Developing indicators for medication-related readmissions based on a Delphi consensus study.

Background: Medication-related readmissions challenge healthcare systems by burdening patients, increasing costs and straining resources. However, to date, there has been no consensus study on indicators for medication-related readmissions.

Objectives: This Delphi study aimed to develop a consensus-based set of indicators for detecting patients at risk of medication-related readmission.

Development and retrospective evaluation of a clinical decision support system for the efficient detection of drug-related problems by clinical pharmacists.

Background: Clinical decision support systems (CDSS) can help identify drug-related problems (DRPs). However, the alert specificity remains variable. Defining more relevant alerts for detecting DRPs would improve CDSS.

Pharmaceutical Interventions on Hospital Discharge Prescriptions: Prospective Observational Study Highlighting Challenges for Community Pharmacists.

Background: Transition between hospital and ambulatory care is a delicate step involving several healthcare professionals and presenting a considerable risk of drug-related problems.

Objective: To investigate pharmaceutical interventions made on hospital discharge prescriptions by community pharmacists.

Method: This observational, prospective study took place in 14 community pharmacies around a Swiss acute care hospital.

External validation of the PAR-Risk Score to assess potentially avoidable hospital readmission risk in internal medicine patients.

Background: Readmission prediction models have been developed and validated for targeted in-hospital preventive interventions. We aimed to externally validate the Potentially Avoidable Readmission-Risk Score (PAR-Risk Score), a 12-items prediction model for internal medicine patients with a convenient scoring system, for our local patient cohort.

Methods: A cohort study using electronic health record data from the internal medicine ward of a Swiss tertiary teaching hospital was conducted.

Using risk analysis to ensure patients' medication safety during hospital relocations and evacuations.

Objectives: To ensure patient safety and the preparedness of medication processes during hospital relocations and evacuations by using Failure Modes, Effects, and Criticality Analysis (FMECA).

Methods: The relocation of six regional hospitals to a single building, resulting in 400 beds being moved, could be compared with an emergency evacuation. An FMECA was performed on the hospital group's internal medicine and intensive care units (IMU and ICU), examining how medication processes would be affected by a hospital relocation or evacuation.

Using risk analysis to anticipate and mitigate failures during a hospital pharmacy relocation.

Objectives: Documented experiences of relocating hospital pharmacies are rare, but adequate preparation is vital to ensuring smooth pharmacy operation and patient safety. In the autumn of 2019, the Pharmacy of Eastern Vaud Hospitals, composed of four units (Logistics, Manufacturing, Clinical Pharmacy, and Nursing Home Supply), was relocated to a new hospital in just a few days. In this context, a failure modes, effects and criticality analysis (FMECA) was carried out before the relocation in order to anticipate any failure modes likely to affect the pharmacy's missions or patient safety during the move.

Development of a predictive score for potentially avoidable hospital readmissions for general internal medicine patients.

Background: Identifying patients at high risk of hospital preventable readmission is an essential step towards selecting those who might benefit from specific transitional interventions.

Objective: Derive and validate a predictive risk score for potentially avoidable readmission (PAR) based on analysis of readmissions, with a focus on medication.

Design/setting/participants: Retrospective analysis of all hospital admissions to internal medicine wards between 2011 and 2014.

SIADH and water intoxication related to ecstasy.

Recreational drug use is a significant societal issue and remains a clinical challenge in emergency and critical care departments. We report on a 19-year-old woman admitted to hospital semiconscious and with severe hyponatraemia. Urinalysis was positive for methamphetamine and supported a diagnosis of hyponatraemia related to ecstasy use together with a syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Prescription of Sedative Drugs During Hospital Stay: A Swiss Prospective Study.

Background: In recent years, the number of prescriptions for sedative drugs has increased significantly, as has their long-term use. Moreover, sedative use is frequently initiated during hospital stays.

Objectives: This study aimed to describe new prescriptions of sedative drugs during hospital stays and evaluate their maintenance as discharge medication.

PIM-Check: development of an international prescription-screening checklist designed by a Delphi method for internal medicine patients.

Objectives: Potentially inappropriate medication (PIM) occurs frequently and is a well-known risk factor for adverse drug events, but its incidence is underestimated in internal medicine. The objective of this study was to develop an electronic prescription-screening checklist to assist residents and young healthcare professionals in PIM detection.

Design: Five-step study involving selection of medical domains, literature review and 17 semistructured interviews, a two-round Delphi survey, a forward/back-translation process and an electronic tool development.

[Hospital readmissions: current problems and perspectives].

Health systems in developed countries are facing the challenge of hospital readmissions, part of which can be considered avoidable. The transition between hospital stay and ambulatory care is a sensitive period in terms of continuity of care and patient safety, and its failure could lead to increased readmissions rate. Various measures have been proposed to reduce the risks associated with this transition, and the combination of various interventions undertaken at all stages of the care process, could reduce readmission rates.

Transition of care: A set of pharmaceutical interventions improves hospital discharge prescriptions from an internal medicine ward.

Background: Continuity of care between hospitals and community pharmacies needs to be improved to ensure medication safety. This study aimed to evaluate whether a set of pharmaceutical interventions to prepare hospital discharge facilitates the transition of care.

Methods: This study took place in the internal medicine ward and in surrounding community pharmacies.

First case of herpetic meningoencephalitis treated with ganciclovir.

Consensus treatment for herpetic meningoencephalitis is intravenous aciclovir but no guidelines are available for alternative treatment in case of renal failure induced by aciclovir. We report to the best of our knowledge, the first case of herpetic meningoencephalitis treated with success by ganciclovir.

Unintentional baclofen intoxication in the management of alcohol use disorder.

In recent years, there has been a growing interest in using baclofen for the management of alcohol use disorder. This off-label indication usually involves high doses of the medication. We report a case of severe baclofen overdose in a 66-year-old man.

[Distribution of antimicrobial guidelines: useful but not enough for an antibiotic stewardship].

Purpose: Evaluate the impact of distribution of antimicrobial guidelines (AG) on anti-infectious prescriptions (AIP) in patients presenting a bacteraemia. Cost evaluation of AIP with and without intervention of an infectious disease specialist.

Methods: The first evaluation of AIP was performed from January to May 2008 in Douai hospital, France, at day 4 after the initial blood sample using French guidelines (FG).

Clinical pharmacist's role in implementing a smoking cessation intervention in a Swiss regional hospital: an exploratory study.

Background: Smoking cessation represents one of the best means of preventing smoking-related complications. In recent years, a majority of hospitals have implemented smoke-free policies, making support for smoker patients a necessary and indispensable task. The clinical pharmacist is well-positioned to provide this kind of support, given a good understanding of the medical condition and pharmacotherapy of hospitalized patients and the possibility to acquire specific smoking cessation training.