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1.
Pharmacy (Basel) ; 8(3)2020 Jul 10.
Article in English | MEDLINE | ID: mdl-32664306

ABSTRACT

In this article the design of three master programs (MSc in Pharmacy) and two postgraduate specialization programs for community or hospital pharmacist is described. After a preceding BSc in Pharmacy, these programs cover the full pharmacy education capacity for pharmacists in primary and secondary health care in the Netherlands. All programs use the CanMEDS framework, adapted to pharmacy education and specialization, which facilitates the horizontal integration of pharmacists' professional development with other health care professions in the country. Moreover, it is illustrated that crossing the boundary from formal (university) education to experiential (workplace) education is eased by a gradual change in time spent in these two educational environments and by the use of comparable monitoring, feedback, and authentic assessment instruments. A reflection on the curricula, based on the principles of the Integrative Pedagogy Model and the Self-determination Theory, suggests that the alignment of these educational programs facilitates the development of professional expertise and professional identity of Dutch pharmacists.

3.
Int J Clin Pharm ; 36(3): 581-8, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24748507

ABSTRACT

BACKGROUND: Surgical adverse events constitute a considerable problem. More than half of in-hospital adverse events are related to a surgical procedure. Medication related events are frequent and partly preventable. Due to the complexity and multidisciplinary nature of the surgical process, patients are at risk for drug related problems. Consistent drug management throughout the process is needed. OBJECTIVE: The aim of this study was to develop an evidence-based bedside tool for drug management decisions during the pre- and postoperative phase of the surgical pathway. SETTING: Tool development study performed in an academic medical centre in the Netherlands involving an expert panel consisting of a surgeon, a clinical pharmacist and a pharmacologist, all experienced in quality improvement. METHOD: Relevant medication related problems and critical pharmacotherapeutic decision steps in the surgical process were identified and prioritised by a team of experts. The final selection comprised undesirable effects or unintended outcomes related to surgery (e.g. pain, infection) and comorbidity related hazards (e.g. diabetes, cardiovascular diseases). To guide patient management, a list of bedside surgical drug rules was developed using international evidence-based guidelines. MAIN OUTCOME MEASURE: 55 bedside drug rules on 6 drug categories, specifically important for surgical practice, were developed: pain, respiration, infection, diabetes, cardiovascular diseases and anticoagulation. RESULTS: A total of 29 evidence-based guidelines were used to develop the Bedside Surgical Drug Rules tool. This tool consist of practical tables covering management regarding (1) the most commonly used drug categories during surgery, (2) comorbidities that require dosing adjustments and, (3) contra-indicated drugs in the perioperative period. CONCLUSION: An evidence-based approach provides a practical basis for the development of a bedside tool to alert and assist the care providers in their drug management decisions along the surgical pathway.


Subject(s)
Clinical Protocols , Medication Errors/prevention & control , Medication Therapy Management/organization & administration , Perioperative Period/methods , Pharmacists , Checklist , Evidence-Based Practice , Humans , Netherlands , Patient Safety , Quality of Health Care
4.
AIDS ; 16(5): 737-45, 2002 Mar 29.
Article in English | MEDLINE | ID: mdl-11964530

ABSTRACT

BACKGROUND: Toxicity is the most important reason for premature switching of highly active antiretroviral therapy (HAART). In order to optimize the benefit-risk ratio of HAART, guidelines for toxicity management are needed. OBJECTIVE: An observational cohort study to estimate the incidence and identify determinants of toxicity-driven switches on second-line HAART after having switched first-line HAART despite successful viral suppression. METHODS: Patients were selected from those in the ATHENA cohort (n = 2470) who switched the initial HIV protease inhibitor (PI)-containing HAART while plasma HIV-1 RNA was

Subject(s)
Anti-HIV Agents/adverse effects , HIV Infections/drug therapy , HIV Protease Inhibitors/adverse effects , HIV-1 , Reverse Transcriptase Inhibitors/adverse effects , Adult , Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active , Cohort Studies , Female , HIV Infections/immunology , HIV Infections/virology , HIV Protease Inhibitors/therapeutic use , HIV-1/drug effects , HIV-1/genetics , Humans , Male , Middle Aged , Recurrence , Reverse Transcriptase Inhibitors/therapeutic use , Viral Load
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