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Content Article
WHO: Medication with harm – Policy brief (7 March 2024)
Patient Safety Learning posted an article in Medication
Harm due to medicines and therapeutic options accounts for nearly 50% of preventable harm in medical care. This World Health Organization (WHO) policy brief is a resource for policy-makers, health workers, healthcare leaders, academic institutions and other relevant institutions to help understand the global burden of medication errors, address and prevent medication-related harm at all levels of healthcare, aligned with the strategic plan of the third WHO Global Patient Safety Challenge: Medication Without Harm.- Posted
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- Medication
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News Article
USA: Supreme Court to hear arguments in abortion pill case
Patient Safety Learning posted a news article in News
The US Supreme Court will hear oral arguments on whether to restrict access to mifepristone, a commonly used abortion pill. It is considered the most significant reproductive rights case since the court ended the nationwide right to abortion in June 2022. The Biden administration hopes the court will overturn a decision to limit access to the drug over safety concerns raised by anti-abortion groups. The pill has been legal since 2000. The current legal battle in the top US court began in November 2022 when the Alliance for Hippocratic Medicine, an umbrella group of anti-abortion doctors and activists, filed a lawsuit against the Food and Drug Administration, or FDA. The group claims that mifepristone is unsafe and further alleges that the federal agency unlawfully approved its use in September 2000 to medically terminate pregnancies through seven weeks gestation. Mifepristone is used in combination with another drug - misoprostol - for medical abortions, and it is now the most common way to have an abortion in the US. Medical abortions accounted for 63% of all abortions in 2023, up from 53% in 2020, according to the Guttmacher Institute. In total, more than five million US women have used mifepristone to terminate their pregnancies. Read full story Source: BBC News, 26 March 2024- Posted
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Content ArticleThe Joint Commission has released a simplified breakdown of eight patient safety goals for US hospitals in 2024.
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Content ArticleMedication errors in ambulatory care settings present unique patient safety challenges. This systematic review explored the prevalence of medication errors in outpatient and ambulatory care settings. Findings indicate that prescribing errors (e.g., dosing errors) are the most common type of medication error and are often attributed to latent factors, such as knowledge gaps.
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Content ArticleThe combination of emerging patient safety threats and the growing amount of published patient safety research, patient safety resources and accrediting body standards makes it increasingly difficult to prioritise adopting and implementing evidence-based practices. The US Agency for Healthcare Research and Quality's (AHRQ’s) fourth iteration of Making Healthcare Safer intends to address this issue by publishing evidence-based reviews of patient safety practices and topics as they are completed. This intentional release of updated reviews will aid healthcare organisation leaders in prioritising implementation of evidence-based practices in a timelier way. The report will also help researchers identify where more research is needed and assist policymakers in understanding which patient safety practices have the supporting evidence for promotion.
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- Pandemic
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News Article
NHS England to stop prescribing puberty blockers
Patient Safety Learning posted a news article in News
Children will no longer routinely be prescribed puberty blockers at gender identity clinics, NHS England has confirmed. The decision comes after a review found there was "not enough evidence" they are safe or effective. Puberty blockers, which pause the physical changes of puberty, will now only be available as part of research. It comes weeks before an independent review into gender identity services in England is due to be published. An interim report from the review, published in 2022 by Dr Hilary Cass, had earlier found there were "gaps in evidence" around the drugs and called for a transformation in the model of care for children with gender-related distress. Health Minister Maria Caulfield said: "We have always been clear that children's safety and wellbeing is paramount, so we welcome this landmark decision by the NHS. "Ending the routine prescription of puberty blockers will help ensure that care is based on evidence, expert clinical opinion and is in the best interests of the child." Read full story Source: BBC News, 13 March 2024- Posted
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Content ArticleAshleigh Hughes is a Senior Sister at an NHS chemotherapy day unit. In this interview she shares her personal story about the impact of antibiotic underdosing on her Mum’s end of life care. Antibiotic underdosing is a medication safety issue that has profound implications for the health service as well as individual patients, but there is currently a lack of understanding and recognition of the issue.
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- Adminstering medication
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Content ArticleThis annual report from ECRI and the Institute for Safe Medication Practices (ISMP) presents the top 10 patient safety concerns currently confronting the healthcare industry. It is a guide for a systems approach to adopting proactive strategies and solutions to mitigate risks, improve healthcare outcomes and enhance the well-being of patients and the healthcare workforce. Drawing on ECRI and ISMP’s evidence-based research, data and insights, this report sheds light on issues that leaders should evaluate within their own institutions as potential opportunities to reduce preventable harm. Some of the concerns represent emerging risks, some are well known but still unresolved, but all of them pertain to areas where organisations can make meaningful change.
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Community Post
Medication supply issues: have you been affected?
Patient_Safety_Learning posted a topic in Medication
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Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? Was there an impact on your health (physical and mental)? Were you told the reason for it not being available? Was the issue resolved? If so, how long did it take? If you are still impacted by medication supply issues, have you been told when you will be able to access them again? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in the comments below. You'll need to register with the hub first, its free and easy to do. We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue. What barriers and challenges have you seen around medication availability? Is there anything that can be done to improve wider systems or processes? Please comment below or email us at content@pslhub.org- Posted
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Content ArticleIn this interview, we talk to Darren Powell, Clinical Lead for NHS England and Community Pharmacist, about medication supply issues. Darren shares his experiences of how medication shortages and tariffs are affecting patients and staff and offers insights into the complexity of the situation. He tells us his thoughts on potential causes and barriers, as well as suggesting three actions for wider system safety.
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Content ArticleThis study aimed to determine whether the use of video telemedicine for paediatric consultations to referring hospital emergency departments (EDs) results in less frequent medication errors than the current standard of care—telephone consultations. The authors found no statistically significant differences in physician-related medication errors between children assigned to receive telephone consultations vs video telemedicine consultations.
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- Telemedicine
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News ArticleMPs are calling for a new review into the dangers of the drug Primodos, claiming that families who suffered avoidable harm from it have been "sidelined and stonewalled". MPs said the suggestion there is no proven link between the hormone pregnancy test and babies being born with malformations is "factually and morally wrong". A report by the All-Party Parliamentary Group (APPG) on hormone pregnancy tests claims evidence was "covered up" and it is possible to "piece together a case that could reveal one of the biggest medical frauds of the 20th century". Around 1.5 million women in Britain were given hormone pregnancy tests between the 1950s and 1970s. They were instructed to take the drug by their GPs as a way of finding out if they were pregnant. But Primodos was withdrawn from the market in the UK in the late 1970s after regulators warned "an association was confirmed" between the drug and birth defects. However, in 2017 an expert working group found there was insufficient evidence of a causal association. But MPs now claim this report is flawed. It's hugely significant because the study was relied upon by the government and manufacturers last year to strike out a claim for compensation by the alleged victims. Read full story Source: Sky News, 1 March 2024
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News Article
First over-the-counter birth control pill in US to go on sale later this month
Patient Safety Learning posted a news article in News
Opill, the first birth control pill approved for over-the-counter distribution, is now being shipped to retailers and pharmacies, the company behind the pill, Perrigo, announced on Monday. It will be available in stores and online later this month. The Food and Drug Administration approved Opill last year, paving the way for the United States to join the dozens of countries that have already made over-the-counter birth control pills available. Opill, which works by using the hormone progestin to prevent pregnancy, is meant to be taken every day around the same time and, when used as directed, is 98% effective. The pill’s arrival on shelves comes at a deeply fraught time for US reproductive rights: not only has the US supreme court demolished the national right to abortion, but the nation’s highest court is set to hear arguments over two abortion-related cases over the next few months. “Week after week, we hear stories of people being denied the reproductive health care they so desperately need because of politicians and judges overstepping into the lives of patients and providers. Today, we get to celebrate different news,” Dr Tracey Wilkinson, a pediatrician in Indiana and a board member with Physicians for Reproductive Health, said in a statement. “As Opill makes its way to pharmacies across the country, I am relieved to know that birth control access will become less challenging for so many people, but especially young people.” Read full story Source: The Guardian, 4 March 2024- Posted
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Content ArticleOnline healthcare services and apps can help people take more control of their health, by getting access to care easily and when it suits them. You need to make sure any medicine, treatment or health advice you get is safe and right for you. These six top tips from UK health organisations will help you keep safe if you decide to go online.
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Content ArticleThis consensus statement co-ordinated by the British In Vitro Diagnostics Association (BIVDA) outlines the role of point of care testing in reducing the amount of antibiotics prescribed in primary care. It highlights the issue of antimicrobial resistance (AMR) and outlines evidence for the effectiveness of the rapid point-of-care C-Reactive Protein (POC CRP) test to assist clinical decision making as to whether an individual presenting with symptoms of respiratory tract infection needs an antibiotic. It makes a series of recommendations for the Department of Health and Social Care (DHSC) and NHS England around the use of POC CRP testing in primary care.
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- Antimicrobial resistance (AMR)
- Medication
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News ArticleHarry Miller was a popular teenager, appreciated for his sharp humour, ability to get on with anyone and eagerness “for the next adventure”. In the autumn of 2017, he was struggling with difficult thoughts and feelings of anger. Harry, who was 14 and lived in south-west London, confided his inner turmoil to friends and family. “I’m just having these anger rages,” he told his mother one day. “It’s like I just go crazy suddenly and I can’t control it. I don’t know what’s going on.” Two years previously, Harry had been prescribed the drug montelukast for his asthma. Unbeknown to his parents, a range of psychiatric reactions had been reported in association with montelukast treatment, including aggression, depression and suicidal thoughts. Harry’s parents, Graham and Alison Miller were not properly warned of the potential side effects. Their son was referred to the NHS child and adolescent mental health services in January 2018, but he missed an appointment because it was sent to the wrong person. On 11 February 2018, Harry was found dead in the family home, with an inquest later recording a verdict of suicide. He was described in a tribute by friends at St Cecilia’s Church of England school in Southfields, south-west London, as a “super star burning brightly”. Two years after his death, his father read an online warning about the adverse reactions involving montelukast by the Medicines and Healthcare Products Regulatory Agency (MHRA). It said these could very rarely include suicidal behaviour. Graham Miller said: “It is an absolute outrage that parents are being given psychoactive substances to give to their children without proper warning of the risk.” This weekend, the MHRA has confirmed that the drug is under review. A montelukast UK action group is calling for more prominent warnings of the drug’s possible side effects. Read full story Source: BBC News, 3 March 2024
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- Asthma
- Medication
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Content ArticleStrategies to reduce medication dosing errors are crucial for improving outcomes. The Medication Education for Dosing Safety (MEDS) intervention, consisting of a simplified handout, dosing syringe, dose demonstration and teach-back, was shown to be effective in the emergency department (ED), but optimal intervention strategies to move it into clinical practice remain to be described. This study aimed tov describe implementation of MEDS in routine clinical practice and associated outcomes. The study was conducted in five stages (baseline, intervention 1, washout, intervention 2, and sustainability phases). The 2 intervention phases taught clinical staff the MEDS intervention using different implementation strategies. The study found that both MEDS intervention phases were associated with decreased risk of error and that some improvement was sustained without active intervention. These findings suggest that attempts to develop simplified, brief interventions may be associated with improved medication safety for children after discharge from the ED
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EventAt this webinar, WHO will launch two WHO publications on Medication Safety, “Global burden of preventable medication-related harm” and “Policy brief on Medication Without Harm”, to create awareness and to support implementation of the WHO Global Patient Safety Challenge: Medication Without Harm. Register
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Content ArticleSalbutamol is a selective beta2-agonist providing short-acting (4-6 hour) bronchodilation with a fast onset (within 5 minutes) in reversible airways obstruction. The nebuliser liquids are licensed for use in the management of chronic bronchospasm unresponsive to conventional therapy, and in the treatment of acute severe asthma. A Medicines Supply Notification (MSN) issued on 14 February 2024, detailed a shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid. The resolution date is to be confirmed. The supply issues have been caused by a combination of manufacturing issues resulting in increased demand on other suppliers. Terbutaline, salbutamol with ipratropium, and ipratropium nebuliser liquids remain available, however, they cannot support an increase in demand. Ventolin® (salbutamol) 5mg/ml nebuliser liquid (20ml) is out of stock until mid-April 2024 and cannot support an increased demand after this date.
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- Lack of resources
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News ArticleThe medical regulator failed to sound the alarm over Covid vaccine side effects and should be investigated, MPs have said. The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for approving drugs and devices and monitors side effects caused by treatments. But the all-party parliamentary group (APPG) on pandemic response and recovery, an influential group of MPs, has raised “serious patient safety concerns”. It has claimed that “far from protecting patients” the regulator operates in a way that “puts them at serious risk”. Some 25 MPs across four parties have written to the health select committee asking for an urgent investigation. In reply, Steve Brine, the health committee chairman, has said an inquiry into patient safety is “very likely”. In a letter to Mr Brine, the APPG said that there was reason to believe that the MHRA had been aware of post-vaccination heart and clotting issues as early as February 2021, but did not highlight the problems for several months. Read full story (paywalled) Source: The Telegraph, 27 February 2024 Related reading on the hub: Interview with Charlet Crichton, founder of UKCVFamily
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Content ArticleTo decrease surgical site infections after appendectomy for acute appendicitis, preoperative broad-spectrum antibiotics are often used in clinical practice. However, this treatment strategy has come under scrutiny because of increasing rates of antibiotic-resistant infections. This multisite quality improvement project aimed to decrease the treatment of uncomplicated acute appendicitis with piperacillin-tazobactam without increasing the rate of surgical site infections. The intervention had two distinct components: Updating electronic health record orders to encourage preoperative administration of narrow-spectrum antibiotics. Educating surgeons and emergency department clinicians about selecting appropriate antibiotic therapy for acute appendicitis. Patient demographics, clinical characteristics and outcomes were compared six months before and after implementation of the quality improvement intervention. The intervention successfully decreased piperacillin-tazobactam administration without increasing the rate of surgical site infections in patients with acute appendicitis.
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- Medication
- Antimicrobial resistance (AMR)
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News Article
ADHD drugs shortage fuels online black market
Patient Safety Learning posted a news article in News
Drugs used to treat ADHD are being openly traded in "potentially lethal" doses to UK buyers on encrypted apps, a BBC North West investigation has found. Criminals are cashing in on a national shortage to offer the prescription tablets in a secret mail-order service. The BBC found an unregulated online market stacked with medication which high street chemists were struggling to stock. It is feared patients are turning to the black market in desperation, but one psychiatrist has warned some of the drugs could contain other potentially harmful chemicals. Thousands of people with ADHD have been unable to get prescribed medication amid a major supply shortage. The BBC has heard how the situation has left children and adults in limbo and with the shortage set to last until December many are believed to be turning to illegitimate traders to help treat the condition. The BBC took these findings to Dr Morgan Toerien, associate specialist in mental health at Beyond Clinics in Warrington, who said: "A lot of these drugs are potentially lethal, not just dangerous - particularly if you weren't used to taking them and if you took a higher dose. "During my work in illicit drug treatment, we've tested people alleged to have taken a lot of the drugs seen on this channel and they don't actually contain what they say they do." He said people could be taking a tablet purporting to be to treat ADHD, but could be "far more dangerous". Read full story Source: BBC News, 28 February 2024 -
News Article
'Daily life is a struggle without my ADHD medicine'
Patient Safety Learning posted a news article in News
"Taking medication meant my brain was quiet for the first time; it was amazing, I cried because I was so happy," Jass Thethi, whose life was transformed after an ADHD diagnosis just over a year ago, told a BBC North West investigation. But the 34-year-old's joy was short-lived because, like more than 150,000 others who live with the condition and are reliant on medication, Jass has been affected by a UK-wide medicine shortage that started in September. Jass, who lives in Levenshulme, Greater Manchester, said: "When the medication shortage started I had to go back to white knuckling everyday life… I had to take the decision to change things and I had to quit the job I was doing." The charity ADHD UK said it had recorded a "significant decline" in the availability of medicines, with only 11% having their normal prescription in January, a drop from 52% in September. The Department of Health and Social Care (DHSC) said increased global demand and manufacturing issues were behind the shortages. Dr Morgan Toerien, associate specialist in mental health at Beyond Clinics in Warrington, said Jass's experience was not unique and many patients' lives had been "completely destabilised". Read full story Source: BBC News, 27 February 2024 Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our Community post. We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue.- Posted
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Content ArticleWellcome Collection long read on two women who battled through decades of medical paternalism: Marie Lyon, who took Primodos, and Dr Isabel Gal, the scientist who first raised the alarm.
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Content ArticleIn this letter to Health Secretary Steve Brine MP, members of the All Party Parliamentary Group (APPG) on Pandemic Response and Recovery raise serious concerns about the approach of the Medicines and Healthcare Products Regulatory Agency (MHRA) to patient safety. They outline problems within the MHRA that continue to put patients at serious risk of harm. The letter also highlights the role of the Independent Medicines and Medical Devices Safety Review (IMMDS), in its thorough investigation of Primodos, sodium valproate and pelvic mesh in bringing some of these concerns to the fore. It points to recent evidence presented to the APPG that indicates that the MHRA is at the heart of wider endemic failings, with issues uncovered so far being "the tip of a sizeable iceberg of failure." The letter outlines concerns about the following areas: The Yellow Card Scheme Conflicts of interest and transparency History of regulatory failures in the MHRA It calls on the Health and Social Care Select Committee to investigate these issues and make recommendations to the government on: legislative changes as to who is obligated to report adverse drug reactions. funding changes to the MHRA. separation of regulatory approval duties from post marketing pharmacovigilance. more inclusion of patients. greater transparency across the board. proper enforcement of Part 14 of the Human Medicines Regulations 2012.
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- Medication
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