Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study
Autoři:
Sue Jordan aff001; Timothy Banner aff001; Marie Gabe-Walters aff003; Jane M. Mikhail aff001; Gerwyn Panes aff001; Jeff Round aff004; Sherrill Snelgrove aff001; Mel Storey aff001; David Hughes aff001;
Působiště autorů:
College of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom
aff001; Cardiff and Vale University Health Board, Wales, United Kingdom
aff002; Swansea Bay University Health Board, Wales, United Kingdom
aff003; Institute of Health Economics, Edmonton, Alberta, Canada
aff004; Hywel Dda University Health Board, Wales, United Kingdom
aff005
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0220885
Souhrn
Introduction
Preventable adverse effects of medicines often pass unnoticed, but lead to real harm.
Intervention
Nurse-led monitoring using the structured Adverse Drug Reaction (ADRe) Profile identifies and addresses adverse effects of mental health medicines.
Objectives
This study investigated the implementation and clinical impact of ADRe, and barriers to and facilitators of sustained utilisation in routine practice.
Methods
Administration of ADRe was observed for 30 residents prescribed mental health medicines in ten care homes. The study pharmacist reviewed completed ADRes against medication records. Policy context was explored in 30 interviews with service users, nurse managers and strategic leads in Wales.
Results
Residents were aged 60–95, and prescribed 1–17 (median 9 [interquartile range (IQR) 7–13]) medicines. ADRe identified a median of 18 [IQR 11.5–23] problems per resident and nurses made 2 [1–2] changes to care per resident. For example: falls were reported for 9 residents, and care was modified for 5; pain was identified in 8 residents, and alleviated for 7; all 6 residents recognised as dyspnoeic were referred to prescribers. Nurses referred 17 of 30 residents to prescribers. Pharmacists recommended review for all 30. Doubts about administering ADRe, sometimes expressed by people who had not yet used it, diminished as it became familiar. ADRe was needed to bridge communication between resident, nurses and prescribers. When barriers of time, complacency, and doctors’ non-availability were overcome, reporting with ADRe made prescribers more likely to heed nurses’ concerns regarding residents’ welfare. Clinical gains were facilitated by one-to-one time, staff-resident relationships, and unification of documentation.
Implications
To our knowledge, ADRe is the only instrument that brings a full account of patients’ problems to medication reviews. This juxtaposition of signs and symptoms against prescriptions facilitates dose adjustments and de-prescribing and leads to: reduced pain and sedation; early identification of problems linked to ADRs, such as falls; and timely medication reviews e.g. for dyspnoea.
Klíčová slova:
People and places – Population groupings – Professions – Medical personnel – Pharmacists – Medicine and health sciences – Health care – Health care providers – Nurses – Medical doctors – Mental health and psychiatry – Pharmacology – Drugs – Antipsychotics – Adverse reactions – Neurology – Sleep disorders – Dyssomnias – Insomnia
Zdroje
1. Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ. 2004;329(7456):15–9. Epub 2004/07/03. doi: 10.1136/bmj.329.7456.15 15231615.
2. National Institute for Health and Care Excellence. Medicines optimisation:the safe and effective use of medicines to enable the best possible outcomes. NICE guideline 5 2015 [Accessed 07 April 2019]. https://www.nice.org.uk/guidance/ng5/evidence/full-guideline-6775454.
3. Kongkaew C, Noyce PR, Ashcroft DM. Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Ann Pharmacother. 2008;42(7):1017–25. Epub 2008/07/03. doi: 10.1345/aph.1L037 18594048.
4. Oscanoa TJ, Lizaraso F, Carvajal A. Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis. Eur J Clin Pharmacol. 2017;73(6):759–70. Epub 2017/03/03. doi: 10.1007/s00228-017-2225-3 28251277.
5. Parameswaran Nair N, Chalmers L, Connolly M, Bereznicki BJ, Peterson GM, Curtain C, et al. Prediction of Hospitalization due to Adverse Drug Reactions in Elderly Community-Dwelling Patients (The PADR-EC Score). PLoS One. 2016;11(10):e0165757. Epub 2016/11/01. doi: 10.1371/journal.pone.0165757 27798708.
6. Frontier Economic. Exploring the costs of unsafe care in the NHS: a report prepared for The Department of Health 2014 [Accessed 07 April 2019]. https://www.frontier-economics.com/media/2459/exploring-the-costs-of-unsafe-care-in-the-nhs-frontier-report-2-2-2-2.pdf.
7. Alhawassi TM, Krass I, Bajorek BV, Pont LG. A systematic review of the prevalence and risk factors for adverse drug reactions in the elderly in the acute care setting. Clin Interv Aging. 2014;9:2079–86. Epub 2014/12/10. doi: 10.2147/CIA.S71178 25489239.
8. Roulet L, Ballereau F, Hardouin JB, Chiffoleau A, Potel G, Asseray N. Adverse drug event nonrecognition in emergency departments: an exploratory study on factors related to patients and drugs. J Emerg Med. 2014;46(6):857–64. Epub 2014/02/26. doi: 10.1016/j.jemermed.2013.11.124 24565882.
9. Walter SR, Day RO, Gallego B, Westbrook JI. The impact of serious adverse drug reactions: a population-based study of a decade of hospital admissions in New South Wales, Australia. British journal of clinical pharmacology. 2017;83(2):416–26. Epub 2016/09/11. doi: 10.1111/bcp.13124 27614089.
10. El Morabet N, Uitvlugt EB, van den Bemt BJF, van den Bemt PMLA, Janssen MJA, Karapinar-Çarkit F. Prevalence and Preventability of Drug-Related Hospital Readmissions: A Systematic Review. Journal of the American Geriatrics Society. 2018;66(3):602–8. doi: 10.1111/jgs.15244 29468640
11. Du Y, Wolf IK, Busch MA, Knopf H. Associations between the use of specific psychotropic drugs and all-cause mortality among older adults in Germany: Results of the mortality follow-up of the German National Health Interview and Examination Survey 1998. PLoS One. 2019;14(1):e0210695. Epub 2019/01/15. doi: 10.1371/journal.pone.0210695 30640945.
12. Avery AJ, Bell BG. Rationalising medications through deprescribing. BMJ. 2019;364:l570. Epub 2019/02/09. doi: 10.1136/bmj.l570 30733211.
13. Hakkarainen KM, Andersson Sundell K, Petzold M, Hagg S. Prevalence and perceived preventability of self-reported adverse drug events—a population-based survey of 7099 adults. PLoS One. 2013;8(9):e73166. Epub 2013/09/12. doi: 10.1371/journal.pone.0073166 24023828.
14. Gabe ME, Davies GA, Murphy F, Davies M, Johnstone L, Jordan S. Adverse drug reactions: treatment burdens and nurse-led medication monitoring. Journal of Nursing Management. 2011;19(3):377–92. doi: 10.1111/j.1365-2834.2011.01204.x 21507109
15. Brenner S, Detz A, Lopez A, Horton C, Sarkar U. Signal and noise: applying a laboratory trigger tool to identify adverse drug events among primary care patients. BMJ Qual Saf. 2012;21(8):670–5. Epub 2012/05/26. doi: 10.1136/bmjqs-2011-000643 22626736.
16. Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. Adverse drug events occurring following hospital discharge. J Gen Intern Med. 2005;20(4):317–23. Epub 2005/04/29. doi: 10.1111/j.1525-1497.2005.30390.x 15857487.
17. Gurwitz JH, Field TS, Judge J, Rochon P, Harrold LR, Cadoret C, et al. The incidence of adverse drug events in two large academic long-term care facilities. Am J Med. 2005;118(3):251–8. Epub 2005/03/05. doi: 10.1016/j.amjmed.2004.09.018 15745723.
18. Steinman MA, Handler SM, Gurwitz JH, Schiff GD, Covinsky KE. Beyond the prescription: medication monitoring and adverse drug events in older adults. J Am Geriatr Soc. 2011;59(8):1513–20. Epub 2011/07/30. doi: 10.1111/j.1532-5415.2011.03500.x 21797831.
19. Gandhi TK, Seger AC, Overhage JM, Murray MD, Hope C, Fiskio J, et al. Outpatient adverse drug events identified by screening electronic health records. J Patient Saf. 2010;6(2):91–6. Epub 2010/06/01. doi: 10.1097/PTS.0b013e3181dcae06 22130350.
20. Medicines Management G. ADRE—THE ADVERSE DRUG REACTION PROFILE Swansea: Swansea University; [Accessed 7 April 2019]. http://www.swansea.ac.uk/adre/
21. Jordan S, Banner T, Gabe-Walters M, Mikhail JM, Round J, Snelgrove S, et al. Nurse-led medicines’ monitoring in care homes study protocol: a process evaluation of the impact and sustainability of the adverse drug reaction (ADRe) profile for mental health medicines. BMJ Open. 2018;8(9):e023377. Epub 2018/10/01. doi: 10.1136/bmjopen-2018-023377 30269073.
22. Jordan S, Logan PA, Panes G, Vaismoradi M, Hughes D. Adverse Drug Reactions, Power, Harm Reduction, Regulation and the ADRe Profiles. Pharmacy (Basel). 2018;6(3). Epub 2018/09/21. doi: 10.3390/pharmacy6030102 30231573.
23. Jordan S, Gabe M, Newson L, Snelgrove S, Panes G, Picek A, et al. Medication monitoring for people with dementia in care homes: the feasibility and clinical impact of nurse-led monitoring. Scientific World Journal. 2014:843621. Epub 2014/04/08. doi: 10.1155/2014/843621 24707218.
24. Jordan S, Gabe-Walters ME, Watkins A, Humphreys I, Newson L, Snelgrove S, et al. Nurse-Led Medicines’ Monitoring for Patients with Dementia in Care Homes: A Pragmatic Cohort Stepped Wedge Cluster Randomised Trial. PLoS One. 2015;10(10):e0140203. Epub 2015/10/16. doi: 10.1371/journal.pone.0140203 26461064.
25. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. Bmj. 2015;350:h1258. Epub 2015/03/21. doi: 10.1136/bmj.h1258 25791983.
26. Willis CD, Saul J, Bevan H, Scheirer MA, Best A, Greenhalgh T, et al. Sustaining organizational culture change in health systems. J Health Organ Manag. 2016;30(1):2–30. Epub 2016/03/12. doi: 10.1108/JHOM-07-2014-0117 26964847.
27. Information Commissioners Office. Anonymisation: managing data protection risk code of practice Cheshire: ICO; 2012 [Accessed 07 April 2019]. https://ico.org.uk/media/1061/anonymisation-code.pdf.
28. Glaser B, Strauss A. The Discovery of Grounded Theory. Chicago: Aldine; 1967.
29. Siafis S, Papazisis G. Detecting a potential safety signal of antidepressants and type 2 diabetes: a pharmacovigilance-pharmacodynamic study. British journal of clinical pharmacology. 2018;84(10):2405–14. Epub 2018/06/29. doi: 10.1111/bcp.13699 29953643.
30. Ble A, Hughes PM, Delgado J, Masoli JA, Bowman K, Zirk-Sadowski J, et al. Safety and Effectiveness of Statins for Prevention of Recurrent Myocardial Infarction in 12 156 Typical Older Patients: A Quasi-Experimental Study. J Gerontol A Biol Sci Med Sci. 2017;72(2):243–50. Epub 2016/05/06. doi: 10.1093/gerona/glw082 27146371.
31. Alldred DP, Kennedy MC, Hughes C, Chen TF, Miller P. Interventions to optimise prescribing for older people in care homes. The Cochrane database of systematic reviews. 2016;2:CD009095. Epub 2016/02/13. doi: 10.1002/14651858.CD009095.pub3 26866421.
32. Page AT, Clifford RM, Potter K, Schwartz D, Etherton-Beer CD. The feasibility and effect of deprescribing in older adults on mortality and health: a systematic review and meta-analysis. British journal of clinical pharmacology. 2016;82(3):583–623. Epub 2016/04/15. doi: 10.1111/bcp.12975 27077231.
33. Johansson T, Abuzahra ME, Keller S, Mann E, Faller B, Sommerauer C, et al. Impact of strategies to reduce polypharmacy on clinically relevant endpoints: a systematic review and meta-analysis. British journal of clinical pharmacology. 2016;82(2):532–48. Epub 2016/04/10. doi: 10.1111/bcp.12959 27059768.
34. Rankin A, Cadogan CA, Patterson SM, Kerse N, Cardwell CR, Bradley MC, et al. Interventions to improve the appropriate use of polypharmacy for older people. The Cochrane database of systematic reviews. 2018;9:CD008165. Epub 2018/09/04. doi: 10.1002/14651858.CD008165.pub4 30175841.
35. Vancampfort D, Firth J, Correll CU, Solmi M, Siskind D, De Hert M, et al. The impact of pharmacological and non-pharmacological interventions to improve physical health outcomes in people with schizophrenia: a meta-review of meta-analyses of randomized controlled trials. World Psychiatry. 2019;18(1):53–66. Epub 2019/01/03. doi: 10.1002/wps.20614 30600626.
36. Ballard C, Orrell M, Sun Y, Moniz-Cook E, Stafford J, Whitaker R, et al. Impact of antipsychotic review and non-pharmacological intervention on health-related quality of life in people with dementia living in care homes: WHELD-a factorial cluster randomised controlled trial. Int J Geriatr Psychiatry. 2016. Epub 2016/09/20. doi: 10.1002/gps.4572 27640872.
37. Desveaux L, Saragosa M, Rogers J, Bevan L, Loshak H, Moser A, et al. Improving the appropriateness of antipsychotic prescribing in nursing homes: a mixed-methods process evaluation of an academic detailing intervention. Implement Sci. 2017;12(1):71. Epub 2017/05/28. doi: 10.1186/s13012-017-0602-z 28549480.
38. Mestres Gonzalvo C, Milosevic V, van Oijen BPC, de Wit H, Hurkens K, Mulder WJ, et al. The use of an electronic clinical rule to discontinue chronically used benzodiazepines and related Z drugs. Eur J Clin Pharmacol. 2018;74(2):227–31. Epub 2017/11/12. doi: 10.1007/s00228-017-2369-1 29127459.
39. Westbury JL, Gee P, Ling T, Brown DT, Franks KH, Bindoff I, et al. RedUSe: reducing antipsychotic and benzodiazepine prescribing in residential aged care facilities. Med J Aust. 2018;208(9):398–403. Epub 2018/05/12. 29747564.
40. Kua CH, Mak VSL, Huey Lee SW. Health Outcomes of Deprescribing Interventions Among Older Residents in Nursing Homes: A Systematic Review and Meta-analysis. J Am Med Dir Assoc. 2019;20(3):362–72 e11. Epub 2018/12/26. doi: 10.1016/j.jamda.2018.10.026 30581126.
41. Sino CG, Bouvy ML, Jansen PA, Schop IM, Egberts TC, Schuurmans MJ. Signs and symptoms indicative of potential adverse drug reactions in homecare patients. J Am Med Dir Assoc. 2013;14(12):920–5. Epub 2013/11/30. doi: 10.1016/j.jamda.2013.09.014 24286711.
42. Shafiee Hanjani L, Long D, Peel NM, Peeters G, Freeman CR, Hubbard RE. Interventions to Optimise Prescribing in Older People with Dementia: A Systematic Review. Drugs Aging. 2019;36(3):247–67. Epub 2018/12/20. doi: 10.1007/s40266-018-0620-9 30565157.
43. Pevnick JM, Shane R, Schnipper JL. The problem with medication reconciliation. BMJ Qual Saf. 2016;25(9):726–30. Epub 2016/01/23. doi: 10.1136/bmjqs-2015-004734 26795914.
44. Jennings E, Gallagher P, O’Mahony D. Detection and prevention of adverse drug reactions in multi-morbid older patients. Age Ageing. 2019;48(1):10–3. Epub 2018/10/10. doi: 10.1093/ageing/afy157 30299453.
45. Lewis G, Wessely S. The epidemiology of fatigue: more questions than answers. Journal of epidemiology and community health. 1992;46(2):92–7. doi: 10.1136/jech.46.2.92 1583440.
46. Goodman C, Davies SL, Gordon AL, Dening T, Gage H, Meyer J, et al. Optimal NHS service delivery to care homes: a realist evaluation of the features and mechanisms that support effective working for the continuing care of older people in residential settings. Health Services and Delivery Research. Southampton (UK) 2017.
47. Drennan VM, Grant RL, Harris R. Trends over time in prescribing by English primary care nurses: a secondary analysis of a national prescription database. BMC Health Serv Res. 2014;14:54. Epub 2014/02/07. doi: 10.1186/1472-6963-14-54 24499423.
48. Hart JT. The inverse care law. Lancet (London, England). 1971;1(7696):405–12. Epub 1971/02/27. doi: 10.1016/s0140-6736(71)92410-x 4100731.
49. Payne RA, Abel GA, Guthrie B, Mercer SW. The effect of physical multimorbidity, mental health conditions and socioeconomic deprivation on unplanned admissions to hospital: a retrospective cohort study. CMAJ. 2013;185(5):E221–8. Epub 2013/02/21. doi: 10.1503/cmaj.121349 23422444.
50. Formica D, Sultana J, Cutroneo PM, Lucchesi S, Angelica R, Crisafulli S, et al. The economic burden of preventable adverse drug reactions: a systematic review of observational studies. Expert Opin Drug Saf. 2018;17(7):681–95. Epub 2018/06/29. doi: 10.1080/14740338.2018.1491547 29952667.
51. McGrattan M, Ryan C, Barry HE, Hughes CM. Interventions to Improve Medicines Management for People with Dementia: A Systematic Review. Drugs Aging. 2017;34(12):907–16. Epub 2017/11/28. doi: 10.1007/s40266-017-0505-3 29177770.
52. Sheikh A, Cornford T, Barber N, Avery A, Takian A, Lichtner V, et al. Implementation and adoption of nationwide electronic health records in secondary care in England: final qualitative results from prospective national evaluation in "early adopter" hospitals. BMJ. 2011;343:d6054. Epub 2011/10/19. doi: 10.1136/bmj.d6054 22006942.
53. Jeffries M, Phipps D, Howard RL, Avery A, Rodgers S, Ashcroft D. Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory. BMJ Open. 2017;7(5):e014810. Epub 2017/05/13. doi: 10.1136/bmjopen-2016-014810 28495815.
54. Lyell D, Magrabi F, Raban MZ, Pont LG, Baysari MT, Day RO, et al. Automation bias in electronic prescribing. BMC Med Inform Decis Mak. 2017;17(1):28. Epub 2017/03/18. doi: 10.1186/s12911-017-0425-5 28302112.
55. Arndt BG, Beasley JW, Watkinson MD, Temte JL, Tuan WJ, Sinsky CA, et al. Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations. Ann Fam Med. 2017;15(5):419–26. Epub 2017/09/13. doi: 10.1370/afm.2121 28893811.
56. Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J, et al. Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction. Mayo Clin Proc. 2016;91(7):836–48. Epub 2016/06/18. doi: 10.1016/j.mayocp.2016.05.007 27313121.
57. Warrington L, Absolom K, Conner M, Kellar I, Clayton B, Ayres M, et al. Electronic Systems for Patients to Report and Manage Side Effects of Cancer Treatment: Systematic Review. J Med Internet Res. 2019;21(1):e10875. Epub 2019/01/27. doi: 10.2196/10875 30679145.
58. Jordan S, Kyriacos U. Medicines’ management: a public health problem on nursing’s agenda. J Nurs Manag. 2014;22(3):271–5. Epub 2014/04/24. doi: 10.1111/jonm.12238 24754749.
59. Keijsers CJ, Leendertse AJ, Faber A, Brouwers JR, de Wildt DJ, Jansen PA. Pharmacists’ and general practitioners’ pharmacology knowledge and pharmacotherapy skills. J Clin Pharmacol. 2015;55(8):936–43. Epub 2015/03/27. doi: 10.1002/jcph.500 25810359.
60. Schnipper JL, Mixon A, Stein J, Wetterneck TB, Kaboli PJ, Mueller S, et al. Effects of a multifaceted medication reconciliation quality improvement intervention on patient safety: final results of the MARQUIS study. BMJ Qual Saf. 2018;27(12):954–64. Epub 2018/08/22. doi: 10.1136/bmjqs-2018-008233 30126891.
61. Sackett DL HR, Guyatt GH, Tugwell P. Clinical Epidemiology: A Basic Science for Clinical Medicine, Second edition. Boston MA: Little, Brown & Co; 1991.
62. Vaganay A. Outcome Reporting Bias in Government-Sponsored Policy Evaluations: A Qualitative Content Analysis of 13 Studies. PLoS One. 2016;11(9):e0163702. Epub 2016/10/01. doi: 10.1371/journal.pone.0163702 27690131.
63. Ellwood A, Airlie J, Cicero R, Cundill B, Ellard DR, Farrin A, et al. Recruiting care homes to a randomised controlled trial. Trials. 2018;19(1):535. Epub 2018/10/05. doi: 10.1186/s13063-018-2915-x 30285850.
64. Mitchell JC. Case and Situation Analysis. The Sociological Review. 1983;31(2):187–211. doi: 10.1111/j.1467-954X.1983.tb00387.x
65. Agbabiaka TB, Savovic J, Ernst E. Methods for causality assessment of adverse drug reactions: a systematic review. Drug Saf. 2008;31(1):21–37. Epub 2007/12/22. doi: 10.2165/00002018-200831010-00003 18095744.
66. Lavan AH, Gallagher P. Predicting risk of adverse drug reactions in older adults. Ther Adv Drug Saf. 2016;7(1):11–22. Epub 2016/02/03. doi: 10.1177/2042098615615472 26834959.
67. Centre UM. The use of the WHO_UMC system for standardised case causality assessment Sweden: UMC; 2018 [Accessed 5 March 2019]. https://www.who.int/medicines/areas/quality_safety/safety_efficacy/WHOcausality_assessment.pdf.
68. Mouton JP, Mehta U, Rossiter DP, Maartens G, Cohen K. Interrater agreement of two adverse drug reaction causality assessment methods: A randomised comparison of the Liverpool Adverse Drug Reaction Causality Assessment Tool and the World Health Organization-Uppsala Monitoring Centre system. PLoS One. 2017;12(2):e0172830. Epub 2017/02/25. doi: 10.1371/journal.pone.0172830 28235001.
69. Willson A. The problem with eliminating ‘low-value care’. BMJ Qual Saf. 2015;24(10):611–4. Epub 2015/07/15. doi: 10.1136/bmjqs-2015-004518 26152137.
70. May CR, Mair F, Finch T, MacFarlane A, Dowrick C, Treweek S, et al. Development of a theory of implementation and integration: Normalization Process Theory. Implement Sci. 2009;4:29. Epub 2009/05/23. doi: 10.1186/1748-5908-4-29 19460163.
71. Robinson J. Research for whom? The politics of research dissemination and application. In: Buckeldee J and McMahon R, editor. The Research Experience in Nursing London: Chapman Hall; 1994. p. 165–88.
72. Gao L, Maidment I, Matthews FE, Robinson L, Brayne C, Medical Research Council Cognitive F, et al. Medication usage change in older people (65+) in England over 20 years: findings from CFAS I and CFAS II. Age Ageing. 2018;47(2):220–5. Epub 2017/10/17. doi: 10.1093/ageing/afx158 29036509.
73. Wu TY, Jen MH, Bottle A, Molokhia M, Aylin P, Bell D, et al. Ten-year trends in hospital admissions for adverse drug reactions in England 1999–2009. Journal of the Royal Society of Medicine. 2010;103(6):239–50. Epub 2010/06/02. doi: 10.1258/jrsm.2010.100113 20513902.
74. Office of National Statistics. Health state life expectancies by national deprivation deciles, England and Wales: 2014 to 2017. 2018 [Accessed 07 April 2019]. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthinequalities/bulletins/healthstatelifeexpectanciesbyindexofmultipledeprivationimd/2015to2017
75. World Health Organisation. Medication without harm 2017 [Accessed 07 April 2019]. http://apps.who.int/iris/bitstream/10665/255263/1/WHO-HIS-SDS-2017.6-eng.pdf?ua=1&ua=1.
76. Donaldson LJ, Kelley ET, Dhingra-Kumar N, Kieny MP, Sheikh A. Medication Without Harm: WHO’s Third Global Patient Safety Challenge. Lancet (London, England). 2017;389(10080):1680–1. Epub 2017/05/04. doi: 10.1016/s0140-6736(17)31047-4 28463129.
77. Curtis K, Fulton E, Brown K. Factors influencing application of behavioural science evidence by public health decision-makers and practitioners, and implications for practice. Prev Med Rep. 2018;12:106–15. Epub 2018/09/21. doi: 10.1016/j.pmedr.2018.08.012 30233998.
78. National Assembly for Wales (NAfW) H, Social Care and Sport Committee,. Use of Antipsychotic medication in care homes. Cardiff Bay: National Assembly, Wales; 2018 [Accessed 21 July 2018]. http://www.assembly.wales/laid%20documents/cr-ld11556/cr-ld11556-e.pdf.
Článek vyšel v časopise
PLOS One
2019 Číslo 9
- Proč se v Česku šíří několik „vymýcených“ infekcí najednou? Ptáme se odborníků
- ADHD jako evoluční výhoda? Výzkum se zaměřil na lovce a sběrače
- Případ Bulovka: Jak postupují jiné nemocnice, aby podobným tragédiím zabránily?
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Není statin jako statin aneb praktický přehled rozdílů jednotlivých molekul
Nejčtenější v tomto čísle
- Graviola (Annona muricata) attenuates behavioural alterations and testicular oxidative stress induced by streptozotocin in diabetic rats
- CH(II), a cerebroprotein hydrolysate, exhibits potential neuro-protective effect on Alzheimer’s disease
- Comparison between Aptima Assays (Hologic) and the Allplex STI Essential Assay (Seegene) for the diagnosis of Sexually transmitted infections
- Assessment of glucose-6-phosphate dehydrogenase activity using CareStart G6PD rapid diagnostic test and associated genetic variants in Plasmodium vivax malaria endemic setting in Mauritania
Zvyšte si kvalifikaci online z pohodlí domova
Všechny kurzy