Drug Safety
Safe Meds for Postpartum Depression?
A new study evaluates the safety and efficacy of two common classes of antidepressants used for the treatment of postpartum depression.
Selective serotonin reuptake inhibitors (SSRIs), or tricyclics, are medications used for care of general depression. While the pharmaceuticals are often used for postpartum depression, the study was the first to compare the medications specifically among women who experienced major depression after childbirth.
The investigation, led by researchers from the University Of Pittsburgh School Of Medicine is published in the August issue of the Journal of Clinical Psychopharmacology.
“We’ve been treating postpartum depression based on the assumption that drugs that work for a woman with depression under usual circumstances will work for a woman who experiences depression after giving birth, but there have not been studies that provide scientific proof that this was an effective and safe course of treatment,” said Katherine L. Wisner, M.D., M.S., professor of psychiatry and obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine. “Treating these women based on that assumption was simply not good enough, and we felt compelled to provide scientific evidence to guide postpartum depression treatment decisions.”
In the study, researchers compared the tricyclic nortriptyline and the SSRI sertraline because both drugs were proven effective in treating general depression in women. In addition, previous studies showed the two drugs were acceptable for use in breastfeeding women. Researchers interviewed 420 women who had major depression with postpartum onset at three sites: Pittsburgh, Cleveland and Louisville, Ky. Of those, 109 qualified and chose to participate in the study. They were randomized to receive either nortriptyline or sertraline. A placebo was not used, as researchers felt it would be unethical and dangerous to the mother and her infant to not treat the illness actively. Using common tools for assessment of depression, the investigators evaluated the women for remission of depressive symptoms at four, eight and 24 weeks. The latter evaluation point included only women who had responded after eight weeks. Of the original 109 participants, 95 provided response data at four weeks, 83 provided data at eight weeks, and 29 completed between 20 and 24 weeks of the study.
The proportion of women who responded with a reduction in depressive symptoms, and those who remitted, having few depressive symptoms consistent with wellness, did not significantly differ between the two drugs at any of the study’s time points. By week four, 46 percent of the participants taking sertraline had responded and 27 percent remitted, while 56 percent of those taking nortriptyline responded and 30 percent remitted. At eight weeks, 56 percent of the participants on sertraline had a reduction of symptoms and 46 percent had no symptoms, while the participants taking nortriptyline had 69 percent respond and 48 percent remit. Of the 29 participants who remained in the study until 20-24 weeks, 93 percent taking sertraline responded and 73 percent remitted, while 100 percent taking nortriptyline responded and 79 percent remitted. None of these differences were significant by statistical analyses.
Learn more about safe meds for postpartum depression.
Safe Medication Principles
Safe medication practices promote patient safety, enhance the results of medication use and reduce liability loss. To achieve these goals, the following principles are offered to assist physicians to form effective therapeutic partnerships with their patients. The global intent of these principles is to identify and address actions that have been shown by experience and numerous studies to be associated with the decreased risk of undesired effects.
In an effective therapeutic partnership, the physician’s contribution is to prescribe the appropriate medication and to educate the patient about its use. The patient’s contribution is to take medications according to instructions and to re p o rt back to the physician both the positive and negative effects. (Pharmacists and nurses also have an important role in the therapeutic partnership. The focus of these principles, however, is on the relationship between the knowledgeable physician and the informed patient.)
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McKesson Medication Safety Advantage
Solving Patient Safety and Medication Safety Challenges with Software, Automation, Packaging, Distribution and Consulting Solutions
The McKesson Medication Safety Advantage is a comprehensive solution that helps ensure patient safety and medication safety at each stage of medication management—prescribing, transcribing, administering, dispensing and monitoring. As the only single-source provider that integrates software, automation, packaging, distribution and consulting solutions, we help health care organizations create a complete medication safety strategy.
In fact, many McKesson customers have created a strong culture of patient safety with process redesign and technology that enables better collaboration and communication among caregivers. These organizations have invested in patient safety technology—from bar code medication dispensing and medication administration systems to electronic prescribing, documentation and alerting solutions—and have enviable results.
Breadth and Depth
As you launch or broaden your patient safety and medication safety strategy, consider this: McKesson is the nation’s leading health care IT services company and provides the greatest depth and breadth of pharmaceuticals and technologies that make health care safer while reducing costs. We’ve been at the forefront of major breakthroughs in medication management and pioneered:
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St. Mary Mercy Livonia - Medication Safety
Safe medication practice is a priority at St. Mary Mercy Hospital. Our team of quality professionals has coordinated a consistent team approach to improving medication safety. The Medication Safety Committee coordinates this approach and actively encourages the reporting of all medication occurrences including those that are identified before potentially reaching our patients.
Our electronic medical record includes automatic alerts informing prescribers of patient allergies and adverse interactions.
The Medication Safety Committee recognizes that patients who actively participate in their healthcare are much less likely to be involved with an adverse medication event. We encourage patients to speak-up about concerns they have related to their hospital stay, especially if these concerns involve medications. An easy, effective way to ensure that you receive appropriate medication therapy is to maintain an accurate and complete list of medications you are currently taking. Present this list to your healthcare provider each and every time you seek care. This simple practice has been proven to significantly reduce medication related errors. We have developed a tri-fold Medication Card that can be kept in your wallet and used to record current medications. The cards are available free of charge by asking any member of the care team.
Learn more about St. Meary Mercy Livonia Hospital’s medication safety .
Alliance for Patient Medication Safety
The Alliance for Patient Medication Safety (APMS) will serve as the premier national patient-centric medication safety evaluation system in the country.
APMS strives to foster a culture of quality within the profession of pharmacy that promotes a continuous systems analysis to develop best practices that will reduce medication errors, improve medication use and enhance patient care. APMS is dedicated to encourage voluntary reporting of patient safety work product and perform analysis and aggregate information to improve quality of care provided by the pharmacy workforce. Through analysis of collected patient safety work product data the PSO will provide recommendations for prevention of reported medication errors in order to improve patient safety and the delivery of quality health care. Our PSO will encourage a culture of safety by providing recommendations on best practices and workflow processes designed to reduce medication errors, improve medication use and minimize patient risk.
Learn more about the Alliance for Patient Medication Safety at MedicationSafety.org .
Medication Safety: Moving From Illusion to Reality
The importance of medication safety has been recognized for many years, but only recently has it reemerged as a major public health issue based on numerous recent studies and high-profile safety events. Drug safety dates back to the 1950s, when in response to reports of chloramphenicol-associated aplastic anemia, the American Medical Association established an adverse drug reaction (ADR) reporting system and the Food and Drug Administration began requiring pharmaceutical manufacturers to report ADRs. This effort to detect heretofore unknown, serious adverse effects of medications in postmarket use relied on voluntary reporting, which also became common practice in most health care organizations.
In the 1960s, Jick and colleagues began to focus on the safety of drugs in everyday practice, using a concurrent study approach instead of voluntary reporting. The authors found that 30% of the medical inpatients in their study experienced at least 1 ADR during their . . .
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Medication Safety Solutions Kit
Helping You Improve Medication Safety
The valuable tools included in the Medication Safety Solutions Kit were developed by the Regional Medication Safety Program for Hospitals (RMSPH), an innovative program launched by the Health Care Improvement Foundation, an affiliate of the Delaware Valley Healthcare Council (DVHC), along with ECRI Institute and the Institute for Safe Medication Practices (ISMP).
The kit contains tools that are ideally suited for patient safety officers, risk managers, educational coordinators, quality improvement coordinators, performance improvement coordinators, CIOs, COOs, CEOs, vice presidents of patient care services, medical directors, pharmacy directors, and more.
Medication Safety Tools
The Medication Safety Solutions Kit includes:
* Medication Safety Binder—An extensive binder designed to help hospitals achieve the program’s 16 action goals. View the Table of Contents.
* Computerized Prescriber Order-Entry Systems—A Practical Guide—A special guide to help facilities plan for and acquire CPOE systems. View the Table of Contents.
* Safe Practices Campaign Poster Series—Posters promoting specific medication safety practices.
Other Medication Safety Educational Tools
The Regional Medication Safety Program for Hospitals also produced four patient safety DVD’s that can help you educate your staff about these issues:
* DVD: Medical Leaders in Patient Safety
* DVD: Patients Play a Vital Role in Patient Safety
* DVD: Patient Safety Requires a Team Effort
* DVD: Building System Safeguards for the Safe Use of High-Alert Medications
Learn more about this medication safety kit.
Pathways for Medication Safety
With the release of Pathways for Medication Safety®, hospitals now have access to a coordinated, extensive set of tools designed to reduce medication errors. Pathways is designed to help hospitals take a process-driven, system-based approach to address this critical issue.
The tools were developed by the American Hospital Association, the Health Research and Educational Trust and the Institute for Safe Medication Practices with support from The Commonwealth Fund.
Learn more about the Pathways for Medication Safety .
IQH - Drug Safety
Drug Safety
Patient Safety & Quality Improvement Assistance for Prescription Drug Therapy
IQH offers quality improvement assistance to all Medicare providers and practitioners, Medicare Advantage and prescription drug plans related to drug safety. The specific components of IQH’s quality improvement drug safety project will focus on clinically significant drug-drug interactions (DDI) and potentially inappropriate medications to individuals 65 years of age or older.
IQH’s drug safety team will identify best practices and educational interventions for practitioners in the effort to reduce the high rate of PIMs and DDIs across Mississippi.
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Aetna Pharmacy -Drug Safety
Use your drugs safely
Learn how to read a drug label, how to avoid medication errors, how medications may effect pregnancy, and more drug information.
Will your drugs cause a dangerous interaction?
Use our rug interaction tool to see if two or more of the drugs you are taking present any health risks.
Learn more about Aetna Pharmacy and drug safety .