Pharmacy - Conference Items

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    Aspirin compared to enoxaparin or rivaroxaban for the prevention of VTE following hip and knee replacement–a retrospective cohort study in Ireland
    (University College Cork, 2019) Ní Cheallaigh, Sadhbh; Kehoe, E.; O'Connell, C.; Fleming, Aoife; Sahm, Laura J.
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    Quality Assurance of the APPEL (Affiliation for Pharmacy Practice Experiential Learning) Experiential Learning Placements in Ireland
    (2021-06-27) McCarthy, Ruth; Donovan, Maria; Morgan, Anne-Teresa; Reynolds, Róisín; Ní Sheachnasaigh, Eimear; Higher Education Authority
    Background: The delivery of the undergraduate pharmacy professional degree programme in Ireland changed in 2014 from a 4 + 1-year internship programme to a five-year integrated programme1. The new programme integrates experiential learning (EL) placements across the undergraduate programme2. APPEL (Affiliation for Pharmacy Practice Experiential Learning) manages the EL placements of the integrated pharmacy programmes of the three Schools of Pharmacy in Ireland. APPEL is a unique collaboration between University College Cork (UCC), the Royal College of Surgeons in Ireland (RCSI), and Trinity College Dublin (Trinity). APPEL provides a single point of contact for Trainers, Training Establishments, and students for all EL placement activities. This programme has been accredited by the regulatory body for Irish pharmacy the Pharmaceutical Society of Ireland (PSI). Aim: The aim of this talk to share the learnings and quality assurance processes of the APPEL EL placement programme. Discussion: This talk links to sub-theme two of the conference, ‘Things that help us in our journey’, linking to the experiential entry point to learning and learning in partnership. We will discuss the policies, processes and review mechanisms used by APPEL to deliver a quality assured EL placement programme in a single unified manner across the three schools of pharmacy in the state. The role of Practice Educators, academics and students in the evolution and delivery of the programme. The on-going improvement mechanisms and vision for the programme in its central role within the Irish undergraduate professional degree programme.
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    The potential contribution of medicines to falls in older persons and the acceptance of pharmacist intervention
    (Wiley, 2020-03) Richardson, M.; O'Dwyer, C.; Gaskin, J.; Conyard, E.; Murphy, Kevin D.
    Introduction: Falls in older patients (≥65 years) is a growing burden on healthcare resources globally. Falls in older persons are responsible for 10–15% of presentations to acute hospitals and are the cause of > 50% of injury‐related hospitalisations in older persons1. Medicines are a modifiable risk factor for falls and the risk varies by class of medicine. Common medicine classes classified as Falls Risk Increasing Drugs (FRIDs) include antihypertensive agents, benzodiazepines, antidepressants, and neuroleptics2. The consequences of a fall can persist after discharge; patients have reported a reduction in quality of life up to 9 months after a fall and the fear of further falls has been associated with decreased physical activity. Aim: The aim of this study was to examine FRID use in older persons presenting with falls at Our Lady of Lourdes Hospital Drogheda (OLOL) in the Republic of Ireland, and the acceptance of a clinical pharmacist (CP) intervention in reducing FRIDs in this cohort. Methods: The study was conducted over a 6‐week period between June 1st and July 13th 2018 at OLOL in the Republic of Ireland. Consent was sought from patients who were ≥ 65 years, presented to the hospital with an acute fall or with injuries sustained due to an acute fall. Data collection involved patient demographics, admission details, reconciled medication list, and relevant patient observations and laboratory results. The CP provided written or oral medicines’ recommendations to physicians, and patient file was examined between July 16th and 20th to review uptake of the CP recommendations. Analysis was in the form of the extent of implementation of CP recommendations and review of polypharmacy. Results: There were 53 patients who took part in the study. There were slightly more females (52.8%) and the mean age was 81 ± 6.7 years. Most patients had had a previous fall (66.0%), with the majority having > 5 previous falls (52.8%). Fractures were reported by 39.6% with hip fractures being the most common type of fracture (11/53, 20.8%). The median number of medicines was 7 (IQR: 5–10.25). The median number of FRIDs was 2 (IQR: 1–3), with antihypertensives accounting for 73.0% (92/126) of FRIDs. The CP made 36 recommendations regarding 26 patients. Less than half (41.7%) of the CP recommendations were implemented. The most common drug classes with recommendations implemented were antihypertensives (19) and benzodiazepines (7). These were also the classes with the highest acceptance rate, with 57.9% of recommendations regarding antihypertensives (11/19) being accepted and 71.4% of recommendations for benzodiazepines being accepted (5/7). Conclusions: CPs have a role to play in highlighting the prescribing of FRIDs and in the reduction of the number of FRIDs taken by older persons with a history of falls. Reducing the number of falls will help older patients maintain their quality of life and reduce the number of acute hospital admissions in a stretched healthcare system.
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    Dispensing error and near miss recording in Irish community pharmacies
    (Wiley, 2020-03) Martin, S.; Murphy, Kevin D.
    Background: Community pharmacies in the Republic of Ireland are required to have a clear and documented system for the management, review and recording of dispensing errors (DEs) and near misses (NMs). Despite this, only 66% of pharmacies inspected in Ireland maintained error or incident logs in 2016 [1]. DEs causing serious patient harm are infrequent; however, their consequences, including death, can be devastating [2]. Aims: To assess the reporting incidence of DEs and NMs in community pharmacies in the Republic of Ireland, and compliance with national guidelines on their management. Method: An invitation was sent to all community pharmacies in Ireland (n = 1,688) to participate in an anonymous, proforma, online survey using LimeSurvey. Data collected include general pharmacy information, data on DEs recorded, data on NMs recorded, and data on compliance with recording DEs and NMs over the period 1/1/2019‐30/6/2019. A DE was defined as an any error detected after the medication had been given to the patient or their representative. An NMs was defined as any error that was detected before the patient or patient's representative was handed the dispensed prescription. Results: One hundred and twenty‐four (7.3%) full or partial responses were received. Independent pharmacies accounted for 52.2% of respondents. 1/96 (0.7%) of pharmacies reported not recording DEs or NMs, while 2/124 (1.5%) pharmacies did not have a Standard Operating Procedure for recording DEs and NMs. Most pharmacies (83/96, 86.6%) manually recorded their DEs and NMs and approximately 2‐in‐3 (69/95, 72.6%) pharmacies reported regularly reviewing DEs and NMs. The mean self‐reported DE rate was 0.035% while the mean NM rate was 0.135%. The mean ratio of NMs to DEs was 4.7:1. A correlation was observed between the number of items dispensed and the rate of DEs (r = −0.354, p = 0.002). The top three recorded DEs were incorrect strength (32.1%), incorrect drug (16.7%), and incorrect quantity (13.5%). The top three recorded causes were picking errors (28.0%), similar packaging (16.6%), and similar drug names (14.5%). Pharmacies rated themselves as less compliant in recording NMs (mean: 5.3 on a 10‐point scale) than DEs (mean: 7.5/10). Conclusion: Dispensing errors and near misses in Irish community pharmacies get reported at a similar rate than in other countries. A nationwide reporting program, similar to the ones used in other countries, such as England, Wales, New Zealand, and Sweden, could improve reporting rates, make data analysis easier, and allow pharmacists to learn from their own and others' mistakes, thereby preventing dispensing errors from happening and improving patient outcomes.
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    Perceived stress experienced by undergraduate healthcare professional students throughout their degree
    (2020-02-13) Casey, Rachel; O'Doherty, Julia; Murphy, Kevin D.; Sahm, Laura J.
    Rationale: Stress can be a part of third level education and experienced by undergraduate students across a range of degree courses. Stress can be positive in stimulating optimum performance. However, excessive stress leads to distress which is correlated with decreased health related quality of life (1). The aim of this research study is to investigate the causes of stress among undergraduate healthcare professional students in University College Cork (UCC) and to characterise the nature of the stress factors. Methods: All undergraduate students (excluding 1st year students) enrolled in degree courses in the College of Medicine and Health in UCC (Dentistry, Medicine, Nursing and Midwifery (NM), Occupational Therapy (OT), Pharmacy, Public Health Sciences, and Speech and Language Therapy (SLT)) were sent an email inviting them to participate in an anonymous online survey. The survey comprised two parts: (i) the Perceived Stress Scale (PSS) (2), which measures the perception of stress on a scale between 0 and 40, and (ii) a customised Academic Stress Factors survey, in which students gave a rating between 1 (little) and 5 (extreme) of how much stress each factor caused. Data were analysed using IBM SPSS Statistics for Windows, Version 26.0. (Armonk, NY: IBM Corporation). Findings: Of the 227 responses received (88.1% female); the majority were from NM students (46; 20.3%) while both OT and SLT had the fewest at 15 (6.6%) responses each. The mean PSS score for the total cohort was 21.3 with medical students reporting the highest mean score (24.5), signifying higher perceived stress and OT having the lowest mean score (19.0). The distribution of PSS scores did not vary significantly across degree courses, (F=1.555, p=0.162) gender, (t=-1.241, p=0.216) or year of study (F=0.210, p=0.811). ‘End of module examinations’, ‘overall academic workload’, and ‘oral presentations’ were the reasons associated with the highest average scores for causing stress. Conclusion: Stress affects students from all healthcare degree courses within the College of Medicines and Health. This study has identified the areas that seem to contribute most to the perceived stress experienced by students and therefore may signpost where UCC can act to support students.