Evidence based development of bedside clinical drug rules for surgical patients

Ramrattan, Maya A.; Boeker, Eveline B.; Ram, Kim; Burgers, Desiree M. T.; Boer, M. de; Lie‐A‐Huen, Loraine; Mulder, W. M. C.; Boermeester, Marja A.

doi:10.1007/s11096-014-9941-x

Cited by 6 publications

(4 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A system approach is based on patient characteristics as well. Our study group is developing a medication safety programme using a combination of a system approach and an individual care approach tailored by patient characteristics .…”

Section: Introductionmentioning

confidence: 99%

An individual patient data meta‐analysis on factors associated with adverse drug events in surgical and non‐surgical inpatients

Boeker

Ram

Klopotowska

et al. 2015

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

AIMThe incidence of adverse drug events (ADEs) in surgical and non-surgical patients may differ. This individual patient data meta-analysis (IPDMA) identifies patient characteristics and types of medication most associated with patients experiencing ADEs and suggests target areas for reducing harm and implementing focused interventions. METHODSAuthors of eligible studies on preventable ADEs (pADEs) were approached for collaboration. For assessment of differences among (non-)surgical patients and identification of associated factors descriptive statistics, Pearson chi-square, Poisson and logistic regression analyses were performed. For identification of high risk drugs (HRDs), a model was developed based on frequency, severity and preventability of medication related to ADEs. RESULTSIncluded were 5367 patients from four studies. Patients aged ≥ 77 years experienced more ADEs and pADEs compared with patients aged ≤ 52 years (odds ratios (OR) 2.12 (95% CI 1.70, 2.65) and 2.55 (95% CI 1.70, 3.84), respectively, both P < 0.05). Polypharmacy on admission also increased the risk of ADEs (OR 1.21 (95% CI 1.03, 1.44), P < 0.05) and pADEs (OR 1.85 (95% CI 1.34, 2.56), P < 0.05). pADEs were associated with more severe harm than non-preventable ADEs (54% vs. 32%, P < 0.05). The top five HRDs were antibiotics, sedatives, anticoagulants, diuretics and antihypertensives. Events associated with HRDs included diarrhoea or constipation, abnormal liver function test and central nervous system events. Most pADEs resulted from prescribing errors (90%). CONCLUSIONElderly patients with polypharmacy on admission and receiving antibiotics, sedatives, anticoagulants, diuretics or antihypertensives were more prone to experiencing ADEs. Efficiency in prevention of ADEs may be improved by targeted vigilance systems for alertness of physicians and pharmacists.

show abstract

Section: Introductionmentioning

confidence: 99%

An individual patient data meta‐analysis on factors associated with adverse drug events in surgical and non‐surgical inpatients

Boeker

Ram

Klopotowska

et al. 2015

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

show abstract

“…31 Recent research showed that evidence-based drug rules seem promising in preventing MRAEs, but their clinical efficacy is yet to be tested. 32 Although in the current study, anticoagulant-related AEs were the most common types of preventable MRAEs, none of the aforementioned interventions specifically targeted this medication group. Anticoagulant care is considered complex, and potential risks of bleeding and thrombosis should always be taken into account.…”

Section: Discussionmentioning

confidence: 71%

“…Although these interventions contributed to the reduction of (preventable) MRAEs, most of them are costly and time consuming and difficult to provide continuously . Recent research showed that evidence‐based drug rules seem promising in preventing MRAEs, but their clinical efficacy is yet to be tested …”

Section: Discussionmentioning

confidence: 99%

Medication‐related adverse events during hospitalization: a retrospective patient record review study in The Netherlands

Damen

Baines

Wagner³

et al. 2016

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

This study provided detailed information on MRAEs during hospital admissions in The Netherlands. A substantial proportion of AEs was medication-related (15.2%), of which 18.4% was judged to be preventable. As preventability in MRAEs was especially high in anticoagulant treatment (42.5%), those medications are a threat to patient safety. Future research and new safety programs should focus on prevention of AEs related to this medication group. Copyright © 2016 John Wiley & Sons, Ltd.

show abstract

“…These trends portend continued integration of clinical pharmacists within the perioperative care team . Institutions expanding clinical pharmacy roles and training programs to encompass perioperative pharmacy services should develop PCPh practices focused on improving surgical patient outcomes and consider integrating perioperative clinical competencies into various levels of elective or related pharmacist learner experiences.…”

Section: Conclusion and Future Of Perioperative Clinical Pharmacymentioning

confidence: 99%

Perioperative clinical pharmacy practice: Responsibilities and scope within the surgical care continuum

Patel

Hyland

Birrer

et al. 2019

J Am Coll Clin Pharm

View full text Add to dashboard Cite

Current published guidelines for perioperative pharmacy services have limited information on the development and implementation of a robust clinical pharmacy program across the surgical continuum of care. This publication defines the responsibilities and scope of practice of the Perioperative Clinical Pharmacist (PCPh), supporting the PCPh as a critical member of the interprofessional surgical patient care team. Opportunities for pharmacist role integration into perioperative medication management processes are described along with published examples of successful PCPh practice models, including those with interventions targeted toward Enhanced Recovery Pathways (ERP). Recommended training and competencies for future and practicing perioperative pharmacists, in addition to considerations for precepting and scholarly activities, are also outlined. Finally, future developments in perioperative pharmacy practice are discussed, including technological advancements, improved predictive models, and expansion of collaborative practice agreements.

show abstract

Evidence based development of bedside clinical drug rules for surgical patients

Abstract: An evidence-based approach provides a practical basis for the development of a bedside tool to alert and assist the care providers in their drug management decisions along the surgical pathway.

Cited by 6 publications

References 42 publications

An individual patient data meta‐analysis on factors associated with adverse drug events in surgical and non‐surgical inpatients

An individual patient data meta‐analysis on factors associated with adverse drug events in surgical and non‐surgical inpatients

Medication‐related adverse events during hospitalization: a retrospective patient record review study in The Netherlands

Perioperative clinical pharmacy practice: Responsibilities and scope within the surgical care continuum

Contact Info

Product

Resources

About