Impact of interventions targeting the inappropriate use of proton‐pump inhibitors by clinical pharmacists in a hepatobiliary surgery department

Zhang, Ying; Yang, Hui; Kong, Jian; Li, Ran; Zhang, Xi; Yun, Juping; Gu, Qing

doi:10.1111/jcpt.13273

Cited by 12 publications

(23 citation statements)

References 33 publications

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“…A 2021 Chinese study found that an intervention by clinical pharmacists halved the rate of inappropriate prescriptions of proton pump inhibitors (from 48.9 to 22.7 prescriptions per 100 patient-days), with no harmful impacts. 378 Encouragingly, a 2018 survey in Ethiopia, a low-income country, assessing attitudes to deprescribing, found that 81.6% (258/316) of people asked were willing to stop one or more medications if possible and if agreed by their doctors. 335 …”

Section: Resultsmentioning

confidence: 99%

Overuse of medications in low- and middle-income countries: a scoping review

Albarqouni

Palagama

Chai

et al. 2023

Bull World Health Organ

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Objective To identify and summarize the evidence about the extent of overuse of medications in low- and middle-income countries, its drivers, consequences and potential solutions. Methods We conducted a scoping review by searching the databases PubMed®, Embase®, APA PsycINFO® and Global Index Medicus using a combination of MeSH terms and free text words around overuse of medications and overtreatment. We included studies in any language published before 25 October 2021 that reported on the extent of overuse, its drivers, consequences and solutions. Findings We screened 3489 unique records and included 367 studies reporting on over 5.1 million prescriptions across 80 low- and middle-income countries – with studies from 58.6% (17/29) of all low-, 62.0% (31/50) of all lower-middle- and 60.0% (33/55) of all upper-middle-income countries. Of the included studies, 307 (83.7%) reported on the extent of overuse of medications, with estimates ranging from 7.3% to 98.2% (interquartile range: 30.2–64.5). Commonly overused classes included antimicrobials, psychotropic drugs, proton pump inhibitors and antihypertensive drugs. Drivers included limited knowledge of harms of overuse, polypharmacy, poor regulation and financial influences. Consequences were patient harm and cost. Only 11.4% (42/367) of studies evaluated solutions, which included regulatory reforms, educational, deprescribing and audit–feedback initiatives. Conclusion Growing evidence suggests overuse of medications is widespread within low- and middle-income countries, across multiple drug classes, with few data of solutions from randomized trials. Opportunities exist to build collaborations to rigorously develop and evaluate potential solutions to reduce overuse of medications.

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Section: Resultsmentioning

confidence: 99%

Overuse of medications in low- and middle-income countries: a scoping review

Albarqouni

Palagama

Chai

et al. 2023

Bull World Health Organ

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“…[46][47][48][49] As a result, a series of targeted measures by pharmacists has been implemented, and preliminary improvements have been achieved worldwide. [50][51][52][53] The addition of PPI recommendations in CPCs is our attempt to contribute to this effort. With the continuous promotion of this method, we hope to further rationalize PPI use and reduce unnecessary drug expenditures.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] In addition, the impacts of interventions by clinical pharmacists targeting the inappropriate use of proton pump inhibitors (PPIs) are impressive, and the intervention methods vary, including reviewing inpatient orders, obtaining prescriptive authority, and rational drug use education for physicians. [15][16][17] Regarding nutrition areas, studies have shown that skilled nutrition pharmacists could be qualified for order review and verification and prompt rational use between enteral feeding and parenteral nutrition. 18 This study was unique in that we not only put forward a new way of giving consultation recommendations but also promoted the management of anticoagulation, PPIs, and nutrition by giving MIMRs in clinical pharmacists' consultations, and hoped to improve the overall prognosis of patients.…”

Section: Introductionmentioning

confidence: 99%

Integrating Multidisciplinary Individualized Medication Recommendations Into the Traditional Pharmacists’ Consultation Method: A Retrospective Study Using Propensity Score Matching Analysis

Fan

Chen

Bao

et al. 2022

INQUIRY

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Chinese clinical pharmacists consider improving the quantity and quality of consultations to be an important task in providing better pharmaceutical care. To achieve this goal, we developed a clinical pharmacist consultation method using multidisciplinary individualized medication recommendations (MIMRs) and studied the effects of its implementation. A retrospective study of 812 clinical pharmacist-led consultations was conducted. In the pre-intervention group, medication advice was given based on the purpose of the consultation. In the post-intervention group, a consultation method using MIMRs was implemented, in which clinical pharmacists with specialties in anticoagulation, gastroenterology, and nutrition were asked to give individualized medication recommendations. Outcomes, including the effectiveness rate of consultations (ERC) and acceptance rate of consultations (ARC), were compared between the two groups using propensity score matching method. Patterns and numbers of consultations and individualized medication recommendations were also compared. The results showed that the ERC in the post-intervention group compared with the ERC in the pre-intervention group was 83.3% vs 74.0%, respectively (P < .05). Significant difference was also shown between the two groups in ARC (98.4% vs 92.2%, P < .05). The total number of consultations increased, as did the number of general consultations, multidisciplinary/difficult consultations, anti-infection consultations, and non–anti-infection consultations specifically. As a result, we proposed that the implementation of MIMRs can improve the effects of treatment and increase the number of consultations by pharmacists, which is worthy of further promotion to better serve physicians and patients.

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“…The recommendations mainly include reasonable therapeutic and preventive dose, choice between oral and intravenous drip dosage form and the incidence of adverse reactions caused by drug interaction, which were generally welcomed and accepted by physicians. In China, due to the increasingly serious problems of PPIs abuse, a series of targeted measures have been implemented and preliminary results have been achieved [29][30] . The addition of PPIs recommendations in clinical pharmacists' consultations is our attempt.…”

Section: Discussion On the Consultation Mode Of Multidisciplinary Individualized Medicationmentioning

confidence: 99%

A retrospective cohort study on a pharmaceutical consultation mode of multidisciplinary individualized medication recommendations

Fan

Chen²,

Bao³

et al. 2021

Preprint

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Aims: To develop a pharmaceutical consultation mode of multidisciplinary individualized medication recommendations, to improve the quantity and quality of clinical pharmacists’ consultations Methods: A retrospective study of 542 clinical pharmacists-led consultations was conducted. In the pre-intervention group, medication advice was given based on the purpose of the consultation. In the post-intervention group, a consultation mode of multidisciplinary individualized medication recommendation was implemented, in which clinical pharmacists with specialties of anticoagulation, gastroenterology and nutrition were asked to give individualized medication recommendations and a set of evaluation criteria for rational drug use was formulated. Outcomes, including the patterns and number of consultations, individualized medication recommendations, acceptance rate and effectiveness rate, were compared between the two periods. Results: A total of 651 cases were reviewed, and 542 cases of which meeting the predesigned inclusion and exclusion criteria were included, with 94 and 448 patients in the pre-intervention and post-intervention groups, respectively. The total number of consultations increased year by year, so did the number of general consultations, multidisciplinary difficult consultations, departments applying for general consultations, departments applying for multidisciplinary difficult consultations, anti-infection consultations and non-anti-infection consultations in details. The effectiveness rate of consultations in the post-intervention group was 81.7% vs 70.2% in the pre-intervention group (P < 0.05). No difference was shown between two groups in acceptance rate (96.9% vs 95.7%, p=0.578).

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Impact of interventions targeting the inappropriate use of proton‐pump inhibitors by clinical pharmacists in a hepatobiliary surgery department

Cited by 12 publications

References 33 publications

Overuse of medications in low- and middle-income countries: a scoping review

Overuse of medications in low- and middle-income countries: a scoping review

Integrating Multidisciplinary Individualized Medication Recommendations Into the Traditional Pharmacists’ Consultation Method: A Retrospective Study Using Propensity Score Matching Analysis

A retrospective cohort study on a pharmaceutical consultation mode of multidisciplinary individualized medication recommendations

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