration with physicians to assess its appropriateness with STOPP/START criteria on admission and during their stay at the hospital. The control group obtained standard care. Main Outcome Measures: The outcomes were measured using the Adapted MAI, GerontoNet Score, and LOS. Results: Thirty patients in the intervention group and 33 patients in the control group were included in this study. The adapted MAI was 2.97 (2.25) and 9.94 (6.14) with P < .001. The GerontoNet score was 3.33 (2.28) and 5.18 (2.10) with P = .003, LOS was 7.63 (3.00) days and 14.18 (9.97) days with P = .011, respectively. Conclusion: The use of STOPP/START as a tool for medication review improved medication appropriateness and reduced ADR risk and LOS.

AbstrakRumah sakit sebagai lini terakhir pelayanan kesehatan berkewajiban memberikan pelayanan berkualitas dan beorientasi pada keselamatan pasien, salah satunya tanggung jawab dalam mencegah medication error. Kolaborasi dan komunikasi yang efektif antar profesi dibutuhkan demi tercapainya keselamatan pasien. Read-back merupakan salah satu cara dalam melakukan komunikasi efektif. Before-after study dengan pendekatan TQM PDCA. Sampel adalah catatan obat pada rekam medik pasien rawat inap RSUP Sanglah pada minggu ke-3 bulan Mei (before) dan minggu ke-3 bulan Juli (after) 2013. Perlakuan dengan menggunakan checklist, meminta waktu 2 menit untuk read-back oleh dokter dan perawat seusai visite bersama. Didapatkan 57 sampel (before) dan 64 sampel (after). Before 45,54% ketidaklengkapan pengisian catatan obat pada rekam medik pasien yang berpotensi risiko medication error menjadi 10,17% setelah perlakuan read-back dengan checklist selama 10 minggu, dengan pencapaian 77,78% berdasarkan pendekatan TQM PDCA. Panduan read-back menggunaan daftar tilik (checklist) sebagai komunikasi efektif dapat menurunkan ketidaklengkapan pengisian catatan obat pada rekam medik yang berpotensi risiko medication error, 45,54% menjadi 10,17%. AbstractHospital as a last line of health services shall provide quality service and oriented on patient safety, one responsibility in preventing medication errors. Effective collaboration and communication between the profession needed to achieve patient safety. Read-back is one way of doing effective communication. Before-after study with PDCA TQM approach. The samples were on the medication chart patient medical records in the 3 rd week of May (before) and the 3 rd week in July (after) 2013. Treatment using the check list, asked for time 2 minutes to read-back by the doctors and nurses after the visit together. Obtained 57 samples (before) and 64 samples (after). Before charging 45.54% incomplete medication chart on patient medical records that have the potential risk of medication error to 10.17% after treatment with a read back check list for 10 weeks, with 77.78% based on the achievement of the PDCA TQM approach. Checklist usage as a guidance on Read-back as an effective communication can reduce charging incompleteness drug records on medical records that have the potential risk of medication errors, 45.54% to 10.17%.

Hospitalized community-acquired pneumonia (CAP) patients are always prescribed intravenous (IV) antibiotics. Inappropriate and unnecessary IV antibiotics usage leads to an increase in healthcare costs and bacterial resistance. IV to per oral (PO) conversion therapy can overcome these problems. The aim of the study was to evaluate the practice of switching from intravenous to oral antibiotics of inpatients with community-acquired pneumonia (CAP). This retrospective observational study was conducted by taking patient medical record from january until december 2019. Outcomes of the study are patient characteristics, pattern use, antibiotic and type conversion therapy. Adult inpatients on conversion therapy were eligible for study enrollment. Data were analyzed descriptively using SPSS 17.0. The study showed that among 78 patients who were eligible for conversion therapy. Most of the patient has mean duration conversion therapy 48-72 hours as much as 55 (70,5%). Beta-lactams were the most commonly converted antibiotics. However, the step-down therapy was the major type of conversion practiced in this study as much as 48 (61,5) followed by sequential and switch over with numbers 21 (27%) and 9 (11,5%) respectively. Based on the study findings wangaya hospital should improve the practice of sequential therapy in order to reduce the burden of CAP.