Should Theu.s. Institute A National Essential Medicine List? Describe Advantage?

Byerly, W. (2009). Working with the institutional review board. American Journal of Health-System Pharmacy: AJHP: Official Journal Of The American Society Of Health System Pharmacists, 66(2), 176-184. Retrieved from http://library.kaplan.edu/content.php?pid=150035

It is composed of actively practicing physicians, other prescribers, pharmacists, nurses, administrators, quality improvement managers, and other health care professionals and staff who participate in the medication-use process. The P&T committee should be responsible for overseeing policies and procedures related to all aspects of medication use within an institution. The P&T committee is responsible to the medical staff as a whole, and its recommendations are subject to approval by the organized medical staff as well as the administrative approval process. The P&T committee’s organization and authority should be outlined in the organization’s medical staff bylaws, medical staff rules and regulations, and other organizational policies as appropriate. Other responsibilities of the P&T committee include medication-use evaluation (MUE), adverse-drug-event monitoring and reporting, medication-error prevention, and development of clinical care plans and guidelines. The hospital’s internal policies follow all national standards for how the P&T committee should

However, changing perceptions of prescribers and consumers will be necessary to launch the initiative. The education of providers regarding the therapeutic equivalent and efficacy of generic medications are therapeutic substitutes is very important—prescribers will be the driving force behind adoption of generics over brand-name drugs. The use of e-prescribing provides information regarding cost, formularies and available generics at the fingertips of providers (United States Department of Health and Human Services, 2010).

Inappropriate prescribing commonly occurs in adults aged 65 or older, who have a higher prevalence of chronic disease, disability, and dependency (Page II, Linnebur, Bryant, & Ruscin, 2010). Exposure to inappropriate medications is associated with increased morbidity, mortality, and health care utilization (Page II, Linnebur, Bryant, & Ruscin, 2010). Below is a list of measures that concentrate on the prescribing of correct medications in the hospital

Often, veteran’s may present as a walk-in with various complaints such as swelling of the extremities, medication renewals, blood pressure issues, or dialysis access problems. As the renal nurse, I am able to triage and document my assessment, including vital signs, and then communicate it to the nephrologist for further recommendations. Medication compliance is a big issue seen in the renal clinic. For example, all veterans are asked to bring in all medication bottles to their visit. As a kidney disease patient, there are always a fluctuation in the patient’s lab values, which may result in change in their medications. One concern that is found for example, a veteran was told by the nephrologist to increase his blood pressure medication from 25 mgs to 50 mgs. That veteran then is to follow up in the renal nurse clinic 4 weeks later for blood pressure monitoring, and bring in all medication bottles to that visit. Upon returning to renal nurse clinic appointment, it is noted that the veteran’s blood pressures are still elevated and the medication request to increase to 50 mg, had not been

The sixth Community Pharmacy Agreement,6CPA (2015 – 2020) takes effect from I July 2015. In 6CPA, an increase in the total funding has been allocated to community pharmacy. One of the continuing community pharmacy programs from 5CPA is the medication management programs which support quality use of medication (QUM) services to reduce adverse medicine events and associated hospital admissions or medical presentations. Three individual programs under this program sections are home medicines review(HMR), residential medication management review (RMMR) and QUM and Medscheck and Diabetes Medscheck. The medication management programs aim to identify, prevent and resolve actual and potential problems related to drugs, optimise pharmacotherapy and

The need for evolving guidelines has stemmed from groundbreaking research on the topic of hypertension and antihypertensive medications. In the last two decades, there has been a change

Prescription drugs in the competitive market offers a starting point allusion, which certain characteristics of medications and healthcare goods and services can be compared to unique goods and services. According to Carter, A, Pharm D Healthline.com say’s “By not taking care of your diabetes may damage your heart, kidneys, nervous system, and your eyes”. Such as, eating foods with a high content of sugar will extremely increase your blood sugar, or not taking medication to treat diabetes. He also states “metformin may need to be used with other medications to help regulate your blood sugar. Some patients with type 2 diabetes may have complications with hypertension as well. This leads us into an example of many prescription drugs to treat diseases. Such as, diabetes, and hypertension. According to Younossi, Z. M., et.al. (2013).authors of Alimentary Pharmacology & Therapeutics, wrote “Explanations for metabolic situations that have been used in the study have been formerly described. Briefly, type 2 diabetes was determined as fasting blood sugar level that is greater than 125 mg/dL , and hypertension was determined as blood pressure level that is greater than 140/90 mmHg .” With this being said the supply and demand of medications to treat diabetes and hypertension depends on the prescribing doctor and the incentives provided by the pharmaceutical company.

When reviewing the medication administration practices, it is important to evaluate it through an evidence-based lens. According to the College of Nurses of Ontario (CNO, 2015), nurses need to “ensure that their medication practices are evidence-informed” (p. 3). Thus, it is crucial for those examining the MAP to review the various evidence-informed healthcare journals that outline the importance of and methods associated with proper administration, which will thereby allow for a comparison of evidence-informed practice with a

One of the most important factors before taking steps is ensuring that the patient is part of the process. One of the strategies that a health care provider can do is assess the therapeutic and overall care goals, which means reviewing medications. The therapeutic goals should fit into the overall care goal. The choice of drug, formulation, and dosage should reflect this goal (Oboh, 2013). The second strategy is about gathering information. This intervention shows the provider drugs that may not be taken as prescribed and possible reason for therapeutic failure. This is the time to check that each drug is still relevant to the patient’s condition. It is also important to ask about perceived and actual harm or benefit of the drug (Oboh, 2013). There are several tools that can be used to identify potential polypharmacy in older people. The two most commonly used tools in Canada are known as the Beers and STOPP criteria. Beers are a list of medications that are divided into three classes allowing providers to see medications to be avoided regardless of the disease, medications considered inappropriate when used in patients with certain diseases, and medications used with caution (Kwan & Farrell, 2014). STOPP on the other hand, are clinically significant criteria for inappropriate prescribing, grouped by physiological system including clinical context and stopping rules (Kwan & Farrell, 2014). According to Kwan & Farrell, “using these criteria does not replace the need for clinical judgments and understanding of a patients values and needs; sometimes potentially inappropriate medications (PIMs) might be appropriate if the benefit outweigh the benefits (2014)” The last strategy that can be use is discontinuing unnecessary drugs. The decision on which drugs should remain or be discontinued is based on the risk associated with discontinuing the drug, available guidance, and

In addition to, reviewing the medication regime, including all over-the-counter medications during every face to face encounter. There is time set aside to discuss what the medications are, why they are taking them and how the are taken. the importance of carrying an up to date medication list with you at all times is also discussed as a safety moment. Upon discharge from each clinic visit, every patient is given a detailed written summary of diagnosis, treatment plan, medications and an allergy list.

 I, personally am not a fan of pharmaceuticals unless it is life-saving. I avoid taking medication at all cost. Unless it is a last resort, meaning before a doctor visit or ER visit. I also avoid medical services, partly because of insurance coverage. Alternative and complementary medicine is also starting to develop a bigger audience now because, of so many celebrities and talk show doctors presenting it. It is disappointing that we look for guidance from these people to promote and bring awareness to other medical options, which our government and doctors are neglecting to

According to the CDC (Centers for Disease Control and Prevention, 2015), “Chronic diseases and conditions such as heart disease, stroke, cancer, diabetes, obesity, and arthritis are among the most common, costly, and preventable of all health problems.” Those diseases cannot be cured by hospital medications alone. For example, if my physician

Drug List", similar to the "Essential Medicine List" in China, which plays active role in controlling drug

INR values, ventricular ejection fraction, body mass index) were not included in the dataset, clinical determinants such as CHA2DS2VASC and CCI helped to control for disease severity by considering hypertension, prior cardiovascular disease, diabetes and other co-morbidities. Furthermore, adherence assessment based on 3, 6, 9, and 12 month windows might lead to truncation of the data, therefore the windows were kept close at every 3 months. It is also important to understand dosing of warfarin is variable and frequently adjusted. We also looked at the distribution of days of supply to explore a potential bias. The distribution of the days of supply for warfarin and NOAC was primarily around 30 and 60 day dosing which substantiated that the therapies might be comparable. Prior use of anti-hypertensive drugs was also accounted and selection of the drugs was based on recommended AF therapy by American Heart Association.(AHA). These drugs were also used as covariates to understand the individual effects in the dabigatran and rivaroxaban pivotal trials. However, aspirin use was not comprehensively captured in claims database due to its availability as OTC drug. Differences in the descriptive charaterstics might be explained by the fact that NOACs might be prescribed to patients who have unmet need after warfarin therapy, this might lead to potential channeling or selection bias, in our study we did not control the selection bias using propensity