Lec 4- Medication review Flashcards
1
Q
Why is it important
A
- Half of regular medicines not used in a way that is fully effective
- ADRs implicated in 5-17% of hospital admissions
- £500 million per year on extra days in hospital due to medication errors
- Under use of evidence-based prophylactic drugs
- Approx £300 million of wasted prescribed medicines per year
2
Q
Definition of medication review
A
- A structured, critical examination of a patients medicines with the objective of reaching an agreement with the patient about treatment, optmising the impact of medicines, minimising the number of medication-related problems and reducing waste
3
Q
The 5 rights
A
- Right patient
- Right drug
- Right dose
- Right route
- Right time
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4
Q
Definition of medication error
A
- A medicaiton error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of health professional, patient or customer
- Such events may be related to the professional practice, health care products, procedures and systems including prescribing, order communication, product labelling, packaging and nomenclature, compounding, dispensing, distribution, administration, education, monitoring and use
5
Q
NPSA- most common types of error
A
6
Q
Never event list 2018
A
- Mis-selection of a strong potassium solution
- Administration of medication by wrong route
- Overdose of insulin due to abbreviation or incorrect device
- Overdose of MTX for non-cancer treatment
- Mis-selection of high strength midazolam during conscious sedation
7
Q
Swiss cheese model
A
8
Q
NPSA- most common drugs associated with harm
A
9
Q
Types of review
A
- Level 1- prescription review
- Level 2- Concordance and compliance review
- Level 3- Clinical medication review
- MURs are NOT clinical medication reviews
10
Q
Level 3 medication review
A
- Explains why review important
- Compile list of ALL medication
- Is there an active diagonosis for each item?
- Is the drug therapy necessary?
- What are the goals of the therapy?
- Has the most appropriate drug been chosen?
- Is the drug being used correctly?
- Is the drug/disease being monitored appropriately?
- Occurence of side-effects
11
Q
Level 3 medication review continued
A
- Patients/carers perception of purpose of medication
- Patients/carers understanding of how medication should be taken
- Is the patient able to take the medication
- Any questions or concerns
12
Q
Medicines Use Review (MUR)
A
- A structured concordance centred review with patients reveiving medicines for long-term conditions, to establish a picture of their use of the medicines- both prescribed and non-prescribed
- The review will help patients understand their therapy and t will identify any problems they are experiencing along with possible solutions
13
Q
Unintentional non-adherence
A
- Problems ordering reveiving repeat prescriptions
- Problems with packaging
- Difficulty reading labels
- Forgetting to take medicines
14
Q
Tipton MM project
A
- Nearly 50% could not read labels
- Nearly 50% could not open bottle
- About 40% could not remove tablets from blister packs
- About 60% had some difficulty in remembering when to take medication
- 20% had difficulty swallowing medicatio
- About 40% had some medication that caused them some difficulty
15
Q
Incidence of medication errors
A
- EQUIP study- nearly 125,000 medication orders in 19 hospital trusts in NW england found a mean prescribing error of 8.9%
- All grades of doctors made errors, but highest rate (10.3%) by foundation year 2 doctors
