Anandi V. Law

Adverse Drug Reactions Among Children Over a 10-Year Period

OBJECTIVES. This study was designed to evaluate (1) the incidence and common types of adverse drug reactions among hospitalized children, (2) the frequency of adverse drug reaction reporting by health care providers, and (3) the follow-up processes resulting from adverse drug reactions. METHODS. A retrospective cohort study of pediatric patients who experienced an adverse drug reaction between January 1, 1995, and December 31, 2004, was conducted at a community-based, tertiary care, childrens teaching hospital. RESULTS. A total of 1087 adverse drug reactions were reported; the overall incidence was 1.6%. The severity of most adverse drug reactions was low (levels 1–3: 89%; high levels 4–6: 11%). Adverse drug reactions with low severity were significantly more common in both the general pediatric unit and the NICU. Adverse reactions resulting from use of antibiotics (particularly penicillins, cephalosporins, and vancomycin) were usually mild. In contrast, adverse drug reactions rated high in severity were significantly more common among reactions that led to hospital admission or occurred during surgery and among certain drug classes, including anticonvulsants and antineoplastic agents. Adverse drug reactions were reported by pharmacists (89%), nurses (10%), and physicians (<1%). Although documentation of physician notification occurred for 93% of adverse drug reactions, only 29% of cases were documented in the patients medical chart, 13% included follow-up education for individuals involved, and 10% were updated in the allergy profile of the hospital computer system. CONCLUSION. Measures to improve detection and reporting of adverse drug reactions by all health care professionals should be undertaken, to enhance our understanding of the nature and impact of these reactions in children.

Ready, willing, and able to provide MTM services?: A survey of community pharmacists in the USA.

BACKGROUNDnChanges in US Medicare legislation could benefit pharmacys attempt to make medication therapy management (MTM) practice more commonplace; however, little is known about pharmacists capabilities and preferences to do so.nnnOBJECTIVESnThe purpose of this study was to explore US pharmacists perceived preparedness, willingness, and challenges toward providing MTM services.nnnMETHODSnA brief purpose of the survey and its website link were included in the electronic weekly newsletter of the National Community Pharmacists Association (NCPA) in January 2007. The web-based survey consisted of 8 demographic questions, 8 questions examining preparedness and willingness of the respondents regarding MTM, 2 questions regarding reimbursement to pharmacists, and 2 checklists for challenges in establishing MTM services.nnnRESULTSnMost of the 143 respondents indicated that they were aware of MTM, and 92 (65%) reported that they were currently practicing MTM. A majority of the sample agreed that pharmacists should provide MTM and have the ability to do so. Major challenges reported by the sample include the different specification of MTM by each health plan, time, staffing, and reimbursement issues. Respondents selected valid measures of program effectiveness but revealed that they needed help with documentation and billing. Expected reimbursement range was

Taking stock of medication wastage: Unused medications in US households

1-10/minute.nnnCONCLUSIONnCommunity independent pharmacists reported being ready, willing, and able to provide MTM services, but need assistance in the process, that is, standardized MTM protocols, documentation and billing.

A Monograph Assignment as an Integrative Application of Evidence-Based Medicine and Pharmacoeconomic Principles

BACKGROUNDnDespite the potential deleterious impact on patient safety, environmental safety and health care expenditures, the extent of unused prescription medications in US households and reasons for nonuse remain unknown.nnnOBJECTIVEnTo estimate the extent, type and cost of unused medications and the reasons for their nonuse among US households.nnnMETHODSnA cross-sectional, observational two-phased study was conducted using a convenience sample in Southern California. A web-based survey (Phase I, nxa0=xa0238) at one health sciences institution and paper-based survey (Phase II, nxa0=xa068) at planned drug take-back events at three community pharmacies were conducted. The extent, type, and cost of unused medications and the reasons for their nonuse were collected.nnnRESULTSnApproximately 2 of 3 prescription medications were reported unused; disease/condition improved (42.4%), forgetfulness (5.8%) and side effects (6.5%) were reasons cited for their nonuse. Throwing medications in the trash was found being the common method of disposal (63%). In phase I, pain medications (23.3%) and antibiotics (18%) were most commonly reported as unused, whereas in Phase II, 17% of medications for chronic conditions (hypertension, diabetes, cholesterol, heart disease) and 8.3% for mental health problems were commonly reported as unused. Phase II participants indicated pharmacy as a preferred location for drug disposal. The total estimated cost for unused medications was approximately

Medication Therapy Management Services Provided by Student Pharmacists

59,264.20 (average retail Rx price) to

A Formal Mentorship Program for Faculty Development

152,014.89 (AWP) from both phases, borne largely by private health insurance. When extrapolated to a national level, it was approximately

Goal-attainment scaling: A review and applications to pharmacy practice

2.4B for elderly taking five prescription medications to

Measuring outcomes of a pharmacist-run travel health clinic located in an independent community pharmacy

5.4B for the 52% of US adults who take one prescription medication daily.nnnCONCLUSIONnTwo out of three dispensed medications were unused, with national projected costs ranging from

A Checklist for the Development of Faculty Mentorship Programs

2.4B to

Assessment of patient communication skills during OSCE: Examining effectiveness of a training program in minimizing inter-grader variability

5.4B. This wastage raises concerns about adherence, cost and safety; additionally, it points to the need for public awareness and policy to reduce wastage. Pharmacists can play an important role by educating patients both on appropriate medication use and disposal.