Age and sex have impact on spontaneous reporting of ADRs. After adjusting for dispensed drugs and by standardisation of age-related differences in prescribed drugs, results indicate that healthcare professionals more frequently reported ADRs for the oldest individuals and for women. Serious reports were more frequently reported for men. Copyright © 2017 John Wiley & Sons, Ltd.

ObjectiveTo explore registered nurses’ experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities.DesignA qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were analysed by qualitative content analysis.SettingFive focus groups in five different long-term care settings in two regions in Sweden.SubjectA total of 21 registered nurses (RNs), four men and 17 women, aged 27–65 years, with 4–34 years of nursing experience.ResultsThe findings reveal that RNs in municipal long-term care settings can be regarded as “vigilant intermediaries” in the patients’ drug treatments. They continuously control the work of staff and physicians and mediate between them, and also compensate for existing shortcomings, both organizational and in the work of health care professionals. RNs depend on other health care professionals to be able to monitor drug treatments and ensure medication safety. They assume expanded responsibilities, sometimes exceeding their formal competence, and try to cover for deficiencies in competence, experience, accessibility, and responsibility-taking.ConclusionThe RNs play a central but also complex role as “vigilant intermediaries” in the medication monitoring process, including the issue of responsibility. Improving RNs’ possibility to monitor their patients’ drug treatments would enable them to prevent adverse drug events in their daily practice. New strategies are justified to facilitate RNs’ pharmacovigilant activities. Key pointsThis study contributes to the understanding of registered nurses’ (RNs’) role in medication management in municipal care of the elderly (i.e. detecting, assessing, and preventing adverse drug events or any drug-related problems). RNs can be considered to be “vigilant intermediaries” in elderly patients’ drug treatments, working at a distance from staff, physicians, and patients.RNs occasionally take on responsibilities that exceed their formal competence, with the patients’ best interests in mind.In order to prevent adverse drug events in municipal care of the elderly, new strategies are justified to facilitate RNs’ pharmacovigilant activities.

Purpose The purpose of this paper is to explore the implications of registered nurses' (RNs) use of a computerized decision support system (CDSS) in medication reviews. Design/methodology/approach The paper employs a quasi-experimental, one-group pre-test/post-test design with three- and six-month follow-ups subsequent to the introduction of a CDSS. In total, 11 RNs initiated and prepared a total of 54 medication reviews. The outcome measures were the number of drug-related problems (DRPs) as reported by the CDSS and the RNs, respectively, the RNs' views on the CDSS, and changes in the quality of drug treatment. Findings The CDSS significantly indicated more DRPs than the RNs did, such as potential adverse drug reactions (ADRs). The RNs detected additional problems, outside the scope of the CDSS, such as lack of adherence. They considered the CDSS beneficial and wanted to continue using it. Only minor changes were found in the quality of drug treatments, with no significant changes in the drug-specific quality indicators (e.g. inappropriate drugs). However, the use of renally excreted drugs in reduced renal function decreased. Practical implications The RNs' use of a CDSS in medication reviews is of value in detecting potential ADRs and interactions. Yet, in order to have an impact on outcomes in the quality of drug treatment, further measures are needed. These may involve development of inter-professional collaboration, such as established procedures for the implementation of medication reviews, including the use of CDSS. Originality/value This is, to the best of the authors' knowledge, the first study to explore the implications of medication reviews, initiated and prepared by RNs who use a CDSS. The paper adds further insight into the RNs' role in relation to quality of drug treatments.

Dedicated university courses improved nurses' self-reported competence in pharmacovigilance but did not increase the number of related activities. Education per se seems to be not sufficient to generate pharmacovigilant activities among nurses.

Aim To describe variations in nurses' perceptions of using a computerised decision support system (CDSS) in drug monitoring. Background There is an increasing focus on incorporating informatics into registered nurses' (RNs) clinical practice. Insight into RNs’ perceptions of using a CDSS in drug monitoring can provide a basis for further development of safer practices in drug management. Method A qualitative interview study of 16 RNs. Data were analysed using a phenomenographic approach. Results The RNs perceived a variety of aspects of using a CDSS in drug monitoring. Aspects of ‘time’ were evident, as was giving a ‘standardisation’ to the clinical work. There were perceptions of effects of obtained knowledge and ‘evidence’ and the division of ‘responsibilities’ between RNs and physicians of using the CDSS. Conclusion The RNs perceived a CDSS as supportive in drug monitoring, in terms of promoting standardised routines, team‐collaboration and providing possibilities for evidence‐based clinical practice. Implications Implementing a CDSS seems to be one feasible strategy to improve RNs’ preconditions for safe drug management. Nurse managers’ engagement and support in this process are vital for a successful result.