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Biomedical subjects

Stig Ejdrup Andersen

Publications and source records attributed to Stig Ejdrup Andersen.

14 recordsLinked to original sources
PubMed2006

[Drug dispensing errors].

INTRODUCTION: Most Danish hospitals have ward-based medication supply systems: frequently used drugs are stored in ward drug cupboards and dispensed by nursing staff. The objective of this study was to describe the frequency of dispensing errors and to identify risk factors. MATERIALS AND METHODS: Cross-sectional study conducted on five hospital wards. Random samples of dispensed drugs were compared to the written drug orders. RESULTS: In total, 619 (94.4%) of the 656 samples were dispensed correctly (95% CI 92.3 to 95.9%). Among 2360 opportunities for error (2336 dispensed plus 24 prescribed but not dispensed doses), 42 errors were detected, error rate 1.8% (95% CI 1.3 to 2.4%). 55% of all errors were omissions. Logistic regression analysis revealed that dispensing errors were associated with the scheduled administration time, the ward and the number of dispensed doses. Having one rather than two nurses dispensing and administering drugs did not affect the error rate. CONCLUSION: For each scheduled time, approximately 19 of 20 patients' drugs are correctly dispensed. Although the clinical significance of errors was not rated, the advantage of having one rather than two nurses dispensing and administering is dubious. Reducing poly-pharmacy, however, might reduce the error rate and this strategy should be tested in a prospective study. As a direct consequence of this study, emphasis will be placed on analysing and learning procedures from wards with low error rates.

Cross-Sectional Studies↗
PubMed2006

[Combination therapy with acetylsalicylic acid and non-aspirin nonsteroidal anti-inflammatory drugs].

Patients may require both low-dose aspirin (ASA) and a nonsteroidal anti-inflammatory drug (NSAID). This raises the questions of whether NSAIDs may inhibit the cardioprotective effects of low-dose ASA; whether the cardioprotective effect of low-dose ASA can be obtained by NSAIDs: and whether the combination of low-dose ASA and NSAIDs increases the risk of adverse effects. This review attempts to answer these questions.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2005

Drug-drug interactions among recently hospitalised patients--frequent but mostly clinically insignificant.

OBJECTIVE: Patients use and store considerable amounts of drugs. The aim of the present study was to identify potential drug-drug interactions between drugs used by patients recently discharged from the hospital and, subsequently, to estimate the clinical implications of these interactions. METHODS: Patients were visited within 1 week following their discharge from hospital and interviewed about their drug use. Stored products were inspected. We used a bibliography (Hansten and Horn; Wolters Kluwer Health, St. Louis, Mo., 2004) to identify and classify potential drug-drug interactions. RESULTS: In total, 83 surgical and 117 medical patients (n = 200) were included in the survey, of which 139 (70%) were women. The median age was 75 years (range: 24-100 years). Patients stored 2119 medications at home (median: nine per patient; range: 2-44) and used 1622 medications daily or on demand (median: eight per patient; range: 1-24). With respect to those drugs used daily or on demand, 476 potential interactions were identified (126 patients); none were class 1 (always avoid drug combination) and 25 were class 2 (usually avoid combination; 24 patients). Eleven of the potential class 2 interactions involved over-the-counter products (aspirin and ginkgo biloba). Of the 52 drugs involved in potential class 2 interactions, 50 had been used for more than 1 month. According to the hospital case notes, none of the potential class 2 interactions had actually caused adverse effects. CONCLUSION: Although potential drug-drug interactions are highly prevalent, serious and clinically significant interactions are rare among recently hospitalised patients.

Adolescent↗
PubMed2005

Disregarded use of herbal medical products and dietary supplements among surgical and medical patients as estimated by home inspection and interview.

PURPOSE: More and more patients use herbal medical products (HMP) and dietary supplements (DS). Due to the possibility of drug interactions and side effects, it is important that physicians are aware of the use. The aim of the present cross sectional survey was to analyse the consumption of HMP and DS among patients recently discharged from two hospital departments. METHODS: Patients were visited within 1 week after discharge and interviewed about their use of HMP and DS. Stored products were inspected and registered. Hospital files and discharge letters were examined to establish the frequency of registration. RESULTS: Totally, 83 surgical and 117 medical patients were included (n = 200), 139 patients (70%) were women. 53 patients (27%) stored no HMP or DS, whereas the home inventories of 147 patients (74%) comprised 343 products. 116 patients (58%) used HMP or DS daily and 25 patients (13%) used the products on demand. The most frequently used product was multivitamins (82 patients = 41%). Totally, 61% of the products were used on the patients' own initiative. In 3% of the used products, patients were aware of possible side effects. No patients were aware of possible drug interactions. Only 21% of the 211 HMP and DS used daily prior to admission were recorded in the hospital files. CONCLUSIONS: The use of HMP and DS was frequent among surgical and medical patients. The use was often not recorded in the hospital files and patients' knowledge of possible side effects and drug-interactions was minimal.

Aged↗
PubMed2004

The use of over-the-counter drugs among surgical and medical patients.

INTRODUCTION: An increasing number of drugs are sold directly to the consumers without a prescription from pharmacies and from non-pharmacies such as supermarkets and gas stations. AIM OF STUDY: To analyse the consumption of over-the-counter drugs (OTCs) among patients recently discharged from two hospital departments. Furthermore, to describe where the drugs had been bought and to which extent OTCs used prior to admission were recorded in the hospital files. METHOD: Patients were visited within 1 week after discharge and interviewed about OTC use. Home inventories were inspected. Hospital files and discharge letters were examined. RESULTS: In totally, 83 surgical and 117 medical patients were included (n=200). Whereas the home inventories of 187 patients comprised 587 OTCs, 13 patients (7%) stored no OTCs. Of the patients, 134 (67%) used OTCs daily and 132 patients (66%) used OTCs on demand; 79 patients (40%) stored a total of 157 OTCs not currently used. Analgesics were used by 138 patients (78%). Acetaminophen was the OTC used most frequently. Of the 240 OTCs used daily, 238 (99%) had been purchased from pharmacies and 169 (70%) had been prescribed. Of the 430 OTCs used daily or on demand, 348 (81%) had been recommended verbally or prescribed by health care professionals. Among the 206 OTCs used daily prior to admission, 162 (79%) were recorded in hospital files, whereas only 41 (24%) of 173 OTCs used on demand were recorded. CONCLUSION: Two of three surgical and medical patients use OTCs daily. Most OTCs are used with the consent of health care professionals and are purchased from pharmacies. Pre-admission OTC use is incompletely recorded in the hospital files. If information was systematically collected from pharmacies and general practitioners, the number of recall biases concerning OTC use in the medication histories may be reduced.

Adult↗
PubMed2003

[Drug costs in departments of internal medicine. An analysis of costs for patients and departments].

INTRODUCTION: The aim of the study was to compute the daily cost of drugs for patients admitted to internal medicine wards and to determine the impact of hospitalization on these costs. Secondly, the aim was to estimate the potential savings on ward drug expenses if the drug prescription was done in accordance with hospital recommendations. MATERIAL AND METHODS: A total of 113 patients from two general internal medicine wards were included consecutively. Drug information was obtained from the case records and through post-discharge telephone interviews. RESULTS: The patients' daily drug costs increased from admission to discharge by DKK 11.95 (95% CI: DKK 5.41-18.49), p = 0.0004. When prescriptions with explicitly determined end dates were excluded, no increment was observed. Post discharge interviews (n = 51) revealed that patients' daily drug costs were similar to the level at admission. The average ward drug expenses per admission were DKK 302.72 (95% CI: DKK 209.07-396.37). A total of 31% and 28% of the prescriptions could have been replaced by drugs in accordance with the hospital drug policy. The average potential amount which could be saved by using a consistent generic prescription was DDK 8.66 (95% CI: DKK 4.61-12.72) per admission. CONCLUSION: The patients' daily drug costs increased significantly from admission to discharge, but the cost increment did not exist one month after discharge. Although roughly one third of the prescriptions could have been substituted, the potential percentage saved only amounted to 2.9.

Adult↗
PubMed2002

[Drug handling in a legal perspective].

In the past few years much attention has been directed towards safety and quality in the dispensing and administration of drugs in hospitals. It has been necessary for the hospital clinics to implement procedures related to the handling of drugs. The present review outlines Danish laws and regulations on the dispensing and administration of drugs in hospitals, with special attention to specific groups of health professions. It includes recommendations on how to supplement the laws and regulations with local operating procedures.

Adverse Drug Reaction Reporting Systems↗
PubMed2002

[Implementation of a new prescription system. A qualitative survey of organizational barriers].

INTRODUCTION: The aim of this study was to identify organisational difficulties faced by physicians and nurses when using drug prescribing sheets for the recording of both drug prescriptions and drug administration. MATERIAL AND METHODS: Qualitative interviews with seven physicians and eight nurses from two general internal medicine wards. Main outcome measures were the difficulties explicitly identified during the interviews. RESULTS: The implementation of procedures conflicted with existing structure, culture, and routines. Insufficient competence within the system to use the drug prescribing sheets created resistance and made people create their own solutions to the problems they faced. A total of nine difficulties were identified: 1) insufficient knowledge and uncertainty about procedures, 2) ignorance of sources of error, 3) unclear responsibilities, 4) low community spirit, 5) insufficient communication, 6) clinician autonomy and low acceptance of change, 7) strong professional identity, 8) low priority task, and 9) logistic problems. DISCUSSION: Unawareness of procedures, insufficient dissemination of knowledge, and insufficient cooperation and skepticism among those who put drug handling into practice is likely to have an impact on the quality of health care. The identification of these obstacles may help managers to improve the quality of the drug handling process and make it possible to select a framework for changing the clinical behavior of doctors and nurses.

Communication Barriers↗