Strategic opportunities for effective optimal prescribing and medication management.

Background: Canadians receive over 422 million prescriptions and spend over $26 billion annually on drugs. Yet, we do not systematically capture information on whether the right drugs reach the right people with the intended benefits, while avoiding unintended harm. It is important to identify and understand the effectiveness of approaches used to improve prescribing and medication use.

Effect of educational and policy interventions on institutional utilization of wet nebulization respiratory drugs and portable inhalers.

Background: Asthma and chronic obstructive pulmonary disease treatment guidelines support the preferential use of portable inhalers (PIs) over wet nebulization (WN) respiratory therapy. Hospital- and community-based educational initiatives and a community-based provincial drug program policy change were previously implemented to promote the conversion of WN therapy to PI and spacer device use in Nova Scotia.

Objective: To examine the effect of these interventions on salbutamol, ipratropium bromide, and spacer device (Aerochamber) use at the Queen Elizabeth II Health Sciences Centre (QEII HSC).

Medication persistence rates and factors associated with persistence in patients following stroke: a cohort study.

Background: Medication nonadherence can be as high as 50% and results in suboptimal patient outcomes. Stroke patients in particular can benefit from pharmacotherapy for thrombosis, hypertension, and dyslipidemia but are at high risk for medication nonpersistence.

Methods: Patients who were admitted to the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, with stroke between January 1, 2001 and December 31, 2002 were analyzed.

Systematic review of the use of patients' own medications in acute care institutions.

Background: Patients' own medications (POM) are medications that patients have obtained in the community setting and bring to the hospital when admitted. The practice of using POMs has not been well studied.

Objective: To identify benefits, risks and other impacts on the use of POM in hospitals.

The use of low-dose aprotinin, epsilon-aminocaproic acid or tranexamic acid for prevention of mediastinal bleeding in patients receiving aspirin before coronary artery bypass operations.

Patients undergoing primary myocardial revascularization were randomized to one of three drug regimens (low-dose aprotinin, epsilon-aminocaproic Acid or tranexamic Acid) to determine which drug regimen would most effectively reduce post-operative bleeding and the need for blood products. All patients had received 325 mg of aspirin within 48 h before operation. All three drug regimens reduced the requirements for blood products and postoperative bleeding after coronary artery bypass operations.