Home Medication Review to Identify the Medication Errors in the Paediatric Population

Medication errors are therapeutic obstacles that have the potential to threaten the patient outcomes and result in unexpected events. Home medication review (HMR) is a patient-focused process which advocates the optimal and quality use of medication at the patient’s home. It involves a systematic and detailed assessment of the patient’s medication in order to identify and meet the medication-related needs as well as to identify and prevent medication errors. The aim of this study is to identify the medication errors in paediatric population. The paediatric population is a vulnerable part of the community as they should be treated with utmost care due to their differing pharmacokinetic properties. This study is a community based prospective observational study including 150 paediatric participants. A specially designed data collection form will be used to collect the data from the patients who are eligible for the study. Several dosing and administration errors were also found in the study. Several studies have been done under home medication review but only a few with paediatric population is seen. Home medication review can be very useful for the society if it is implemented. It will be helpful to the community in clarifying any misunderstandings regarding the treatment and can lead to better outcomes. Keywords: Home medication review, paediatric population, adherence.

Assessment of Storage of Medicines at Home using Home Medication Review in Pediatric Population - A Community Based Study

People take medicines and vitamins to feel well and to stay well. However, any medicine, including those we buy without a prescription, can cause harm if taken in the wrong way or by the wrong person. That too in case of pediatric population it has to be considered very much.Medicines stored incorrectly at home can pose a health risk. Adult cold medications and antibiotics were the most commonly stored drugs at home, followed by analgesics. The most popular location for storing drugs was the refrigerator (50.6 percent). The majority of people did not read the packaging inserts. Self-medication was reported by a large percentage of homeowners (53.6%), and antibiotics recommended by doctors were frequently reused. There was a link between self-medication and educational attainment, but not with age, sex, marital status, occupation, or insurance type. There is a need for more public awareness and information about the storage and risks of reusing prescription drugs. The study conducted here is a community based prospective study where the paediatric storage of medicines was obtained through home medication review. Out of 150 pediatric participants, it was found that 20.66% of them stored in box or drawer or bag with lock and 79.33% without lock. The checking of expiry date was also enquired and in that those who checked expiry date never was 28%, timely 25% and before administration 47%.Therefore awareness of storage of medicines and looking into the expiry date of medicines is a less focused area among people.Consumers who use medications in the community should be urged to keep them in a way that preserves the medicine's quality while also protecting the consumer, their family, and visitors to their house. Keywords: Pediatric storage of medicines, Home medication review, Expiry date of medicines.

Impact Analysis of a Pharmacist-Led Home-Medication Review Service Within an Interprofessional Outreach Team

Objective To describe the demographic and clinical characteristics of frail and homebound community-dwelling older patients receiving a home medication review (HMR) conducted by a home-visiting pharmacist; the types of drug therapy problems (DTPs) that were identified; the types of clinical interventions being recommended and their implementation rate. Design Retrospective, cross-sectional chart-review study using data from patient records. Setting Homes of patients receiving a HMR by a community pharmacy-based consulting home-visiting pharmacist. Patients 171 patients received a HMR between January 1, 2016, and May 31, 2018. Intervention Patients received a comprehensive HMR by a home-visiting pharmacist working as a member of an interprofessional geriatrics team. Main Outcome Measures Charlson Comorbidity Index (CCI) score, comorbidities, use of potentially inappropriate medications, DTPs identified, number and type of clinical interventions being recommended and successfully implemented. Results Patients had a mean age of 81 years (range: 54-100 years), majority were 65 years of age or older (95%), and female (59%). Fifty-three percent of patients had a CCI score of 1 to 2, and 93.6% were experiencing multi-morbidity and polypharmacy. Patients used an average of 13.0 medications, and 76.1% were found to be using at least 1 potentially inappropriate medication. In total, the home-visiting pharmacist identified 827 DTPs and made 1088 recommendations with a successful implementation rate of 74%. Conclusions Frail and homebound community-dwelling older adults referred for a HMR were observed to be using a high number of medications with a significant number of DTPs identified. Offering HMRs was an effective method for a community-based pharmacist to make acceptable recommendations to optimize medication therapy management for frail older patients.

Impact Analysis of a Pharmacist-Led Home-Medication Review Service Within an interprofessional Outreach Team

OBJECTIVE: To describe the demographic and clinical characteristics of frail and homebound communitydwelling older patients receiving a home medication review (HMR) conducted by a home-visiting pharmacist; the types of drug therapy problems (DTPs) that were identified; the types of clinical interventions being recommended and their implementation rate. DESIGN: Retrospective, cross-sectional chart-review study using data from patient records. SETTING: Homes of patients receiving a HMR by a community pharmacy-based consulting home-visiting pharmacist. PATIENTS: 171 patients received a HMR between January 1, 2016, and May 31, 2018. INTERVENTiON: Patients received a comprehensive HMR by a home-visiting pharmacist working as a member of an interprofessional geriatrics team. MAIN OUTCOME MEASURES: Charlson Comorbidity Index (CCI) score, comorbidities, use of potentially inappropriate medications, DTPs identified, number and type of clinical interventions being recommended and successfully implemented. RESULTS: Patients had a mean age of 81 years (range: 54-100 years), majority were 65 years of age or older (95%), and female (59%). Fifty-three percent of patients had a CCI score of 1 to 2, and 93.6% were experiencing multi-morbidity and polypharmacy. Patients used an average of 13.0 medications, and 76.1% were found to be using at least 1 potentially inappropriate medication. In total, the home-visiting pharmacist identified 827 DTPs and made 1088 recommendations with a successful implementation rate of 74%. CONCLUSIONS: Frail and homebound communitydwelling older adults referred for a HMR were observed to be using a high number of medications with a significant number of DTPs identified. Offering HMRs was an effective method for a community-based pharmacist to make acceptable recommendations to optimize medication therapy management for frail older patients.

Engaging hospital patients in the medication reconciliation process using tablet computers

Objective Unintentional medication discrepancies contribute to preventable adverse drug events in patients. Patient engagement in medication safety beyond verbal participation in medication reconciliation is limited. We conducted a pilot study to determine whether patients’ use of an electronic home medication review tool could improve medication safety during hospitalization. Materials and Methods Patients were randomized to use a toolbefore orafter hospital admission medication reconciliation to review and modify their home medication list. We assessed the quantity, potential severity, and potential harm of patients’ and clinicians’ medication changes. We also surveyed clinicians to assess the tool’s usefulness. Results Of 76 patients approached, 65 (86%) participated. Forty-eight (74%) made changes to their home medication list [before: 29 (81%),after: 19 (66%),p = .170].Before group participants identified 57 changes that clinicians subsequently missed on admission medication reconciliation. Thirty-nine (74%) had a significant or greater potential severity, and 19 (36%) had a greater than 50-50 chance of harm.After group patients identified 68 additional changes to their reconciled medication lists. Fifty-one (75%) had a significant or greater potential severity, and 33 (49%) had a greater than 50-50 chance of harm. Clinicians reported believing that the tool would save time, and patients would supply useful information. Discussion The results demonstrate a high willingness of patients to engage in medication reconciliation, and show that patients were able to identify important medication discrepancies and often changes that clinicians missed. Conclusion Engaging patients in admission medication reconciliation using an electronic home medication review tool may improve medication safety during hospitalization.