Experience of taking part as an Asian member of the European Framework 7th Research Programme

Theme: Forging the future of higher educationpostprin

Improving Medication Safety and Diabetes Management in Hong Kong – A Multi-disciplinary Approach

AIM: To characterise drug-related problems (DRPs) among patients with diabetes in Hong Kong and their clinical significance and to explore pharmacists’ role in the multi-disciplinary diabetes management team by evaluating the outcome of their clinical interventions. METHODS: An observational study was conducted at the Diabetes Clinic of a local public hospital from October 2012 to March 2014. Following weekly screening, selected high-risk patients were interviewed by a pharmacist prior to doctors’ consultations for medication reconciliation and review. DRPs were identified and documented by the pharmacists, who presented clinical recommendations to doctors to optimise patients’ drug regimens and resolve or prevent potential DRPs. RESULTS: A total of 522 patients were analysed and 417 DRPs were identified. The incidence of patients with DRPs was 62.8% with the mean number of DRPs per patient being 0.9±0.6. The most common DRP categories were related to dosing (43.9%), drug choice (17.3%) and non-allergic adverse reactions (15.6%). Drugs most frequently involved targeted the endocrine and cardiovascular system (CVS). The majority (71.9%) of DRPs were of moderate clinical significance and 28.1% were considered minor problems. DRPs were totally solved by doctors’ acceptance of pharmacists’ recommendations (50.1%), partially solved (11.0%) or received acknowledgement from doctors (5.5%). CONCLUSIONS: Pharmacists, in collaboration with the multi-disciplinary team, demonstrated positive impact by identifying, resolving and preventing DRPs in patients with diabetes. Further plans for sustaining a pharmacy service in the Diabetes Clinic would enable further studies to explore pharmacists’ long-term impact on improving patients’ clinical outcomes in diabetes management. New knowledge added by this study: Studies have demonstrated pharmacists’ important contribution to the identification, resolution and prevention of drug-related problems through medication reconciliation and review. Most of the identified problems were related to dosing with moderate clinical significance according to Dean and Barber’s validated scale for scoring medication errors. Over half of pharmacists’ clinical interventions were accepted or acknowledged by doctors to improve medication management. IMPLICATIONS FOR CLINICAL PRACTICE OR POLICY: Collaboration between pharmacists and other healthcare professionals is valuable for the improvement of medication safety in the management of diabetes

Raising the ante in anti-counterfeit drug legislation

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Association between oral fluoroquinolone use and the development of retinal detachment: a systematic review and meta-analysis of observational studies

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The variation of psychopharmacological treatment for people with autistic spectrum disorder (ASD): an international study

Conference Theme: Applying pharmacoepidemiology to improve health care in AsiaPoster PresentationAIM/OBJECTIVE: There is a variation of prescription for ASD treatment between countries. It has been suggested that many people with mental disorders in low/middle-income countries do not receive adequate treatment. This study aimed to investigate psychopharmacological treatment patterns in thirty countries which previously had no published data and the association between country’s income and ASD treatment …published_or_final_versio

The prevalence of potentially inappropriate prescribing among Hong Kong older adults: a comparison among Beers 2003, Beers 2012, and STOPP/START criteria

INTRODUCTION/OBJECTIVES: Inappropriate prescribing can lead to adverse drug events and older adults are at greater risk due to multiple chronic co-morbidities and multiple medications prescribed. Various criteria (eg Beers or STOPP [Screening Tool of Older Person’s Prescriptions]) on medication usage have been developed to assess prescribing appropriateness. The objectives of this study were (1) to determine the prevalence of potentially inappropriate prescribings (PIPs) among Hong Kong older adults using 2003 Beers, 2012 Beers, and STOPP criteria, and (2) to evaluate the association between …published_or_final_versio

Drug wastage among the elderly living in old aged homes in Hong Kong

The extend of drug wastage among elderly living in old aged homes was never investigated. Upon the completion of the previous study on pharmaceutical services provided to elderly living in old aged homes, the amount of drugs wasted from 3,020 residents in one of the delegated pharmacies over a 4-month period were counted and their costs were calculated. The total cost of wasted drugs amounted to be HKD$96,924, with drugs acting on the central nervous system contributed to the highest cost of HKD$26,872 (27.7%), followed by respiratory drugs of HKD$23,875 (24.6$22,965 (23.7%). The results showed that for health institutes dispensing prescriptions of long duration to the elderly could lead to considerable amount of drug wastage and this issue should be addressed.link_to_subscribed_fulltex

The pharmaceutical services to the elderly in the old aged homes in Hong Kong: a scope exercise

Various models of pharmaceutical services have been provided by pharmacists to old aged home residents, however, these models have never been summarised and compared. The aim of this scoping exercise is to identify different kinds of pharmaceutical services currently available to the old aged home residents, by means of systemic literature review, qualitative in-depth interviews with service providers in order to understand their models and qualitative semi-structured interviews with non-pharmaceutical service users in an attempt to investigate reasons why some homes do not subscribe to these services. The results showed that none of the pharmaceutical services currently available can uproot the causes of medication errors, and there is a need to elaborate the roles of pharmacists in a primary care setting.link_to_subscribed_fulltex

Adverse Events Associated with Melatonin for the Treatment of Primary or Secondary Sleep Disorders: A Systematic Review

Background: Melatonin is widely available either on prescription for the treatment of sleep disorders or as an over-the-counter dietary supplement. Melatonin has also recently been licensed in the UK for the short-term treatment of jetlag. Little is known about the potential for adverse events (AEs), in particular AEs resulting from long-term use. Concern has been raised over the possible risks of exposure in certain populations including pre-adolescent children and patients with epilepsy or asthma. / Objectives: The aim of this systematic review was to assess the evidence for AEs associated with short-term and longer-term melatonin treatment for sleep disorders. / Methods: A literature search of the PubMed/Medline database and Google Scholar was conducted to identify randomised, placebo-controlled trials (RCTs) of exogenous melatonin administered for primary or secondary sleep disorders. Studies were included if they reported on both the types and frequencies of AEs. Studies of pre-term infants, studies of < 1 week in duration or involving single doses of melatonin and studies in languages other than English were excluded. Findings from open-label studies that raised concerns relating to AE reports in patients were also examined. Studies were assessed for quality of reporting against the Consolidated Standards of Reporting Trials (CONSORT) checklist and for risk of bias against the Cochrane Collaboration risk-of-bias criteria. / Results: 37 RCTs met criteria for inclusion. Daily melatonin doses ranged from 0.15 mg to 12 mg. Subjects were monitored for up to 29 weeks, but most studies were of much shorter duration (4 weeks or less). The most frequently reported AEs were daytime sleepiness (1.66%), headache (0.74%), other sleep-related AEs (0.74%), dizziness (0.74%) and hypothermia (0.62%). Very few AEs considered to be serious or of clinical significance were reported. These included agitation, fatigue, mood swings, nightmares, skin irritation and palpitations. Most AEs either resolved spontaneously within a few days with no adjustment in melatonin, or immediately upon withdrawal of treatment. Melatonin was generally regarded as safe and well tolerated. Many studies predated publication of the CONSORT checklist and consequently did not conform closely to the guidelines. Similarly, only eight studies were judged ‘good’ overall with respect to the Cochrane risk-of-bias criteria. Of the remaining papers, 16 were considered ‘fair’ and 13 ‘poor’ but publication of almost half of the papers preceded that of the earliest version of the guidelines. / Conclusion: Few, generally mild to moderate, AEs were associated with exogenous melatonin. No AEs that were life threatening or of major clinical significance were identified. The scarcity of evidence from long-term RCTs, however, limits the conclusions regarding the safety of continuous melatonin therapy over extended periods. There are insufficient robust data to allow a meaningful appraisal of concerns that melatonin may result in more clinically significant adverse effects in potentially at-risk populations. Future studies should be designed to comply with appropriate quality standards for RCTs, which most past studies have not

Exposure to selective serotonin reuptake inhibitors during pregnancy and risk of autism spectrum disorder in children: A systematic review and meta-analysis of observational studies

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