Cinzia Pezzolesi

Is There a Recreational Misuse Potential for Pregabalin? Analysis of Anecdotal Online Reports in Comparison with Related Gabapentin and Clonazepam Data

1 „ReDNet‟ and „Psychonaut Web Mapping‟ Projects; University of Hertfordshire School of Pharmacy, Hatfield, UK 2 Psychiatry and Clinical Psychology Department, Umberto I, “La Sapienza” University of Rome Medical School, Rome, Italy; Viale Regina Elena 244, 00161, Rome,Italy; doffizi.stefano@gmail.com; michele.piccione@uniroma1.it 3 Psychonaut Web Mapping Project; National Addiction Centre, Institute of Psychiatry, Kings College London, London, UK; 4 Windsor Walk; SE5 AF; paolo.deluca@kcl.ac.uk; zoe.davey@kcl.ac.uk 4 Psychonaut Web Mapping Project; Servizio Salute Regione Marche, Ancona, Italy; Assessorato Salute Regione Marche. Address. Via Gentile da Fabriano 3. Ancona 60100; lucia.difuria@regione.marche.it; stefy.pagani@gmail.com 5 Psychonaut Web Mapping Project; IAPS-IMIM-Hospital del Mar-UAB, Barcelona, Spain; Passeig Maritim 25-29. Barcelona 08003; MTorrens@imim.es; Mfarre@imim.es 6 Psychonaut Web Mapping Project; Bergen Clinics Foundation, Centre of Competence, Bergen, Norway; Vestre Torggate 11 5015 Bergen; arvid.skutle@bergenclinics.no; liv.holmefjord.flesland@bergenclinics.no 7 Psychonaut Web Mapping Project; A-Clinic Foundation, Department of Communications, Helsinki, Finland; Paasivuorenkatu 2A; 00530; Helsinki; teuvo.peltoniemi@a-klinikka.fi; aino.majava@a-klinikka.fi; miia.mannonen@a-klinikka.fi 8 Psychonaut Web Mapping Project; Addiction Research Group at the Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Hospital of the University Duisburg-Essen, Germany; Virchowstrase 174. D-45122 Essen; norbert.scherbaum@uni-due.de; holger.siemann@lvr.de 9 Psychonaut Web Mapping Project; De Sleutel Technische Bedrijfseen heid Provincialaat der Broeders van Liefde, Merelbeke, Jozef Guislainstraat 43 a; B-9000; Gent Belgium; peer.van.der.kreeft@fracarita.org

Phenomenon of new drugs on the Internet: The case of ketamine derivative methoxetamine

On the basis of the material available both in the scientific literature and on the web, this paper aims to provide a pharmacological, chemical and behavioural overview of the novel compound methoxetamine. This is a dissociative drug related to ketamine, with a much longer duration of action and intensity of effects. A critical discussion of the availability of information on the web of methoxetamine as a new recreational trend is here provided. Those methodological limitations, which are intrinsically associated with the analysis of online, non‐peer reviewed, material, are here discussed as well. It is concluded that the online availability of information on novel psychoactive drugs, such as methoxethanine, may constitute a pressing public health challenge. Better international collaboration levels and novel forms of intervention are necessary to tackle this fast‐growing phenomenon. Copyright

Promoting innovation and excellence to face the rapid diffusion of Novel Psychoactive Substances in the EU: the outcomes of the ReDNet project

The recent emergence of new psychoactive compounds (novel psychoactive substances (NPS)) has raised prominent challenges in the fields of drug policy, substance use research, public health and service provision. The Recreational Drugs European Network project, funded by the European Commission, was implemented to improve the information stream to young people and professionals about effects/risks of NPS by identifying online products and disseminating relevant information through technological tools.

Clinical handover incident reporting in one UK general hospital

OBJECTIVE To determine the prevalence and characteristics of clinical handover incidents that occurred across a medium-size UK hospital. DESIGN A retrospective review of 36 consecutive months of data from the hospital electronic database of critical incidents was conducted. MAIN OUTCOME MEASURES Number of incidents reported, characterization of handover incidents according to clinical setting, severity and type of incidents. RESULTS We identified 334 handover incidents. The number of reported incidents increased over the 3 years. The transfer of patient care within the same specialty accounted for 51% (170) of incidents of which 75% (143) occurred during a change of shift. The specialties reporting the highest number of adverse events were: Obstetrics and Gynaecology, 42% (140); Medicine for the Elderly, 12.2% (41) and General Medicine, 12% (40). The most common types of handover incident scenario were poor or incomplete handover, 45% (151) and no handover of a patient at all, 29% (98). Reported severity was generally low (99%). CONCLUSIONS Current reporting rate is low if compared with prospective studies highlighting an issue of under-reporting. Many incidents appear to be of modest harm for patients because of response time; however, further research is required to assess potential severity and level of harm linked to low-quality handovers.

Is Mindful Reflective Practice the way forward to reduce medication errors

Medication errors can seriously affect patients and healthcare professionals. In over 60% of cases, medication errors are associated with one or more contributory; individual factors including staff being forgetful, stressed, tired or engaged in multiple tasks simultaneously, often alongside being distracted or interrupted. Routinised hospital practice can lead professionals to work in a state of mindlessness, where it is easy to be unaware of how both body and mind are functioning.

A systematic review of the nature of dispensing errors in hospital pharmacies

Background Dispensing errors are common in hospital pharmacies. Investigating dispensing errors is important for identifying the factors involved and developing strategies to reduce their occurrence. Objectives To review published studies exploring the incidence and types of dispensing errors in hospital pharmacies and factors contributing to these errors. Methods Electronic databases including PubMed, Scopus, Ovid, and Web of Science were searched for articles published between January 2000 and January 2015. Inclusion criteria were: studies published in English, and studies investigating type, incidence and factors contributing to dispensing errors in hospital pharmacies. One researcher searched for all relevant published articles, screened all titles and abstracts, and obtained complete articles. A second researcher assessed the titles, abstracts, and complete articles to verify the reliability of the selected articles. Key findings Fifteen studies met the inclusion criteria all of which were conducted in just four countries. Reviewing incident reports and direct observation were the main methods used to investigate dispensing errors. Dispensing error rates varied between countries (0.015%–33.5%) depending on the dispensing system, research method, and classification of dispensing error types. The most frequent dispensing errors reported were dispensing the wrong medicine, dispensing the wrong drug strength, and dispensing the wrong dosage form. The most common factors associated with dispensing errors were: high workload, low staffing, mix-up of look-alike/ sound-alike drugs, lack of knowledge/experience, distractions/interruptions, and communication problems within the dispensary team. Conclusion Studies relating to dispensing errors in hospital pharmacies are few in number and have been conducted in just four countries. The majority of these studies focused on the investigation of dispensing error types with no mention of contributing factors or strategies for reducing dispensing errors. Others studies are thus needed to investigate dispensing errors in hospital pharmacies, and a combined approach is recommended to investigate contributing factors associated with dispensing errors and explore strategies for reducing these errors.

Phenomenon of new drugs on the Internet

On the basis of the material available both in the scientific literature and on the web, this paper aims to provide a pharmacological, chemical and behavioural overview of the novel compound methoxetamine. This is a dissociative drug related to ketamine, with a much longer duration of action and intensity of effects. A critical discussion of the availability of information on the web of methoxetamine as a new recreational trend is here provided. Those methodological limitations, which are intrinsically associated with the analysis of online, non‐peer reviewed, material, are here discussed as well. It is concluded that the online availability of information on novel psychoactive drugs, such as methoxethanine, may constitute a pressing public health challenge. Better international collaboration levels and novel forms of intervention are necessary to tackle this fast‐growing phenomenon. Copyright

CP-015 An evaluation of the types and contributing factors of dispensing errors in hospital pharmacy

Background Dispensing medication is a chain of multiple stages, and any error during the dispensing process may cause high potential risk for the patient. Few research studies have investigated the nature and the contributory factors that are associated with dispensing errors in hospital pharmacies. Purpose To determine the nature and severity of unprevented dispensing errors reported in the hospital pharmacy at Luton and Dunstable Hospital in the UK; and to explore the pharmacy staff’s perceptions of contributory factors to dispensing errors and strategies to reduce these errors. Material and methods A mixed method approach was used and encompassed two phases. Phase I: a retrospective review of dispensing error reports for an 18 month period from 1 January 2012 to 30 June 2013 was conducted. An assessment of the potential clinical significance of the dispensing errors was undertaken. Data were analysed using descriptive statistics. Phase II: self-administered qualitative questionnaires were distributed to the dispensary team at the hospital. Content analysis using NVivo software was undertaken. Results 766 medication error reports were documented and 49 (6.4%) reports were related to dispensary incidents. The most frequently reported dispensing errors were: dispensing the wrong medicine (n = 9, 18.4%), labelling the wrong strength (n = 8, 16.3%) and dispensing the wrong strength (n = 7, 14.3%). The majority of the dispensing errors had minor or moderate potential to harm patients. Look-alike/sound-alike medicines, high workload, lack of staff experience, fatigue and loss of concentration during work, hurrying through tasks and distraction in the dispensary were the most common contributory factors. Furthermore, ambiguity of the prescriptions was also reported as a contributory factor in the hospital. Conclusion Decreasing distractions in the pharmacy are needed to enhance patient safety. Furthermore, monitoring and reporting errors, and educating the dispensary team about these errors are also needed. An e-prescribing system may help to improve dispensing efficiency and safety. The findings of this study re-emphasise the fact that dispensing errors are widespread in hospital pharmacy. Therefore, efficient interventions need to be implemented to mitigate these errors. References and/or Acknowledgements Many thanks to the Saudi Ministry of Health for the scholarship and funding my study No conflict of interest.

Phenomenon of new drugs on the Internet: the case of ketamine derivative methoxetamine: NEW DRUGS ON THE INTERNET

On the basis of the material available both in the scientific literature and on the web, this paper aims to provide a pharmacological, chemical and behavioural overview of the novel compound methoxetamine. This is a dissociative drug related to ketamine, with a much longer duration of action and intensity of effects. A critical discussion of the availability of information on the web of methoxetamine as a new recreational trend is here provided. Those methodological limitations, which are intrinsically associated with the analysis of online, non‐peer reviewed, material, are here discussed as well. It is concluded that the online availability of information on novel psychoactive drugs, such as methoxethanine, may constitute a pressing public health challenge. Better international collaboration levels and novel forms of intervention are necessary to tackle this fast‐growing phenomenon. Copyright