bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of Trigger Tools for Detecting Adverse Drug Reactions
Authors: Zolezzi Monica , Forbes Alison , Parsotam Nirasha , Asamoah Philomina , Cheng Grace , Ngieng May LL , Oldfield Benjamin , Park Sarah SH 
Published: April 2015

ABSTRACTBackgroundDespite the high morbidity and mortality associated with adverse drug events (ADEs) and adverse drug reactions (ADRs) the ability to detect and report them systematically remains inefficient.AimTo investigate if the use of a modified ADE trigger tool could improve the identification of ADRs in hospitals.MethodRetrospective review of patients' discharge summaries was conducted at a tertiary care facility over a 5‐week period. A modified ADE trigger tool (based on a previous model) was used to assess four high‐risk medicines (warfarin, heparin, morphine, benzodiazepines). ADEs identified were classified using both the Naranjo probability scale and the WHO ADR classification.ResultsData from 528 patients were reviewed, of which 286 (54%) received at least 1 of the 4 high‐risk medicines. 45 patients (8.5%) were identified using the modified trigger tool as having had an ADE during their hospital stay. The modified ADE trigger tool improved the identification of ADRs compared with the spontaneous reporting system, regardless of the classification method used. Both the WHO and Naranjo classification scales yielded higher rates than the spontaneous reporting rate of 0.07% recorded by the New Zealand Centre for ADR Monitoring.ConclusionThe modified ADE trigger tool appears to be a sensitive method for identifying ADRs. The results indicate that using the modified trigger tool yields significantly higher ADR reporting rates than the traditional spontaneous reporting system.
Specialised Compounding—Practices and Opinions of Australian Community Pharmacists
Authors: Giam Jennifer A , McLachlan Andrew J , Krass Ines 
Published: April 2015

ABSTRACTBackgroundAnecdotal reports of the increase in dispensing of compounded products have resulted in a review of pharmacy compounding by regulatory authorities. However, little is known about the compounding practices of community pharmacists.AimTo investigate the extent and nature of compounding in community pharmacies, to assess the differences between specialised and non‐specialised compounding practices and to evaluate pharmacists' attitudes to compounding as a specialty.MethodA 42‐item self‐completion questionnaire was sent to 500 randomly selected Australian community pharmacies. This was followed by 3 additional mailings to non‐responders. A final non‐respondent telephone survey was also conducted.ResultsInclusion criteria were met by 465 pharmacies. Surveys were completed by 271 pharmacists (58% response rate). Although the extent of compounding is unchanged (less than 1% of prescriptions) some pharmacists have adopted compounding as a specialty practice. Specialised compounding was provided by 9.6% of pharmacies dispensing an average of 25 compounded products weekly compared to 3 products by non‐specialised pharmacies. Specialised pharmacies have different equipment and training, and dispensed a variety of dosage forms for a wide range of therapeutic areas.ConclusionSpecialised compounding service is being increasingly offered by community pharmacies. Pharmacists felt strongly that compounding should be provided by all pharmacies but accepted that there should be accreditation of specialised practices. More research is needed to enable the development of appropriate standards and guidelines.
Young Pharmacists as Mentors to Pharmacy Students: Partnerships for the Future of the Profession
Authors: Moles Rebekah J , Roberts Alison S , Diamandis Simone , Bell J Simon , Nichols Cecily 
Published: April 2015

ABSTRACTBackgroundThere is a well‐documented shortage of pharmacists in Australia and overseas. Mentoring has been proposed as a strategy to help bridge the gap between university and the workforce, and to maintain enthusiasm in young pharmacists and students for their profession.AimTo develop, implement and evaluate a mentoring program, matching young pharmacists working in a range of pharmacy practice settings with pharmacy students.MethodThe mentoring program was divided into 3 phases: Phase 1—literature review and feasibility study; Phase 2—recruitment of young pharmacists (mentors) and pharmacy students (mentees), matching mentors and mentees by areas of pharmacy interest and encouraging them to discuss their individual needs, desires and work goals; Phase 3—program evaluation.Results151 mentees and 56 mentors (n = 207) were recruited (April 2003 to October 2004). Of the 56 mentors, 13 were from a hospital pharmacy background. 42% of students selected hospital pharmacy as their first preference and 21% selected hospital pharmacy as their second preference. 58 students were recorded as having a hospital mentor. Due to poor response rates to the program evaluation survey, the data reported for phase 3 is for all participants and is not specific to hospital. No differences in qualitative results could be seen between the sectors.ConclusionThe mentoring program was flexible and appears transportable. Further studies are needed to determine whether mentoring impacts on the retention of young pharmacists and pharmacy students within the profession. We recommend that the profession support a national mentoring program where further outcomes of this model could be evaluated.
Surface Contamination from Cytotoxic Chemotherapy Following Preparation and Administration
Authors: Lee Su‐Gil , Tkaczuk Michael , Jankewicz Ganyk , Ambados Fotios 
Published: April 2015

ABSTRACTBackgroundSurface contamination with cytotoxic drug residue is a potential occupational health hazard to staff working in cytotoxic compounding areas and oncology wards.AimTo identify surfaces contaminated with cytotoxic drug residue and to indicate the risk of exposure to health workers handling cytotoxic drug residue.MethodWipe sampling was used to investigate surface contamination and occupational skin exposure to the marker cytotoxic drugs, fluorouracil (5‐FU) and gemcitabine (GEM), in the pharmacy cytotoxic compounding section and oncology wards. Drug packaging, primary containers and gowns were also examined. Samples were analysed using a validated HPLC method. Repeat sampling was performed on selected surfaces to monitor any impact after implementing changes in practice.ResultsThe majority of surfaces tested were contaminated. The cytotoxic work room (5‐FU 56.7–320 μg/m2; GEM 75–370 μg/m2) and oncology wards had similar levels of contamination. Cytotoxic drug residue was detected on original containers and drug vials (5‐FU < 3–6 μg; GEM 7.8–7.9 μg/wipe sample) stored in the cytotoxic work room but not on containers delivered directly from the distributor, suggesting that accidental contamination by pharmacy personnel does occur. Contamination was also detected on sections of the gowns (GEM around 0.9 mg/m2) worn by nurses in the oncology wards.ConclusionThere is a risk of dermal contamination and accidental ingestion from inappropriate use of gloves, hand washing and cleaning, during and after preparation and administration of cytotoxic drugs. Implementing effective cleaning practices to decontaminate work surfaces is recommended in all cytotoxic drug compounding and administration areas. Regular environmental monitoring is warranted in these areas to ensure that background contamination is kept to a minimum and that decontamination protocols are adhered to.
Trans‐Tasman Comparison of Non‐Prescription Medicine Purchasing Behaviour
Authors: Bialy Leisa H , Emmerton Lynne M 
Published: April 2015

ABSTRACTBackgroundThe non‐prescription medicine market is subject to professional practice policy and legislative influences, including trans‐Tasman harmonisation initiatives.AimTo establish a baseline comparison of purchasing behaviour for non‐prescription medicines in community pharmacies in Australia and New Zealand.Method2 comparable survey databases were merged and analysed. The Australian survey was conducted in 15 pharmacies in August 2004 (n = 3017) and the New Zealand survey was conducted in 6 pharmacies in July 2005 (n = 1092). Both used the same questionnaire, completed via observation of the sale and interview with all available customers. Data included customer demographics, purchasing behaviour and the observed incidence of staff‐customer consultation during the sale.ResultsGeneral descriptors of the 2 cohorts were similar. Analysis of purchasing behaviour variables revealed significantly higher incidence of pharmacy staff involvement in product selection and customers' predetermined brand choices in Queensland compared to New Zealand. However, there was a significantly higher rate of observed questioning and advice by pharmacy staff in New Zealand across all schedules of medicines, with greater involvement of pharmacists alone in Queensland.ConclusionA number of trans‐Tasman differences were identified in non‐prescription medicine purchasing behaviour from two limited samples of pharmacies. Future concurrent and national‐scale research is recommended to explore and monitor these findings with respect to trans‐Tasman medicines regulatory harmonisation and professional pharmacy initiatives.
Measuring Pharmacy Workload Associated with Clinical Trials
Authors: Rice Carol A , Dooley Michael J , Kirsa Suzanne W 
Published: April 2015

ABSTRACTAimTo develop and evaluate a method to quantify hospital pharmacy workload associated with clinical trials.MethodWorkload measures were developed and then applied to quantify workload associated with clinical trials within the pharmacy department at Peter MacCallum Cancer Centre.Results4 workload measures were developed and included a setup score for trial establishment and 3 complexity indices for the specific activities associated with patients accrued to clinical trials. The setup score was assigned to each trial based on the initial workload required to set up the trial in preparation for patient recruitment and dispensing. The complexity indices were assigned to the activities associated with the preparation of study medication, dispensing of individual patient treatments and documentation requirements. Application of these measures to all clinical trials open for patient accrual for the calendar years, 2000 and 2004 showed a 33% increase in dispensing (1299 compared to 1726 clinical medicine supplies) with a total complexity increase of 51% and an average setup score increase of 6%. The data collected were successfully used to support an application for increased funding for the clinical trials service within the pharmacy department.ConclusionThe complexity index and setup score are valuable tools to quantify workload within a hospital pharmacy clinical trials service and identifies the key aspects of a clinical trial that require pharmacy resources.
Acute Renal Failure in Patients on Diuretics and/or NSAID, COX‐2 inhibitors, ACEI, ARA
Authors: Ng Chin Soon , Pillans Peter I , Johnson David W , Sturtevant Joanna M 
Published: April 2015

ABSTRACTAimTo review acute renal failure in patients on one or more target drugs – diuretics, non‐steroidal anti‐inflammatory drugs (NSAID), cyclo‐oxygenase‐2 (COX‐2) inhibitors, angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor antagonists (ARA).MethodRetrospective review of drug charts of patients admitted to hospital with acute renal failure from 2003 to 2005. Patients taking one or more of the target drugs prior to admission were identified. Data were collected on patient demographics, target drugs, other factors contributing to acute renal failure, medical history, baseline and peak creatinine concentration, and clinical outcome. The baseline and lowest estimated glomerular filtration rate (eGFR) were calculated.ResultsOf the 289 patients admitted with acute renal failure, 108 (37%) were taking one or more of the target drugs. The mean age was 73 years and 84 patients (79%) had a baseline eGFR of = 60 mL/min. There was a marked decline in kidney function from a mean baseline eGFR of 50 mL/min to 17 mL/min (60% decline). 44% of patients were dehydrated, 12% were septic and 60% had more than 4 comorbid diseases. Only 6 patients were on more than 3 target drugs. The decline in eGFR exceeded 50% with each drug/drug combination and except for ACEI and ARA (withheld in 50% of cases) other drugs/drug combinations were withheld in most patients. Acute renal failure was reversible after treatment of the underlying illness and withdrawal of the target drugs in the majority of patients.ConclusionOver a third of patients with acute renal failure were taking diuretics, NSAID/COX‐2 inhibitors, ACEI/ARA, which may have played a causal or contributory role in the decline in their renal function. Other risk factors for developing acute renal failure included dehydration, sepsis, multiple comorbidities and older age.
Variation in Paediatric Omeprazole Dosing
Authors: Graudins Linda V 
Published: April 2015

ABSTRACTAimTo characterise enteral omeprazole prescribing for paediatric inpatients; to compare doses prescribed for tablets and mixtures; and to compare doses prescribed to a nationally recognised paediatric dosing guideline.MethodA cross‐sectional study conducted at a paediatric hospital where pharmacists prospectively collected dose and formulation data for all paediatric inpatients prescribed enteral omeprazole over a 2–week period.Result35 children (8.6% inpatients) were prescribed enteral omeprazole. Omeprazole doses varied from 0.5 to 3.7 mg/kg/day (median 1.2), higher doses were prescribed for infants and for the mixture formulation. Less than half of the prescriptions followed the nationally recognised paediatric dosing guideline.ConclusionThere was a wide variation in omeprazole dosing in children. Studies of the stability and bioavailability of omeprazole along with clinical outcomes are needed to establish optimal dosing, especially in younger children.
Cytochrome P450 Part 1: Multiplicity and Function
Authors: McKinnon Ross A , Sorich Michael J , Ward Michael B 
Published: April 2015

ABSTRACTWhile new cytochrome P450 (CYP450) enzymes continue to be identified, it is now possible to predict with some confidence the total number of human CYP450 enzymes. This review is an update of the CYP450 superfamily of drug metabolising enzymes. It comprises a brief history of CYP450 research, outlines the standard P450 nomenclature system, and describes CYP450 multiplicity, structure and function.
Prevalence and Validity of Self‐Reported Antibiotic Allergy in Emergency Department Patients
Authors: Wong Jeremy , Knott Jonathan C , Taylor David McD , MacBean Catherine E 
Published: April 2015

ABSTRACTAimTo determine the prevalence of self‐reported antibiotic allergy and the likelihood of true antibiotic hypersensitivity in emergency department patients.MethodA convenience sample of emergency department patients were reviewed for antibiotic allergy. Patients with self‐reported allergy were invited to participate in a structured interview to obtain a detailed allergy history. The interview findings were reviewed to determine the likelihood of the self‐reported reaction being an allergy.Results141/1087 (13%; 95%CI 11.1–15.2) patients reported an antibiotic allergy. 18 antibiotics were reported as allergens, with penicillin reported 107 times (prevalence 9.8%; 95%CI 8.2–11.8). 41 patients underwent a structured interview. More than 20 different allergy symptoms were reported, especially rash, redness and itchiness. 9 (19%; 95%CI 0.7–15.7) patients were classified as unlikely to have a true antibiotic hypersensitivity.ConclusionAlthough, self‐reported antibiotic allergy is common, a considerable proportion are unlikely to be true hypersensitivities. Further education, referral and skin‐prick testing of patients is needed.
Australian General Practitioners' Views on Pharmacist Prescribing
Authors: Vracar Dijana , Bajorek Beata V 
Published: April 2015

ABSTRACTAimTo explore Australian general practitioners' views on extending prescribing rights to pharmacists, the appropriateness of pharmacist prescribing models, and the influence of general practitioners' characteristics on their preference for a particular pharmacist prescribing model.MethodThe study consisted of two parts. Part A was a scenario‐based questionnaire using Likert‐scale responses and Part B was a semi‐structured interview. General practitioners were randomly recruited from two Sydney divisions of general practice. Data were analysed using descriptive statistics and qualitative responses were thematically analysed.ResultsCompleted questionnaires were received from 22/150 general practitioners (response rate 15%), with 10 general practitioners providing additional comments. 10/12 (83%) general practitioners participated in the interviews. Repeat prescribing and prescribing by referral were the most favoured models; 53% of general practitioners rated them as appropriate or somewhat appropriate models of pharmacist prescribing. 6 major themes emerged: focus on safety issues, lack of awareness of pharmacist training and capabilities, division of professional/clinical responsibility, conflict in definition of prescribing versus treating, interference with the general practitioner‐patient relationship and remuneration.ConclusionGeneral practitioners favoured the dependent pharmacist prescribing approach, which is the most widespread practice overseas. The issues raised by the general practitioners need to be addressed before pharmacist prescribing can be pursued in Australia.
Optimal Level of Liaison Pharmacist Intervention to Facilitate a Post‐Discharge Home Medicines Review
Authors: Bollella Giuseppe , Angley Manya T , Pink Jennifer A , Caird Cathy J , Goldsworthy Sharon J 
Published: April 2015

ABSTRACTBackgroundInterventions by hospital liaison pharmacists make general practitioners aware that the hospital deems it appropriate for their patient to have a post‐discharge home medicines review.AimTo determine the frequency of patient referrals for a post‐discharge home medicines review by general practitioners using two less resource intensive models than that previously developed at the Royal Adelaide Hospital.MethodPatients were randomly assigned to either Group A or Group B. Group A patients were counselled about the benefits of an home medicines review and their general practitioner and community pharmacist were sent a medication discharge summary highlighting the hospital's suggestion for a postdischarge home medicines review (standard care). Group B patients received standard care plus their medication discharge summaries included reasons for why an home medicines review was recommended, the community pharmacist's contact details were provided, and a general practitioner appointment was also made via a practice nurse/receptionist.ResultsThe lower level of intervention in Group A patients resulted in a 7% home medicines review referral rate while a higher level of intervention in Group B patients resulted in a 53% home medicines review referral rate (p = 0.0052).ConclusionThe Group B model resulted in a significantly higher general practitioner referral rate when compared to ‘standard care'. A compromise in referral rates occurs if a less resource intensive model is used compared to the previously developed resource intensive model involving the liaison pharmacist.
Pharmacist's Role in the Hospital Discharge Process
Authors: Marriott Jennifer L , Bessell Tracey L 
Published: April 2015

ABSTRACTAimTo determine pharmacist involvement in the hospital discharge process and to explore the potential for further involvement.MethodQuestionnaires were distributed to staff at participating hospitals with pharmacy departments and followed‐up with focus groups to further explore relevant issues. Qualitative data were explored thematically.Results163 questionnaires were completed by pharmacists, nurses, doctors and administrators from 53 hospitals. Writing of discharge prescriptions was the problematic component of the discharge process and the pressure to discharge the patient contributed to errors. A range of solutions was discussed and it was generally noted that increased pharmacist involvement in the discharge process would improve efficiency.ConclusionThe increased involvement of pharmacists in the hospital discharge process by writing discharge prescriptions would benefit the health system, notwithstanding the need for legislative change and a commitment to systems and workforce reform.
Experiential Placements: Nurturing Interactive Pharmacists By Planning and Scaffolding for Improved Communication
Authors: Owen Susanne M , March Geoff 
Published: April 2015

ABSTRACTBackgroundUniversities' pharmacy experiential placements are important in bridging the theory‐practice connection, with learning ‘just happening' from being in the actual environment with patients and practitioners and reflecting on events with students. There is an expectation that preceptors will support and accelerate this process by coaching for specific skills and giving explicit feedback. The university's role involves using comprehensive planning and aligning learning with outcomes including graduate attributes and professional competencies. The development of communication skills requires scaffolding and nurturing to ensure students develop into interactive professionals.AimTo map pharmacy experiential placement programs (objectives, learning and assessment, evaluation strategies) across Australian universities; to highlight successful practices; and to identify areas for improvement and quality indicators.MethodThis qualitative study used semi‐structured interviews with staff from pharmacy schools to map experiential placement programs and identify practices and issues, as well as, focus group consultations with professional/registration organisations, student representatives and preceptors. University experiential placement handbooks were analysed, with key categories and issues emerging through thematic data analysis.ResultsConsultations with over 250 participants and handbooks' analyses indicated a range of structures and approaches for pharmacy experiential placements. To develop communication and patient counselling skills some universities use elements of a planning process but consistent use of comprehensive planning and scaffolding was not evident.ConclusionThe need for planning and scaffolding of learning was highlighted, including university‐based role play practices at the pre‐placement stage, linked closely with demonstrations and explicit feedback from preceptors during placements and feedback and discussion at the debriefing stage.