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Content ArticleThis article in Translational and Clinical Pharmacology aims to highlight the need to reconsider current medication dosing strategies in reproductive women. It uses the example of schizophrenia to illustrate how a woman's clinical symptoms can change throughout the ovulatory cycle, leading to fluctuations in medication responses. The authors found that healthcare professionals need to consider hormonal and clinical changes that occur with the menstrual cycle when prescribing treatments. They also call for further research to increase knowledge of the issues and find better treatment strategies in women whose symptoms change with cyclical changes in ovarian hormones. However, they warn that results from such studies should never override the symptoms and treatment responses experienced by individual clinical patients.
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Content ArticleIn this study, 156 participants were recruited and randomised to placebo (n=83) or ketamine (n=73), stratified by centre and diagnosis: bipolar, depressive, or other disorders. Two 40-minute intravenous infusions of ketamine (0.5 mg/kg) or placebo (saline) were administered at baseline and 24 hours, in addition to usual treatment. The primary outcome was the rate of patients in full suicidal remission at day 3, according to the scale for suicidal ideation total score ≤3. Analyses were conducted on an intention-to-treat basis. The findings indicate that ketamine is rapid, safe in the short term, and has persistent benefits for acute care in suicidal patients. Comorbid mental disorders appear to be important moderators. An analgesic effect on mental pain might explain the anti-suicidal effects of ketamine. There are also some useful and thought-provoking comments on this research, and a helpful visual aid.
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Content ArticleThis white paper documents a roundtable discussion held at the International Forum on Quality and Safety in Health Care in Europe 2021. Participants discussed how smart medication management can be improved to optimise healthcare quality and efficiency. The meeting was chaired by Yu-Chuan (Jack) Li, a researcher of artificial intelligence (AI) in medicine and medical informatics, and editor-in-chief of BMJ Health and Care Informatics.
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News ArticleHormone replacement therapy (HRT) could be made available to buy over the counter. Health watchdogs are proposing a re-classification of the medication so women would be able to buy it in pharmacies without a prescription, it’s claimed. HRT is mainly used to treat menopause symptoms but it is not yet known which version of the medication will be a part of the proposal, the Daily Telegraph reports. Symptoms can include hot flushes, reduced sex drive and mood swings and usually pass after a few years. More than one million women a year are believed to suffer each year but treatment is currently only available after consultation with a GP or a specialist. A spokesperson for the Department of Health and Social Care said: "We understand that for some women menopause symptoms can have a significant impact on their quality of life, and we are committed to improving the care and support they receive. "That’s why we’re developing the first ever government-led Women’s Health Strategy, informed by women’s lived experience. Menopause, including improving access to Hormone Replacement Therapy, will be a priority under the Strategy." Read full story Source: The Independent, 2 February 2022
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Content ArticleThis scoping review in JMIR Human Factors looked at existing research into how including the reason for use on a prescription impacts pharmacists. It suggests that including the reason for use on a prescription can help the pharmacist catch more errors, reduce the need to contact prescribers, support patient counselling, impact communication and improve patient safety. Concerns about workflow and patient privacy may be factors that prevent the inclusion of use information. The review identified that more research is needed to better understand how the inclusion of use information affects pharmacists.
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Content ArticleThis index of medications provides evidence-based patient leaflets about the use of different medicines in pregnancy. The leaflets are produced by the UK Teratology Information Service (UKTIS). Women can look up medications to understand their impact on pregnancy and how they may affect the chances of miscarriage and birth defects, and provide information on their own pregnancy to add to the knowledge base around medicines in pregnancy.
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News ArticleMPs will be asked this week to end the “shocking” practice of making cystic fibrosis patients in England pay prescription charges for the drugs that they need to stay alive. The condition is the nation’s most common inherited, life-threatening disease and affects more than 7,000 people. Prescription charges, first introduced in 1952, were abolished in 1965; then, when they were reintroduced in 1968, exemptions were made for those suffering from long-lasting ailments such as cancers, diabetes and epilepsy. But children with cystic fibrosis were not expected to live to adulthood and so the condition was not exempted. As a result of new medicines and the creation of special physiotherapy regimes, cystic fibrosis patients now live well into their 40s. “Medicine and society have moved on, so should the exemption list to reflect modern-day experience,” said Paul Maynard, the Conservative MP for Blackpool North and Cleveleys, who will call for an end to prescription charges for the disease at a special Commons debate on the illness this week. “As someone who has a long-term medical condition – epilepsy – it has always amazed me that adults with cystic fibrosis have to pay for their prescriptions whilst I do not.” Read full story Source: The Guardian, 30 January 2022
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Content Article
Blog - Safe medicine saves lives (14 January 2022)
Patient-Safety-Learning posted an article in Medication
In this blog, Roohil Yusuf, Global Pharmacy Advisor at Save the Children, looks at the different factors involved in providing access to life-saving medication, including planning, sourcing, use and management of medicines. She tells the story of Habibah, a three-year-old girl from Nigeria, who was able to access medication for Severe Acute Nutrition and tuberculosis at one of Save the Children's treatment centres. She also looks at the dangers of counterfeit and expired medicines, and explores how organisations can take steps to prevent poor quality, counterfeit or expired medicines being given to patients. -
Content ArticleThis study in the British Journal of General Practice looked at the association between continuity of GP care and potentially inappropriate prescribing in patients with dementia, as well as the incidence of adverse health outcomes. The study authors found that for patients with dementia, consulting with the same doctor consistently, resulted in: 35% less risk of delirium 58% less risk of incontinence 10% less risk in emergency admission to hospital less inappropriate prescribing. The results demonstrate that increasing continuity of care for patients with dementia could improve their treatment and outcomes.
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Content ArticleMedication errors are any Patient Safety Incidents (PSI) where there has been an error in the process of prescribing, preparing, dispensing, administering and monitoring or providing advice on medicines. From 1 April 2015 until 31 March 2020 NHS Resolution received 1420 claims relating to medication errors. This leaflet from NHS Resolution analyses closed claims that have been settled with damages paid and concern an element of the medication process: prescribing, transcribing, dispensing, administering and monitoring.
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EventThis conference focuses on reducing medication errors and the level of severe, avoidable harm related to medications. The conference focuses on prioritising high risk medications and high risk patient groups to enable your interventions to have the highest impact on patient care and reduction in patient harm. The conference which aims to bring together clinicians and pharmacists, managers, and medication safety officers and leads will reflect on medication safety issues that have arisen as a result of the Covid-19 pandemic, help you to understand current national developments, and allow you to debate and discuss key issues and areas in improving and monitoring medication safety, reducing medication errors and harm in hospitals. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/reducing-medication-errors or email kate@hc-uk.org.uk hub members receive a 20% discount. Email infor@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #MedicationErrors
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Content Article
This blog calls for action on the careful review of established pain medication when a patient is admitted to hospital. Richard describes the experience of two elderly patients who suffered pain due to their long term medication being stopped when they were admitted to hospital. Pain control needs must not be ignored or undermined, there needs to be carer and patient involvement and their consent, and alternative pain control must be considered.- Posted
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News Article
CQC threatens to suspend licence of ‘large scale’ GP provider
Patient Safety Learning posted a news article in News
A major GP group in Plymouth covering tens of thousands of patients could have its licence removed after failing to make ‘substantial improvements’ ordered by the Care Quality Commission (CQC). In August, the CQC rated the Mayflower Medical Group “inadequate” and last month the regulator said it had served a “letter of intent” on the group after another inspection. Such a letter is the last step the CQC takes before a provider’s licence is suspended. Licence suspension would affect around 40,000 people (a sixth of Plymouth’s population), who live in one of the highest areas of deprivation in the country – according to Public Health England (now the UK Health Security Agency). Among the CQC’s concerns were safety fears about the way medicines were prescribed, poor management of high-risk patients, coding issues, limited monitoring of the outcomes of care and treatment, and patients experiencing difficulties accessing care and treatment. Read full story (paywalled) Source: HSJ, 2 December 2021 -
Content ArticleWhere a new or under-recognised risk identified through the NHS England's review of patient safety events doesn’t meet the criteria for a National Patient Safety Alert, NHS England look to work with partner organisations, who may be better placed to take action to address the issue. To highlight this work and show the importance of recording patient safety events, they publish regular case studies. These case studies show the direct action taken in response to patient safety events recorded by organisations, staff and the public, and how their actions support the NHS to protect patients from harm.
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Content Article
At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That’s why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples. To mark World Antimicrobial Awareness Week, which takes place every year in November, we’ve selected ten resources related to antimicrobial resistance. Shared with us by hub members and patient safety advocates, they provide valuable insights and practical guidance about AMR. -
Content ArticleThis e-book provides an extensive overview of the day-to-day challenges posed by antimicrobial resistance, tools for setting up stewardship programmes and guidance of how to make the most of existing programmes. Its resources apply the principles of antimicrobial stewardship to a wide range of professions, populations and clinical/care settings. It was published by the British Society for Antimicrobial Chemotherapy in collaboration with the European Society of Clinical Microbiology and Infectious Diseases.
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Content ArticleAntibiotic resistance is a natural phenomenon that happens when bacteria develop the ability to defeat the drugs designed to kill them. This case study focuses on large outbreaks of antibiotic-resistant strains of cholera and typhoid in Zimbabwe. It describes the steps taken to tackle the outbreaks, including a mass typhoid Vi-conjugate vaccine (TCV) vaccination campaign from February to March 2019 in nine suburbs of Harare that were severely affected by the outbreak.
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Content Article
WHO: World Antimicrobial Awareness Week 2021
Patient-Safety-Learning posted an article in Medication
World Antimicrobial Awareness Week takes place from the 18-24 November every year. On this page the WHO explains what antimicrobial resistance is and provides several short explanatory videos about how this can be prevented. -
Content ArticleThere are many respects in which the modern medical system is not fit for purpose and poses a threat to human health. In so many situations, our superficial assumptions about medicine are wrong. Having more tests to identify disease is often not better than leaving those “well enough” alone, labelling people with a specific disease may not be helpful, and more medicine may not be better than less medicine or no medicine at all. In our eagerness to intervene, we can end up doing harm. This fits with the estimation that around 30% of medical care is ineffective and another 10% is harmful. But why do doctors recommend tests, or diagnose and prescribe treatments that don’t help people? Ian A Harris, an orthopaedic surgeon, and Rachelle Buchbinder, a professor of clinical epidemiology, discuss in this BMJ opinion article.
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News Article
Hidden pandemic of antibiotic-resistant infections, health officials warn
Patient Safety Learning posted a news article in News
UK health officials are warning of a "hidden pandemic" of antibiotic-resistant infections if people fail to act responsibly after Covid. Cold symptoms will be more common this winter, with social mixing - but taking antibiotics is not the answer. This could encourage harmful bacteria to evade treatment and put everyone's health at risk, the UK Health Security Agency says. One in five people with an infection in 2020 had an antibiotic-resistant one. And if the bacteria causing their infection no longer responds to treatment with these common medicines, this can cause serious complications and lead to hospital admission. Antibiotics should be taken or prescribed only when really needed, for example to treat bacterial infections such as sepsis, meningitis or pneumonia. They can also help protect against infection during chemotherapy, Caesarean sections and other common surgeries. However they are sometimes prescribed to treat coughs, earache and sore throats, on which they have little or no effect. UKHSA chief medical adviser Dr Susan Hopkins said antimicrobial resistance was a "hidden pandemic" and it was important "we do not come out of Covid-19 and enter into another crisis". Serious antibiotic-resistant infections "will rise once again if we don't act responsibly", she added. "As we head into winter, with increasing amounts of respiratory infections in circulation, it is important to remember that antibiotics are not needed for many cold-like symptoms. "Stay at home if you feel unwell," she said. "Taking antibiotics when you do not need them only puts you and your loved ones at more risk in the future, so please listen to your GP, nurse, dentist or pharmacist's advice." Read full story Source: BBC News, 17 November 2021 -
Content ArticleThis study in the British Journal of Clinical Pharmacology involved searching electronic health records to uncover how many people in prisons have been affected by a potential problem related to their prescribed medication. Researchers looked at published studies and worked with prison healthcare staff to develop and implement prescribing safety indicators (PSIs) for prison electronic health records. The authors found that PSIs provide a significant opportunity to measure and improve medication safety for people in prisons and that more patients were affected by some PSIs than others. The study also investigated how the searches could be used more widely in prisons and interviewed 20 prison health care staff to explore this topic. The staff they spoke to said that it was important to have people who can take on leadership of the searches and to promote team-based responses to them.
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Content ArticleSoojin Jun, a pharmacist and a patient advocate, discusses three ways in which pharmacists can help solve the health crisis in the US."The first and foremost value of recognizing pharmacists as providers is that we can help deprescribing medications and guide patients to healthier lives for many chronic illnesses. Many insurance and government sponsored programs are wasting money by “restricting” how pharmacists should practice under their laws and regulations when they can better use the time and money by “guiding” how pharmacists could practice as providers."
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News Article
GPs to follow new digital standard for sending medicines and allergy information
Patient Safety Learning posted a news article in News
A new information standard has been developed for sharing digital information on medication and allergies across different parts of health and social care services. The standard, which aims to reduce medicines errors comes into effect this month. NHS and social care organisations will have to show compliance by March 2023. GP practices, hospitals, mental health trusts, pharmacists, community teams and residential care homes will all have to meet the standard when transferring medication and prescription information between teams. The standard will be particularly helpful in reducing medication errors when patients transfer between care locations NHS Digital said. Having specific requirements in place for how medicine and allergy information is transferred will also provide clinicians with a more detailed and consistent source of medicines related information across all care settings and allow them to obtain medicines information more quickly and efficiently, they added in a document outlining the changes. The standard defines how the send and receive messages involving medicines information are constructed, and how the data within is structured so that it is machine-readable when sent between different IT systems. Dr Simon Eccles, deputy CEO of NHSX and national chief clinical information officer said: ‘This new standard will make medicine prescribing safer for patients and easier for clinicians, reducing errors in prescription and improving the monitoring of medications that can cause harm. ‘This is the result of a true collaborative effort between NHSX, NHS Digital, industry and the frontline that will make a real difference to the care and support local clinicians can provide to their patients." Read full story Source: Pulse, 28 October 2021 -
News Article
Pharmacists 'to be given right to prescribe so GPs have more time with patients'
Patient Safety Learning posted a news article in News
Pharmacists will be allowed to write prescriptions under plans reportedly being considered by England's Health Secretary Sajid Javid. Mr Javid last month vowed the Government will "do a lot more" to ensure GPs see more patients face-to-face following complaints from the public. The proposals would see more prescriptions provided through pharmacies and hospitals for routine illnesses to allow doctors more time to see patients in person, according to The Sunday Times. GPs will also reportedly be able to pass off bureaucratic processes such as providing supporting medical evidence to the Driver and Vehicle Licensing Agency (DVLA) over a patient's fitness to drive. The plans are expected to include sanctions for doctors who do not increase the number of face-to-face appointments with patients, the paper added. Read full story Source: 11 October 2021, Medscape -
Content ArticleThe authors of this research study, published in BMJ Quality & Safety looked at the issues of hazardous prescribing and inadequate monitoring in patients with mental health issues being managed in primary care. They identified a lack of data in this area, despite most patients with mental illness receiving treatment in a primary care setting. The study found that: 9.4% of patients ‘at risk’ triggered at least one indicator for potentially hazardous prescribing. The risk was greatest for patients aged 35–44, females and those receiving more than 10 repeat prescriptions. 90.2% of patients ‘at risk’ triggered at least one indicator for inadequate monitoring. The risk was particularly high in people under the age of 25, females and those with one or no repeat prescription. The authors of the study hope their findings will support providers to reduce risk and improve care for patients who receive mental health treatment in primary care.
