Identification and Clarification of Drug Therapy Problems by Indian Health Service Pharmacists

1996 ◽  
Vol 30 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Cynthia P Smith ◽  
Dale B Christensen
Keyword(s):  
Drug Therapy ◽  
Detection Rate ◽  
Indian Health Service ◽  
Potential Drug ◽  
Detection Rates ◽  
Indian Health ◽  
Problem Detection ◽  
Drug Therapy Problem ◽  
Drug Therapy Problems ◽  
Over Time

OBJECTIVE: To describe drug therapy problem intervention activities of Indian Health Service (IHS) pharmacists and to characterize the types of drug therapy problems encountered. DESIGN: Longitudinal descriptive study of documented potential drug therapy problems detected by pharmacists during the conduct of routine dispensing activities during a 6-month period. SETTING: All 18 IHS hospitals and ambulatory care facilities in one geographic area. MAIN OUTCOME MEASURES: Potential drug therapy problem detection rates by pharmacists and problem detection rates per 100 dispensed prescriptions are reported. Problems are characterized as to type, nature of intervention activities undertaken, and results of interventions. Changes in problem detection rate across clinics and over time are reported. RESULTS: Pharmacists detected and reported problems at a rate of slightly less than one per 100 prescriptions dispensed; however, drug therapy changes occurred 78% of the time as a result of the interventions. The types of drug therapy problems occurring most frequently were incorrect information (40.7%), prescription clarification (39.6%), clinical problems (10.4%), and inappropriate drug (9.3%). Physician acceptance of pharmacist interventions varied by type of drug therapy problem. Drug therapy changes occurred 77.7% of the time as a result of the interventions. Pharmacists at several sites used records of the drug therapy problems to make changes in policy or procedures as a part of continuous quality improvement activities. As a result, the problem detection rate declined over time in several settings. CONCLUSIONS: In comparison with other settings where cognitive services have been reported, IHS pharmacists detected fewer problems, but their interventions resulted in a higher percentage of drug therapy changes.

Detection of medium-sized ground-dwelling mammals using infrared digital cameras: an alternative way forward?

2010 ◽  
Vol 32 (2) ◽  
pp. 165 ◽  
Author(s):  
Andrew W. Claridge ◽  
David J. Paull ◽  
Simon C. Barry
Keyword(s):  
Detection Rate ◽  
Detection Efficiency ◽  
Digital Cameras ◽  
Target Species ◽  
Detection Rates ◽  
Reporting Rates ◽  
Swamp Wallaby ◽  
Over Time

Infrared digital cameras were used to examine temporal detection rates of medium-sized ground-dwelling mammals in a coastal woodland landscape. From three successive deployments at fixed stations, a range of mammals was detected, including three target species: the long-nosed bandicoot, the long-nosed potoroo and the southern brown bandicoot. Reporting rates of target species were largely consistent and in some cases high. The swamp wallaby was the most commonly detected species, ranging from 47–67% of cameras on any given deployment. Long-nosed bandicoots were detected at 37–53% of cameras, long-nosed potoroos 13–23% and southern brown bandicoots 10–17%. In total, bandicoots and potoroos were detected at 23 of 30 sites (77%) while forage-diggings of these mammals were universally present. There were differences in the detection rate of bandicoots and potoroos in relation to 24-hourly cycles: all three species were less likely to be detected between dawn and dusk than dusk and dawn. Otherwise, with few exceptions, the rate at which bandicoots and potoroos were detected over time within a deployment did not vary markedly. Infrared digital cameras offer great potential as sampling devices for bandicoots and potoroos because of their greater detection efficiency relative to other techniques.

scholarly journals Assessment of drug therapy problem and associated factors among adult hypertensive patients at Ayder comprehensive specialized hospital, Northern Ethiopia

2019 ◽  
Vol 19 (3) ◽  
pp. 2571-2579
Author(s):  
Asgedom Solomon Weldegebreal ◽  
Fekadu Tezeta ◽  
Atey Tesfay Mehari ◽  
Wubetu Gashaw ◽  
Kassa Tesfaye Dessale ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Therapy ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Northern Ethiopia ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Drug Therapy Problem ◽  
Drug Therapy Problems

Background: Drug-therapy problems(DTPs) among hypertensive patients can result in patient’s morbidity and mortality. The main aim of this study was to assess drug therapy problem and associated factors among <="" span="" style="font-family: hypertensive patients.Methods: A hospital based cross sectional study was conducted. The data was collected from patients’ medical charts and through interview. Drug therapy problem was categorized according to Cipolle methods of DTP classification. Thedata was analyzed using the Statistical Package for the Social Sciences (SPSS), version 21.Results: A total of 241 patients were studied. The mean number of antihypertensive medications prescribed were 1.41±0.53. A total of 357 drug therapy problems(DTPs) were identified. From the patients studied,134(55.6%) had at least one evidence of drug therapy problem. Non adherence was the most commonly identified drug therapy problem occurred in (143(59.3%)) patients. Substance use (AOR=0.445, 95% CI= 0.227-0.870, p=0.018) and comorbidity (AOR= 2.099, 95% CI= 1.192-3.694, p=0.010) werethe predictors of DTP.Conclusion: More than half of the participants had evidence of onset drug therapy problem. Thus efforts that could boost antihypertensive compliance and minimizes substance use should be adopted to reduce patients’s drug therapy problems.Keywords: assessment, drug, therapy, problem, Ethiopia.

scholarly journals Visualizing heterogeneities of earthquake hypocenter catalogs: modeling, analysis, and compensation

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Yosihiko Ogata
Keyword(s):  
Seismic Activity ◽  
Detection Rate ◽  
Empirical Bayes ◽  
Rate Function ◽  
Change Over Time ◽  
Detection Rates ◽  
Earthquake Catalogs ◽  
Earthquake Hypocenter ◽  
Large Earthquakes ◽  
Over Time

AbstractAs basic data for seismic activity analysis, hypocenter catalogs need to be accurate, complete, homogeneous, and consistent. Therefore, clarifying systematic errors in catalogs is an important discipline of seismicity research. This review presents a systematic model-based methodology to reveal various biases and the results of the following analyses. (1) It is critical to examine whether there is a non-stationary systematic estimation bias in earthquake magnitudes in a hypocenter catalog. (2) Most earthquake catalogs covering long periods are not homogeneous in space, time, and magnitude ranges. Earthquake network structures and seismometers change over time, and therefore, earthquake detection rates change over time and space. Even in the short term, many aftershocks immediately following large earthquakes are often undetected, and the detection rate varies, depending on the elapsed time and location. By establishing a detection rate function, the actual seismic activity and the spatiotemporal heterogeneity of catalogs can be discriminated. (3) Near real-time correction of source locations, far from the seismic observation network, can be implemented based on better determined source location comparisons of other catalogs using the same identified earthquakes. The bias functions were estimated using an empirical Bayes method. I provide examples showing different conclusions about the changes in seismicity from different earthquake catalogs. Through these analyses, I also present actual examples of successful modifications as well as various misleading conclusions about changes in seismic activity. In particular, there is a human made magnitude shift problem included in the global catalog of large earthquakes in the late nineteenth and early twentieth centuries.

scholarly journals A Prospective Observational Study of Drug Therapy Problems in Pediatric Ward of a Referral Hospital, Northeastern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Gizachew Kassahun Bizuneh ◽  
Betelhem Anteneh Adamu ◽  
Getenet Tadege Bizuayehu ◽  
Solomon Debebe Adane
Keyword(s):  
Risk Factors ◽  
Drug Therapy ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Dose Calculation ◽  
Referral Hospital ◽  
Pediatric Ward ◽  
Drug Therapy Problem ◽  
Drug Therapy Problems ◽  
Dessie Referral Hospital

Background. A drug therapy problem is any undesirable event experienced by a patient during drug therapy that interferes with achieving the desired goals of therapy. It has been pointed out that hospitalized pediatric patients are particularly prone to drug-related problems. Identifying drug therapy problems enables risk quantification and determination of the potential impact of prevention strategies. The purpose of this study was to assess the drug therapy problems in a pediatric ward of Dessie Referral Hospital, northeast of Ethiopia, and to identify associated factors for drug therapy problems. Methods. A prospective observational study design was carried out to assess drug therapy problems in a pediatric ward of Dessie Referral Hospital from February 1, 2018, to May 30, 2018. Ethical approval was obtained, and informed consent was signed by each study participant’s parent before the commencement of the study. All patients admitted to the ward during the study period were included in the study. Data was collected by trained pharmacy staffs through medical record reviews of patients using a prepared standard checklist and semistructured questionnaire. The collected data were cleared and checked every day for completeness and consistency before processing. Data were entered, and descriptive statistical analysis was done using SPSS Version 20 Software. A P value of less than 0.05 was considered significant. Results. The participants’ mean age was 2.32 years with the standard deviation (SD) of 0.76 years. Among 81 patients, 71 (87.7%) of them had at least one drug therapy problem per patient which indicates that the prevalence of the drug therapy problem was substantially high. Needs additional drug was the most predominantly encountered drug therapy problem accounted (30 (25.2%)). On the other hand, ineffective drug was the least (3 (2.5%)) drug therapy problem. Antibiotics (47 (39.5%)) followed by fluid and electrolyte (25 (21%)) were classes of drugs mostly involved in the drug therapy problem. The main risk factors reported to the occurrence of the drug therapy problems were prescribing and dose calculation errors. Conclusion. The present study revealed that majority of the patients had at least one DTP per patient; this indicates that prevalence of DTP was very high in the study area. Needs additional drug therapy followed by noncompliance was the major cause of the occurrence of DTP. Antibiotics were the main class of drugs involved in the drug therapy problem, and among the risk factors assessed, prescribing and dose calculation errors showed statistical significance.

scholarly journals Increasing rates of SSA/P detection in a large open-access Australian colonoscopy cohort

2019 ◽  
Vol 07 (03) ◽  
pp. E310-E316
Author(s):  
Kumanan Nalankilli ◽  
Xuan Huynh ◽  
Stephen Lade ◽  
Mark Stephens ◽  
Robert Hewett ◽  
...  
Keyword(s):  
Detection Rate ◽  
Lesion Detection ◽  
Direct Access ◽  
Time Range ◽  
Published Data ◽  
Serrated Adenoma ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Expert Pathologist ◽  
Over Time

Abstract Background and study aims There are limited longitudinal data regarding detection rates for sessile serrated adenoma/polyps (SSADR) and right-sided hyperplastic polyps (RHPDR) that constitute the proximal serrated lesion detection rate (PSLDR). Recently, a minimum PSLDR of 4.5 % has been suggested. This study was designed to assess SSADR, PSLDR and adenoma detection rate (ADR) for a newly qualified gastroenterologist and compare them to published data and to assess the change in SSADR, PSLDR and ADR over time for potential improvement with experience. Patients and methods All colonoscopies performed by a single colonoscopist (AM), at one Australian ambulatory direct-access endoscopy center over 4 years from 2011 to 2015 were retrospectively analyzed. Histology was reported by a single expert pathologist (SL). ADR, SSADR, RHPDR and PSLDR were recorded. Results A total of 841 colonoscopies were performed on 637 patients. Of them, 454 (54 %) were males. Mean age was 59 years. Of the colonoscopies, 87 % were performed for patients with ASA scores of 1 – 2, 422 (50.2 %) were for screening or surveillance, 374 (44.5 %) for investigation of symptoms and 45 (5.4 %) had therapeutic indications. Conventional adenomas were detected in 346 colonoscopies (ADR = 41.1 %), SSA/P in 124 (SSADR = 14.7 %) and RHP in the absence of SSA/P in 35 (RHPDR = 4.2 %). PSLDR was 18.9 %. ADR was stable over time (range 33 %-50 %). SSADR and PSLDR increased over time [SSADR: 8.6 % (2011), 8.4 % (2012), 14.9 % (2013), 18.5 % (2014), 25.0 % (2015); PSLDR: 10.5 % (2011), 11.3 % (2012), 16.8 % (2013), 27.2 % (2014), 29.4 % (2015)]. There was a statistically significant improvement in SSADR (IRR 1.37) and PSLDR (IRR 1.36) over the study period (P < 0.001), whereas the ADR remained stable (IRR 1.04, P = 0.334). Conclusions SSADR and PSLDR in this unselected direct-access cohort are high and exceed previously reported detection rates in the final 2 years. Detection rates improved with experience, likely representing a learning effect. The minimum expected PSLDR may need to be revised upwards and further studies are required, particularly in areas where screening colonoscopies are offered only for patients with increased colorectal cancer risk (family history or fecal immunochemical test-positive).

Beliefs of Community Pharmacists on Prevention and Correction of Potential Drug Therapy Problems

1996 ◽  
Vol 12 (5) ◽  
pp. 223-230
Author(s):  
Karen B Farris ◽  
Duane M Kirking
Keyword(s):  
Drug Therapy ◽  
Pharmaceutical Care ◽  
Mail Survey ◽  
Community Pharmacists ◽  
Normative Belief ◽  
Utilization Review ◽  
Potential Drug ◽  
Affective Evaluation ◽  
Salient Beliefs ◽  
Drug Therapy Problems

Objective: To describe likelihood and affective evaluation ratings for salient beliefs of community pharmacists about trying to prevent and correct potential drug therapy problems, and to describe normative belief and motivation to comply ratings about trying to prevent and correct potential drug therapy problems. Design: Descriptive statistics from a self-administered mail survey. Participants: A convenience sample identified salient beliefs about trying to prevent and correct potential drug therapy problems, and a random sample of Michigan community pharmacists (n = 555) completed a self-administered mail survey regarding these beliefs. Main Outcome Measures: Likelihood and affective evaluation ratings of 22 salient beliefs and normative belief and motivation to comply ratings of six salient others. Results: Pharmacists believed that trying to prevent and correct drug therapy problems could lead to valuable consequences, regardless of whether the efforts were a success or a failure. The pharmacists also believed they could have a positive impact on the quality of drug therapy; however, they seemed less convinced that failure would lead to health complications in patients or unnecessary health expenditures. Pharmacists were most motivated to comply with the expectations of patients. Conclusions: Assisting community pharmacists in adopting pharmaceutical care can be accomplished by (1) providing programs where the process of trying to prevent and correct drug therapy problems can be experienced, (2) promoting an understanding of the relationships between drug product costs and healthcare costs due to patient morbidity, (3) devising mechanisms to increase patient demand for pharmaceutical care and drug utilization review, and (4) assisting community pharmacists to obtain reimbursement for time spent trying to prevent and correct drug therapy problems.

scholarly journals Drug Therapy Problem and its Contributing Factors among Pediatric patients with Infectious Diseases admitted to Jimma University Medical Center, South West Ethiopia: Prospective observational study

2019 ◽  
Author(s):  
Desalegn Mechessa Feyissa ◽  
Tsegaye Melaku ◽  
Dula Dessalegn
Keyword(s):  
Infectious Disease ◽  
Drug Therapy ◽  
Hospital Stay ◽  
Prospective Observational Study ◽  
Pediatric Patients ◽  
Medical Center ◽  
Contributing Factors ◽  
Drug Therapy Problem ◽  
Drug Therapy Problems ◽  
Jimma University

Abstract Background: Drug therapy problem is a significant challenge to provide high quality health care service for the patients. It is associated with morbidity, mortality, increased hospital stay and reduced quality of life. Moreover, pediatric patients are quite susceptible to drug therapy problems.Thus this study aimed to assess drug therapy problem and its contributing factors among pediatric patients diagnosed with infectious disease admitted to pediatric ward of Jimma university medical center, from April ,2018 to June 30, 2018. Methodology: Prospective observational study was conducted among pediatric patients with infectious disease admitted to Jimma university medical center from April 01,2018 to June 30, 2018. Drug therapy problems were identified by using Cipolle’s and strand’s drug therapy problem classification method. Patient’s written informed consent was obtained after explaining the purpose of the study. Patient’s specific data were collected using structured questionnaire. Data was entered into Epi data version 4.0.2 and then exported to statistical software package version 21.0 for analysis. To identify predictors of drug therapy problems occurrence, multiple stepwise backward logistic regression analysis were done. The 95% CI was used to show the accuracy of data analysis and statistical significance was considered at p-value <0.05. Results: A total of 304 pediatric patients were included in the study. Of these, 226(74.3%) patients had at least one drug therapy problem during their hospital stay. A total of 356 drug therapy problems were identified among two hundred twenty six patients. Non-compliance (28.65%) and dose too low (27.53%) were the most common type of drug therapy problems while disease comorbidity [AOR=3.39, 95% CI= (1.89-6.08)], Polypharmacy [AOR=3.16, 95% CI= (1.61-6.20)] and more than six days stay in hospital [AOR=3.37, 95% CI= (1.71-6.64) were independent predictors of drug therapy problem occurrence. Conclusion and recommendation: Drug therapy problems were common in pediatric patients with infectious disease in the study area. Presence of comorbidity, Polypharmacy and Prolonged hospital stay were the predictors of drug therapy problem in this finding. Therefore, to overcome the significant gaps in pediatric pharmaceutical care, clinical pharmacists, Pediatricians and other health care professional have to work in collaboration. Keywords: Drug therapy problem, Pediatric, infectious disease, Ethiopia

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