PurposeTo determine the nature and frequency of medication errors during medication delivery processes in a public teaching hospital geriatric ward in Bali, Indonesia.MethodsA 20-week prospective study on medication errors occurring during the medication delivery process was conducted in a geriatric ward in a public teaching hospital in Bali, Indonesia. Participants selected were inpatients aged more than 60 years. Patients were excluded if they had a malignancy, were undergoing surgery, or receiving chemotherapy treatment. The occurrence of medication errors in prescribing, transcribing, dispensing, and administration were detected by the investigator providing in-hospital clinical pharmacy services.ResultsSeven hundred and seventy drug orders and 7,662 drug doses were reviewed as part of the study. There were 1,563 medication errors detected among the 7,662 drug doses reviewed, representing an error rate of 20.4%. Administration errors were the most frequent medication errors identified (59%), followed by transcription errors (15%), dispensing errors (14%), and prescribing errors (7%). Errors in documentation were the most common form of administration errors. Of these errors, 2.4% were classified as potentially serious and 10.3% as potentially significant.ConclusionMedication errors occurred in every stage of the medication delivery process, with administration errors being the most frequent. The majority of errors identified in the administration stage were related to documentation. Provision of in-hospital clinical pharmacy services could potentially play a significant role in detecting and preventing medication errors.
All PPIs were associated with hypomagnesemia, with esomeprazole having the lowest risk and pantoprazole having the highest risk. The risk of PPI-associated hypomagnesemia was higher in males and the elderly population. Hypocalcemia and hypokalemia commonly coexisted with PPI-associated hypomagnesemia.
1. Prevention of hypertension and improved blood pressure control can be achieved through dietary modification. In particular, population studies and randomised controlled trials have indicated a beneficial effect of both dietary protein and dietary fibre on level of blood pressure. 2. A large population study indicates that an increase in 37 g/day of protein leads to a decrease in mean systolic and diastolic blood pressure by approximately 3 and 2.5 mmHg, respectively. This protective effect is independent of the source of dietary protein. 3. Meta-analysis suggests that a fibre increase of approximately 17 g/day will decrease systolic blood pressure by 1.15 mmHg and diastolic blood pressure by 1.65 mmHg, with soluble fibre showing a stronger effect than insoluble fibre. 4. Protein and dietary fibre may have additive effects to lower blood pressure. One feasible approach to increasing both protein and fibre in the daily diet could be through the incorporation of legumes, a protein- and fibre-rich food. 5. This review assesses the evidence for effects of protein and fibre to reduce blood pressure and the potential of incorporation of legumes into the daily diet as a feasible approach to achieving such benefits for blood pressure.
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