Conference Papers
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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
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Item Management of paracetamol overdose in primary care hospitals in Sri Lanka: Are all the transfers justifiable?(Sri Lanka Medical Association, 2018) Pathiraja, V. M.; Gawarammana, I. B.; Buckley, N. A.; Mohamed, F.; Jayamanna, S. F.; Dawson, A. H.INTRODUCTION AND OBJECTIVES: National guidelines on the management of self-poisoning allows treatment of paracetamol poisoning in rural hospitals. Non-adherence to these guidelines may lead to unnecessary and costly transfers to larger referral hospitals. The objective of this study was to investigate if non-adherence to guidelines is justifiable.METHODS: In a prospective study, data was linked between primary and tertiary hospitals in Kurunegala and Matara districts. We examined the transfer patterns to two tertiary hospitals (THK and THM) and attempted to justify if the transfers were necessary.RESULT: There were 3129 admissions to primary hospitals and 904 (29%) patients were transferred to THK (809)and THM (95). The reason for transfer was mentioned as antidote requirement in 297, and in 607, antidote treatment was not mentioned as the reason for transfer. There was a significant difference of the median number of tablets ingested between those who had a reason mentioned 23 (IQR=18-30) and otherwise 21.5 (IQR 13-28) (p<0.000).485 (54%) were given an antidote at the tertiary care hospitals. 398 (44%) patients were not given an antidote andshould not have been transferred. Of the 297, who were transferred for antidotes, 147 (60%) were given antidotes and 51 were lost to follow up. Of those 607 who were transferred for other reasons, 238(48%) received antidotes and 112 were lost to follow up.CONCLUSION: Large numbers of patients who do not require treatment are transferred. A significant number of patients who require antidotes are not treated in the primary hospitals. This reflects that understanding treatment guidelines is poor.Item A case series of duplication errors due to brand name confusion - experience from a Sri Lankan teaching hospital(Sri lanka Medical Association, 2015) Mamunuwa, A.M.V.G.N.; Jayamanne, S.F.; Coombes, J.; Lynch, C.B.; Perera, D.M.P.; Pathiraja, V.M.; Shanika, L.G.T.; Mohamed, F.; Dawson, A.H.INTRODUCTION AND OBJECTIVES: Confusion with drug names has been identified as a leading cause of medication errors. The majority of these errors result from look-alike or sound-alike drugs. This case series aims to provide examples of duplication errors due to brand confusion where there are no similarities in the names. METHOD: Information for this case series was extracted from a database prospectively collected from Colombo North Teaching Hospital as part of a study conducted to evaluate the impact of the addition of a clinical pharmacist to the standard inpatient care. RESULTS: Of 800 patients reviewed during the study period of 7 months, clinical pharmacist identified 8 cases of duplication errors due to prescribing both generic and brand names of the same drug, but with no similarities in names. Cases identified include a duplication of frusemide caused by the lack of awareness that 'Amifru' {a combination of frusemide and amiloride) contains frusemide. Similarly, a patient was prescribed 'H. Pylori Kit' plus the three individual drugs included in the 'Kif prescribed using their generic names. A patient was found to be taking two different brands of carbidopa plus levodopa not knowing the two contained the same drugs. CONCLUSION: Brand confusion does not necessarily arise from look-alike or sound-alike drug names. It can be due to numerous brands of generic ingredients and lack of awareness of drug names among the patients. Employing trained clinical pharmacists in the wards, educating patients on discharge drugs and appropriate labeling of medicines may prevent these errors.Item Importance of communicating medication changes to patients at discharge -a prospective case study(Sri lanka Medical Association, 2015) Pathiraja, V.M.; Jayamanne, S.F.; Lynch, C.B.; Coombes, J.; Perera, D.M.P.; Mamunuwa, A.M.V.G.N.; Shanika, L.G.T.; Mohamed, F.; Dawson, A.H.INTRODUCTION AND OBJECTIVES: Patients may inadvertently continue their previous medication regimen without understanding changes made by prescribers as part of in-patient care. Inadequate patient education at discharge can lead in some instances to readmission and increased morbidity. The objective of this study is to identify the importance of patient education with regard to changes to their medications. METHOD: This study was part of a prospective study carried out in two medical wards of Ragama teaching hospital to evaluate the effect of a clinical pharmacist's interventions on quality use of medicines. We identified cases from the control group of this study to illustrate the importance of patient education at discharge. RESULTS: From telephone follow-up (six days post discharge), only 89 of 337 patients in the control group reported being informed of changes to their pre-admission medications by a doctor or nurse. There were!24 cases where we have identified patients continuing at least one pre-admission medication which was stopped or changed while they were in hospital. A particular instance is a patient who continued to take sodium valproate post-discharge as per previous drug regimen after being diagnosed with valproate induced hepatitis. He was discharged on phenytoin. CONCLUSION: This study highlights the importance of ensuring patient education about changes made to existing medications whilst in hospital to ensure improved outcomes and reduce the risk of adverse events. The clinical pharmacist is well placed to assist medical teams by providing patients with appropriate education about medication changes and to provide appropriate educational material.