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An audit of adherence to heart failure guidelines in an Australian hospital: A pharmacist perspective.
Related Articles

An audit of adherence to heart failure guidelines in an Australian hospital: A pharmacist perspective.

J Eval Clin Pract. 2017 May 17;:

Authors: Khalil V, Danninger M, Wang W, Khalil H

Abstract
RATIONALE, AIMS, AND OBJECTIVES: The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evidence-based therapy (EBT) for CHF on discharge at this Australian metropolitan hospital and factors affecting its prescribing. The secondary aims are to examine the proportion of patients prescribed EBT on discharge on cardiac wards compared to medical wards and to explore the role of the pharmacist in the management of these patients.
METHOD: A retrospective audit of patients' medical notes who were admitted consecutively for CHF management was conducted over 6 months to examine their management.
RESULTS: The results showed at discharge, a total of 52% of patients were discharged on angiotensin converting enzyme inhibitors/angiotensin receptor blockers, 49% were discharged on β-blockers, 15% were on Aldosterone receptor antagonists, 90% were discharged on diuretics, and 29% were discharged on Digoxin. The main determinants of prescribing EBT on discharge were the presence of prescribing contraindications and patients' comorbidities. Patients discharged from cardiac wards were more likely to be prescribed EBT than if discharged on medical wards. Furthermore, in the subset of the cohort who was reviewed by a pharmacist during admission, a higher percentage of patients were discharged on EBT compared with those who did not have a pharmaceutical input.
CONCLUSION: This study highlighted existing gaps between the National CHF Guidelines and clinical prescribing practice in this hospital. Patients who were discharged from cardiac wards were more likely to be prescribed medications concordant with the guidelines, and there is further opportunity for pharmacists to assist in closing gaps in prescribing practice by the promotion of adherence to these guidelines.

PMID: 28512920 [PubMed - as supplied by publisher]




Different perspectives of validity in psychiatry.
Related Articles

Different perspectives of validity in psychiatry.

J Eval Clin Pract. 2017 May 17;:

Authors: Correia DT

Abstract
It is important to improve our understanding about what might be the specific characteristics of mental disorders to strengthen the scientific credibility of psychiatry and to clarify its position among other medical and nonmedical sciences. On the other hand, this issue has diagnostic, research, therapeutic, legal, financial, and moral implications. Some authors defend a realistic and absolutist attitude towards validity and others an instrumental and relativistic stance. Regarding the organization of concepts, dimensional or categorical approaches have both advantages and disadvantages. Regarding the methodology by which validity is sought, it can be oriented externally or internally to the concept in question. On the other hand, the validity can be expert driven or data driven, the research can be based on disorders or in symptoms and quantitative or qualitative methods may be used. In this article, we review all these different kinds of perspectives that can be taken towards the definition of validity in psychiatry and the methodology to search for it.

PMID: 28512760 [PubMed - as supplied by publisher]