Features:

• Discusses drug therapy and medications use from a comprehensive, systems perspective
• Synthesizes selected research from seven countries on adverse outcomes from the use of medications
• Describes what a properly designed and managed drug therapy system would look like and how the components should fit together
• Covers processes for evaluating medication-use systems and identifying and correcting ineffective system operations
• Presents detailed data on patient outcomes and why standards must change to improve drug safety and effectiveness

Read this book in order to learn:

• Why medicines often fail to produce the desired result and how such failures can be avoided
• How to think about drug product safety and effectiveness
• How the main participants in a medications use system can improve outcomes and how professional and personal values, attitudes, and ethical reasoning fit into drug therapy
• What a properly designed and managed medications use system would look like - specific components, how the components fit together into a system, and how the system can be maintained and improved
• Ways to evaluate medications use systems, how to recognize ineffective systems operations, how to identify missing system components and how to correct them
• How the environment of medications use affects systems operations and patient outcomes, and why standards must change to improve drug safety and effectiveness

Synthesizing research studies from seven nations, Preventing Medication Errors and Improving Drug Therapy Outcomes explores medications use from a social perspective. It identifies and describes the preventable adverse outcomes of drug therapy, discusses the safety, cost-effectiveness, and quality of medications use from a management systems perspective, and proposes systematic solutions.

Contents

1. THE SECOND DRUG PROBLEM
   • Why do These Problems Persist?
   • Thesis - A Systems Approach
   • The Way Forward

2. MORBIDITY AND MORTALITY FROM MEDICATION USE
   • Review of Research Data on Adverse Outcomes of Drug Therapy

3. UNDERSTANDING ADVERSE DRUG THERAPY OUTCOMES
   • Changing Attitudes Toward Adverse Outcomes of Drug Therapy
   • Causal Attributions of DRM: From the "Four Bads" to System Failure
   • A Model of the Medications Use Process
   • Where do Medications Use Systems Fail?
   • Conclusion: Looking Forward to Systematic Medications Use Management

4. PEOPLE AND PURPOSE IN MEDICATIONS USE
   • The People in Medication Use
   • Objectives of Medication Use
   • Quality of Life
   • Three Basic Relationships
   • Models of Disease and Therapy

5. ACCESS, COST, AND QUALITY ISSUES IN MEDICATION USE
   • Relationship of Access, Cost, and Quality
   • Accessibility of Care
   • Costs of Drug Therapy
   • Quality of Care
   • Patient Satisfaction with Care
   • Drug Law - Quality of Drug Products as Legal Requirements for Safety and Efficacy

6. PRESCRIBING AND PRESCRIBING INFLUENCE
   • Prescribing in Medications Use
   • Understanding the Prescribing Process
   • Methods of Influencing Prescribing
   • Summary: Toward Systematic Improvement of Prescribing

7. MEDICATIONS USE SYSTEM PERFORMANCE INFORMATION
   • Performance Database
   • Performance Guidelines
   • Performance Indicator
   • Standards
   • Pharmaceutical Care and Medications Use Management

8. OUTLINE OF A MEDICINES MANAGEMENT SYSTEM
   • Pharmaceutical Care and Pharmaceutical Care System
   • Flow Diagrams: Pharmaceutical Care and Medications Management Systems
   • Concepts in the Systems Paradigm
   • System Model of Error Prevention

9. EFFECT OF PHARMACEUTICAL CARE SYSTEMS ON OUTCOMES AND COSTS
   • Simulation Model of Medications Use
   • Review of Research Evidence

10. A PHARMACEUTICAL CARE SYSTEM
    • Drug Therapy Problems
    • Documentation: Problem Oriented Medical Records and SOAP Notes
    • Professional Dialog

11. MEDICINES MANAGEMENT SYSTEM
    • Pharmaceutical Care and Medications Management
    • Elements of Systematic Improvement in the Quality of Medications Use
    • Example of Medications Management on the Program and Practice Levels

12. MANAGED CARE

13. MANAGED CARE STRATEGIES TO INFLUENCE THE COST, ACCESS, AND QUALITY IN MEDICATIONS USE

14. A MARKET PERSPECTIVE
    • Professions as Marketing Mechanisms
    • Adoption of Medications Use Systems
    • System Learning Disabilities: Psychological Barriers to System Improvement
    • Summary: Performance Indicators are Crucial

15. FINDING A WAY TOWARD MEDICATIONS USE SYSTEMS
    • Organizational and Environmental Context of PDRM Managed Care
    • A Vision of Medication Use on the High Plateau
    • Moving Forward

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