Patients admitted noncompliance in 12 (12%) of the 101 identified prescription discrepancies. Such noncompliance resulted in a dosing discrepancy that might or might not have resulted in the medication incorrectly appearing inactive on the patient’s PIP profile. The most common reason for noncompliance was unauthorized self-adjustment of the medication regimen.
Thirteen (5%) of the 282 current prescription medications did not appear on the patients’ 4- or 12-month PIP profiles. These accounted for 13% of the identified discrepancies involving prescription medications. When using PIP information to obtain a medication history, it is essential to ask the patient if they take any medication provided by the Saskatchewan Cancer Agency or Tuberculosis Control Program or any sample, investigational, special access, or study medications. Methods to capture prescribing information from other databases, along with information about sample, investigational, and study medications, should be investigated to ensure that patients’ PIP profiles more accurately represent all of their current prescription medications. canadian antibiotics
Saskatchewan’s Drug Plan uses temporary alphanumeric codes for medications that are new on the market. Identification of these medications within the PIP profile is not possible unless the patient can provide the name and strength of the medication dispensed. Although this situation accounted for a minimal number of discrepancies, it is important that the Drug Plan avoid the use of temporary codes. Instead, new medications should be entered into the PIP as soon as they are approved for use. A task force of the Canadian Society of Hospital Pharmacists is now working with Saskatchewan Health to improve the PIP database.
There were several limitations to this study. First, the study population was a small sample of adult patients admitted to one ward at a single hospital. Even though these patients had a wide range of clinical issues, the results reported here may not be representative of the general population. Second, 34% of the patients interviewed reported having been admitted to hospital in the previous year.
This might have affected the number of discrepancies identified, as the authors know from experience that hospital admissions affect the frequency and timing of prescription refills. Third, medication doses and directions for use are not provided in the PIP profile. Therefore, the investigators calculated the daily dose from the amount of medication dispensed and the number of days’ supply entered by the community pharmacy. Unfortunately, only 18% of the patients interviewed had a medication list, medication vials, and/or compliance pack available for inspection. Because of the stress of a hospital stay, the patient and/or the patient’s primary caregiver may not remember the complete medication regimen, which might have affected the discrepancies that were identified. It would be interesting to evaluate the clinical implications of the discrepancies, but this was beyond the scope of the current study. A considerable amount of time was required to prepare for and interview each patient (mean 22.5 minutes). Reallocation of existing pharmacy resources or assignment of extra resources would be required to interview each newly admitted patient. Finally, the PIP is designed to capture information about prescription medications. Therefore, discrepancies between the PIP and the BPMH with respect to over-the-counter and herbal medications were not analyzed or reported. erectalis 20
From this study, it is evident that we need to educate patients to assume greater responsibility for their health care, specifically their use of prescription medications. The importance of carrying an accurate and up-to-date list of all current medications at all times needs to be stressed. A multifaceted educational approach is recommended to achieve this behavioural change.
Most prescription medications that a patient reported taking (during a BPMH interview) appeared somewhere in his or her PIP profile. However, in many cases these medications incorrectly appeared inactive and the total daily dose suggested in the PIP profile often differed from the patient’s actual daily dose. Thus, the PIP profile can be used to assist the health care provider in determining a patient’s medication use on admission but should never be used as a substitute for interviewing the patient. Viagra Super Active