Quality of drug use in asthma Background: The National Airway Register is a quality register, which provides opportunities for quality follow-up and improvement. It contains data on individuals with asthma disease, their drug treatment and outcomes obtained in health care.  Aim: To examine how representative data on drug treatment contained in the National Airway Register are for adult patients with asthma in Region Stockholm and Sweden, respectively. Methods: A cross-sectional study based on data from the National Airway Register and the Prescribed Drug Register, where the study population consisted of asthma patients aged 18-44. Open data from the Prescribed Drug Register was limited to 15–44-year-old patients. Data were collected for the period 2016–2020 regarding drugs within ATC code R03 and dupilumab with ATC code D11AH05.  Results: A difference in the use of asthma drugs between the National Airway Register and Prescribed Drug Register with the same trend for all studied years was seen. In the National Airway Register, the proportion of individuals who used bronchodilators without having obtained any ICS was lower and a higher proportion (74-82% vs 65-70%) had obtained ICS. Drugs administered in clinics cannot be studied in the Prescribed Drug Register. Conclusions: Drug treatment in the National Airway Register generally seems to comply better with international guidelines than in the Prescribed Drug Register, which may be an indication that the quality of asthma treatment is higher for patients registered in the National Airway Register. This causes problems in generalizability since obtained data only correspond to individuals who are selected.

Pharmaceutical services in pharmacies from the pharmacist’s perspective- with focus on inhalation check  Background: Wrong use of drugs is a major problem today. Pharmaceutical services can be a solution to this problem. By ensuring that the patient receives sufficient information to be able to use his/her drugs in the right way. Developments in performing new pharmaceutical services at Swedish pharmacies are currently under investigation. Previous studies showed that pharmacists have a major impact on the development of pharmaceutical services.  Aim: The aim is to investigate the attitude of community pharmacists to perform pharmaceutical services in pharmacies with focus on the service of inhalation check.   Method: A qualitative semi-structured interview was conducted in this study among 9 pharmacists who work at community pharmacies. The interviews took place at 7 different pharmacies in the Stockholm area.  Results: The results showed that pharmacists who participated in the study have a positive attitude towards the introduction of the inhalation check service in pharmacies. The inhalation check service is considered a service that can contribute to reducing incorrect inhalation technique and optimal treatment. Prerequisites for being able to implement the service in pharmacies from the participant’s perspective are more employees, more time, a suitable place, and some type of financial compensation.  Conclusion: Pharmaceutical services provide an opportunity for pharmacies to show their usefulness in society, while at the same time providing an opportunity for pharmacists to utilize their expertise. The inhalation check service is a service needed in a Swedish pharmacy. To be able to perform the service at Swedish pharmacies, different conditions are required.

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8 Abstract Analysis of antibiotic administration in prophylaxis I Author: Petr Domecký Tutor: PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Lucie Hauschke, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Antibiotic prophylaxis (AP) plays an important role in reduction of surgical site infection (SSI). It is the administration of an eligible antibiotic or chemotherapeutic (ATB) in a single dose, usually 30 minutes before surgery, followed by two to three doses during or after the surgery, regarding the selected ATB and the surgical procedure. The aim of this work was to analyse the AP in surgical procedures at the Masaryk Hospital in Ústí nad Labem (MNUL) in the context of the MNUL guideline (DP) and the research on available AP work. Methods: A cross-sectional observational study ran from January 2018 to March 2018 in surgical departments at MNUL. The study included patients aged ≥ 18 years who underwent surgery in a defined period (5 February 2018 to 9 February 2018) and gave their consent to the study. The practicability of the study was verified by a pilot part. Initially, a research of published studies concerning AP was carried out which provided outputs for AP establishment (PPA). Subsequently, a form for...

Background: Uppsala University Hospital Sweden is planning to implement a closed loop medication system, with the aim of reducing risk prescriptions from the point of drugs being prescribed to orders being produced and administered. With inspiration from Leuven, an advanced system for pharmaceutical validation; System Assisted Pharmaceutical VALidation (SAPVAL) is planned to be developed. Aim: The aim of the study was to obtain a deeper understanding of clinical rules as an important element for building the SAPVAL system. This study will review and further develop a first set of clinical rules and validate these on the intended study population.  Methods: A retrospective cross-sectional study was performed to validate the clinical rules on a study population of 500 patients who were discharged from Uppsala University Hospital between May to July 2020. The clinical rules were applied cross-sectionally based on patient data from the electronic health records. From the total generated alerts, 10 % was randomly selected for assessment of the clinical relevance. Results: The clinical rules generated 893 alerts in 500 patients, of which 84 % alerts still remained two days after the patient was admitted to the hospital or at discharge. From the randomly selected alerts, 26 % were deemed clinically relevant. Conclusions: The developed clinical rules generate a large number of alerts for risk prescriptions for inpatients at Uppsala University hospital. The majority of the alerts remained during the care period and approximately a quarter of them were considered to be clinically relevant to remedy.

Background: Drugs are an important part of treating diseases but can also come with its risks. To reduce the risks, a system assisted pharmaceutical validation (SAPVAL) is being developed at Uppsala University Hospital. This will include the generation of alerts regarding different risks, sent to a clinical pharmacist who assesses whether the alerts should be forwarded to a physician or not. One of the risks included is QT prolongation, a relatively uncommon condition which however can result in sudden cardiac death. Aim: The aim was to map the management and the consequences of QT-related risk prescriptions and to determine the clinical relevance of QT-related alerts. Method: A retrospective cross-sectional study was performed at Uppsala University Hospital. It included the review of patients´ electronic health records (EHR) and determination of risk periods. The clinical relevance of the alerts was assessed by a physician and a developed flowchart. Results: 65 patients (age=71 ± 15 years, 54% women), and their 85 QT-related alerts were included, with a median risk period of 145 days. Within the risk period, 46 patients had an ECG taken with 35% having one or more prolonged QTc ≥ 480 ms. The risk of QT prolongation had been noticed or mitigated for 23% of the 65 patients. 89% of the alerts were concluded to be clinically relevant. Conclusion: The management and documentation of QT-related risks could be improved. It is also important to further study QT-related risk factors to better assess which patients are at the highest risk.

<p>The opioid epidemic is an ongoing public health crisis in the United States (US). Although many treatment options exist for opioid use disorder (OUD), including evidence-based counseling, medications, rehabilitation programs, and support groups, access to care is a significant barrier. Pharmacists can play an important role in increasing patient access to OUD care; however, insufficient training is a well-documented barrier. Integrating comprehensive training into Doctor of Pharmacy coursework is a practical approach to preparing pharmacists to provide appropriate OUD care in a variety of practice settings. A shared OUD curriculum is one strategy to facilitate the integration of comprehensive training into Doctor of Pharmacy coursework.</p> <p><br></p> <p>My current research aimed to collect data from four key stakeholder groups – Doctor of Pharmacy program faculty, community pharmacists, multidisciplinary professionals, and patients experiencing OUD – to inform a shared OUD curriculum through a convergent, parallel, mixed methods study design. Specifically comprising this thesis are the quantitative findings from telephone surveys with Doctor of Pharmacy program faculty (“Study One”) and community pharmacists (“Study Two”); qualitative findings from multidisciplinary professional focus groups and patient interviews, as well as synthesized findings across quantitative and qualitative data sources, will be reported in future publications. Collectively, the results presented in this thesis provide a “snapshot” of the current pharmacy landscape with respect to the OUD education delivered to student pharmacists and opioid-related practices in community pharmacies.</p> <p><br></p> <p>The findings from Study One and Study Two indicate that OUD education in Doctor of Pharmacy programs and pharmacist-provided opioid interventions are inconsistent at best. The three main areas identified as needing future emphasis were: (1) the disease model of addiction and accompanying stigma of OUD; (2) harm reduction-, prescription-, screening-, and resource referral-related opioid interventions; and (3) skills-based, experiential education (vs. didactic education) for opioid intervention delivery and communication techniques. A shared OUD curriculum was of interest to faculty and is a viable solution to addressing OUD education gaps in Doctor of Pharmacy programs. Once qualitative data analyses are completed and findings from all four stakeholder groups are synthesized, development of the proposed shared OUD curriculum will commence.</p>

Abstract [en] Title: Discrepancies in medication lists at hospital wards identified by medication reconciliation Authors: Anderberg M. Institute: Uppsala University, Uppsala, Sweden Background and objective: An accurate medication list is essential for a correct assessment of a patient´s condition at hospitals. Previous studies have shown that patients in emergency departments often are affected by discrepancies in medication lists at hospital admission. Less research has been done regarding discrepancies after transferring patients to medical wards. The aim of this study was to identify discrepancies in the electronic medical record in hospital wards for patients admitted via the emergency department. Design: Observational study. Medication reconciliation was performed by a pharmacist shortly after the arrival of patients from the emergency department. This included a patient interview and the investigation of the patient’s medical record. The discrepancies identified at the wards were classified as either omitted drug, wrong dose, additional drug, incorrect frequency or duplicate therapy. Descriptive statistics were used and the proportion of medication lists with at least one discrepancy was presented with 95 % confidence interval. Setting: Three medical wards at Capio S:t Görans Hospital in Stockholm.  Main outcome measures: The proportion of medication lists with at least one discrepancy. The mean value of discrepancies among all patients. Classification and categorization of discrepancies regarding type and ATC index.  Results: In total, 63 patients were included with a mean age of 63 years. At least one discrepancy was identified in 43 % (95 % CI 31-55) of the medication lists. 52 discrepancies were found in total generating a mean value of 0,83 ± 1,17 discrepancies per medication list. The two most common categories were Omitted drug(33%) and Wrong dose(33%). The most frequent drug class associated with medication discrepancies was Drugs for obstructive airway diseases.  Conclusion: 43 % of the patients had at least one discrepancy in the medication list. This indicates the importance of medication reconciliations at medical wards even though the medication list has been updated at the emergency department.

Analysis of the Effect of Pharmacotherapy on the Risk of a Fall I. Author: Klára Šturcová1 Tutor: Josef Malý1 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Pague Introduction: Falls of hospitalized patients are one of the most common problems in health institutions. In terms of prevention of falls it is necessary to analyze all the factors that might have contributed to the emergence of a fall and subsequently minimize these risk factors. Objectives: The aim of the thesis was to analyze the possible drugs and other causes of falls of patients hospitalized in a certain rehabilitation institution. Methods: The data were collected from 21 March to 31 July 2014 in an institution providing rehabilitation care. The evaluated group consisted of patients who fell during the hospitalization in this period. The data about the fall, personal and drug anamnesis were transferred to an electronic form and subsequently evaluated by means of the frequency analysis, converted into graphs and tables and discussed. Results: 67 patients experienced 79 falls. Women experienced 53 % of falls; men experienced 47 % of falls. 87 % of the patients fell once, 9 % of the patients fell twice, 4 % of the patients fell three times. 58 % of all falls were experienced by...