Medication Dispensing Research Articles

Frequency of Medication Errors at the University Hospital Center Of Point-G, Mali

Background: Medical errors are considered as a major threat to patient safety. The objective of our study was to describe essential steps in drug circuitry from prescription to administration at the University Hospital Center of Point-G. Methods: We conducted a prospective cross-sectional study design at the University hospital center of Point G from January 30, 2021 to June 30, 2021. We collected data using a Case Report Form (CRF) and reviewed medication order sheets, medication administration records, and patient charts. To identify the independent predictors of medication errors, we analyzed the collected data using Stata version 12. Results: The study included 41 patients with 96 prescriptions with 35 medication errors. The highest error rate was detected in prescription step (15.6%) followed by administration drug step (12.5%) and drug dispensation step (8.3%). The most frequent type of errors was the prescription of wrong drug combination (65.85%) followed by wrong indication (36.58%), wrong treatment duration (12.2%), wrong medication dispensing (15.5%), drug erroneously omitted during dispensation (4.4%), wrong drug delivery during dispensation (64%), wrong route for drug administration (20%) and wrong frequency of administration (12%). These errors did not compromise the health of the patients. Conclusion: Medication errors were common at the University Hospital of Point G involving mainly errors in drug prescription, administration and dispensation.

Antidiabetic Medication Utilisation before and during Pregnancy in Switzerland between 2012 and 2019: An Administrative Claim Database from the MAMA Cohort.

The incidence of diabetes mellitus (both pregestational and gestational) is increasing worldwide, and hyperglycemia during pregnancy is associated with adverse pregnancy outcomes. Evidence on the safety and efficacy of metformin during pregnancy has accumulated resulting in an increase in its prescription in many reports. We aimed to determine the prevalence of antidiabetic drug use (insulins and blood glucose-lowering drugs) before and during pregnancy in Switzerland and the changes therein during pregnancy and over time. We conducted a descriptive study using Swiss health insurance claims (2012-2019). We established the MAMA cohort by identifying deliveries and estimating the last menstrual period. We identified claims for any antidiabetic medication (ADM), insulins, blood glucose-lowering drugs, and individual substances within each class. We defined three groups of pattern use based on timing of dispensation: (1) dispensation of at least one ADM in the prepregnancy period and in or after trimester 2 (T2) (pregestational diabetes); (2) dispensation for the first time in or after T2 (GDM); and (3) dispensation in the prepregnancy period and no dispensation in or after T2 (discontinuers). Within the pregestational diabetes group, we further defined continuers (dispensation for the same group of ADM) and switchers (different ADM group dispensed in the prepregnancy period and in or after T2). MAMA included 104,098 deliveries with a mean maternal age at delivery of 31.7. Antidiabetic dispensations among pregnancies with pregestational and gestational diabetes increased over time. Insulin was the most dispensed medication for both diseases. Between 2017 and 2019, less than 10% of pregnancies treated for pregestational diabetes continued metformin rather than switching to insulin. Metformin was offered to less than 2% of pregnancies to treat gestational diabetes (2017-2019). Despite its position in the guidelines and the attractive alternative that metformin represents to patients who may encounter barriers with insulin therapy, there was reluctance to prescribe it.

Medication Dispensing by Pharmacy Technicians Improves Efficiency and Patient Safety at a Geriatric Ward at a Danish Hospital: A Pilot Study.

This study aims to evaluate medication dispensing by pharmacy technicians at a geriatric inpatient ward at a Danish hospital. Four pharmacy technicians were trained in delivering a dispensing service at a geriatric ward. At baseline, the ward nurses recorded the time spent dispensing the medication and the number of interruptions. Similar recordings were completed twice during the period in which the pharmacy technicians delivered the dispensing service. Satisfaction among the ward staff with the dispensing service was assessed by a questionnaire. Reported medication errors were collected during the dispensing service period and compared to a similar time period during the previous two years. The time spent on dispensing medications was on average reduced with 1.4 h per day ranging from 4.7 to 3.3 h per day when the pharmacy technicians performed the service. Interruptions during the dispensing process decreased from a daily average of more than 19 times to an average of 2-3 per day. The nursing staff reported positive feedback on the medication dispensing service provided, especially about easing their workload. There was a tendency toward decreased reporting of medication errors. The medication dispensing service performed by the pharmacy technicians reduced time spent on dispensing medication and increased patient safety by reducing interruptions during the process and decreasing the number of medication errors reported.

Antecedents of fatal overdose in an adult cohort identified through administrative record linkage in Indiana, 2015–2022

BackgroundThe United States continues to experience unprecedented rates of overdose mortality and need to identify effective policies or practices that can be implemented. This study aims to measure the prevalence, frequency, timing, and rate of touchpoints that occurred prior to a fatal overdose where communities might intervene. MethodsIn collaboration with Indiana state government, we conducted record-linkage of statewide administrative datasets to vital records (January 1, 2015, through August 26, 2022) to identify touchpoints (jail booking, prison release, prescription medication dispensation, emergency department visits, and emergency medical services). We examined touchpoints within 12-months prior to a fatal overdose among an adult cohort and explored variation over time and by demographic characteristics. ResultsOver the 92-month study period there were 13,882 overdose deaths (89.3% accidental poisonings, X40-X44) in our adult cohort that were record-linked to multiple administrative datasets and revealed nearly two-thirds (64.7%; n=8980) experienced an emergency department visit, the most prevalent touchpoint followed by prescription medication dispensation, emergency medical services responses, jail booking, and prison release. However, with approximately 1 out of every 100 returning citizens dying from drug overdose within 12-months of release, prison release had the highest touchpoint rate followed by emergency medical services responses, jail booking, emergency department visits, and prescription medication dispensation. ConclusionRecord-linking administrative data from routine practice to vital records from overdose mortality is a viable means of identifying where resources should be situated to reduce fatal overdose, with potential to evaluate the effectiveness of overdose prevention efforts.

Effect of a customized digital adherence tool on retention in care and adherence to antiretroviral treatment in breastfeeding women, children and adolescents living with HIV in Tanzania: a mixed-methods study followed by clinical trials

BackgroundAdherence to antiretroviral (ARV) treatment for HIV infection is challenging because of many factors. The World Health Organization (WHO) has recommended using digital adherence technologies (DATs). However, there is limited evidence on how DATs improve adherence. Wisepill® is an internet-enabled medication dispenser found feasible and acceptable in several studies. However, limited evidence is available on its effectiveness in improving ART adherence, specifically among children and adolescents. Furthermore, DATs are often developed without involving the target groups. We propose a two-stage project consisting of a formative study to customize an existing Wisepill DAT intervention and a randomized clinical trial to investigate the effectiveness of DAT combined with reminder cues and tailored feedback on adherence to ARV treatment among children and adolescents living with HIV and retention in care among breastfeeding women living with HIV in Kilimanjaro and Arusha Region, Tanzania.MethodsWe will conduct a formative mixed-methods study and three sub-trials in Kilimanjaro and Arusha Regions among (1) children aged 0–14 years and their caregivers, (2) adolescents aged 15–19 years and (3) breastfeeding women and their HIV-negative infants. In the formative study, we will collect and analyse data on needs and contents for DATs, including the contents of short message service (SMS) texts and tailored feedback. The results will inform the customization of the DAT to be tested in the sub-trials. In the trials, participants will be randomized in the intervention arm, where the DAT will be implemented or the control arm, where standard care will be followed. Participants in the intervention arm will take their medication from the Wisepill box and receive daily reminder texts and tailored feedback during clinic visits.DiscussionIf the intervention improves adherence to ART and the devices are acceptable, accurate and sustainable, the intervention can be scaled up within the National Aids Control Programmes.Trial registrationPACTR202301844164954, date 27 January 2023.

A qualitative exploration of patient safety in a hospital setting in Spain: Policy and practice recommendations on patients' and companions' participation.

Patients' and companions' participation in healthcare could help prevent adverse events, which are a significant cause of disease and disability. Before designing interventions to increase participation, it is first necessary to identify attitudes to patient safety. This study aimed to explore patients' and companions' perceptions, attitudes and experiences of patient safety, taking into account contextual factors, such as cultural background, which are not usually captured in the literature. We conducted a qualitative study with a theoretical sampling of 13 inpatients and 3 companions in a university hospital in Barcelona, Spain. Information was obtained from individual and triangular interviews. A descriptive thematic content analysis was conducted by four analysts and a consensus was reached within the research team on the key categories that were identified. We also conducted a card-sorting exercise. All informants emphasized the role of good communication with health professionals, a calm environment and the need for patient education. Discursive positions differed by cultural background. Informants from a Pakistani-Bangladeshi background emphasized language barriers, while those from European and Latin-American backgrounds stressed health professionals' lack of time and the need for more interdisciplinary teamwork. The card-sorting exercise identified several opportunities to enhance participation: checking patient identification and medication dispensation, and maintaining personal and environmental hygiene. This exploration of informants' discourse on patient safety identified a wide variety of categories not usually considered from institutional perspectives. The findings of this study could enrich interventions in areas with diverse cultural backgrounds, as well as current frameworks based exclusively on institutional perspectives. The results of the study were communicated to patients and accompanying persons via telephone or email. Similarly, a focus group was held with a patient forum to comment on the results. In the design of subsequent interventions to improve patient safety at the hospital, the proposals of patients and companions for their participation will be included together with healthcare professionals' opinions.

Changes in daily dose in open-label compared to double-blind: The role of clients’ expectations in injectable opioid agonist treatment

IntroductionThough double-blind studies have indicated that hydromorphone and diacetylmorphine produce similar effects when administered through injectable opioid agonist treatment (iOAT) programs, participant preferencemay influence some aspects of medication dispensation such as dose. MethodsThis is a retrospective longitudinal analysis. Participants (n = 131) were previously enrolled in a double-blind clinical trial for iOAT who continued to receive treatment in an open-label follow up study. Data includedmedication dispensation records from 2012 to 2020. Using linear regression and paired t-tests, average daily dose totals of hydromorphone and diacetylmorphine were examined comparatively between double-blind and open-label periods. A subgroup analysis explored dose difference by preference using the proxy, blinding guess, a variable used to facilitate the measurement of treatment masking during the clinical trial by asking which medication the participant thought they received. ResultsDuring the open-label period, participants prescribed diacetylmorphine received49.5 mg less than during the double-blind period (95% CI −12.6,-86.4).Participants receiving hydromorphone did not see a significant dose decrease. Participants who guessed they received hydromorphone during the clinical trial, but learned theywere on diacetylmorphine during the open-label period, saw adecrease in total daily dose of 78.3 mg less (95% CI −134.3,–22.4) during the open-label period. ConclusionIf client preference is consideredin the treatment of chronic opioid use disorder, clients may be able to better moderate their dose to suit their individual needs. Together with their healthcare providers, clientscan participate in their treatment trajectories collaboratively to optimize client outcomes and promote person-centeredtreatment options.

441 Understanding the unintended consequences of new healthcare technologies aimed at supporting patient safety: a qualitative study

Abstract Introduction Technologies such as electronic prescribing, clinical decision support systems, and electronic medication dispensers, are increasingly being introduced into healthcare. Existing toolkits focus on the implementation of such technologies, rather than identifying and mitigating any unintended consequences technologies may have on patient safety. They also focus on high-level organisational issues instead of those faced by end-users: frontline staff, patients and carers. Aim To identify and classify types of unintended consequences that may be encountered by technologies’ end-users, in order to inform development of a tool for identifying and preventing technology-related risks on patient safety. Methods Five focus group discussions with healthcare professionals, patients and carers were conducted through video-conferencing. Healthcare professionals with experience of using/implementing healthcare technologies and known to the research team via professional networks were invited to participate. Patient/carer participants were recruited using convenience sampling via an external research-participant organisation. Participants were asked to identify patient safety risks associated with the use of healthcare technologies, drawn from their own experiences and through consideration of hypothetical risks. Discussions were audio-recorded and transcribed verbatim. Transcripts were analysed by two researchers (NVivo R1.6) and two public partners (manually), using iterative inductive thematic analysis. Results Eleven healthcare professionals and 29 patients and carers participated in focus groups. Three focus groups comprised patients, carers, and healthcare professionals. Two involved solely patients and carers. Analysis revealed five areas of unintended consequences (Table 1). Most unintended consequences identified by patients and carers were similar to those described by healthcare professionals. Healthcare professionals also described additional unintended consequences associated with technologies designed specifically for their use. Conclusion A limitation of the study is that many of the unintended consequences identified related to virtual health technologies used during the COVID-19 pandemic, which may affect generalisability. A strength is that unintended consequences that have been overlooked in existing literature, such as the build-up of patients’ psychological dependence on technologies, were identified. Developing a tool based on these will allow implementers and users of healthcare technologies to consider such issues and address the potential risks they may have on patient safety before healthcare technologies are fully implemented in practice.

Effect of improvement measures in reducing interruptions in a Japanese hospital pharmacy using a synthetic approach based on resilience engineering and systems thinking

BackgroundWorkflow interruptions in pharmacies contribute to dispensing errors, a high-priority issue in patient safety, but have rarely been studied from a systemic perspective partly because of the limitations of the conventional reductionistic approach. This study aims to identify a mechanism for the occurrence of interruptions in a hospital pharmacy and find interventional points using a synthetic approach based on resilience engineering and systems thinking, and assess implemented measures for reducing them.MethodsAt a Japanese university hospital, we gathered information about performance adjustments of pharmacists in the inpatient medication dispensing unit for oral and topical medicines (IMDU-OT) and nurses in the inpatient wards (IPWs) in the medication dispensing and delivery process. Data about the workload and workforce of pharmacists were collected from hospital information systems. Telephone inquiries and counter services in the IMDU-OT, the primary sources of interruptions to pharmacists' work, were documented. The feedback structure between the IMDU-OT and the IPWs was analyzed using a causal loop diagram to identify interventional points. The numbers of telephone calls and counter services were measured cross-sectionally before (February 2017) and four months after implementing measures (July 2020).ResultsThis study found that interruptions are a systemic problem emerging from the adaptive behavior of pharmacists and nurses to their work constraints, such as short staffing of pharmacists, which limited the frequency of medication deliveries to IPWs, and lack of information about the medication dispensing status for nurses. Measures for mitigating cross-system performance adjustments—a medication dispensing tracking system for nurses, request-based extra medication delivery, and pass boxes for earlier pick-up of medicines—were introduced. Following their implementation, the daily median number of telephone calls and counter services was significantly reduced (43 to 18 and 55 to 15, respectively), resulting in a 60% reduction in the total number of interruptions.ConclusionThis study found interruptions in the hospital pharmacy as a systemic problem that can be reduced by mitigating difficulties being compensated for by clinicians' cross-system performance adjustments. Our findings suggest that a synthetic approach can be effective for solving complex problems and have implications for methodological guidance for Safety-II in practice.

Improve the Process of Patient’S Own Medications Dispensed from Inpatient Pharmacy

Background: During hospitalization, some admitted patients might need to continue on their non-formulary medications as per physician order. Yet, there is a potential for medication dispensing and administration errors. Therefore, this study aimed to improve the efficiency of handling and administering patients’ own medications (POM) and reduce the variations in practice by standardizing the workflow and documentation. Materials and Methods: This is a quality improvement study. A new standardized checklist for the POM was designed to apply to pediatric and adult hospitalized patients and then shared with nursing units to be completed upon receiving POM. The study period is 7 months (August 2021 to February 2022). Results: The initial target was to cover (60%) of the hospital’s nursing units by the end of December 2021. Consequently, by December 2021, the target was exceeded successfully by implementing the checklist in (82.6%) of nursing units. By February 2022, the checklist was implemented successfully in all 23 inpatient hospital wards (100%) with nearly 500 patients. Conclusion: The new checklist’s implementation ensures that patients receive their medications through a unified dispensing system in nursing units, and it complies with the Joint Commission International and Saudi Central Board for Accreditation of Healthcare Institutions accreditation standards. Over time, this will help reduce medication errors and increase patient safety.

Is use of opioid agonist treatment associated with broader primary healthcare use among men with recent injecting drug use histories following release from prison? A prospective cohort study

BackgroundA precipitous decline in health status among people recently released from prison is common. In Victoria, Australia, opioid agonist treatment (OAT) in the community involves frequent contact with primary care, potentially facilitating broader use of primary healthcare services. Among a cohort of men who injected drugs regularly pre-imprisonment, we estimated differences in rates of primary healthcare use and medication dispensation between people who did and did not receive OAT post-release.MethodsData came from the Prison and Transition Health Cohort Study. Three-month post-release follow-up interviews were linked with primary care and medication dispensation records. Generalised linear models were fit with one exposure (OAT: none/partial/complete) for 13 outcomes relating to primary healthcare use, pathology testing, and medication dispensation, adjusted for other covariates. Coefficients were reported as adjusted incidence rate ratios (AIRR).ResultsAnalyses included 255 participants. Compared to no OAT use, both partial and complete OAT use were associated with increased rates of standard (AIRR: 3.02, 95%CI: 1.88–4.86; AIRR: 3.66, 95%CI: 2.57–5.23), extended (AIRR: 2.56, 95%CI: 1.41–4.67; AIRR: 2.55, 95%CI: 1.60–4.07) and mental health-related (AIRR: 2.71, 95%CI: 1.42–5.20; AIRR: 2.27, 95%CI: 1.33–3.87) general practitioner (GP) consultations, total medication (AIRR: 1.88, 95%CI: 1.19–2.98; AIRR: 2.40, 95%CI: 1.71–3.37), benzodiazepine (AIRR: 4.99, 95%CI: 2.81–8.85; AIRR: 8.30, 95%CI: 5.28–13.04) and gabapentinoid (AIRR: 6.78, 95%CI: 3.34–13.77; AIRR: 4.34, 95%CI: 2.37–7.94) dispensations, respectively. Partial OAT use was also associated with increased after-hours GP consultations (AIRR: 4.61, 95%CI: 2.24–9.48) and complete OAT use? with increased pathology utilisation (e.g. haematological, chemical, microbiological or immunological tissue/sample testing; AIRR: 2.30, 95%CI: 1.52–3.48).ConclusionWe observed higher rates of primary healthcare use and medication dispensation among people who reported partial and complete OAT use post-release. Findings suggest that access to OAT post-release may have a collateral benefit in supporting broader health service utilisation, underscoring the importance of retention in OAT after release from prison.

Update of a Multivariable Opioid Overdose Risk Prediction Model to Enhance Clinical Care for Long-term Opioid Therapy Patients.

Clinical opioid overdose risk prediction models can be useful tools to reduce the risk of overdose in patients prescribed long-term opioid therapy (LTOT). However, evolving overdose risk environments and clinical practices in addition to potential harmful model misapplications require careful assessment prior to widespread implementation into clinical care. Models may need to be tailored to meet local clinical operational needs and intended applications in practice. To update and validate an existing opioid overdose risk model, the Kaiser Permanente Colorado Opioid Overdose (KPCOOR) Model, in patients prescribed LTOT for implementation in clinical care. The retrospective cohort study consisted of 33, 625 patients prescribed LTOT between January2015 and June2019 at Kaiser Permanente Colorado, with follow-up through June2021. The outcome consisted of fatal opioid overdoses identified from vital records and non-fatal opioid overdoses from emergency department and inpatient settings. Predictors included demographics, medication dispensings, substance use disorder history, mental health history, and medical diagnoses. Cox proportional hazards regressions were used to model 2-year overdose risk. During follow-up, 65 incident opioid overdoses were observed (111.4 overdoses per 100,000 person-years) in the study cohort, of which 11 were fatal. The optimal risk model needed to risk-stratify patients and to be easily interpreted by clinicians. The original 5-variable model re-validated on the new study cohort had a bootstrap-corrected C-statistic of 0.73 (95% CI, 0.64-0.85) compared to a C-statistic of 0.80 (95% CI, 0.70-0.88) in the updated model and 0.77 (95% CI, 0.66-0.87) in the final adapted 7-variable model, which was also well-calibrated. Updating and adapting predictors for opioid overdose in the KPCOOR Model with input from clinical partners resulted in a parsimonious and clinically relevant model that was poised for integration in clinical care.

Study on drug utilization evaluation of anti epileptic drugs

INTRODUCTION: Drug utilization evaluation (DUE) also referred as drug utilization reviews (DUR) or medication utilization evaluation (MUE) are defined as an authorized, structured, ongoing review of healthcare provider prescribing, pharmacist dispensing, and patient use of medication. Anti-epileptic drugs (AEDs) are those which are used for epilepsy and also for other neurological disorders. METHODOLOGY: A prospective observational questionnaire based cross sectional study in 200 patients of various departments receiving at least one AEDs. The subjects were included in the study only after they met the criteria for the study and after properly filling a informed consent form. The data was obtained by a questionnaire format and it is evaluated for utilization patterns, medication adherence. The cost of AEDs were calculated to evaluate total costs on each drug. RESULTS: Out of 200 patients, 140 were male and 60 were female. The age group 11- 20 years were found prominent with epilepsy. The average number of AEDs per patient was found to be 1.54. Among all the drugs prescribed phenytoin was the most common drug prescribed 148 (47.89%) for the treatment, followed by lorazepam 59 (19.09 %) and sodium valproate 27 (8.73 %). Maximum of the patients are high in utilization patterns and also in medication adherence. The chi-square value was 1.1373 and 1.3886 for medication adherence and utilization patterns respectively. CONCLUSION: Medication adherence was also high in patients which was found using morisky medication adherence scale. The utilization pattern was also 82 % by the patients. The cost effectiveness was done by comparing the costs of drugs prescribed during the study. It was found that topiramate is having high cost which can be burden to patient to adhere the therapy.

Epidemiology of male osteoporosis in Denmark (1996–2018)

The aim of this study was to describe epidemiology of male osteoporosis in Denmark. In this nationwide registry-based cohort study, we identified men with osteoporosis, 50years or older, residing in Denmark, during the years 1996-2018. Osteoporosis was defined as one of the following: a hospital diagnosis of osteoporosis; a hospital diagnosis of osteoporosis fracture; or an outpatient dispensing of an anti-osteoporosis medication. We reported annual incidence and prevalence and described the distribution of fractures, comorbidities, socioeconomic status, and initiation of anti-osteoporosis therapy among men with osteoporosis. Selected characteristics were also described among men without osteoporosis of similar age. There were 171,186 men fulfilling the study criteria for osteoporosis. The overall age-standardized incidence rate of osteoporosis was 8.6 per 1000 person-years (95% confidence interval (CI), 8.5-8.6), varying between 7.7 and 9.7, while the prevalence increased from 4.3% (95% CI, 4.2-4.3) to 7.1% (95% CI, 7.0-7.1) during the 22-year period. The remaining-lifetime risk of developing osteoporosis after age of 50years was close to 30%. The proportion of men initiating anti-osteoporosis treatment within 1year of diagnosis increased from 6.9% to 29.8%. Men with osteoporosis had more comorbidities and redeemed more medication than did men without osteoporosis of similar age. Osteoporosis among men may be undertreated despite increasing treatment initiation.

Patient Safety Management Practices by Community Pharmacy Pharmacists～Telephone Follow-up by Community Pharmacy Pharmacists in Cancer Drug Therapy～

As a patient safety management practice in outpatient cancer drug therapy at community pharmacies, continuous follow-up after the dispensing of medication is required. In 2013, QOL Pharmacy Kohoku and its affiliated stores started the "Telephone Follow-up for Cancer Patients" program, which utilizes telephones and information communication devices to communicate with patients and provide information to hospitals. Specifically, follow-up, including phone calls, is used to ascertain medication status and side effects before the next visit to the hospital, and feedback is provided to the prescribing source using trace reports. In some cases, this initiative has led to an early detection of side effects, reduction in the usage of anticancer drugs, and enhancement of supportive care, leading to patient safety and security. In addition, on August 1, 2021, a new pharmacy accreditation system was launched with two new functional categories, namely "Community Cooperative Pharmacies" and "Specialty Medical Institution Cooperative Pharmacies." Specialty medical institution-linked pharmacies are defined as pharmacies that can provide specialized and more advanced pharmacological management and dispensing of medications in cooperation with other pharmacies and medical institutions for patients who require specialized pharmacological management, such as in the case of cancer. Following our certification as a specialized medical institution collaborative pharmacy, we intend to continue the efforts we have invested to date and create a community that can assume a prevailing role in patient safety management.

Oversight of In-Office Dispensing and Samples in Dermatology.

The provision of samples and in-office dispensing of products and medications to patients are important, yet often controversial, practices in dermatology. Opinions on the practices of sampling and in-office dispensing vary greatly among dermatologists. Ultimately, there are several advantages and disadvantages associated with each practice, and common topics of discussion include ethics, costs, safety, and adherence. Many of the concerns associated with the practices of sampling and dispensing in dermatology may be mitigated by careful consideration and action by prescribers. Providers should be aware of their current practices surrounding these issues and, if utilized, methods by which these practices can be improved in order to optimize patient care. With careful consideration, it may be possible to practice sampling and dispensing of products and medications safely, ethically, and to patients' advantage as an integral part of the dermatology practice.

Self-medication: a current self-care practice amongst tertiary college students

Background: Self-medication is the action of taking medication without consulting a physician or healthcare professional. It is one element of self-care coupled with social support during unwellness and aid. Though advocated for by health promoters it has its own fair share of cons. Methods: A descriptive cross-sectional study was conducted where a sample was obtained using published tables and simple random sampling technique was used to draw the sample from a population of 800 student’s gaining a total sample of 267 and to account for non-response and loss 10% was added giving a total of 294 respondents. Results: The prevalence was 82.6% (218) and the age group with the highest frequency of 77.4% was 19-21 years. The male prevalence was higher than for the female with 60.1% (131). The study revealed highest source of information to be pharmacist with 37.8%, highest source of medication was drug shops with 38.1%, highest used medication to be coughs and cold syrups with 78% (205). The reason for self-medication with the highest percentage was suffering from minor illness with 75.37% (199). The symptoms that are highly self-medicated for were coughs and cold (78.7%), pains and headaches (74.2%), stomach discomforts (72.4) and fever (70%). Conclusions: This study revealed a high prevalence of self-medication with 82.6% among the students. Creating awareness, enforcing the laws, informing the relevant stakeholders on availability of medicines and sealing the loops on dispensing of medication could save a generation.

Mailing abortion pills does not delay care: A cohort study comparing mailed to in-person dispensing of abortion medications in the United States

ObjectiveGiven the substantial barriers to abortion access in the United States, many clinics now mail patients abortion medications. We examined whether dispensing the medications by mail prolonged time to medication use. Study designWe analyzed data from no-test medication abortions with medication provided either by mail or in a clinic from 11 United States clinics from February 2020 to January 2021. We examined mean number of days from patients’ first contact with the clinic to mifepristone ingestion, its two-component intervals (first contact to medication dispensing and dispensing to mifepristone ingestion), and pregnancy duration at mifepristone ingestion. We used Poisson regression to compare mean outcomes across three dispensing methods: in-person, mailed from the clinic, and mailed from a mail-order pharmacy. ResultsAmong the 2600 records, patients took mifepristone on average at 49 days of gestation (95% CI, 47–51) and 7 days (95% CI, 4–10) after first contact. Mean time from first contact to mifepristone ingestion was 6 days when medications were dispensed in-person and 9 days when mailed (p = 0.38). While time from first contact to dispensing was similar across methods (6 days in-person, 5 days mailed, p = 0.77), more time elapsed from dispensing to mifepristone ingestion when medications were mailed (4 days from clinic, 5 days from mail-order pharmacy) versus dispensed in-person (0.3 days, p < 0.001). Time to mifepristone ingestion was shorter with higher pregnancy duration. Pregnancy duration at ingestion was similar across methods (48 days in-person, 50 days mailed). ConclusionsMailing medications did not significantly prolong time from patients’ first contact with the clinic to mifepristone ingestion or increase pregnancy duration at mifepristone ingestion. ImplicationsAbortion providers should offer a range of medication abortion dispensing options, prioritizing patient preference.

Inpatient WiFi-enabled medication dispenser for improving ward-based clinical pharmacy services

Medications are vital for patients and especially for those who are receiving treatment in hospitals. Providing medications for these people is essential to maintain their health. On the other hand, medication dispensing error is one of the most common challenges that face clinical pharmacists and medical staff. These errors frequently occurred due to poor medication systems and/or human factors (i.e. environmental conditions, fatigue or staff shortage). These factors may affect prescribing, transcribing, administration, dispensing and monitoring practices which can result in disability, severe harm and even death. Avoiding medication dispensing errors is the key motivation of this paper. Consequently, a biometric-based dispensing system has been designed and implemented. The system can be installed at hospital wards and used for delivering and monitoring inpatients doses. It consists of three parts; hardware, software and mechanical part. Three 4-phase stepper motors are used for controlling the mechanical part of this system. An optical fingerprint sensor is used which is compatible with the ESP32 low-power SoC for scanning patients’ fingerprints to recognize and store their data. The system directly updates its database whenever is used by the inpatients, so that nobody can get additional doses. This system is cost-effective, reliable and easy to use.

Psychological distress during the Covid-19 pandemic: an analysis of antipsychotic drug usage patterns in a sample of Italian residents.

The ongoing pandemic has not only placed significant strain on healthcare systems and global economies but has also exacerbated psychiatric issues, undermining the mental well-being of countless individuals. It is widely recognized that epidemic events, particularly periods of lockdown, heighten the risk of developing anxiety disorders, depression, and aggressive behaviors. In an Italian cohort, a retrospective study was conducted to examine the consumption and costs of antipsychotic medications during and after the Covid-19 pandemic, specifically in the years 2020-2022. Utilizing a database known as the "Sistema Tessere Sanitaria", data on medication dispensations from publicly accessible community pharmacies were extracted, covering a population of approximately one million individuals. The findings for the years 2020-2021 showed relatively stable patterns, with overall consumption and expenditure slightly decreasing from 2020 to 2021. However, it is worth noting that the antipsychotic drug aripiprazole exhibited an opposite trend, with an increase in consumption. Despite expectations of heightened antipsychotic medication use, real-world evidence indicates a different phenomenon, suggesting that the pandemic might not have significantly influenced the consumption of these medications. The limited accessibility to healthcare and medical appointments likely played a role in this observation, potentially masking the therapeutic needs of the population. It will be crucial to monitor the situation in the upcoming years, as normal clinical activities resume, to determine whether there will be an upsurge in the consumption of antipsychotic drugs, which represent a significant portion of the National Healthcare System's expenditure.