The economics of medication safety

OECD health working papers, Journal Year: 2022, Volume and Issue: unknown

Published: Sept. 13, 2022

Poor medication practices and inadequate system infrastructure—resulting in poor adherence, medication-related harms, errors—too often results patient harm. As many as 1 10 hospitalizations OECD countries may be caused by a event one five inpatients experience harms during hospitalization. Together, costs from avoidable admissions due to events added length of stay preventable hospital-acquired total over USD 54 billion countries. This report includes four components; it 1) assess the human impact economic safety countries, 2) explores opportunities improve prescribing 3) examines state-of-the art systems policies for improving safety, 4) provides recommendations at national level.

Language: Английский

---

Polypharmacy Management in the Older Adults: A Scoping Review of Available Interventions

Frontiers in Pharmacology, Journal Year: 2021, Volume and Issue: 12

Published: Nov. 26, 2021

Polypharmacy paves the way for non-adherence, adverse drug reactions, negative health outcomes, increased use of healthcare services and rising costs. Since it is most prevalent in older adults, there an urgent need introducing effective strategies to prevent manage problem this age group.

Language: Английский

---

Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes

Frontiers in Pharmacology, Journal Year: 2023, Volume and Issue: 14

Published: Aug. 2, 2023

Clinical pharmacy as an area of practice, education and research started developing around the 1960s when pharmacists across globe gradually identified need to focus more on ensuring appropriate use medicines improve patient outcomes rather than being engaged in manufacturing supply. Since that time numerous studies have shown positive impact clinical services (CPS). The for wider adoption CPS worldwide becomes urgent, global population ages, prevalence polypharmacy well shortage healthcare professionals is rising. At same time, there great pressure provide both high-quality cost-effective health services. All these challenges urgently require a new paradigm system architecture. One most answers increase utilization potential highly educated skilled widely available countries, i.e., pharmacists, who are positioned prevent manage drug-related problems together with safe effective medications further care relating medication adherence. Unfortunately, still underdeveloped underutilized some parts Europe, namely, Central Eastern European (CEE) countries. This paper reviews current situation development CEE countries prospects future region.

Language: Английский

---

Addressing the Challenge of Polypharmacy

The Annual Review of Pharmacology and Toxicology, Journal Year: 2019, Volume and Issue: 60(1), P. 661 - 681

Published: Oct. 7, 2019

Polypharmacy describes the concomitant use of multiple medicines and represents a growing global challenge attributable to aging populations with an increasing prevalence multimorbidity. can be appropriate but is problematic when increased risk harm from interactions between drugs or diseases burden administering monitoring outweighs plausible benefits. has substantial economic impact in service demand hospitalization as well detrimental on patients' quality life. Apart causing avoidable harm, polypharmacy also lead therapeutic failure, up 50% patients who take four more medications not taking them prescribed. Guidance needed support clinicians defining achieving realistic goals drug treatment, system change necessary aid implementation. This article outlines lessons two programs that aim address these challenges: Scottish guidance prescribing European Union SIMPATHY project.

Language: Английский

---

The definition of a community paramedic: An international consensus

Paramedicine, Journal Year: 2023, Volume and Issue: 20(1), P. 4 - 22

Published: Jan. 1, 2023

Community paramedicine is a globally evolving model of care where paramedics provide community-based, preventative and primary healthcare services. With increased global interest adaptation the community model, there lack clear definition role paramedic. This study sought to come an international consensus on A four-phase Delphi methodology was utilised achieve systematic approach expert identification performed reported in line with Conducting REporting DElphi Studies standard. total 94 experts were identified 76 consented involvement this Delphi. Response rate ranged from 81.6% (Phase 1) 63.1% 2). Participants expressed importance paramedic having components attributed health care, promotion, chronic disease management advanced clinical assessment. that these are essential skill set, which distinguishes other frontline paramedics. final 91% agreement achieved. The achieved as follows: provides person-centred diverse range settings address needs community. Their practice may include provision management, assessment needs-based interventions. They should be integrated interdisciplinary teams aim improve patient outcomes through education, advocacy system navigation. adoption will enhance efforts promote value specialist role, enabling better understanding how contributes wider system. [Media: see text]

Language: Английский

---

A case study of polypharmacy management in nine European countries: Implications for change management and implementation

PLoS ONE, Journal Year: 2018, Volume and Issue: 13(4), P. e0195232 - e0195232

Published: April 18, 2018

Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, healthcare spending. This study aimed address: what exists regarding management the European Union (EU); why programs were, or were not, developed; and, how identified initiatives developed, implemented, sustained. Methods Change principles (Kotter) normalization process theory (NPT) informed data collection analysis. Nine case studies conducted eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), United Kingdom (Northern Ireland Scotland). The workflow included a review of country/region specific policies, key informant interviews with stakeholders involved policy development implementation focus groups clinicians managers. Data analyzed using thematic analysis individual cases framework across cases. Results Polypharmacy five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, Uppsala) all care settings. There was agreement, even without initiatives, that is significant issue address. Common themes were: locally adapted solutions, organizational culture supporting innovation teamwork, adequate workforce training, multidisciplinary teams, changes workflow, redefinition roles responsibilities professionals, policies legislation initiative, information communication systems assist implementation. Depending on setting, these considered either facilitators barriers Conclusion Within studied countries, not widely addressed. These results highlight importance change theory-based strategies, provide examples can managers policymakers developing new scaling up existing ones, particularly places currently lacking such initiatives.

Language: Английский

---

Consensus‐based recommendations for titrating cannabinoids and tapering opioids for chronic pain control

International Journal of Clinical Practice, Journal Year: 2020, Volume and Issue: 75(8)

Published: Nov. 29, 2020

Opioid misuse and overuse have contributed to a widespread overdose crisis many patients physicians are considering medical cannabis support opioid tapering chronic pain control. Using five-step modified Delphi process, we aimed develop consensus-based recommendations on: 1) when how safely initiate titrate cannabinoids in the presence of opioids, 2) taper opioids 3) monitor evaluate outcomes treating with cannabinoids.

Language: Английский

---

Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus

ESC Heart Failure, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 4, 2025

The Heart Failure Frailty Score (HFFS) is a novel, multidimensional tool to assess frailty in patients with heart failure (HF). It has been developed overcome limitations of existing assessment tools while being practical for clinical use. HFFS reflects the concept as multidimensional, dynamic and potentially reversible state, which increases vulnerability stressors risk poor outcomes HF. was through Delphi consensus process involving 54 international experts. This approach involved iterative rounds questionnaires interviews, where panel experts provided their opinions on specific questions prepared by Steering Committee. were invited vote share views anonymously, using 5-point Likert scale over rounds. An 80% threshold set agreement or disagreement each statement. Twenty-two variables from four domains (clinical, functional, psycho-cognitive social) have selected inclusion after third round process. A shorter version (S-HFFS), including 10 variables, also daily new identification should enables healthcare providers identify potential 'red flags' order develop personalized care plans. next step will be validate score

Language: Английский

---

Development of a Program Evaluation Framework for Improving the Quality of Undergraduate Medical Education

Korean Medical Education Review, Journal Year: 2025, Volume and Issue: 27(1), P. 60 - 81

Published: Feb. 28, 2025

The development and implementation of a systematic program evaluation framework is critical for improving the quality undergraduate medical education. At Yonsei University College Medicine, we established following five domains that encompass various aspects educational experiences: (1) preclinical curriculum; (2) clinical (3) environment, resources, systems; (4) performance students graduates outcomes; (5) outcomes curriculum. Specific indicators were designed within these validated through Delphi technique, which integrated expert opinions. In total, 98 identified across domains. These will function as comprehensive tool assessing education programs. proposed addresses both shortand long-term changes, facilitating monitoring, continuous improvement curricula, better students. As this grounded in unique context institution, it appropriate interactions at stages. Furthermore, may serve strategic foundation identifying areas require improvement, ensuring curriculum aligns with current standards practices. framework’s structured approach continuing processes make possible to obtain essential data ongoing development, potentially contributing robust system findings study are expected valuable reference developing similar frameworks other schools.

Language: Английский

---

Development of Principles for Health-Related Information on Social Media: Delphi Study

Journal of Medical Internet Research, Journal Year: 2022, Volume and Issue: 24(9), P. e37337 - e37337

Published: Sept. 8, 2022

Background Health-related misinformation can be propagated via social media and is a threat to public health. Several quality assessment tools principles evaluate health-related information in the domain exist; however, these were not designed specifically for media. Objective This study aims develop Principles Information on Social Media (PRHISM), which used of content. Methods A modified Delphi approach was obtain expert consensus functions PRHISM. Health experts recruited Twitter, email, snowballing. total 3 surveys administered between February 2021 May 2021. The first survey informed by literature review included open-ended questions items from existing tools. Subsequent results proceeding survey. Consensus deemed if ≥80% agreement reached, with considered relevant include After third survey, finalized, an instruction manual scoring tool PRHISM developed circulated participants final feedback. Results 34 consented participate, whom 18 (53%) responded all surveys. In total, 13 When instructions circulated, no objections wording received. Conclusions tool, along system implementation tool. promote accessibility, transparency, provision authoritative evidence-based support consumers’ relationships health care providers. provided These may also useful content creators developing high-quality assist consumers discerning high- low-quality information.

Language: Английский

---