Objective: This systematic review aims to investigate the role and responsibilities of pharmacists in the prevention of medication errors. The study also aims to evaluate pharmacist-centered strategies that have an impact on medication error reduction and prevention. Methods: A search was conducted through the following databases PubMed Central, Scopus, Trip, Prospero, Medline and Google Scholar using terms related to “medication errors prevention” or “pharmacist-related errors”. Other search terms included “pharmacist(s)”, “prevention”, “medication error(s)”, “dispensing error(s)”, “drug incidence(s)”, “medication malpractice(s)”. Included studies were prospective and retrospective cohort, case-control and cross-sectional full-text studies published in the last 10 years (2010-2020). The review team screened the articles for inclusion criteria and evaluated the quality of the articles. The PRISMA guidelines were used to report the selected articles and screening process. Then, the articles were sent to a third independent reviewer for the quality assessment using the STROBE Checklist. Results: A clinical pharmacist’s duties are to supervise the medication treatment of admitted patients and to notify the healthcare team when a discrepancy is found. A total of seven reviewed studies highlighted the importance and positive impact of increasing the number of clinical pharmacist’s interventions. Literature showed that an average of 64.9% of medication discrepancies happen during patient discharge, highlighting the necessity of a clinical pharmacist intervention at that stage. The systematic review focused on the significant impact of clinical pharmacists’ role in preventing errors (studies reported=5); encouraging pharmacist-led education to increase medication error awareness (studies reported =5), incorporating better and innovative pharmacy-related work approaches (studies reported =4); and implementing appropriate and secured policies for medication error reporting (studies reported =1). The screened literature highlighted the significant reduction in the number of medication errors and an increase in medication error identification and awareness. These findings suggest the crucial role of a pharmacist in healthcare policies for the prevention of medication errors and patient safety. Conclusion: This systematic review suggests multiple pharmacist-centered strategies that have been implemented in several studies showing the positive impact on the reduction and prevention of medication errors commenced by not only the pharmacist but the rest of the healthcare team.
Background/Objectives: Antimicrobial stewardship programs improve antimicrobial use and help combat antimicrobial resistance. The Infectious Disease Society of America’s (IDSA) recommended core interventions include prospective audit and feedback along with formulary restriction and preauthorization. IDSA recommends any one of these interventions be implemented in acute care hospitals to improve antimicrobial stewardship. The objective of this project was to implement a prospective audit and feedback system using selected antimicrobials at a tertiary care hospital in the United Arab Emirates as the foundation to build an antimicrobial stewardship program. Results: A total of 497 patients met the inclusion and exclusion criteria during the study period; the post-intervention group had 260 patients, and the control group had 237 patients. After the implementation of the program, a total of 186 interventions were recommended, and 76% were accepted. The length of stay, length of therapy, and days of therapy were lower in the intervention group compared to the control group (p < 0.05). There was no statistically significant difference in clinical outcome measures (e.g., 30-day readmission, 30-day all-cause mortality, 30-day emergency visit with the same infection, and 60-day readmission). Methods: This single-center quasi-experimental research was conducted from August 2023 to July 2024. A pharmacist-led prospective audit and feedback system was initiated in February 2024 after review and approval of the medical staff, in addition to formulary restrictions. Data from patients receiving the selected antimicrobial before February 2024 were collected from their charts and related medical records without any intervention; this was used by our control group. After implementation, the hospital pharmacy’s records were evaluated during the night shift to determine whether they met the inclusion criteria. The records of the eligible patients were then evaluated by the clinical pharmacist. In case of antimicrobial inappropriateness, feedback was provided to the prescriber. If the recommendation was not accepted, succeeding reviews and feedback were provided on subsequent days. The effectiveness of the intervention was measured using clinical and antibiotic use measures. Conclusions: Implementation of a pilot pharmacist-led antimicrobial stewardship program resulted in modification in antimicrobial use measures (i.e., defined daily doses of targeted antimicrobials and days of antimicrobial therapy) without an increase in length of stay or readmissions or mortality.
Introduction. Coronavirus disease 2019 (COVID-19) can progress to severe respiratory compromise and lead to mortality due to induction of cytokine storm. Tocilizumab (TCZ) is approved by the FDA for the treatment of cytokine release syndrome (CRS). This study aims to analyze the outcomes among patients who received TCZ in the United Arab Emirates. Methods. A retrospective cohort study was conducted among COVID-19 patients who received TCZ in a tertiary care hospital from May 2020 to August 2021. For analysis, patients were divided into two groups based on survival and clinical improvement. Results. Overall, 80% of patients receiving TCZ were discharged by day 28. There was a gradual improvement in oxygen requirements in our patients with a majority of them on room air by day 28. Age more than 50 years ( ) and comorbidities such as cardiovascular disease (CVD) ( ) and renal insufficiency ( ) were significantly associated with mortality. Discussion. In our analysis, patients who were mechanically ventilated at the time of administration of TCZ had a significantly higher risk of death by day 28. In both survived and improved groups, younger patients had better outcomes than older patients. Patients who received TCZ earlier during therapy from the onset of symptoms had better survival outcomes. There was only one death among 14 patients who received vaccination. There was no significant difference in mortality among patients with comorbidities such as diabetes, hypertension, dyslipidemia, obesity, and pulmonary diseases, hypothesizing that administration of TCZ improves the outcomes in COVID-19 patients with these comorbidities.
Background: This study aims to evaluate the effectiveness of an online Moodle-based lesson for pharmacy students developed and designed for a research course focused on different methodologies, study variables, and research process applications. Methods: An experimental research methodology was used to determine the effectiveness of the Moodle-based lesson. All fourth term Pharm.D. students were required to complete and provide self-reflection reports. The outcome variables were cluster-based completion time, earned score, subjective feedback on contents, gender differences, and performance. Mean values were used to conduct statistical analysis, and a logistic regression model was applied to identify the significance of independent variables. Results: A total of 35 students completed the Moodle-based lesson. The mean earned score for the module was 81.0%, with an average completion time of 28.5 (range 26.8-30.1) hours. Females showed completion in less time compared to males. The reported knowledge and understanding showed a significant (p<0.001) pre-post increase in mean percentages in all three clusters. The intragroup pool analysis also reported significant (p<0.001) differences among gender and performance. The general feedback was limited to technical difficulties and selfreflection questions. Conclusions: The findings of this study showed that the online Moodlebased lesson module for a research course is an effective and validated tool to improve the knowledge and understanding of pharmacy students.
1 September 2021 in Current Issues in Pharmacy and Medical Sciences
The objective of this meta-analysis study was to evaluate the comparative efficacy of empagliflozin (25 mg) with placebo in the treatment and management of type 1 diabetes mellitus. This study is a meta-analysis, so an ethical statement is not required. Different databases and individual journal websites like SCOPUS, Science direct, Cochrane review library etc. were used. The articles were evaluated based on the search and eligibility criteria. A total of five RCTs were incorporated in this meta-analysis. These studies contained a total of 1058 patients, including 526 patients with placebo (or control-treated patients), and 532 patients with empagliflozin (25 mg) treated combination. The mean follow-up time ranged from 7 days to 6 months. Overall, mean reduction in placebo was -0.50% and empa-treated was -0.85%, while the pooled WMD was 3.82 995% CI 1.20 – 5.88, p=0.0001). Regarding urinary glucose excretion, that the pooled WMD was 6.67 (95% CI 4.87-10.14, p=0.001) indicated a significant increase in empa-arm compared to placebo. No heterogeneity was found (I2 – 15.03%). This meta-analysis underlined the therapeutic benefit of empagliflozin as an adjunctive therapy for patients with type 1 diabetes.