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At least 37 records · Page 2Linked to original sources
PubMed1976

Communication, compliance, and concordance between physicians and patients with prescribed medications.

Forty-six practicing physicians and 357 patients with diabetes mellitus or congestive heart failure were the subjects for this study, which focuses on the impact of medication regimen and doctor-patient communication in affecting patient medication-taking behavior and physician awareness of these behaviors. Four types of medication errors were defined: omissions, commissions, scheduling misconceptions and scheduling non-compliance. The average error rates were 19 per cent, 19 per cent, 17 per cent and 3 per cent, respectively. The combined average error was 58 per cent; scheduline non-compliance on the part of the patient was a minor component. Specific aspects of the medication regimen were associated with increased errors: (1) the more drugs involved between the doctor-patient pair, the greater the errors of omission and commission; and (2) the greater the complexity of the scheduling, the greater the errors of commission and scheduling misconceptions. If the patient did not know the function of all his drugs, errors of commission and scheduling misconception increased. Neither characteristics of patients nor the severity of disease were influential in determining the extent of medication errors. For patients with congestive heart failure, good communication of instructions and information from physician to patient was associated with low levels of all types of errors.

Aged↗
PubMed1979

Pharmacology program produces results.

A traditional inservice pharmacology program presented problems for the participants, educators, and head nurses and, despite the program, a significant number of medication errors occurred. A new program, based on principles of adult education, has had positive effects on patient care and is viewed favorably by educators and participants. The results suggest that competency-based education in other areas could have similar benefits.

Curriculum↗
PubMed1977

Improving drug compliance after hospital discharge.

The effect of counselling on medication errors was assessed in 165 elderly patients after leaving hospital. Counselling was effective, with counselled patients making under one-third of the errors made by uncounselled patients. Three types of memory aid were tried to supplement counselling. The pill wheel increased errors, a tablet identification card was unhelpful, and only a tear-off daily calendar seemed to improve results modestly. Counselling was virtually as effective in improving compliance in poorly orientated patients. A designated member of staff should spend about 15 minutes with each elderly patient before discharge to ensure that the discharge drug regimen is fully understood and remembered, that old tablets are destroyed and that other people's tablets are not taken.

Aged↗
PubMed1977

Dose-dependent kinetics of theophylline disposition in asthmatic children.

Prior assumptions of first-order elimination for theophylline were tested by administering theophylline by intravenous infusion at two dosage levels to 20 children with chronic asthma. The resulting steady-state serum concentrations increased to a greater degree than would have been predicted if increases in serum concentration were proportional to changes in dose, and the subsequent calculation of clearance revealed values of 1.37 +/- 0.09 ml/kg/minute (mean +/- SE of the mean) at the lower infusion rate and of 1.21 +/- 0.06 ml/kg/minute at the higher infusion rate (p less than 0.02). Even greater differences in clearance were present among ten of these children whose higher infusion rates were at least two times greater than the lower rate. An additional child was observed who experienced a seizure following a medication error that resulted in a 50% increase in daily dosage and a greater than threefold increase of serum concentration. The nonlinear nature of the relationship between dose and serum concentration suggests that theophylline dosage adjustment should be performed cautiously using small increments.

Adolescent↗