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Preventing Medication Errors and Improving Drug Therapy Outcomes: A Management Systems Approach, 1st Edition (Hardback) book cover

Preventing Medication Errors and Improving Drug Therapy Outcomes

A Management Systems Approach, 1st Edition

By Charles D. Hepler, Richard Segal


434 pages | 34 B/W Illus.

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Hardback: 9780849315763
pub: 2003-02-25
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pub: 2003-02-25
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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

Drug-related illnesses and complications cost the health care system billions of dollars each year. Medical errors account for approximately 100,000 deaths each year, and drugs are the most common cause of medical errors in hospitals. Synthesizing research studies from seven nations, Preventing Medication Errors and Improving Drug Therapy Outcomes: A Management Systems Approach 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.

Table of Contents

The Second Drug Problem

Why do These Problems Persist?

Thesis — A Systems Approach

The Way Forward

Morbidity and Mortality from Medication Use

Review of Research Data on Adverse Outcomes of Drug Therapy

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

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

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

Prescribing and Prescribing Influence

Prescribing in Medications Use

Understanding the Prescribing Process

Methods of Influencing Prescribing

Summary: Toward Systematic Improvement of Prescribing

Medications Use System Performance Information

Performance Database

Performance Guidelines

Performance Indicator


Pharmaceutical Care and Medications Use Management

Summary and Conclusion

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

Connective Summary

Effect of Pharmaceutical Care Systems on Outcomes and Costs

Simulation Model of Medications Use

Review of Research Evidence

Connective Summary

A Pharmaceutical Care System

Drug Therapy Problems

Documentation: Problem Oriented Medical Records and SOAP Notes

Professional Dialog


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

Connective Summary

Managed Care

Managed Care Strategies to Influence the Cost, Access, and

Quality in Medications Use

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

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

Subject Categories

BISAC Subject Codes/Headings:
MEDICAL / Health Care Delivery
MEDICAL / Pharmacology
MEDICAL / Pharmacy