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Found 323 results
  1. Content Article
    This blog by Dr Anna Bayes from Altera Digital Health looks at the benefits of closed-loop medication administration (CLMA) in preventing avoidable medication errors. CLMA provides an extra validation at the point of drug administration by using barcode technology to positively identify the patient and validate their prescribed medications against the physical medication product (for example, pills, infusions or creams) at the point of care. Anna also considers CLMA's role in advancing digital maturity.
  2. Content Article
    Medications and specifically fall-risk-increasing drugs (FRIDs) are associated with increased risk of falls: reducing their prescription may improve this risk. This study from Cox et al. explored patient characteristics associated with FRID use, prevalence and type of FRIDs and changes in their prescriptions among older people with arm fractures over 6 months. The study found that more than one FRID prescription had a significantly higher number of co-morbidities and medications and higher rates of male gender, polypharmacy, frailty and sarcopenia. The most frequently prescribed FRIDs were antihypertensives, opioids and antidepressants. Use of FRIDs among older people with upper limb fragility fractures was high. Although overall use decreased over time, 59% were still on 1 or more FRID at the 6-month follow-up, with trends to stop opioids and start antidepressants. Older people presenting with upper limb fractures should be offered a structured medication review to identify FRIDs for targeted deprescribing.
  3. News Article
    Hundreds of thousands more women than men have been prescribed powerful anti-anxiety drugs which experts warn are harder to come off than heroin, The Independent can reveal. New information obtained under freedom of information (FOI) laws shows women in England were 59% more likely to be prescribed benzodiazepines – better known by the brand names of Valium, Xanax and Temazapam – than men between January 2017 and December 2021. Benzodiazepines are commonly prescribed for anxiety and insomnia, with the drug’s withdrawal symptoms including depression, acute anxiety, insomnia, vivid nightmares, headaches, vomiting, shakes, cramps and, in the worst cases, seizures which can cause death. Many countries explicitly state benzodiazepines should not be taken for more than four weeks, while research has found benzodiazepines can cause memory loss and Alzheimer’s. In September 2020, the US Food and Drug Administration announced its “black box warning” must be placed on all benzodiazepines to inform patients withdrawal from the drugs can be life-threatening. Stephen Buckley, head of information at Mind, a leading UK mental health charity, told The Independent it was difficult to “know the exact reasons behind why women are more likely to be prescribed benzodiazepines than men” but said the FOI “findings support others which show gender discrepancies in prescribing have been occurring for a long time”. “Previous research in some parts of the world has found that male prescribers were more likely to prescribe benzodiazepines to female patients than male patients. Research into the reasons behind gender differences in prescribing psychiatric medication is important.” Read full story Source: The Independent, 3 October 2022 Related reading: Medicines, research and female hormones: a dangerous knowledge gap Gender bias: A threat to women’s health
  4. News Article
    India faces a “pandemic” of superbugs, the country’s top public health experts have warned, as resistance to common antibiotics has jumped by 10% in just one year In the fifth edition of its annual report on antimicrobial resistance (AMR), the Indian Council of Medical Research warned that urgent action is needed to prevent a major health crisis caused by the rampant misuse of antibiotics. “The resistance level is increasing to five to ten per cent every year for broad spectrum antimicrobials, which are highly misused,” said Dr Kamini Walia, who led the ICMR’s report. “Antibiotic resistance has the potential of taking the form of a pandemic in the near future if corrective measures are not taken immediately.” The report warned that only 43% of pneumonia infections in India could be treated with first line antibiotics in 2021 – down from 65% in 2016. “We could absolutely see a pandemic driven by AMR infections in India,” said Ramanan Laxminarayan, director of the One Health Trust, a global public health think tank. “It is certainly within the realms of possibility, it could be next year or over the next two decades. “Bacterial infections were the biggest killers in the early 20th Century and we risk going back to that time where there are no effective antibiotics and infections can spread rapidly,” he added. Read full story (paywalled) Source: The Telegraph, 16 September 2022
  5. News Article
    A pregnant woman who died after being given the wrong dosage of drugs was one of almost 6,000 people harmed and 29 killed following prescription errors in the NHS in England last year. Figures from NHS England show that 98 hospital trusts experienced an increase in the number of prescription errors reported in 2021, including cases where patients were given the wrong drug, wrong dosage or were not given medicine when needed. Meanwhile, the number of errors fell at 105 trusts. Leeds Community healthcare trust had a sixfold increase in prescription errors – with 111 errors, up from just 17 in 2020. At the Royal National Orthopaedic hospital errors rose from 60 to 193, while Herefordshire partnership university NHS trust had 55 errors, up from 20 in 2020. The NHS said that some trusts still did not have a fully funded plan to introduce electronic prescribing, meaning they are still run at least partially using paper notes. Peter Walsh, the chief executive of Action against Medical Accidents, said: “These are very disappointing statistics and behind every one there is a story of personal suffering or tragedy. What is particularly frustrating is that prescription errors are probably easier to avoid than many things that go wrong in healthcare". “We are particularly concerned about vulnerable people such as elderly or disabled people in care homes, who may be more at risk because they may be less able to check for themselves and because they tend to get a less personalised service than the average patient.” Read full story Source: The Guardian, 26 September 2022
  6. News Article
    Many pharmacies and physicians are forced to deny patients access to drugs, such as methotrexate, that can be used to help induce an abortion A few weeks after the supreme court’s 24 June decision to overturn the nationwide abortion rights established by Roe v Wade, the pharmacy chain Walgreens sent Annie England Noblin a message, informing her that her monthly prescription of methotrexate was held up. Noblin, a 40-year-old college instructor in rural Missouri, never had trouble getting her monthly prescription of methotrexate for her rheumatoid arthritis. So she went to her local Walgreens to figure out why, standing in line with other customers as she waited for an explanation. When it was finally her turn, a pharmacist informed Noblin – in front of the other customers behind her – that she could not release the medication until she received confirmation from Noblin’s doctor that Noblin would not use it to have an abortion. Since the supreme court’s elimination of federal abortion rights, many states have been enacting laws which highly restrict access to abortion, affecting not only pregnant women but also other patients as well as healthcare providers. As a result, many pharmacies and physicians have been forced to deny and delay patients’ access to essential medications – such as methotrexate – that can be used to help induce an abortion. Noblin is one of the 5 million methotrexate users across the US and one of the country’s many autoimmune patients. Although she was eventually given her prescription, Noblin and other patients are now forced to grapple both with a monthly invasion of privacy at pharmacies that ask them about their reproductive choices as well as the possibility of being wholly denied the medication in the future due to restrictive laws. Read full story Source: The Guardian, 26 September 2022
  7. Content Article
    Joint safety alert from the British Menopause Society, Faculty of Sexual & Reproductive Healthcare, Royal College of General Practitioners, Royal College of Obstetricians & Gynaecologists, Society for Endocrinology and the Royal College of Nursing Women’s Health Forum.
  8. Content Article
    To receive and participate in medical care, patients need high quality information about treatments, tests, and services—including information about the benefits of and risks from prescription drugs. Provision of information can support ethical principles of patient autonomy and informed consent, facilitate shared decision making, and help to ensure that treatment is sensitive to, and meets the needs and priorities of, individuals. Patients value high quality, written information to supplement and reinforce the verbal information given by clinicians. This is the case even for those who do not want to participate in shared decision making. The aim of this study was to evaluate the frequency with which relevant and accurate information about the benefits and related uncertainties of anticancer drugs are communicated to patients and clinicians in regulated information sources in Europe. The findings of this study highlight the need to improve the communication of the benefits and related uncertainties of anticancer drugs in regulated information sources in Europe to support evidence informed decision making by patients and their clinicians.
  9. Content Article
    A survey of over 4,000 people with long-term conditions on prescription charges has found the charge is a barrier to accessing medicine. The findings come following the UK government's announcement that the prescription charge will rise on 1 April 2023.
  10. Content Article
    The Medicines and Healthcare products Regulatory Agency issued this guidance following recent cases, including cases with fatal outcomes, in which patients have received the wrong medicine due to confusion between similarly named or sounding brand or generic names.
  11. Content Article
    The existence of confusing drug names is one of the most common causes of medication error and is of concern worldwide. With tens of thousands of drugs currently on the market, the potential for error due to confusing drug names is significant. This includes nonproprietary names and proprietary (brand or trade-marked) names. Many drug names look or sound like other drug names. Contributing to this confusion are illegible handwriting, incomplete knowledge of drug names, newly available products, similar packaging or labelling, similar clinical use, similar strengths, dosage forms, frequency of administration, and the failure of manufacturers and regulatory authorities to recognise the potential for error and to conduct rigorous risk assessments for nonproprietary and brand names, prior to approving new product names This article from the WHO Collaborating Centre for Patient Safety Solutions looks at the issues and suggests actions.
  12. Content Article
    The Prescription Charges Coalition is a group of 50 organisations calling on the Government to scrap prescription charges for people with long-term conditions in England. This report by the Coalition outlines the results of a survey of over 4,000 people with long-term conditions about prescription charges. It highlights that the prescription charge is a barrier to patients with long-term conditions accessing medicine.
  13. Content Article
    This guide from the Patient Safety Movement Foundation gives actions and resources for creating and sustaining safe practices for reducing medication errors. In it, you’ll find: Executive summary checklist What we know about medication errors Leadership plan Action plan Technology plan Measuring outcomes Conflicts of interest disclosure. Workgroup References.
  14. Content Article
    NHS England working in partnership with integrated care system (ICS) leads and representatives, has devised actions to help systems develop plans that can support people who are taking medicines associated with dependence and withdrawal symptoms. The actions will support ICSs to deliver on their 4 key objectives of: improving outcomes in population health and healthcare tackling health inequalities in outcomes, experience and access enhancing productivity and value for money helping the NHS support broader social and economic development.
  15. Content Article
    Electronic prescribing (ePrescribing) systems allow healthcare professionals to enter prescriptions and manage medicines using a computer. Sheikh and colleagues set out to find out how these ePrescribing systems are chosen, set up and used in English hospitals. Given that these systems are designed to improve medication safety, we looked at whether or not these systems affected the number of prescribing errors made (mistakes such as ordering the wrong dose of medication). They also tried to see whether or not the systems were good value for money (or more cost-effective). Finally, they made recommendations to help hospitals choose, set up and use ePrescribing systems.
  16. News Article
    A review of the clinical records of 44 patients who died under the care of former neurologist Michael Watt has found "significant failures in their treatment" and "poor communication with families". While this review looked at a sample of cases in which people died, potentially thousands more could be affected. The review arises from a 2018 recall of 2,500 outpatients who were in Dr Watt's care at the Belfast Health Trust. About one in five patients had to have their diagnoses changed. This separate review into 44 deaths was conducted by the Royal College of Physicians at the request of the regulator, the Regulation and Quality Improvement Authority (RQIA). It highlighted concerns over clinical decision-making, prescribing and diagnostics. It reveals a misdiagnosis rate of 45% among this group of patients, twice that for living patients. Speaking to BBC News NI, the RQIA's chair, Christine Collins, said the outcome of the review was "shocking and gut-wrenching as so many had experienced unpleasant deaths which they ought not to have done". Read full story Source: BBC News, 29 November 2022
  17. News Article
    Doctors are prescribing heating to patients with conditions that get worse in the cold as part of a health trial. The Warm Home Prescription pilot paid to heat the homes of 28 low-income patients to avoid the cost of hospital care if they became more ill. Michelle Davis, who has arthritis and serious pulmonary illness, had her energy bills paid for and said the difference was "mind-blowing". "When the weather turns cold, I tend to seize up," she told the BBC. "It's very painful, my joints ache and my bones are like hot pokers." In 2020 Ms Davis spent most of the winter in bed, trying to keep warm and was admitted to hospital with pneumonia and pleurisy. But not in winter 2021. "You're not stuck in bed, you're not going to hospital, my children were able to have a life, they were able to go out and play and get cold," she said. Academics estimate that cold homes cost NHS England £860m a year and that 10,000 people die every year due a cold home. But that research was completed before the current cost of living crisis took hold. This first trial achieved such good results, that it's being expanded to 150 households in NHS Gloucestershire's area, plus about 1,000 in Aberdeen and Teesside. Dr Matt Lipson helped design the pilot programme and feels like this preventative step is a no-brainer for the health service. "If we buy the energy people need but can't afford, they can keep warm at home and stay out of hospital," he said. "That would target support to where it's needed, save money overall and take pressure off the health service." The change in patients was swift: "The NHS were telling us they were seeing a benefit much more quickly than pills and potions," Dr Lipson added. "It was taking days, not weeks and months." Read full story Source: BBC News, 22 November 2022
  18. News Article
    Patients in Oklahoma, USA, who get their prescription medications by mail may soon have better protections for the safety of those drugs than any other state. On Wednesday, Oklahoma regulators proposed the nation’s first detailed rule to control temperatures during shipping, according to pharmacy experts. “This is a huge step,” said Marty Hendrick, executive director of the Oklahoma State Board of Pharmacy, after the board voted to approve the rule Wednesday. “We’ve got a tremendous amount of prescriptions that get mailed to patients. … What we did today was make sure our patients in Oklahoma are receiving safe products.” Exposure to extreme temperatures can degrade or weaken drugs, potentially changing their dosage or chemical makeup and rendering them ineffective or unsafe for patients. But while government oversight of how pharmacies store medications to keep them in defined safe temperature ranges is very detailed, an NBC News investigation in 2020 found oversight of shipping to patients — during which drugs might be exposed to heat waves and below-freezing temperatures — is largely a system of blind trust. Mail-order pharmacy is a booming business, with soaring profits for some of the nation’s largest companies last year and more than 26 million people receiving their medication by mail in 2017 — more than double the number two decades earlier, according to federal data. NBC News found that most state pharmacy boards, the regulators responsible for pharmacy safety, did not have specific rules for how pharmacies should ship customers’ medication, few asked about this process in their inspections, and many said it was simply up to the pharmacy to ensure safe shipping. Read full story Source: NBC News, 17 November 2022
  19. News Article
    Responding to a backlash from pain patients in the USA, the Centers for Disease Control and Prevention (CDC) have released updated guidelines that offer clinicians more flexibility in the way they prescribe opioids for short- and long-term pain. The new recommendations eliminate numerical dose limits and caps on length of treatment for chronic pain patients that had been suggested in the landmark 2016 version of the agency’s advice, which was aimed at curbing the liberal use of the medication and controlling a rampaging opioid epidemic. Those guidelines cautioned doctors that commencing opioid therapy was a momentous decision for patients. Parts of that nonbinding document were widely misinterpreted, resulting in unintended harm to patients who were benefiting from use of opioids without much risk of addiction. Patients reported they were rapidly tapered off medication by doctors or saw their medication abruptly discontinued, the CDC acknowledged in the new document. The new 100 pages of guidance — which remain only recommendations for doctors, nurse practitioners and others authorised to prescribe opioids — emphasize returning the focus to the caregiver and patient deciding on the best course of treatment. Read full story (paywalled) Source: The Washington Post, 3 November 2022
  20. News Article
    GPs are breaching medical guidelines by prescribing antidepressants for children as young as 11 who cannot get other help for their mental health problems, NHS-funded research reveals. Official guidance says that under-18s should only be given the drugs in conjunction with talking therapies and after being assessed by a psychiatrist. But family doctors in England are “often” writing prescriptions for antidepressants for that age group even though such youngsters have not yet seen a psychiatrist, according to a report by the National Institute for Health and Care Research (NIHR), the NHS research body. The report linked the prescriptions to the long wait many young people, some self-harming or suicidal, face before starting treatment with NHS child and adolescent mental health services (CAMHS). Under-18s are prescribed the drugs for anxiety, depression, pain and bedwetting. The guidance on antidepressants has been issued by the National Institute for Health and Care Excellence (NICE), which advises the NHS on which treatments are effective. Referencing NICE’s recommendation of a two-step approval process, the NIHR study said “this often” did not happen. “No antidepressants are licensed in the UK for anxiety in children and teenagers under 18 years, except for obsessive compulsive disorder. Yet both specialists [psychiatrists] and GPs prescribe them. Thousands of children and teenagers in the UK are taking antidepressants for depression and anxiety. The numbers continue to rise and many have not seen a specialist.” Read full story Source: The Guardian, 4 November 2022
  21. News Article
    Following four deaths and more than 300 incidents with steroid replacement therapy involving patients with adrenal insufficiency in the past two years, patients at risk of adrenal crisis will be issued with a steroid emergency card. All adults with primary adrenal insufficiency (AI) will be issued an NHS steroid emergency card to support early recognition and treatment of adrenal crisis, a National Patient Safety Alert has said. The cards will be issued by prescribers — including community pharmacists — from 18 August 2020. AI is an endocrine disorder, such as Addison’s disease, which can lead to adrenal crisis and death if not identified and treated. Omission of steroids in patients with AI, particularly during physiological stress such as an additional illness or surgery, can also lead to an adrenal crisis. The alert has requested that “all organisations that initiate steroid prescriptions should review their processes/policies and their digital systems/software and prompts to ensure that prescribers issue a steroid emergency card to all eligible patients” by 13 May 2021. Read full story Source: The Pharmaceutical Journal, 17 August 2020
  22. News Article
    A senior coroner has demanded action by Simon Stevens, chief executive of NHS England, to ensure that GPs monitor repeat prescriptions properly, after an 84 year old man with dementia died from an overdose of tramadol. Peter Cole, who was found collapsed at his home in Welwyn in Hertfordshire by a neighbour, had amassed a large quantity of unused prescription drugs at his house. He had numerous drugs on repeat prescription, said Geoffrey Sullivan, chief coroner for Hertfordshire. Read full story (paywalled) Source: BMJ, 5 August 2020
  23. News Article
    A Scottish Government committee has found that the “profound failings” of IT systems are the biggest problem facing a medicine-prescribing service that does not sufficiently focus on patients. A report from the members of Scottish Parliament on the Health and Sport Committee describes a medicines system “burdened by market forces, public sector administrative bureaucracy and under resourcing, inconsistent leadership and a lack of comprehensive, strategic thinking and imagination, allied to an almost complete absence of useable data”. The committee particularly criticised the failure of the NHS to introduce appropriate IT systems. “We are extremely disappointed that once again all roads lead to the dismal failure of the NHS in Scotland to implement comprehensive IT systems which maximise the use of patient data to provide a better service,” the report says. Committee members are calling for an overhaul of the system to allow for collection and analysis of data that would ensure the best possible outcomes for patients and cost savings for the NHS. MSPs found a “lack of care” to understand patients’ experience of taking medicines and a lack of follow up to ensure that medicines were effective or even being used. Prescribers were “instinctively reaching for the prescription pad” and not taking the time to discuss medicines with patients, nor were the principals of realistic medicine, in which patients and clinicians share decision making about their care, being followed. Read full story Source: Public Technology.net, 1 July 2020
  24. News Article
    The toxicity of a commonly prescribed beta blocker needs better recognition across the NHS to prevent deaths from overdose, a new report warns today. The Healthcare and Safety Investigation Branch (HSIB) report focuses on propranolol, a cardiac drug that is now predominately used to treat migraine and anxiety symptoms. It is highly toxic when taken in large quantities and patients deteriorate quickly, making it difficult to treat. The investigation highlighted that these risks aren’t known widely enough by medical staff across the health service, whether issuing prescriptions to at risk patients, responding to overdose calls or carrying out emergency treatment. Dr Stephen Drage, ICU consultant and HSIB’s Director of Investigations, said: “Propranolol is a powerful and safe drug, benefitting patients across the country. However, what our investigation has highlighted is just how potent it can be in overdose. This safety risk spans every area of healthcare – from the GPs that initially prescribe the drug, to ambulance staff who respond to those urgent calls and the clinicians that administer emergency treatment." The report also emphasises that there is a link between anxiety, depression and migraine, and that more research is needed to understand the interactions between antidepressants and propranolol in overdose. Read full story Source: HSIB, 6 February 2020
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