bluuebunny/crossref_metadata_2025_split huggingface dataset:
A primer for hydrology: the beguiling simplicity of Water's journey from rain to stream at 30
Authors: Bishop Kevin , Seibert Jan 
Published: April 2015

AbstractWater's journey from rain to stream by Harald Grip and Allan Rodhe (1985, in Swedish: Vattnets väg från regn till bäck) was one of the first textbooks to present groundwater contributions as a major feature of runoff generation, with implications for water quality and management. Three decades later, we have the privilege of presenting a special issue of Hydrological Processes, ‘Runoff Generation in a Nordic Light: 30 Years with Water's Journey from Rain to Stream’ that seeks to introduce the book to a larger audience and continue the journey of ideas that the authors set in motion with their book. Copyright © 2015 John Wiley & Sons, Ltd.
Access to High‐Cost Drugs: Decision Makers' Perspectives
Authors: Gallego Gisselle , Melocco Terry , Taylor Susan J , Brien Jo‐anne E 
Published: April 2015

ABSTRACTAimTo explore the attitudes, perceptions and concerns among decision makers about equity of access to high‐cost drugs in public hospitals.Method25 in‐depth, semi‐structured interviews were conducted with senior hospital administrators, directors of pharmacy and senior medical doctors. Topics included the decision‐making process and associated problems, and solutions to issues of access to high‐cost drugs. Interviews were audiotaped, transcribed verbatim and thematically analysed.ResultsHealthcare funding models were perceived as obstacles to equity of access to high‐cost drugs. Participants were concerned that there were inequities in decisions for individual patients according to public or private sector status. Tertiary public hospitals were seen to be at the ‘cutting edge’ and therefore were required to fund new and expensive drugs. This meant prioritising between patient groups and individuals. Participants had difficulty in identifying solutions. They suggested that ethical principles should be considered in addition to safety, efficacy and cost. Most wanted a transparent, accountable, evidence‐based decision‐making process.ConclusionDecision makers were concerned about equity of access to high‐cost drugs in public hospitals. They were also concerned about processes for decision making and the outcomes of these decisions.
Does Antibiotic Choice Affect Length of Stay for Community‐Acquired Pneumonia?
Authors: McKellar Alice C 
Published: April 2015

ABSTRACTBackgroundAntibiotic choice for community‐acquired pneumonia (CAP) should reflect disease severity, likely pathogens and its effect on antimicrobial resistance. Consensus guidelines do not recommend third‐generation cephalosporins for routine therapy in CAP.AimTo determine whether the choice of antibiotics may have an impact on how long patients with CAP remain hospitalised.MethodA retrospective review of patients with pneumonia admitted to a hospital was conducted for a 10‐month period. Adult patients with pneumonic consolidation on chest X‐ray were included. Pneumonia Severity Index (PSI) was used to stratify severity and antibiotic therapy was assessed for concordance with the Therapeutic Guidelines: Antibiotic, version 11.Results99 patients were included. The average length of stay across all risk classes was 8.5 days (range: 1–43). For patients receiving antibiotics concordant with the Therapeutic Guidelines: Antibiotic, there was a trend towards decreased length of stay in all classes, except for the most severe category (class V). Length of stay was significantly less for patients with the least severe disease (class I). The main reason for non‐concordance was the use of ceftriaxone in patients without contraindications to a combination of benzylpenicillin, gentamicin and a macrolide.ConclusionConcordant use of antibiotics in patients with CAP could be associated with a decreased length of stay for inpatients with a PSI class of I to IV.
Contrast Media—Implications for Pharmacists
Authors: To The‐Phung , Boon Ou Daniel Kwong , Schelleman Anthony 
Published: April 2015

ABSTRACTAlthough contrast media are commonly used in hospital practice, there is limited attention to their use by pharmacists. Contrast media have the potential to cause a range of adverse reactions, including contrast‐induced nephropathy. Some reactions are unpredictable and cannot be prevented; however, other reactions may be abated with careful consideration of the patient's clinical status and risk factors, as well as various prophylactic measures. An understanding of contrast media properties can help pharmacists to enhance drug safety when reviewing or dispensing drug orders or counselling patients around the time of contrast‐enhanced diagnostic procedures.
Complementary and Alternative Medicine Use in the Elderly
Authors: Moses Geraldine 
Published: April 2015

ABSTRACTRecent surveys suggest that the elderly are more frequent users of complementary and alternative medicines (CAMs) than the general population—up to 80% have reported using at least one CAM on a regular basis in the past year. Although many reasons are cited for their interest in CAMs, the elderly commonly state that CAMs are not used as ‘alternatives’, but rather as ‘supplements’ to compensate for aspects perceived to be lacking in conventional care. Although high‐level evidence supports the use of some CAMs in specific conditions, their use in the elderly presents significant challenges as this population is burdened by polypharmacy, decreased functional reserve and chronic disease. Preventing adverse reactions and drug interactions associated with CAM use is complicated by the fact that fewer than 50% of older patients disclose CAM use to their doctor or pharmacist. This article is a guide for health professionals who wish to advise the elderly consumer on the rational use of CAMs.
Consumer use of Consumer Medicine Information
Authors: Koo Michelle MM , Krass Ines , Aslani Parisa 
Published: April 2015

ABSTRACTAimTo examine the use of Consumer Medicine Information (CMI) by Australian consumers.MethodA structured questionnaire was administered to eligible consenting consumers from randomly selected community pharmacies in metropolitan Sydney in 2001. All data were coded and frequency distributions were examined for responses to all questions. The construct validity and reliability of the ‘attitude to CMI’ statements were tested using exploratory factor analysis and Cronbach's alpha, respectively.ResultsA total of 226 useable questionnaires were collected from 17 community pharmacies. Consumers had a median age of 56.5 (range 18–92) years and 51% (n = 136) were female. Consumers had variable understanding of CMI and the majority reported receiving one on the day of interview or in the past—mainly as a package insert, and without the involvement of a health professional. Of those who received CMI in the past, two‐thirds reported reading it, resulting in positive as well as negative impacts. Analysis of the ‘attitude to CMI’ section yielded 4 factors explaining 52.8% of the total variance. These were interpreted as: perception of disease/condition (α = 0.86), role of carer (α = 0.85), health locus of control (α = 0.67), and readability and presentation (α = 0.59).ConclusionMany consumers read CMI, mainly in the form of package inserts. There are issues that need to be addressed to optimise the use of CMI by consumers. In order to achieve this, greater involvement from health professionals is necessary.
Initial Assessment of an Internet‐Based Medication Record
Authors: Calabretto Jean‐Pierre , Warren Jim 
Published: April 2015

ABSTRACTAimTo assess the usability of an Internet‐based medication record designed to enhance communication between patients and community pharmacists following discharge from hospital.MethodA secure, Internet‐based ‘medicine cabinet’ to record consumers' medicines and related issues was developed. It was shared by consumers and community pharmacists under the control of the consumer. Opinions were sought via questionnaire from participating consumers and pharmacists.ResultsA pilot ran from December 2001 to August 2003 and responses of 8 families and 6 pharmacists were evaluated. In general, consumers considered the virtual medicine cabinet to be of value and easy to use although it was not often used. Half the group indicated that they would continue to use the system. Pharmacists similarly thought the concept useful, although usage was low. Technology issues, particularly with smartcards, caused problems for both groups.ConclusionMany participants found the virtual medicine cabinet useful, and most thought that the concept had worth. This pilot did not identify any stimulation of consumer‐pharmacist communication.
Extemporaneous Isoniazid Mixture: Stability Implications
Authors: Haywood Alison , Mangan Martina , Grant Gary , Glass Beverley 
Published: April 2015

ABSTRACTBackgroundIsoniazid mixtures are compounded in Australia using commercially available isoniazid tablets.AimTo determine the stability of isoniazid 10 mg/mL mixture compounded from commercially available isoniazid tablets.MethodThe stability of the compounded isoniazid mixture stored at a range of temperatures (4–60 °C) was assessed with high performance liquid chromatography. Differential scanning calorimetry was used to investigate the compatibility of isoniazid with the excipient, lactose.ResultsThe compounded isoniazid mixture exhibited significant degradation (≥ 10% after 3 days at 4 and 25 °C), whereas the control (using isoniazid powder) retained desired stability (> 90% at 30 days) under identical conditions. A replicate control formulation, spiked with lactose, produced statistically similar degradation profiles to that of the compounded isoniazid mixture (p > 0.05), indicating lactose to be responsible for the degradation of isoniazid. The thermoanalytical studies demonstrated an incompatibility between isoniazid and lactose (broadening and shifting of melting endotherm of isoniazid at 171.46 °C).ConclusionThe British Pharmaceutical Codex specifies the use of isoniazid powder for compounding isoniazid mixture. This study highlights the importance for stability evaluations on all modified extemporaneous preparations in order to ensure that quality pharmaceuticals are delivered to patients.
Paediatric Severe Community‐Acquired Pneumonia in India
Authors: Angalakuditi Mallik V , Sunderland V Bruce 
Published: April 2015

ABSTRACTAimTo evaluate the prescribing patterns of antibiotics and antipyretics and their dosage for severe community‐acquired pneumonia (SCAP) in a paediatric population before and after an educational intervention in a rural Indian hospital.MethodPhysician prescribing patterns for SCAP were collected prospectively in a cohort of paediatric patients (pre‐intervention group). An educational intervention strategy was developed and implemented using data from baseline prescribing patterns and the Therapeutic Guidelines: Antibiotic recommendations for treatment of SCAP. An analysis to evaluate the impact of drug selection and dosing following the intervention was conducted in a second patient cohort (post‐intervention group).ResultsThere were 146 patients in the pre‐intervention group and 155 in the post‐intervention group. Antibiotic choices were within the guidelines in both groups. All of the patients in the pre‐intervention group received dexamethasone with every dose of antibiotic. Post‐intervention, the use of dexamethasone was eliminated. For the pre‐intervention group, 97% of the antibiotic doses and 55% of the antipyretic doses were classified as inappropriate. Inappropriate prescribing of antibiotic and antipyretic doses was significantly reduced to 89% (p = 0.002) and 10% (p < 0.001) respectively, following the intervention.ConclusionThere was some improvement in prescribing appropriate doses of antibiotics and antipyretics for SCAP following the educational intervention.
Emergence of Adverse Reactions to Tramadol in Children and Adolescents at a Paediatric Hospital
Authors: Juliana Gisela Santa , Titchen Thirza , Cranswick Noel 
Published: April 2015

ABSTRACTBackgroundThe use of tramadol at The Royal Children's Hospital, Melbourne has dramatically increased. This has coincided with the emergence of adverse drug reactions (ADRs).AimTo investigate potential adverse reactions to tramadol in children and adolescents as compared with adults.MethodThe ADR program at the hospital detects both spontaneously reported ADRs and those identified by medical records coding reports. For this study, reported reactions to tramadol were retrieved from the hospital's ADR database. Comparison with reports from the Australian Adverse Drug Reaction Advisory Committee and the literature was made.Results8 ADR reports implicating tramadol in patients aged from 14 months to 22 years were identified.ConclusionSome insight was gained into the possible adverse effects of tramadol in children and adolescents, which are similar to the reported profile of adverse reactions in adults. Further pharmacovigilance studies are required to expand on these findings and provide direction to ensure the safe use of tramadol in this age group.
Identification of Medication Errors by Nurses During a Simulated Ward, Medication Safety Orientation Program
Authors: Coombes Ian D , Heel Alison CY , Stowasser Danielle A , Reid Carol M , Henderson Amanda , Mitchell Charles A 
Published: April 2015

ABSTRACTAimTo assess the ability of nurses to identify medication errors and apply strategies to prevent adverse drug events.MethodThis was a prospective study of the incidence of error detection in simulated medication scenarios at a teaching hospital. All newly employed registered nurses (n = 591) were asked to administer medications in six scenarios containing errors with potential for patient harm. Feedback was provided to participants at the end of each scenario. The main outcome measures were: self‐reported incidence of detection of errors and modification of practice in accordance with knowledge, knowledge of concept but error not detected, or the error being a new concept.Results63 to 85% of nurses reported that they would have detected the error and taken appropriate action; 11 to 30% had some concept of the error but would not have detected it; and for 2 to 7% the error was a new concept. 32% could identify the errors in all six scenarios and initiate appropriate action.ConclusionIn this study, nurses frequently failed to detect medication errors. Practical medication risk awareness training, improvements in the safety of medication systems and pharmacist review of medication are of paramount importance.
Experiencing Pharmacy Practice in Rural Tanzania
Authors: McLachlan Gina B 
Published: April 2015

ABSTRACTMvumi Hospital is located in a rural area of central Tanzania. It is a general hospital that has to cope with the wide variety of medical and surgical presentations encountered in this area of East Africa. Health care delivery is limited by distance and the endemic poverty of the population. Common presentations include malaria, anaemia, meningitis, cholera, dysentery, tick‐borne relapsing fever, severe malnutrition in children, and complications of AIDS. Helping to provide the pharmacy service during a six‐month period of voluntary work was a rewarding experience that can be highly recommended for pharmacists wishing to broaden their global perspective.
Mandatory Electronic Sources of Approved Product Information—Are They Up‐To‐Date?
Authors: Baker Jaclyn L 
Published: April 2015

ABSTRACTBackgroundThe Pharmacy Board of Victoria mandates that all pharmacies and pharmacy departments have access to an up‐to ‐date source of approved product information.AimTo compare the currency of product information profiles from electronic sources to those obtained from the manufacturer.MethodProduct information profiles for 48 commonly dispensed medicines were obtained from the manufacturers and approval/amendment dates compared to those in the two electronic sources. Profiles with discrepancies in dates were manually scanned to determine the extent of the differences.Results81 product information profiles were reviewed and 20 had discrepancies in dates between the profiles obtained from the manufacturers and that on the electronic sources. 18 profiles were found to be not current. 16% of the profiles examined contained discrepancies. The most common changes were in presentation and drug interactions.ConclusionThis study showed that electronic sources have delays in capturing changes to product information.
Smoking Cessation: COPD Patients' Perspective
Authors: George Johnson , Kong David CM , Santamaria Nick M , Ioannides‐Demos Lisa L , Stewart Kay 
Published: April 2015

ABSTRACTBackgroundSmoking cessation is the most useful and cost effective way to reduce the risk of developing chronic obstructive pulmonary disease (COPD) and stop its progression. Long‐term success rates with smoking cessation programs are known to be poor.AimTo identify factors influencing the outcomes of smoking cessation programs in COPD patients from their perspective.MethodIn‐depth interviews were conducted with 27 patients with a history of smoking, chosen from a cohort of 173 patients with moderate to severe COPD participating in a community‐based randomised trial.ResultsThe study sample consisted of 6 females and 21 males with a mean age of 69.6 years and a mean smoking history of 58.5 ± 34.1 pack years. 6 patients continued to smoke at the time of the interview. Patients had attempted both pharmacological and non‐pharmacological methods for quitting. Smoking cessation in COPD patients was influenced by various barriers and facilitators pertaining to patient, health, treatment and healthcare providers.ConclusionHealth professionals may be able to improve the outcomes of smoking cessation programs in COPD patients by being more proactive in offering combination smoking cessation interventions with adequate follow‐up.
Pre‐emptive Discharge Prescription‐Processing System
Authors: Masood Noman , Garrett Timothy , Sumpter Margaret , Buchan Dona 
Published: April 2015

ABSTRACTAimTo implement and evaluate a pre‐emptive discharge prescription‐processing system.MethodPatients on two wards were reviewed in anticipation of their discharge. Medications were prepared in advance of the discharge prescription using a pharmacist‐generated order. Pharmacist‐generated discharge orders were compared and tested for concordance with the final prescription at the time of discharge.Results260 patients taking 2014 medications were reviewed of which 897 (45%) did not require dispensing (p < 0.05) based on information gathered during pharmacist review. The total estimated cost of items was $10 790.50 while cost for items dispensed was $5818.80—a 46% reduction was achieved (p < 0.05). 154 patients were given printed lists of their medications and 208 consumer medicine information leaflets were supplied. A significant level of concordance was found between pharmacist and doctor‐generated prescriptions.ConclusionA pre‐emptive discharge prescription‐processing system can potentially result in cost and time savings.
Improving Quality Improvement Models
Authors: Maxwell David J , Graudins Linda , Kaye Karen I 
Published: April 2015

ABSTRACTBackgroundThe quality of health care can be improved through the monitoring, evaluation, reporting and feedback of current practice. Drug use evaluation methodology has been used for many years as a process for improving health care through the optimisation of prescribing practice. The Institute for Healthcare Improvement 'Breakthrough Series' has also been promoted widely as a useful tool for improving health care.AimThe aim of this paper is to familiarise readers with these methods, by analysing similarities and differences, and qualitatively evaluating their merits as quality improvement tools.DiscussionAlthough both methods involve similar activities (identifying desired practice, measuring current practice, developing and implementing changes, feeding back into the process) there are differences in the application of each model in the healthcare setting that should be considered when planning quality improvement activities. We hypothesise that synergy may be achieved by combining elements of both approaches.ConclusionFurther research is required to test if a combination of these methods results in effective and sustainable improvements in the quality of medicines use and measurable improvements in healthcare outcomes.
Telepharmacy—Enabling Technology to Provide Quality Pharmacy Services in Rural and Remote Communities
Authors: Kimber Michael B , Peterson Gregory M 
Published: April 2015

ABSTRACTThe provision of quality pharmacy services to rural and remote communities is influenced by the National Strategy for the Quality Use of Medicines. The implementation of this strategy is challenged by the shortage of pharmacists in rural areas. Australia compares unfavourably with both the UK and US in this regard. The Fourth Community Pharmacy Agreement between the Commonwealth of Australia and the Pharmacy Guild commits the parties to 13 key objectives and makes provision for funding initiatives for professional pharmacy programs. Two of these programs are medication reviews and e‐health initiatives. Telepharmacy, as an enabling technology, represents a unique and innovative way to deliver quality pharmacy services to rural areas. Telepharmacy operations are in place in other countries. In the US, two principal models are in Washington State and North Dakota, although other states such as Texas, Nebraska and Alaska also have telepharmacy models in place. Studies in Australia have had mixed results and have not been as successful. However, there are some promising models that have been employed in telemedicine, including for the delivery of physiotherapy and other allied health services. It is of key importance to involve pharmacists in telepharmacy services and a key initiative to be studied soon in Far North Queensland will involve home medication reviews being conducted via telepharmacy.
Analgesic Selection in Patients on Abstinence Therapies
Authors: Valoppi Glenn , Taylor Simone E 
Published: April 2015

ABSTRACTMany Australians are prescribed drugs such as naltrexone, methadone and buprenorphine to assist with abstinence from illicit drug abuse and alcoholism. Abstinence therapies influence the efficacy of standard opioid analgesics. Non‐opioid alternatives can often provide effective analgesia. In some situations the use of opioids is unavoidable. The acute pain management of two patients using naltrexone is described, followed by a review of acute pain management options for patients receiving abstinence therapies.
Audit of Ticarcillan/Clavulanate Usage in a Large Teaching Hospital
Authors: Mackenzie Fraser D , Pillans Peter I , Reinhold Johannes , Looke David F , Sturtevant Joanna M 
Published: April 2015

ABSTRACTAimTo assess compliance with ticarcillin/clavulanate prescribing guidelines, appropriateness of prescribing and to identify any patterns of inappropriate use that may aid in improving prescribing.MethodPatients on ticarcillin/clavulanate were prospectively reviewed over an 8‐week period. Data collected included: demographics, diagnosis, hospital or community‐acquired infection, specific bacteriology, type of treatment, dose, dose quantity, appropriateness of treatment, and compliance with guidelines.Results100 patients on ticarcillin/clavulanate were reviewed and 65% were compliant with guidelines. Treatment was considered appropriate in 76% of patients. Non‐compliant/inappropriate usage was most commonly observed in community‐acquired pneumonia.ConclusionThis audit indicated widespread use of ticarcillin/clavulanate outside hospital prescribing guidelines, although in some cases, use was considered appropriate.