Effect and associated factors of a clinical pharmacy model in the incidence of medication errors in the hospital Pablo Tobón Uribe eacpharmodel study: stepped wedge randomized controlled Trial (NCT03338725) / Juan Pablo Botero Aguirre ; Natalia Andrea Ortíz Cano ; Andrés Felipe Valencia Quintero  

Público ISBD Título : Effect and associated factors of a clinical pharmacy model in the incidence of medication errors in the hospital Pablo Tobón Uribe eacpharmodel study: stepped wedge randomized controlled Trial (NCT03338725) Tipo de documento : documento electrónico Autores : Juan Pablo Botero Aguirre, ; Natalia Andrea Ortíz Cano, ; Andrés Felipe Valencia Quintero, Fecha de publicación : 2022 Títulos uniformes : International Journal of Clinical Pharmacy Idioma : Inglés (eng) Palabras clave : Medication error  Model  Pharmacist Resumen : Background: The World Health Organization considers medication errors to be an issue that requires attention at all levels of care, to reduce the severe and preventable harm related to drug therapy. Different standards for clinical pharmaceutical practices have been proposed by various organizations across the world, where the pharmacist, as part of the multidisciplinary health team, can help improve patient safety. Objective To assess the impact of the introduction of a clinical pharmacy practice model on medication error in patients of a university hospital. Setting: The study was conducted in a tertiary care hospital, Medellín, Colombia. Methods: A randomized, controlled cluster-wedge staggered trial with a duration of 14 months was conducted to compare the clinical pharmacy practice model with the usual care process in the hospital. Five hospital health care units were included, which were initially assigned to the control group, and after an observation period of 2 months, they were randomly assigned to the intervention group. The trial protocol was registered in ClinicalTrials.gov (identifier NCT03338725). Main outcome measure: The incidence of medication errors in hospitalized patients was the main outcome measure. Results: The incidence of medication error was 13.3% and 22.8% for the intervention group and control group, respectively. The probability of presenting a medication error was 48% lower when the patient was in the intervention group (RR 0.52; 95% CI: 0.34–0.79). The probability of presenting a medication error over time was 44% lower in the intervention group (p = 0.0005); meanwhile, the resolution of a medication error over time was 70% higher in the intervention group (p = 0. 0029). Conclusion: The clinical pharmacy practice model, made up of strategies focused on reducing medication errors, significantly reduces medication errors in patients during hospitalization compared with usual practice. This work assessed the effect of a clinical pharmacy model on the incidence of medication errors and demonstrated its effectiveness in reducing these errors in hospitalized patients. Mención de responsabilidad : Johan Granados, Pedro Amariles, Juan Pablo Botero-Aguirre, Natalia Andrea Ortiz-Cano, Andrés-Felipe Valencia-Quintero & Andrea Salazar-Ospina Referencia : Int J Clin Pharm. 2022 Apr;44(2):439-447. DOI (Digital Object Identifier) : 10.1007/s11096-021-01361-9 PMID : 34977994 En línea : https://link.springer.com/article/10.1007/s11096-021-01361-9 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5996 Effect and associated factors of a clinical pharmacy model in the incidence of medication errors in the hospital Pablo Tobón Uribe eacpharmodel study: stepped wedge randomized controlled Trial (NCT03338725) [documento electrónico] / Juan Pablo Botero Aguirre, ; Natalia Andrea Ortíz Cano, ; Andrés Felipe Valencia Quintero,  . - 2022. Obra : International Journal of Clinical Pharmacy Idioma : Inglés (eng) Palabras clave : Medication error  Model  Pharmacist Resumen : Background: The World Health Organization considers medication errors to be an issue that requires attention at all levels of care, to reduce the severe and preventable harm related to drug therapy. Different standards for clinical pharmaceutical practices have been proposed by various organizations across the world, where the pharmacist, as part of the multidisciplinary health team, can help improve patient safety. Objective To assess the impact of the introduction of a clinical pharmacy practice model on medication error in patients of a university hospital. Setting: The study was conducted in a tertiary care hospital, Medellín, Colombia. Methods: A randomized, controlled cluster-wedge staggered trial with a duration of 14 months was conducted to compare the clinical pharmacy practice model with the usual care process in the hospital. Five hospital health care units were included, which were initially assigned to the control group, and after an observation period of 2 months, they were randomly assigned to the intervention group. The trial protocol was registered in ClinicalTrials.gov (identifier NCT03338725). Main outcome measure: The incidence of medication errors in hospitalized patients was the main outcome measure. Results: The incidence of medication error was 13.3% and 22.8% for the intervention group and control group, respectively. The probability of presenting a medication error was 48% lower when the patient was in the intervention group (RR 0.52; 95% CI: 0.34–0.79). The probability of presenting a medication error over time was 44% lower in the intervention group (p = 0.0005); meanwhile, the resolution of a medication error over time was 70% higher in the intervention group (p = 0. 0029). Conclusion: The clinical pharmacy practice model, made up of strategies focused on reducing medication errors, significantly reduces medication errors in patients during hospitalization compared with usual practice. This work assessed the effect of a clinical pharmacy model on the incidence of medication errors and demonstrated its effectiveness in reducing these errors in hospitalized patients. Mención de responsabilidad : Johan Granados, Pedro Amariles, Juan Pablo Botero-Aguirre, Natalia Andrea Ortiz-Cano, Andrés-Felipe Valencia-Quintero & Andrea Salazar-Ospina Referencia : Int J Clin Pharm. 2022 Apr;44(2):439-447. DOI (Digital Object Identifier) : 10.1007/s11096-021-01361-9 PMID : 34977994 En línea : https://link.springer.com/article/10.1007/s11096-021-01361-9 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5996

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Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: a systematic review and meta-analysis of randomised clinical trials / Carlos Esteban Builes Montaño ; Natalia Andrea Ortíz Cano ; Natalia Andrea Rojas Henao  

Público ISBD Título : Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: a systematic review and meta-analysis of randomised clinical trials Tipo de documento : documento electrónico Autores : Carlos Esteban Builes Montaño, ; Natalia Andrea Ortíz Cano, ; Natalia Andrea Rojas Henao, Fecha de publicación : 2022 Títulos uniformes : Journal of Human Nutrition and Dietetics Idioma : Inglés (eng) Palabras clave : carbohydrate counting  diabetes mellitus  diet therapy  dietary carbohydrates  glycated haemoglobin A Resumen : Background and aims: Diabetes mellitus (DM) is one of the most prevalent chronic noncommunicable diseases globally, and the only way to reduce its complications is good glycaemic control. Insulin remains the only approved treatment for type 1 DM (T1DM) and is used by many with type 2 DM (T2DM). Carbohydrate counting is considered the ideal way to calculate meal-related insulin doses as it allows greater flexibility in diet and could, in some people, reduce the burden of the disease. The primary objective of this systematic review was to assess carbohydrate counting efficacy in reducing glycated haemoglobin (HbA1c) levels and safety by not increasing hypoglycaemia risk, inducing an increase in body weight or blood lipids, or reducing the quality of life of people with T1DM. Methods: We included randomised controlled clinical trials with a parallel-group design comparing any carbohydrate counting forms with standard care or other forms of dietary advice or insulin dose calculation in people with T1DM with a follow up period of at least 3 months and with no restrictions in language, age or settings. As a primary outcome, we consider the change of HbA1c levels within at least 3 months. Secondary outcomes were hypoglycaemia events, body weight changes, blood lipids levels, and the total daily insulin dose. We also evaluated health-related quality-of-life changes and questionnaires on satisfaction with treatment of diabetes. Results: Data from 11 studies with 899 patients were retrieved with a mean follow-up of 52 ± 35.5 weeks. Carbohydrate counting is not better in reducing HbA1clevels (SMD-0.24%, 95% CI −0.68 to 0.21) than all dietary advice forms. However, this finding was highly heterogeneous. We identified three studies that account for most of the heterogeneity using clustering algorithms. A second analysis excluding these studies shows a meaningful reduction in HbA1c levels (SMD-0.52%, 95% CI −0.82 to −0.23) with low heterogeneity. In the subgroup analysis, carbohydrate counting significantly reduces HbA1c levels compared with usual diabetes education. Carbohydrate counting does not relate to any substantial change in blood lipids, body weight, hypoglycaemia risk or daily insulin dose. Finally, we analysed the effect of trial duration on reduction in HbA1c levels and found no significant change related to time. Conclusions: Carbohydrate counting is an efficacious technique to safely reduce the levels of HbA1c in adults and children compared with standard diabetes education, and its effect does not appear to change with prolonged time. Standardisation in reporting important outcomes such as hypoglycaemia and quality of life are vital to produce comparable evidence in carbohydrate counting clinical trials. This systematic review was registered in PROSPERO under code: CRD42020218499. Mención de responsabilidad : Carlos E. Builes-Montaño, Natalia A. Ortiz-Cano, Alex Ramirez-Rincón, Natalia A. Rojas-Henao Referencia : J Hum Nutr Diet. 2022 Dec;35(6):1030-1042. DOI (Digital Object Identifier) : 10.1111/jhn.13017 PMID : 35436364 En línea : https://onlinelibrary.wiley.com/doi/10.1111/jhn.13017 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6026 Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: a systematic review and meta-analysis of randomised clinical trials [documento electrónico] / Carlos Esteban Builes Montaño, ; Natalia Andrea Ortíz Cano, ; Natalia Andrea Rojas Henao,  . - 2022. Obra : Journal of Human Nutrition and Dietetics Idioma : Inglés (eng) Palabras clave : carbohydrate counting  diabetes mellitus  diet therapy  dietary carbohydrates  glycated haemoglobin A Resumen : Background and aims: Diabetes mellitus (DM) is one of the most prevalent chronic noncommunicable diseases globally, and the only way to reduce its complications is good glycaemic control. Insulin remains the only approved treatment for type 1 DM (T1DM) and is used by many with type 2 DM (T2DM). Carbohydrate counting is considered the ideal way to calculate meal-related insulin doses as it allows greater flexibility in diet and could, in some people, reduce the burden of the disease. The primary objective of this systematic review was to assess carbohydrate counting efficacy in reducing glycated haemoglobin (HbA1c) levels and safety by not increasing hypoglycaemia risk, inducing an increase in body weight or blood lipids, or reducing the quality of life of people with T1DM. Methods: We included randomised controlled clinical trials with a parallel-group design comparing any carbohydrate counting forms with standard care or other forms of dietary advice or insulin dose calculation in people with T1DM with a follow up period of at least 3 months and with no restrictions in language, age or settings. As a primary outcome, we consider the change of HbA1c levels within at least 3 months. Secondary outcomes were hypoglycaemia events, body weight changes, blood lipids levels, and the total daily insulin dose. We also evaluated health-related quality-of-life changes and questionnaires on satisfaction with treatment of diabetes. Results: Data from 11 studies with 899 patients were retrieved with a mean follow-up of 52 ± 35.5 weeks. Carbohydrate counting is not better in reducing HbA1clevels (SMD-0.24%, 95% CI −0.68 to 0.21) than all dietary advice forms. However, this finding was highly heterogeneous. We identified three studies that account for most of the heterogeneity using clustering algorithms. A second analysis excluding these studies shows a meaningful reduction in HbA1c levels (SMD-0.52%, 95% CI −0.82 to −0.23) with low heterogeneity. In the subgroup analysis, carbohydrate counting significantly reduces HbA1c levels compared with usual diabetes education. Carbohydrate counting does not relate to any substantial change in blood lipids, body weight, hypoglycaemia risk or daily insulin dose. Finally, we analysed the effect of trial duration on reduction in HbA1c levels and found no significant change related to time. Conclusions: Carbohydrate counting is an efficacious technique to safely reduce the levels of HbA1c in adults and children compared with standard diabetes education, and its effect does not appear to change with prolonged time. Standardisation in reporting important outcomes such as hypoglycaemia and quality of life are vital to produce comparable evidence in carbohydrate counting clinical trials. This systematic review was registered in PROSPERO under code: CRD42020218499. Mención de responsabilidad : Carlos E. Builes-Montaño, Natalia A. Ortiz-Cano, Alex Ramirez-Rincón, Natalia A. Rojas-Henao Referencia : J Hum Nutr Diet. 2022 Dec;35(6):1030-1042. DOI (Digital Object Identifier) : 10.1111/jhn.13017 PMID : 35436364 En línea : https://onlinelibrary.wiley.com/doi/10.1111/jhn.13017 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6026

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Effect and associated factors of a clinical pharmacy model in the incidence of medication errors (EACPharModel) in the Hospital Pablo Tobón Uribe: study protocol for a stepped wedge randomized controlled trial (NCT03338725) / Juan Pablo Botero Aguirre ; Andrés Felipe Valencia Quintero ; Natalia Andrea Ortíz Cano    

Público ISBD Título : Effect and associated factors of a clinical pharmacy model in the incidence of medication errors (EACPharModel) in the Hospital Pablo Tobón Uribe: study protocol for a stepped wedge randomized controlled trial (NCT03338725) Tipo de documento : documento electrónico Autores : Juan Pablo Botero Aguirre, ; Andrés Felipe Valencia Quintero, ; Natalia Andrea Ortíz Cano, Fecha de publicación : 2020 Títulos uniformes : Trials Idioma : Inglés (eng) Palabras clave : Medication errors  Drug-related problems  Pharmacy service  Hospital (clinical pharmacy services)  Pharmacists Resumen : Background: According to WHO, medication error (ME) is a subject that requires attention at all levels of care to reduce severe and preventable damage related to medication use. Clinical pharmacy practice standards have been proposed around the world so that the pharmacist, as part of a multidisciplinary health team, can help improve patient safety; however, further evidence derived from adequate studies is needed to demonstrate this. This study aims to assess the effect of a clinical pharmacy practice model (CPPM) in preventing MEs associated with the medication use process. Methods: A prospective, stepped-wedge, cluster-randomized, controlled trial with a duration of 14 months will be performed to compare the effect of a CPPM along with the usual care process of patients in the Pablo Tobón Uribe Hospital (Medellin, Colombia). The study is designed as a cluster-randomized controlled trial, involving five hospital wards (clusters) and 720 patients. Medical wards are allocated to interventions using a stepped-wedge design. Clusters are initially assigned to the control group. After a 2-month observation period, hospital clusters were randomly allocated to the intervention group. Study outcomes will be assessed at baseline and at 2, 4, 6, 8, 10, and 12 months after randomization. The primary outcome will be to assess the effect of a CPPM on the incidence of medication errors associated with the medication use process. Drug-related problems and factors that contribute to the occurrence of MEs will be assessed as secondary outcomes. Statistical analyses will be performed using a mixed model, with the treatment group and time as fixed effects and the clustering structure as a random effect. Statistical analysis will be performed using Pearson chi-square tests and Student's t-tests, and a P value Mención de responsabilidad : J Granados, A Salazar-Ospina, J P Botero-Aguirre, A F Valencia-Quintero, N Ortiz, P Amariles Referencia : Trials. 2020;21(1):26. DOI (Digital Object Identifier) : 10.1186/s13063-019-3945-8 PMID : 31907009 Derechos de uso : CC BY En línea : https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3945-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5074 Effect and associated factors of a clinical pharmacy model in the incidence of medication errors (EACPharModel) in the Hospital Pablo Tobón Uribe: study protocol for a stepped wedge randomized controlled trial (NCT03338725) [documento electrónico] / Juan Pablo Botero Aguirre, ; Andrés Felipe Valencia Quintero, ; Natalia Andrea Ortíz Cano,  . - 2020. Obra : Trials Idioma : Inglés (eng) Palabras clave : Medication errors  Drug-related problems  Pharmacy service  Hospital (clinical pharmacy services)  Pharmacists Resumen : Background: According to WHO, medication error (ME) is a subject that requires attention at all levels of care to reduce severe and preventable damage related to medication use. Clinical pharmacy practice standards have been proposed around the world so that the pharmacist, as part of a multidisciplinary health team, can help improve patient safety; however, further evidence derived from adequate studies is needed to demonstrate this. This study aims to assess the effect of a clinical pharmacy practice model (CPPM) in preventing MEs associated with the medication use process. Methods: A prospective, stepped-wedge, cluster-randomized, controlled trial with a duration of 14 months will be performed to compare the effect of a CPPM along with the usual care process of patients in the Pablo Tobón Uribe Hospital (Medellin, Colombia). The study is designed as a cluster-randomized controlled trial, involving five hospital wards (clusters) and 720 patients. Medical wards are allocated to interventions using a stepped-wedge design. Clusters are initially assigned to the control group. After a 2-month observation period, hospital clusters were randomly allocated to the intervention group. Study outcomes will be assessed at baseline and at 2, 4, 6, 8, 10, and 12 months after randomization. The primary outcome will be to assess the effect of a CPPM on the incidence of medication errors associated with the medication use process. Drug-related problems and factors that contribute to the occurrence of MEs will be assessed as secondary outcomes. Statistical analyses will be performed using a mixed model, with the treatment group and time as fixed effects and the clustering structure as a random effect. Statistical analysis will be performed using Pearson chi-square tests and Student's t-tests, and a P value Mención de responsabilidad : J Granados, A Salazar-Ospina, J P Botero-Aguirre, A F Valencia-Quintero, N Ortiz, P Amariles Referencia : Trials. 2020;21(1):26. DOI (Digital Object Identifier) : 10.1186/s13063-019-3945-8 PMID : 31907009 Derechos de uso : CC BY En línea : https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3945-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5074

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