ORCID Profile
0000-0002-3365-6650
Current Organisations
University of Wollongong
,
University of Sydney
,
Woonona Medical Practice
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Publisher: The Royal Australian College of General Practitioners
Date: 07-2022
Publisher: Wiley
Date: 28-07-2019
DOI: 10.1111/AJAG.12712
Abstract: To compare rates and trends in hospital admissions due to medication misadventure for older adults (≥65 years) with and without dementia. A retrospective analysis of hospital admissions that occurred between 2012 and 2016, for medication misadventures among older adults living in regional Australia. Medication misadventures contributed to 10 555 (4.6%) of the total 228 165 admissions for older adults over the study period. Among these admissions, older adults with dementia were three times more likely to be hospitalised with medication misadventures (14.0%), than their non-dementia counterparts (4.2%). Medication misadventures relating to "anticoagulants" and "opioids/related analgesics" accounted for the majority of admissions (24.3% dementia vs 30.7% non-dementia). This study highlights that the proportion of older adults hospitalised for a medication misadventure is much higher among those with dementia, than those without dementia. Strategies should target older adults, and especially those with dementia, to reduce medication-related harm and improve patient safety.
Publisher: Oxford University Press (OUP)
Date: 12-10-2023
DOI: 10.1093/IJPP/RIAD061
Publisher: Springer Science and Business Media LLC
Date: 09-11-2022
DOI: 10.1007/S11096-021-01340-0
Abstract: Background Opioid prescribing has escalated, particularly long-term in chronic noncancer pain. Innovative models of care have been recommended to augment regulatory and harm-minimisation strategies and to review the safety and benefits of opioids for the in idual patient. Medication stewardship and pharmacist integration are evolving approaches for general practice. Aim To explore enablers, barriers, and outcomes of a pharmacist-led intervention to improve opioid management in general practice, from the perspectives of general practitioners (GPs) and practice personnel. Method The study was part of a mixed-methods investigation into a general practice pharmacist pilot. Qualitative data relevant to opioids were analysed. Data from 13 semi-structured interviews were coded, analysed iteratively and thematically, and interpreted conceptually through the framework of Opioid Stewardship fundamentals proposed by the National Quality Forum. Results Seven themes and 14 subthemes aligned with stewardship fundamentals. Participants considered organisational policy, supported by leadership and education, fostered collaboration and consistency and improved practice safety. Patient engagement with in idualised resources, 'agreements' and 'having the conversation' with the pharmacist enabled person-centred opioid review and weaning. GPs reported greater accountability and reflection in their practices, in the broader context of opioid prescribing and dilemmas in managing patients transitioning through care. Receiving feedback on practice deprescribing outcomes encouraged participants' ongoing commitment. Patient communication was deemed an early barrier however, learnings were applied when transferring the model to other high-risk medicines. Conclusion Improved opioid management was enabled through implementing pharmacist-led coordinated stewardship. The findings offer a practical application of guideline advice to in idualise opioid deprescribing.
Publisher: Therapeutic Guidelines Limited
Date: 10-2012
Publisher: Wiley
Date: 13-06-2021
DOI: 10.1111/BCP.14915
Abstract: To undertake a scoping review of pharmacist activities in opioid medicines management in primary care settings, including those developed or led by pharmacists, or in which pharmacists were members of broader multidisciplinary teams, and to collate the activities, models of care and settings, and reported outcomes. The bibliographic databases MEDLINE, EMBASE, International Pharmaceutical Abstracts, CINAHL, SCOPUS and Web of Science were searched. Studies with quantitative evaluation and published in English were eligible. Participants were patients with any pain category or an opioid use disorder, and healthcare providers. Studies originating in hospitals or involving supply functions were not included. Screening of literature and data charting of results were undertaken by two researchers. The 51 studies included in the scoping review occurred in primary care settings collated into four categories: general practice or primary care clinics, healthcare organisations, community pharmacies and outreach services. Studies were primarily of opioid use in chronic, noncancer pain. Other indications were opioid use disorder, cancer and dental pain. Pharmacist activities targeted risk mitigation, patient and provider education and broader, strategic approaches. Patient‐related outcomes included reduced opioid load, improved functionality and symptom management, enhanced access to services and medication‐assisted treatments, and engagement in risk‐mitigation strategies. Behaviour change of providers was demonstrated. The review has identified the significant contribution that pharmacists working in primary care settings can make to minimise harm from opioids. Strategies implemented in isolation have the potential to further reduce adverse clinical outcomes with greater collaboration and coordination, such as opioid stewardship.
Publisher: Wiley
Date: 06-2019
DOI: 10.1002/JPPR.1550
No related grants have been discovered for Margaret Jordan.