Patient-controlled oral analgesia for acute abdominal pain: A before-and-after intervention study on pain intensity and use of analgesics

Madsen, Sandra Bruun; Qvist, Niels; Möller, Sören; Schultz, Helen

doi:10.1016/j.apnr.2018.01.007

Cited by 8 publications

(4 citation statements)

References 27 publications

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“…This element is central because self-management of medication must reduce hospital costs and/or improve health outcomes in order to be used broadly in daily hospital practice. An example of improved health outcome by self-management of medication are reduced pain identity in orthopedic patients who self-controlled analgesics [ 42 ]. A recent publication by Vanwesemael et al suggests additional strengths of patient self-management of medication, including enhanced medication adherence, better patient education, better monitoring of medication use, and reduced disruption of daily medication routines [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

One-Stop Dispensing: Hospital Costs and Patient Perspectives on Self-Management of Medication

et al. 2018

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(1) Objective: To assess hospital medication costs and staff time between One-Stop Dispensing (OSD) and the Traditional Medication System (TMS), and to evaluate patient perspectives on OSD. (2) Methods: The study was conducted at Hvidovre Hospital, University of Copenhagen, Denmark in an elective gastric surgery and acute orthopedic surgery department. This study consists of three sub-studies including adult patients able to self-manage medication. In Sub-study 1, staff time used to dispense and administer medication in TMS was assessed. Medication cost and OSD staff time were collected in Sub-study 2, while patient perspectives were assessed in Sub-study 3. Medication costs with two days of discharge medication were compared between measured OSD cost and simulated TMS cost for the same patients. Measured staff time in OSD was compared to simulated staff time in TMS for the same patients. Patient satisfaction related to OSD was evaluated by a questionnaire based on a five-point Likert scale (‘very poor’ (1) to ‘very good’ (5)). (3) Results: In total, 78 elective and 70 acute OSD patients were included. Overall, there was no significant difference between OSD and TMS in medication cost per patient ($2.03 [95% CI −0.57–4.63]) (p = 0.131). Compared with TMS, OSD significantly reduced staff time by an average of 12 min (p ≤ 0.001) per patient per hospitalization. The patients’ satisfaction for OSD was high with an average score of 4.5 ± 0.7. (4) Conclusion: There were no differences in medication costs, but staff time was significantly lower in OSD and patients were overall satisfied with OSD.

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Section: Discussionmentioning

confidence: 99%

One-Stop Dispensing: Hospital Costs and Patient Perspectives on Self-Management of Medication

et al. 2018

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“…pain scale score and the consumption of analgesics) have also recently been indicated. 27 SAM during hospitalization may provide patients with an opportunity to continue medication management routines from home. 25 However, concerns regarding medication safety due to risk of overdose, underdose and nonadherence have surfaced.…”

Section: Introductionmentioning

confidence: 99%

Self-administration of medication: a pragmatic randomized controlled trial of the impact on dispensing errors, perceptions, and satisfaction

Sørensen

Lisby

Olesen

et al. 2020

Therapeutic Advances in Drug Safety

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Background: Our aim was to investigate whether self-administration of medication (SAM) during hospitalization affects the number of dispensing errors, perceptions regarding medication, and participant satisfaction when compared with nurse-led medication dispensing. Methods: A pragmatic randomized controlled trial was performed in a Danish cardiology unit. Patients aged ⩾ 18 years capable of SAM were eligible for inclusion. Patients were excluded if they did not self-administer medication at home, were not prescribed medication suitable for self-administration, or did not speak Danish. Intervention group participants self-administered their medication. In the control group, medication was dispensed and administered by nurses. The primary outcome was the proportion of dispensing errors collected through modified disguised observation of participants and nurses. Dispensing errors were divided into clinical and procedural errors. Secondary outcomes were explored through telephone calls to determine participant perceptions regarding medication and satisfaction, and finally, deviations in their medication list two weeks after discharge. Results: Significantly fewer dispensing errors were observed in the intervention group, with 100 errors/1033 opportunities for error (9.7%), compared with 132 errors/1028 opportunities for error (12.8%) in the control group. The number of clinical errors was significantly reduced, whereas no difference in procedural errors was observed. At follow up, those who were self-administering medication had fewer concerns regarding their medication, found medication to be less harmful, were more satisfied, preferred this opportunity in the future, and had fewer deviations in their medication list after discharge compared with the control group. Conclusion: In conclusion, the reduced number of dispensing errors in the intervention group, indicate that SAM is safe. In addition, SAM had a positive impact on (a) perceptions regarding medication, thus suggesting increased medication adherence, (b) deviations in medication list after discharge, and (c) participant satisfaction related to medication management at the hospital.

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“…Some patients in our study reported similar problems, with six percent of elective patients rating "poor" satisfaction with bedside lockers. We believe that three findings from our patient questionnaire are self-controlled analgesics [38].…”

Section: Discussionmentioning

confidence: 85%

One-Stop Dispensing: Hospital Costs and Patient Perspectives on Self-Administration of Medication

Houlind¹,

Hbo²,

Treldal³

et al. 2018

Preprint

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1) Objective: to assess staff time and hospital medication costs between One-Stop Dispensing (OSD) and the Traditional Medication System (TMS), and to evaluate patient perspectives on OSD. 2) Methods: The study was conducted at Hvidovre Hospital, University of Copenhagen, Denmark in an elective gastric surgery and acute orthopedic surgery department. The study was designed as an intervention study with a historical control group receiving TMS. The intervention group included adult patients able to self-administer medication. Time measurements included time used by nurses and pharmacy staff to dispense and administer medication as well as medication dialogue. Medication costs with two days of discharge medication were compared between OSD and TMS. Patient satisfaction related to OSD was evaluated by a questionnaire based on a five-point Likert scale ('very poor' (1) to 'very good' (5)). 3) Results: Seventy-eight elective and 70 acute patients were included. Compared with TMS, OSD significantly reduced used staff time by an average of 12 minutes (P < 0.0001) per patient per hospitalization. Overall, there was no significant increase in medication cost per patient for OSD (1.68 € [CI 95 -0.51―3.87]) (P = 0.13). Mean scores for the OSD satisfaction questionnaire ranged from 4.3―4.8. OSD was associated with significantly lower used staff time. 4) Conclusion: Staff time in OSD was significantly lower, there were no differences in medication costs and the patients were overall satisfied with OSD.

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Patient-controlled oral analgesia for acute abdominal pain: A before-and-after intervention study on pain intensity and use of analgesics

Cited by 8 publications

References 27 publications

One-Stop Dispensing: Hospital Costs and Patient Perspectives on Self-Management of Medication

One-Stop Dispensing: Hospital Costs and Patient Perspectives on Self-Management of Medication

Self-administration of medication: a pragmatic randomized controlled trial of the impact on dispensing errors, perceptions, and satisfaction

One-Stop Dispensing: Hospital Costs and Patient Perspectives on Self-Administration of Medication

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