ABSTRACT
WHAT IS KNOWN AND OBJECTIVE: The technique of highlighted capital letters, Tall Man lettering, is a tool that allows differentiating the names of similar drugs in a way that contributes to reduce medication errors related to the drug identification. The objective was to implement and monitor the application protocol of the Tall Man lettering tool in drug information systems in the healthcare environment to improve the quality of care and patient safety in the pharmacy service and the medical institution. METHODS: Scope: Tertiary general hospital with 1000 beds in which a Tall Man lettering application protocol was approved in the pharmacy service information systems. DESIGN: Retrospective observational study. PERIOD: 2019-2021. POPULATION: Information systems and databases used in the pharmacy service. Working group: Made up of people in charge of information areas and systems. IMPLEMENTATION: Five phases were defined: organization of the working group, selection of drug names and information systems, establishment of actions, their execution, and results monitoring. VARIABLES: Number of pharmaceutical specialties, names of active ingredient and brands incorporated in the information systems. RESULTS AND DISCUSSION: The application of Tall Man lettering was authorized in 13/13 information systems, six have been fully implemented and seven are in the database update phase. Of the implanted systems, a total of 210 drug names have been modified (168/210 active ingredient and 42/210 brand names), corresponding to 659 pharmaceutical specialties. WHAT IS NEW AND CONCLUSION: The application of Tall Man lettering in hospital information systems is a tool for improving the quality of the pharmacy service and guarantees the safety of medicines in the hospital.
Subject(s)
Drug Labeling , Medication Errors , Databases, Factual , Hospitals , Humans , Male , Medication Errors/prevention & control , Pharmaceutical PreparationsABSTRACT
OBJECTIVES: To analyse the applicability of the STOPP/START criteria as a tool to identify patients with potentially inappropriate medications (PIM) during pharmaceutical validation of prescriptions in a long-term care hospital, to identify risk factors for PIM and to characterise the physiological systems and drugs more frequently associated with these PIM. METHODS: An interventional, prospective and longitudinal study was conducted in polypathological patients aged >65 years. Usual pharmaceutical care and the STOPP/START criteria were used to identify PIM and to plan pharmaceutical interventions at admission. At discharge, the discharge summaries were reviewed using the STOPP/START criteria. RESULTS: 112 patients were included. The prevalence of patients with PIM at admission was 76.8%. The STOPP criteria identified a high number of PIM and almost all entailed pharmaceutical intervention. On the other hand, most of the START criteria identified did not entail pharmaceutical intervention. Usual pharmaceutical care detected a different type of PIM; a high percentage of pharmaceutical interventions to resolve them were accepted. At discharge, the prevalence of patients with PIM was 61.3%. At admission, none of the analysed variables was associated with the PIM identified using any of the tools. At discharge STOPP criteria identified a higher percentage of patients with PIM in the geriatric outpatient consultation group. CONCLUSIONS: The prevalence of PIM in older polypathological patients is high. The STOPP criteria are useful for reducing inappropriate prescribing during the pharmaceutical validation process. In contrast, routine incorporation of the START criteria in the pharmaceutical validation may be not necessary in a hospital of this type.
ABSTRACT
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