Drug-related emergency department visits: external validation of an assessment tool in a general emergency department population.

Background: The process of identifying drug-related hospitalisations is subjective and time-consuming. Assessment tool for identifying hospital admissions related to medications (AT-HARM10) was developed to simplify and objectify this process. AT-HARM10 has not previously been externally validated, thus the predictive precision of the tool is uncertain.

Impact of systematic medication review in emergency department on patients' post-discharge outcomes-A randomized controlled clinical trial.

Introduction: The main objective of this study was to investigate whether systematic medication review conducted by clinical pharmacists can impact clinical outcomes and post-discharge outcomes for patients admitted to the emergency department.

Method: This parallel group, non-blinded, randomized controlled trial was conducted in the emergency department, Diakonhjemmet Hospital, Oslo, Norway. The study was registered in ClinicalTrials.

Effect of high-intensity exercise on cardiorespiratory fitness, cardiovascular disease risk and disease activity in patients with inflammatory joint disease: protocol for the ExeHeart randomised controlled trial.

Introduction: Inflammatory joint disease (IJD) is associated with increased risk of cardiovascular disease (CVD) fostered by systemic inflammation and a high prevalence of CVD risk factors. Cardiorespiratory fitness (CRF) is an important health parameter and CRF-measures are advocated in routine health evaluations. CRF associates with CVD risk, and exercise modalities such as high intensity interval training (HIIT) can increase CRF and mitigate CVD risk factors.

Drug-related emergency department visits: prevalence and risk factors.

The study aimed to investigate the prevalence of drug-related emergency department (ED) visits and associated risk factors. This retrospective cohort study was conducted in the ED, Diakonhjemmet Hospital, Oslo, Norway. From April 2017 to May 2018, 402 patients allocated to the intervention group in a randomized controlled trial were included in this sub-study.

Emergency department physicians' distribution of time in the fast paced-workflow-a novel time-motion study of drug-related activities.

Background In the emergency department physicians are forced to distribute their time to ensure that all admitted patients receive appropriate emergency care. Previous studies have raised concerns about medication discrepancies in patient's drug lists at admission to the emergency department. Thus, it is important to study how emergency department physicians distribute their time, to highlight where workflow redesign can be needed.

2020 EULAR points to consider for the prevention, screening, assessment and management of non-adherence to treatment in people with rheumatic and musculoskeletal diseases for use in clinical practice.

Background: Non-adherence to treatment could preclude reaching an optimal outcome. Thirty to 80% of patients with rheumatic and musculoskeletal diseases (RMDs) do not adhere to the agreed treatment.

Objectives: The objective was to establish points to consider (PtCs) for the prevention, screening, assessment and management of non-adherence to (non-)pharmacological treatments in people with RMDs.

Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews informing the 2020 EULAR points to consider.

Objective: To analyse how non-adherence to prescribed treatments might be prevented, screened, assessed and managed in people with rheumatic and musculoskeletal diseases (RMDs).

Methods: An overview of systematic reviews (SR) was performed in four bibliographic databases. Research questions focused on: (1) effective interventions or strategies, (2) associated factors, (3) impact of shared decision making and effective communication, (4) practical things to prevent non-adherence, (5) effect of non-adherence on outcome, (6) screening and assessment tools and (7) responsible healthcare providers.

Serum Concentrations and Elimination Rates of Direct-Acting Oral Anticoagulants (DOACs) in Older Hip Fracture Patients Hospitalized for Surgery: A Pilot Study.

Background: Use of direct-acting oral anticoagulants (DOACs) is increasing, but knowledge about pharmacokinetics and safety in frail patients is lacking.

Objective: The aim was to determine serum concentrations and elimination rates of DOACs in older hip fracture patients hospitalized for surgery.

Methods: The study included patients ≥ 65 years of age hospitalized for acute hip fracture surgery over a period of 6 months.

Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial.

Introduction: Drug-related problems (DRPs) are common in the elderly, leading to suboptimal therapy, hospitalisations and increased mortality. The integrated medicines management (IMM) model is a multifactorial interdisciplinary methodology aiming to optimise individual medication therapy throughout the hospital stay. IMM has been shown to reduce readmissions and drug-related hospital readmissions.

Drug safety at admission to emergency department: an innovative model for PRIOritizing patients for MEdication Reconciliation (PRIOMER).

Objective: This study aimed to develop an innovative prioritizing model for conducting medication reconciliation (MR) at a fast-paced workflow emergency department (ED) and to implement an efficient working model for MR.

Patients And Methods: A total of 276 patients were included at the ED, Diakonhjemmet Hospital, Norway, and medication discrepancies (MDs) between hospital admission records and information on prehospital medication use were recorded. Clinically relevant medication discrepancies (crMDs) were assessed by a multidisciplinary panel.

Should nurses or clinical pharmacists perform medication reconciliation? A randomized controlled trial.

Purpose: To study differences in outcomes of medication reconciliation (MR) when performed by clinical pharmacists compared to nurses.

Methods: 201 patients (21-92 years) admitted to the Department of Cardiology at the University Hospital of North Norway, autumn 2012, were randomized into a pharmacist group (PG) and a nurse group (NG). The nurses and the pharmacists were trained for performing the MR process by an independent clinical pharmacist.

Beliefs about medicines among Norwegian outpatients with chronic cardiovascular disease.

Objective: To investigate the beliefs of Norwegian outpatients about medicines, and to explore if some patient-specific factors and drug use are associated with the beliefs.

Methods: Patients from an outpatient clinic for chronic cardiovascular diseases were referred by physicians to a pharmacist-led medication outpatient clinic. Here the patients were asked to complete the Beliefs about Medicines Questionnaire.

Use of antibiotics in nursing homes--surveillance with different methods.

Background: Residents in nursing homes have a heightened risk of developing infections that should be treated with antibiotics. Inappropriate use of antibiotics may generate drug-related problems and increase resistance. In this study, we describe the use of antibiotics in nursing homes on the basis of prevalence surveys and drug sales statistics.

How are drug regimen changes during hospitalisation handled after discharge: a cohort study.

Objectives: To investigate drug regimen changes during hospitalisation and explore how these changes are handled after patients are transferred back into the care of their general practitioners (GPs).

Design: Cohort study.

Setting: Patients in this multicentre study had undergone at least one change in their drug regimens at discharge from the general medicine departments at six hospitals in Norway.

Multidisciplinary intervention to identify and resolve drug-related problems in Norwegian nursing homes.

Objective: To describe an innovative team intervention to identify and resolve DRPs (drug-related problems) in Norwegian nursing homes.

Design: Descriptive intervention study. Setting.

Evaluating categorisation and clinical relevance of drug-related problems in medication reviews.

Objectives: We aimed to evaluate the categorisation and clinical relevance of DRPs identified by community pharmacists, and further, to assess the quality of interventions with the patients and the physicians as documented by the pharmacists.

Setting: 23 Norwegian community pharmacies.

Method: Patients with type 2 diabetes were recruited by 24 community pharmacists who performed structured medication reviews based on the patients' drug profiles and patient interviews.

Drugs with narrow therapeutic index as indicators in the risk management of hospitalised patients.

Unlabelled: Drugs with narrow therapeutic index (NTI-drugs) are drugs with small differences between therapeutic and toxic doses. The pattern of drug-related problems (DRPs) associated with these drugs has not been explored.

Objective: To investigate how, and to what extent drugs, with a narrow therapeutic index (NTI-drugs), as compared with other drugs, relate to different types of drug-related problems (DRPs) in hospitalised patients.

Use of antirheumatic drugs in mothers and fathers before and during pregnancy-a population-based cohort study.

Purpose: Exploring the use of antirheumatic drugs in pregnant women and expectant fathers.

Methods: Population-based cohort study, based on linkage of two nationwide databases: the Norwegian Prescription Database was linked to data on 106 000 pregnancies during 2004-2006 from the Medical Birth Registry of Norway. Antirheumatic drugs dispensed to mothers 3 months prior to conception, during pregnancy, and up to 6 months after delivery, and prescriptions to fathers 3 months prior to conception were identified.

Risk of drug-related problems for various antibiotics in hospital: assessment by use of a novel method.

Purpose: To investigate the use of antibiotics in hospitals, to explore drug-related problems (DRPs) linked to antibiotics and to introduce a novel way of expressing the risks accompanying use of various antibiotics.

Methods: Patients from internal medicine departments in four Norwegian hospitals were prospectively included in 2002. Demographics, drugs used, medical history, laboratory data and clinical/pharmacological risk factors were recorded.

The impact of clinical pharmacists on drug-related problems and clinical outcomes.

Drug-related problems are frequent and may result in reduced quality of life, and even morbidity and mortality. Many studies have shown that clinical pharmacists can effectively identify and prevent clinically significant drug-related problems and that physicians acknowledge and act on the clinical pharmacist's suggestions for interventions to the drug-related problems. A pro-active rather than a reactive approach on the part of the pharmacists seems prudent for obtaining most benefit.

[Classification of drug-related problems].

Background: Drug-related problems are prevalent and cause considerable patient morbidity and in some cases death, as well as increased health care expenditures. A classification system may contribute to identify such problems, and further to resolve and prevent them.

Material And Methods: A draft classification was circulated to a panel of physicians and pharmacists and comments were requested.

Characteristics of drug-related problems discussed by hospital pharmacists in multidisciplinary teams.

Objective: To investigate pharmacist contribution in the therapeutic hospital team by studying drug-related problems (DRPs), pharmacist therapy advice and consequences of the advice.

Methods: From May to December 2002, 827 patients in five Norwegian hospitals were included in the study. Demographic data, drugs used, relevant medical history, laboratory data and clinical/pharmacological risk factors were recorded prospectively at the wards.

Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug-related problems.

Aim: To investigate whether polypharmacy defined as a definite number of drugs is a suitable indicator for describing the risk of occurrence of drug-related problems (DRPs) in a hospital setting.

Methods: Patients admitted to six internal medicine and two rheumatology departments in five hospitals were consecutively included and followed during the hospital stay, with particular attention to medication and DRPs. Comparisons were made between patients admitted with five or more drugs and with less than five drugs.

Use of renal risk drugs in hospitalized patients with impaired renal function--an underestimated problem?

Background: Inappropriate use of drugs in patients with renal impairment (RI) may be harmful and may have deleterious effects. We aimed to investigate the use of renal risk drugs in such patients in general hospitals and to analyse the relationship to demographic factors, risk factors and occurrence of drug-related problems (DRPs).

Methods: Patients admitted to departments of internal medicine and rheumatology in five general hospitals were included.

Interview of patients by pharmacists contributes significantly to the identification of drug-related problems (DRPs).

Purpose: To investigate whether pharmacist interviews of hospitalised patients about their medication would result in identification of more drug-related problems (DRPs) than those found by usual care procedures and further to characterise the DRPs revealed at the interviews.

Methods: Patients from five internal medicine and two rheumatology departments in four hospitals in Norway were prospectively included in the study. Clinical pharmacists assessed DRPs by reviewing medical records and by participating in multidisciplinary team discussions.