Audit of physiotherapy supplementary prescribing practice and polypharmacy in secondary care neurological rehabilitation and pain management clinics

Physiotherapy ◽  
2016 ◽  
Vol 102 ◽  
pp. e98-e99 ◽  
Author(s):  
A. Robertson ◽  
M. Hey ◽  
P. Merrifield
Keyword(s):  
Pain Management ◽  
Secondary Care ◽  
Neurological Rehabilitation ◽  
Supplementary Prescribing ◽  
Prescribing Practice

scholarly journals Assessment of implementation of antibiotic stewardship program in surgical prophylaxis at a secondary care hospital in Ras Al Khaimah, United Arab Emirates

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hessa Saleh Alshehhi ◽  
Areeg Anwer Ali ◽  
Duaa Salem Jawhar ◽  
Essam Mahran Aly ◽  
Srinivas Swamy ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
United Arab Emirates ◽  
Antibiotic Stewardship ◽  
Secondary Care ◽  
Care Hospital ◽  
Surgical Prophylaxis ◽  
Patient Profile ◽  
Stewardship Program ◽  
Prescribing Practice ◽  
Surgical Antibiotic Prophylaxis

AbstractAntibiotic overuse is a major factor for causing antibiotic resistance globally. However, only few studies reported the implementation and evaluation of antimicrobial stewardship programs in Gulf Cooperation Council. This study was conducted within 8-months periods to evaluate the effect of the newly implemented antibiotic stewardship program on improving the prescribing practice of surgical antibiotic prophylaxis in a secondary care hospital in the United Arab Emirates by releasing local hospital guidelines. The data of 493 in patients were documented in the predesigned patient profile form and the prescribing practice of surgical antibiotic prophylaxis for clean and clean-contaminant surgical procedures was compared and analyzed two months’ prior (period A) and post (period B) the implementation of antibiotic stewardship program. The 347 patient’s data (PD) were analyzed during period A and 146 PD during period B. The prescription of piperacillin/tazobactam was decreased from 2.4% from all surgical prophylaxis antibiotic orders in period A to 0% in period B. The appropriateness of the antibiotic therapy was found to differ non significantly for the selection of prophylactic antibiotic (p = 0.552) and for the timing of first dose administration (p = 0.061) between A and B periods. The total compliance was decreased non significantly (P = 0.08) from 45.3 to 40.2%. Overall, the guidelines have improved the prescribing practice of antibiotics prior to surgery. However, further improvement can be achieved by initiating educational intervention via cyclic auditing strategy.

scholarly journals A needs assessment study for optimising prescribing practice in secondary care junior doctors: the Antibiotic Prescribing Education among Doctors (APED)

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Myriam Gharbi ◽  
Luke S. P. Moore ◽  
Enrique Castro-Sánchez ◽  
Elpiniki Spanoudaki ◽  
Charlotte Grady ◽  
...  
Keyword(s):  
Needs Assessment ◽  
Secondary Care ◽  
Junior Doctors ◽  
Antibiotic Prescribing ◽  
Assessment Study ◽  
Prescribing Practice

scholarly journals Drugs for pain management in the neurological rehabilitation department: What are our clinical practices?

2011 ◽  
Vol 54 ◽  
pp. e41
Author(s):  
S. Bauler ◽  
A. Janoly-Dumenil ◽  
T. Khayi ◽  
L. Tell ◽  
F. Costaz ◽  
...  
Keyword(s):  
Pain Management ◽  
Neurological Rehabilitation ◽  
Clinical Practices

scholarly journals An audit on prescribing practice and risk of serotonin syndrome among patients with chronic pain

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S152-S152
Author(s):  
Salakan Rai ◽  
Aizad Yusof
Keyword(s):  
At Risk ◽  
Chronic Pain ◽  
Pain Management ◽  
Drug Interactions ◽  
Serotonin Syndrome ◽  
Pain Clinic ◽  
Antidepressant Agents ◽  
Concurrent Use ◽  
Prescribing Practice ◽  
Serotonin Toxicity

AimsTo determine the incidence of prescribing practice with associated risk of serotonin toxicity among patients with chronic pain conditions.BackgroundSerotonin syndrome is a potentially life-threatening condition caused by excessive serotonergic activity, usually from drug interactions. Concurrent use of antidepressants is strongly linked to serotonin syndrome, with recent data revealing record numbers of NHS prescribed antidepressants in 2019. Antidepressant medications are also used in chronic pain management for their anti-neuropathic pain properties. However, it is well-recognised that a significant number of chronic pain patients suffer from anxiety and depression. This cohort of patients is therefore vulnerable to being exposed to multiple concurrent antidepressant agents, and thus at relatively higher risk of serotonin syndrome compared to other patient groups. Additionally, these patients are likely to be exposed to the concurrent use of antidepressants and certain analgesic agents particularly phenylpiperidine derivatives which increases serotonin toxicity risk.MethodMedications of patients presenting to a secondary care pain clinic within the last year were looked into. Patients were selected at random by pain management secretaries. Concurrent use of multiple antidepressant agents including Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin Noradrenaline Reuptake Inhibitors (SNRIs), Tricyclic Antidepressants (TCAs) or Tetracyclic Antidepressant (TeCA) was noted. Additionally, concurrent use of any of these antidepressant agents and phenylpiperidine derivatives such as Fentanyl and Tramadol was noted.ResultData on medications of 97 patients were collected. A total of 28 patients (28.8%) were observed to have at-risk medication combinations. Out of these, five patients were on both SSRI and TCA. Two patients were on both TCA and TeCA. Four other patients were on either a combination of SSRI and SNRI, SNRI and TCA, SSRI and TeCA, or TCA and TCA. Three patients were on both Fentanyl patches and an antidepressant. Fourteen patients were on both an antidepressant and Tramadol. None of these patients were diagnosed with serotonin syndrome; however, it is unclear as to whether these patients experienced milder symptoms of the syndrome.ConclusionA considerable number of patients in this group were on medication combinations putting them at risk of serotonin syndrome. Despite no documented patient harm, there is an urgent need for an increased awareness among prescribers on drug interactions which may lead to this syndrome and a subsequent change in prescribing practice.

scholarly journals Coxibs: recent controversies

2005 ◽  
Vol 4 (10) ◽  
pp. 270-272
Author(s):  
Pauline Bourne ◽  
Marwan Bukhari ◽  
Andrew Vickers
Keyword(s):  
Primary Care ◽  
Pain Management ◽  
Secondary Care

The recent public and press interest in the cyclo-oxygenase type 2 inhibitors (Coxibs) has led to discussions between primary care trusts, pharmacists in both primary and secondary care, and clinicians. Two years ago the Journal reported on the gastrointestinal (GI) safety of this new and potentially promising class of drugs, but more recent evidence has suggested a cardiovascular (CV) risk. With one manufacturer voluntarily withdrawing its product from the market, another issuing statements in defence of its product, and the Committee on Safety of Medicines weighing in with its own advice, it was felt that a meeting of interested parties was appropriate. The Journal asked Pauline Bourne, Pharmacist, Marwan Bukhari, Consultant Rheumatologist, and Andrew Vickers, Consultant in Pain Management, for their views.

Evaluation of Prescribing Practice at Secondary Care Units in Annajaf Governorate, Iraq

2019 ◽  
Vol 13 (4) ◽  
pp. 1049
Author(s):  
Ali Mohammed Abd Alridha ◽  
Hayder Chassib Assad ◽  
Karrar Mohammed Hasan Al-Gburi ◽  
Abulfadhel Jaber Neamah Al-Shaibani ◽  
Karrar Talib Khudair Albo Hamrah
Keyword(s):  
Secondary Care ◽  
Prescribing Practice
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