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Discrepancies in drug histories at admission to gastrointestinal surgery, internal medicine and geriatric hospital wards in Central Norway: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature292100
Source
BMJ Open. 2017 Sep 24; 7(9):e013427
Publication Type
Journal Article
Multicenter Study
Date
Sep-24-2017
Author
Janne Kutschera Sund
Olav Sletvold
Trude Cecilie Mellingsæter
Randi Hukari
Torstein Hole
Per Einar Uggen
Petra Thiemann Vadset
Olav Spigset
Author Affiliation
Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Source
BMJ Open. 2017 Sep 24; 7(9):e013427
Date
Sep-24-2017
Language
English
Publication Type
Journal Article
Multicenter Study
Keywords
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Digestive System Surgical Procedures - methods
Female
Hospital Departments - statistics & numerical data
Hospitals, General - statistics & numerical data
Hospitals, University - statistics & numerical data
Humans
Male
Medical History Taking - methods - statistics & numerical data
Medication Errors - prevention & control
Medication Reconciliation - statistics & numerical data
Middle Aged
Norway
Patient Admission - statistics & numerical data
Young Adult
Abstract
To compare discrepancies in drug histories among patients acutely admitted to different hospital wards, classify the discrepancies according to their potential clinical impact and identify appropriate selection criteria for patients that should be subject to a detailed drug history at admission.
Cross-sectional study.
Two gastrointestinal surgery wards and one geriatric ward at St Olav's University Hospital in Trondheim and two general internal medicine wards at Ålesund Hospital in Ålesund, Norway.
All patients acutely admitted to these wards during a period of three?months were asked to participate in the study. A total of 168 patients were included. For each patient, drug information available at admission was compared with information from drug lists obtained from the general practitioner and (if applicable) the home care services/the nursing home.
Number of patients with one or more discrepancies in their drug history. Type and clinical impact of the discrepancies found. Selection criteria for patients that should be subject to a detailed drug history.
In total, 83% had at least one discrepancy in their drug history. Omission of a drug accounted for 72% of the discrepancies, whereas a difference in dosing was the cause of the remaining 28%. 9% of the discrepancies had the potential to cause severe harm or discomfort. We found no significant differences in the number of discrepancies between hospital wards, genders, ages or levels of care.
This study demonstrates the importance of collecting drug information from all available sources when a patient is admitted to hospital. As we found no significant differences in discrepancies between subgroups of patients, we suggest that medication reconciliation should be performed for all patients.
Notes
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PubMed ID
28947434 View in PubMed
Less detail

Discrepancies in drug histories at admission to gastrointestinal surgery, internal medicine and geriatric hospital wards in Central Norway: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature286047
Source
BMJ Open. 2017 Sep 24;7(9):e013427
Publication Type
Article
Date
Sep-24-2017
Author
Janne Kutschera Sund
Olav Sletvold
Trude Cecilie Mellingsæter
Randi Hukari
Torstein Hole
Per Einar Uggen
Petra Thiemann Vadset
Olav Spigset
Source
BMJ Open. 2017 Sep 24;7(9):e013427
Date
Sep-24-2017
Language
English
Publication Type
Article
Abstract
To compare discrepancies in drug histories among patients acutely admitted to different hospital wards, classify the discrepancies according to their potential clinical impact and identify appropriate selection criteria for patients that should be subject to a detailed drug history at admission.
Cross-sectional study.
Two gastrointestinal surgery wards and one geriatric ward at St Olav's University Hospital in Trondheim and two general internal medicine wards at Ålesund Hospital in Ålesund, Norway.
All patients acutely admitted to these wards during a period of three?months were asked to participate in the study. A total of 168 patients were included. For each patient, drug information available at admission was compared with information from drug lists obtained from the general practitioner and (if applicable) the home care services/the nursing home.
Number of patients with one or more discrepancies in their drug history. Type and clinical impact of the discrepancies found. Selection criteria for patients that should be subject to a detailed drug history.
In total, 83% had at least one discrepancy in their drug history. Omission of a drug accounted for 72% of the discrepancies, whereas a difference in dosing was the cause of the remaining 28%. 9% of the discrepancies had the potential to cause severe harm or discomfort. We found no significant differences in the number of discrepancies between hospital wards, genders, ages or levels of care.
This study demonstrates the importance of collecting drug information from all available sources when a patient is admitted to hospital. As we found no significant differences in discrepancies between subgroups of patients, we suggest that medication reconciliation should be performed for all patients.
Notes
Cites: Pharm World Sci. 2008 Jan;30(1):92-817661157
Cites: J Gen Intern Med. 2008 Sep;23(9):1414-2218563493
Cites: Qual Saf Health Care. 2010 Oct;19(5):e4220688757
Cites: Can J Hosp Pharm. 2009 Jul;62(4):284-922478906
Cites: Am J Geriatr Pharmacother. 2010 Apr;8(2):115-2620439061
Cites: Ann Pharmacother. 2010 Oct;44(10):1596-60320736427
Cites: Arch Intern Med. 2012 Jul 23;172(14):1057-6922733210
Cites: Am J Health Syst Pharm. 2008 May 1;65(9):857-6018436732
Cites: CMAJ. 2005 Aug 30;173(5):510-516129874
Cites: Br J Clin Pharmacol. 2011 Mar;71(3):449-5721284705
Cites: Ann Intern Med. 2012 Jul 3;157(1):1-1022751755
Cites: Res Social Adm Pharm. 2012 Jan-Feb;8(1):60-7521511543
Cites: Qual Saf Health Care. 2010 Oct;19(5):371-520595717
Cites: Arch Intern Med. 2005 Feb 28;165(4):424-915738372
Cites: Pharmacoepidemiol Drug Saf. 2003 Sep;12(6):491-814513663
Cites: Pharm World Sci. 2008 Dec;30(6):840-518654837
Cites: Am J Med Qual. 2008 Mar-Apr;23(2):115-2718305099
Cites: J Gen Intern Med. 2007 Dec;22(12):1751-517963009
Cites: BMC Clin Pharmacol. 2012 Apr 03;12:922471836
Cites: Eur J Clin Pharmacol. 2009 Oct;65(10):1037-4619557400
Cites: J Gen Intern Med. 2010 May;25(5):441-720180158
Cites: Ann Pharmacother. 2010 Nov;44(11):1747-5420923946
Cites: Eur J Clin Pharmacol. 2011 Jul;67(7):741-5221318595
PubMed ID
28947434 View in PubMed
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Multidose drug dispensing and discrepancies between medication records.

https://arctichealth.org/en/permalink/ahliterature141716
Source
Qual Saf Health Care. 2010 Oct;19(5):e42
Publication Type
Article
Date
Oct-2010
Author
Liv Johanne Wekre
Olav Spigset
Olav Sletvold
Janne Kutschera Sund
Anders Grimsmo
Author Affiliation
Department of Community Medicine and General Practice, Norwegian University of Science and Technology NTNU, MTFS, Trondheim, Norway. liv.j.wekre@ntnu.no
Source
Qual Saf Health Care. 2010 Oct;19(5):e42
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Drug Therapy, Combination
Female
General practice
Home Care Agencies
Humans
Male
Medical Audit
Medical Records - standards
Middle Aged
Norway
Abstract
The objective of this study was to investigate whether implementation of multidose drug dispensing (MDD) for elderly outpatients is associated with a change in the number of discrepancies in the medication record at the general practitioners (GPs) and at the community home-care services.
A controlled follow-up study with paired design of patients' medication records was performed during implementation of MDD. Medication records from the home care units and from the GPs were reviewed, and the discrepancies were noted. The discrepancies were rated into four classes based upon the potential harm, and a risk score system was applied, giving the potentially most harmful discrepancies the highest score.
Medication records from 59 patients with a mean age of 80 years were included. The number of discrepancies was reduced from 203 to 133 (p
PubMed ID
20688757 View in PubMed
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Stroke risk after transient ischemic attack in a Norwegian prospective cohort.

https://arctichealth.org/en/permalink/ahliterature298199
Source
BMC Neurol. 2019 Jan 03; 19(1):2
Publication Type
Journal Article
Multicenter Study
Date
Jan-03-2019
Author
Fredrik Ildstad
Hanne Ellekjær
Torgeir Wethal
Stian Lydersen
Janne Kutschera Sund
Hild Fjærtoft
Stephan Schüler
Jens Wilhelm Horn
Geir Bråthen
Ann-Grete Midtsæther
Åse Hagen Morsund
Marja-Liisa Lillebø
Yngve Müller Seljeseth
Bent Indredavik
Author Affiliation
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, P.O.Box 8905, N-7491, Trondheim, Norway. fredrik.ildstad@ntnu.no.
Source
BMC Neurol. 2019 Jan 03; 19(1):2
Date
Jan-03-2019
Language
English
Publication Type
Journal Article
Multicenter Study
Keywords
Humans
Ischemic Attack, Transient - epidemiology
Norway - epidemiology
Prospective Studies
Risk factors
Stroke - epidemiology
Abstract
Transient ischemic attack (TIA) is a risk factor of stroke. Modern treatment regimens and changing risk factors in the population justify new estimates of stroke risk after TIA, and evaluation of the recommended ABCD2 stroke risk score.
From October, 2012, to July, 2014, we performed a prospective, multicenter study in Central Norway, enrolling patients with a TIA within the previous 2?weeks. Our aim was to assess stroke risk at 1?week, 3?months and 1?year after TIA, and to determine the predictive value of the dichotomized ABCD2 score (0-3 vs 4-7) at each time point. We used data obtained by telephone follow-up and registry data from the Norwegian Stroke Register.
Five hundred and seventy-seven patients with TIA were enrolled of which 85% were examined by a stroke specialist within 24?h after symptom onset. The cumulative incidence of stroke within 1?week, 3?months and 1?year of TIA was 0.9% (95% CI, 0.37-2.0), 3.3% (95% CI, 2.1-5.1) and 5.4% (95% CI, 3.9-7.6), respectively. The accuracy of the ABCD2 score provided by c-statistics at 7?days, 3?months and 1?year was 0.62 (95% CI, 0.39-0.85), 0.62 (95% CI, 0.51-0.74) and 0.64 (95% CI, 0.54-0.75), respectively.
We found a lower stroke risk after TIA than reported in earlier studies. The ABCD2 score did not reliably discriminate between low and high risk patients, suggesting that it may be less useful in populations with a low risk of stroke after TIA.
Unique identifier: NCT02038725 (retrospectively registered, January 16, 2014).
PubMed ID
30606138 View in PubMed
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