British Journal of Clinical Pharmacology Impact Factor & Information

Publisher: British Pharmacological Society, Wiley

Journal description

The Journal of The British Pharmacological Society. Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology contains papers and reports on all aspects of drug action in humans: invited review articles, original papers, short communications and correspondence. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. Proceedings of the meetings of the Clinical Section of the British Pharmacological Society are published in abstract form and supplements containing information on new methods, new drugs and new approaches to treatment are supplied free of charge.

Current impact factor: 3.69

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 3.688
2012 Impact Factor 3.578
2011 Impact Factor 2.958
2010 Impact Factor 3.063
2009 Impact Factor 3.246
2008 Impact Factor 3.128
2007 Impact Factor 2.681
2006 Impact Factor 2.718
2005 Impact Factor 2.777
2004 Impact Factor 2.546
2003 Impact Factor 2.531
2002 Impact Factor 2.274
2001 Impact Factor 2.213
2000 Impact Factor 2.151
1999 Impact Factor 2.545
1998 Impact Factor 1.846
1997 Impact Factor 1.809
1996 Impact Factor 2.214
1995 Impact Factor 2.048
1994 Impact Factor 1.922
1993 Impact Factor 1.891
1992 Impact Factor 1.733

Impact factor over time

Impact factor
Year

Additional details

5-year impact 3.56
Cited half-life 8.70
Immediacy index 1.15
Eigenfactor 0.02
Article influence 0.99
Website British Journal of Clinical Pharmacology website
Other titles British journal of clinical pharmacology (Online), BJCP
ISSN 1365-2125
OCLC 45425630
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Wiley

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • On a non-profit server
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • Jose de Leon
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12659
  • Frank Kloprogge, Rose McGready, Aung Pyae Phyo, Marcus J Rijken, Warunee Hanpithakpon, Hla Hla Than, Nathar Hlaing, Naw Thida Zin, Nicholas P J Day, Nicholas J White, François Nosten, Joel Tarning
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    ABSTRACT: To compare the pharmacokinetic properties of artesunate and dihydroartemisinin in the same women: i) pregnant with acute uncomplicated malaria on day 1 and 2, ii) pregnant with convalescent malaria on day 7 and iii) in a healthy state 3 months post-partum on day 1, 2 and 7. Nonlinear mixed-effects modelling was used to compare plasma concentration-time profiles of artesunate and dihydroartemisinin over 7 days of treatment following oral and intravenous artesunate administration to pregnant women with uncomplicated Plasmodium falciparum malaria during their second or third trimesters of pregnancy. The same women were restudied three months after delivery when fully recovered. Non-compartmental results of the same study have been published previously. Twenty pregnant patients on the Thailand-Myanmar border were studied and 15 volunteered to be restudied three months post-partum. Malaria and pregnancy had no effect on the pharmacokinetic properties of artesunate or dihydroartemisinin after intravenous artesunate administration. However, malaria and pregnancy had opposite effects on the absorption of orally administered artesunate. Malaria increased the absolute oral bioavailability of artesunate by 87%, presumably by inhibiting first-pass effect, whereas pregnancy decreased oral bioavailability by 23%. The population pharmacokinetic analysis demonstrated opposite effects of malaria and pregnancy on the bioavailability of orally administered artesunate. Lower drug exposures during the second and third trimesters of pregnancy may contribute to lower cure rates and thus the development of drug resistance. Dose optimisation studies are required for artesunate containing ACTs in later pregnancy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12660
  • Bauke Schievink, Dick de Zeeuw, Hans-Henrik Parving, Peter Rossing, Hiddo Jan Lambers Heerspink
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    ABSTRACT: Angiotensin Receptor Blockers (ARBs) are renoprotective and targeted to blood pressure. However, ARBs have multiple other (off-target) effects which may affect renal outcome. It is unknown whether on-target and off-target effects are congruent within individuals. If not, this variation in short-term effects may have important implications for the prediction of individual long-term renal outcomes. Our aim was to assess intra-individual variability in multiple parameters in response to ARBs in type 2 diabetes. Change in systolic blood pressure (SBP), albuminuria, potassium, hemoglobin, cholesterol and uric acid after 6 months of losartan treatment were assessed in the RENAAL database. Improvement in predictive performance of renal outcomes (ESRD or doubling serum creatinine) for each individual using ARB-induced changes in all risk markers was assessed by relative integrative discrimination index (RIDI). SBP response showed high variability (mean -5.7 mmHg; 5(th) to 95(th) percentile -36.5 to +24.0 mmHg) between individuals. Changes in off-target parameters also showed high variability between individuals. No congruency was observed between responses to losartan in multiple parameters within individuals. Using individual responses in all risk markers significantly improved renal risk prediction (RIDI 30.4%;p < 0.01) compared to using only SBP changes. Results were successfully replicated in two independent trials with irbesartan; IDNT and IRMA-2. In this post-hoc analysis we showed that ARBs have multiple off-target effects which vary between and within individuals. Combining all ARB-induced responses beyond SBP provides a more accurate prediction of who will benefit from ARB therapy. Prospective trials are required to validate these findings. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12655
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    ABSTRACT: KEYWORDS: European Medicines Agency; Food and Drug Administration; drug safety; erectile dysfunction; phosphodiesterase (PDE)-5 inhibitors; post-marketing surveillance; vision loss
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12658
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    ABSTRACT: To conduct a meta-analysis of controlled trials assessing the impact of pharmaceutical care interventions (e.g., medication review) on medication underuse in older patients (≥65 years). The databases MEDLINE and EMBASE were searched for controlled studies and data on interventions, patient characteristics, and exposure and outcome assessment were extracted. Risk of bias was assessed using the Cochrane "Risk of Bias Table". Results from reported outcomes were synthesized in multivariate random effects meta-analysis, subgroup meta-analysis, and meta-regression. From 954 identified articles, 9 controlled studies mainly comprising a medication review were included (2542 patients). These interventions were associated with significant reductions in the mean number of omitted drugs per patient (estimate from 6 studies with 1469 patients: - 0.44, 95% confidence interval [-0.61; -0.26]) and the proportion of patients with ≥1 omitted drugs (odds ratio from 8 studies with 1833 patients: 0.29, 95% confidence interval [0.13; 0.63]). The only significant influential factor for improving success was the utilization of explicit screening instruments when conducting a medication review (P = 0.033). Pharmaceutical care interventions including medication reviews can significantly reduce medication underuse in older people. The use of explicit screening instruments alone or in combination with implicit reasoning is strongly recommendable for clinical practice. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12657
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    ABSTRACT: This study investigated the effect of the fixed-dose combination of lopinavir/ritonavir on the pharmacokinetics (PK) of selexipag and its active metabolite ACT-333679. This was an open-label, randomised, single-centre, two-way, crossover study. Twenty healthy male subjects were treated with a single dose of 400 µg selexipag alone and in combination with multiple doses of lopinavir/ritonavir (400/100 mg) twice daily (b.i.d.). The results showed that lopinavir/ritonavir approximately doubled the exposure to selexipag. The area under the plasma concentration-time curve from time zero to infinity (AUC0-∞ ) and the maximum plasma concentration (Cmax ) of selexipag were 2.2- and 2.1-fold higher, respectively, than under selexipag alone, with a 90% confidence interval (CI) of the geometric mean ratio (GMR) of 1.9-2.7 and 1.7-2.6, respectively. For ACT-333679, the clinically more relevant component of selexipag, systemic exposure was increased by 8% (GMR of AUC0-∞ : 1.1; 90% CI 0.9-1.3), when lopinavir/ritonavir was co-administered with selexipag. The most frequently reported adverse event (AE) was headache. A single dose of selexipag, administered either alone or together with multiple doses of lopinavir/ritonavir, was safe and well tolerated. Lopinavir/ritonavir does not affect the PK parameters of selexipag and ACT-333679 to a clinically relevant extent. Therefore, adaptation of the selexipag dose is not required when co-administered with inhibitors of the organic anion-transporting polypeptide (OATP) 1B1/ 1B3, P-glycoprotein (P-gp), and/or CYP3A4. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12650
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    ABSTRACT: To characterize the extent of indication bias resulting from the excessive use of NSAIDs on the days preceding a spontaneous abortion to relieve pain. We used data from a retrospective cohort study assessing the risk for spontaneous abortions following exposure to NSAIDs. Three definitions of exposure for cases of spontaneous abortions were compared, from the first day of pregnancy until the day of spontaneous abortion and until three and two days before a spontaneous abortion. Statistical analysis was performed using multivariate time programmed COX regression. A sharp increase was observed in the dispensation of indomethacin, diclofenac and naproxen, and a milder increase was found in the use of ibuprofen during the week before a spontaneous abortion. Non- selective COX inhibitors in general and specifically diclofenac and indomethacin were found to be associated with spontaneous abortions when the exposure period was defined until the day of spontaneous abortion (HR= 1.15, 95%CI 1.04-1.28; HR=1.31, 95%CI 1.08-1.59 and HR= 3.33, 95%CI 2.09-5.29, respectively). The effect disappears by excluding exposures occurring on the day before the spontaneous abortion for non-selective COX inhibitors and on the last week before the spontaneous abortion for indomethacin. In general, decreasing hazard ratios were found with the exclusion of exposures occurring on the days immediately before the spontaneous abortion. The increased use of NSAIDs during the last few days that preceded a spontaneous abortion to relieve pain associated with the miscarriage could bias studies assessing the association between exposure to NSAIDs and spontaneous abortions. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12653
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    ABSTRACT: Interleukin-6 (IL-6), a multifunctional cytokine exists in several forms ranging from a low-molecular-weight (MW; 20-30 kDa) non-complexed form to high-MW (200-450 kDa), complexes. Accurate baseline IL-6 assessment is pivotal to understand clinical responses to IL-6-targeted treatments. Existing assays measure only the low-MW, non-complexed IL-6 form. The present work aimed to develop a validated assay to accurately measure total IL-6 (complexed and non-complexed) in serum or plasma as matrix in a high-throughput and easily standardized format for clinical testing. Commercial capture and detection antibodies were screened against humanized IL-6 and evaluated in an enzyme-linked immunosorbent assay format. The best antibody combinations were screened to identify an antibody pair that gave minimum background and maximum recovery of IL-6 in the presence of 100% serum matrix. A plate-based total IL-6 assay was developed and transferred to the Meso Scale Discovery (MSD) platform for large-scale clinical testing. The top-performing antibody pair from 36 capture and 4 detection candidates was validated on the MSD platform. The lower limit of quantification in human serum samples (n = 6) was 9.77 pg/L, recovery ranged from 93.13-113.27%, the overall pooled coefficients of variation were 20.12% (inter-assay) and 8.67% (intra-assay). High MW forms of IL-6, in size fractionated serum samples from myelodysplastic syndrome and rheumatoid arthritis patients, were detected by the assay but not by a commercial kit. This novel panoptic (sees all forms) IL-6 MSD assay that measures both high- and low-MW forms may have clinical utility. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12652
  • British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12651
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    ABSTRACT: A biosimilar is a high-quality biological medicine shown to be equivalent to an original product. The European Medicines Agency (EMA) paved the way in the regulatory arena by creating a safeguarding framework for biosimilars development. Biosimilar is thus a regulatory term that alludes to the evidence-based studies required to demonstrate such equivalence. They are therefore not innovative products, but the pathway laid down by the EMA for their approval represented a new paradigm. This has brought some confusion, and has casted doubts among healthcare professionals about the scientific evidence behind their authorization. Many papers have been published to clarify the concept, and to reassure those professionals, but misconceptions still arise frequently. Unfortunately, this prevents biosimilars from deploying their full therapeutic added value. This paper is intended to approach those misconceptions from a new angle; by explaining what a biosimilar is not…and why. A biosimilar is neither a generic, nor an original product. It is not a biobetter or a "stand-alone". Therefore, it should not be managed as such therapeutically, commercially, or from a healthcare policy viewpoint. The EMA's criteria were acknowledged by other agencies, but a significant regulatory gap with a vast majority of regulatory bodies still remains. This leaves room for the so-called non-original biologics (NOB) to be launched in many regions. Raising awareness of what a biosimilar is, and what it is not, will generate trust among healthcare professionals in biosimilars, and will ultimately benefit patients. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12656
  • British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12654
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    ABSTRACT: AimsThe aims of this study were (i) to develop a population pharmacokinetic (PK) model of tacrolimus in a Mexican renal transplant paediatric population (n=53), and (ii) test the influence of different covariates on its PK properties to facilitate dose individualization.Methods Population PK and variability parameters were estimated from whole blood drug concentration profiles obtained at steady state using the nonlinear mixed-effect modelling software NONMEM® Version 7.2.ResultsTacrolimus PK profiles exhibited high inter-patient variability (IPV). A two compartment model with first order input and elimination described the tacrolimus PK profiles in the studied population. The relationship between CYP3A5 genotype and tacrolimus CL/F was included in the final model. CL/F in CYP3A5*1/*1 and *1/*3 carriers was approximately 2- and 1.5-fold higher than in CYP3A5*3/*3 carriers (nonexpressers) respectively, and explained almost the entire IPV in CL/F. Other covariates retained in the final model were the tacrolimus dose and formulation type. In fact Limustin®, shows marked lower concentrations that the rest of formulations.Conclusions Population PK modelling of tacrolimus in paediatric renal transplant recipients identified the tacrolimus formulation type as a significant covariate affecting the blood concentrations and confirmed the previously reported significant effect of CYP3A5 genotype on CL/F. Further allowed the design of a proposed dosage based on the final model that is expected to help to improve tacrolimus dosing.
    British Journal of Clinical Pharmacology 04/2015; DOI:10.1111/bcp.12649
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    ABSTRACT: Cholangiocarcinoma (CCA) is the second most common primary liver cancer in the world. Because of lacking effective treatments, the survival rate of CCA is low and it is usually considered difficult to diagnose early. To date, no effective strategies for the prevention of CCA have been developed. Statins are cholesterol-lowering agents which posses pleiotropic properties and the use of statins may reduce cancer risk. To investigate the effect of statin use on the risk of CCA. We used nationwide insurance data to perform a case-control study including 3174 CCA patients diagnosed in 2002-2011 and 3174 propensity score matched controls. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated to assess the association between CCA risk and statin uses by type of statin and dose. Patients with CCA were slightly younger than controls with mean ages of 67.4 (SD 12.3) and 68.5 (SD 13.2) years (p = 0.001), respectively, and had less users of statins (22.7 vs. 26.5%, p < 0.001). The overall adjusted OR of statin uses associated CCA was 0.80 (95% CI = 0.71-0.90) and lowered for those with longer medications. The OR ranged from 0.65 to 0.77. Stronger dose-response association was seen for using lovastatin. Statin use is associated with reduced risk of CCA and there is a dose-response relationship between the use of statins and risk of CCA. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 03/2015; DOI:10.1111/bcp.12641
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    ABSTRACT: The antiviral agent favipiravir is likely to be co-prescribed with acetaminophen (paracetamol). The present study evaluated the possiblility of a pharmacokinetic interaction between favipiravir and acetominophen, in vitro and in vivo. The effect of favipivir on the transformation of acetaminophen (APAP) to its glucuronide and sulfate metabolites was studied using pooled human hepatic S9 fraction in vitro. The effect of acute and extended adminstration of favipiravir on the pharmacokinectis of acetaminophen and metabolites was evaluated in human volunteers. Favipiravir inhibited the in vitro formation of acetaminophen sulfate, but not acetaminophen glucuronide. In human volunteers, both acute (one day) and extended (six days) administration of favipiravir slightly but significantly increased (by about 20 %) systemic exposure to acetaminophen (total AUC), whereas Cmax was not significantly changed. AUC for APAP-glucuronide was increased by 23 to 35 % above control by favipiravir, while AUC for APAP-sulfate was reduced by about 20 % compared to control. Urinary excretion of APAP-sulfate was likewise reduced to 44 to 65 % of control values during favipiravir coadministration, while excretion of APAP-glucuronide increased to 17 to 32 % above control. Favipiravir inhibits APAP sulfate formation in vitro and in vivo. However the increase in systemic exposure to APAP due to favipiravir coadministration, though statistically significant, is small in magnitude and unlikely to be of clinical importance. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 03/2015; DOI:10.1111/bcp.12644
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    ABSTRACT: Regulatory review time has been shown to influence the assessment of medication safety in the United States. Our objective was to evaluate whether regulatory review time and near deadline approval are associated with post-market safety events (PMSEs) for novel medicines approved by the European Medicines Agency (EMA). We performed a cross-sectional analysis of all novel medicines approved by the EMA through the centralized authorization procedure between 2001 and 2010. PMSEs were defined as withdrawals and communications identified through Dear Healthcare Professional Communications (DHPCs). Regulatory review time was defined as the time that elapsed between the start of the assessment procedure and approval. Near regulatory deadline approval was defined as approval within the 30 days before the EMA's 210 day regulatory deadline. Among 161 eligible medicines, PMSEs were identified for 49 (30.4%), 44 of which were DHPCs, 5 of which were withdrawals. Median regulatory review time was 337 days (IQR, 276-406) and was not associated with PMSEs (p = 0.57). However, when categorized by regulatory review speed tertile, there were differences in risk of PMSEs, with higher rates among medicines in the middle tertile (25 of 55; 45.4%; p = 0.01). Finally, 26 medicines were approved near the 210 day regulatory deadline, but were not more likely to have PMSEs (38.5% vs. 28.7%; p = 0.32). Neither faster EMA regulatory review speed nor approval near regulatory deadlines was associated with greater likelihood of PMSEs among recently approved novel medicines. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 03/2015; DOI:10.1111/bcp.12643
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    ABSTRACT: TNF-α inhibitors are considered relatively safe in pregnancy but experience is still limited. The aim of this study was to evaluate the risk of major birth defects, spontaneous abortion, preterm birth, and reduced birth weight after first trimester exposure to TNF-α inhibitors. Pregnancy outcomes of women on adalimumab, infliximab, etanercept, certolizumab pegol, or golimumab were evaluated in a prospective observational cohort study and compared to outcomes of a non-exposed random sample. The samples were drawn from pregnancies identified by institutes collaborating in the European Network of Teratology Information Services. In total, 495 exposed and 1532 comparison pregnancies were contributed from 9 countries. The risk of major birth defects was increased in the exposed (5.0%) compared to the non-exposed group (1.5%; ORadj 2.2; 95% CI 1.0-4.8). The risk of preterm birth was increased (17.6%; ORadj 1.69; 95% CI 1.1-2.5), but not the risk of spontaneous abortion (16.2%; HRadj 1.06; 95% CI 0.7-1.7). Birth weights adjusted for gestational age and sex were significantly lower in the exposed group compared to the non-exposed cohort (p = 0.02). As a diseased comparison group was not possible to ascertain, the influence of disease and treatment on birth weight and preterm birth could not be differentiated. TNF-α inhibitors may carry a risk of adverse pregnancy outcome of moderate clinical relevance. Considering the impact of insufficiently controlled autoimmune disease on the mother and the unborn child, TNF-α inhibitors may nevertheless be a treatment option in women with severe disease refractory to established immunomodulatory drugs. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 03/2015; DOI:10.1111/bcp.12642
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    ABSTRACT: Glucocorticosteroids are a group of structurally related molecules that includes natural hormones and synthetic drugs with a wide range of anti-inflammatory potencies. For synthetic corticosteroid analogues it is commonly assumed that the therapeutic index cannot be improved by increasing their glucocorticoid receptor binding affinity. The validity of this assumption particularly for inhaled corticosteroids has not been fully explored. Inhaled corticosteroids exert their anti-inflammatory activity locally in the airways and hence this can be dissociated from their potential to cause systemic side-effects. The molecular structural features that increase glucocorticoid receptor binding affinity and selectivity drive topical anti-inflammatory activity. But in addition, these structural modifications also result in physicochemical and pharmacokinetic changes that can enhance targeting to the airways and reduce systemic exposure. As a consequence potency and therapeutic index can be correlated. However, this consideration is not reflected in asthma treatment guidelines that classify inhaled corticosteroid formulations as low, mid and high doses and imbed a simple dose equivalence approach where potency is not considered to affect the therapeutic index. This article describes the relationship between potency and therapeutic index and concludes that higher potency can potentially improve the therapeutic index. Therefore both efficacy and safety should be considered when classifying inhaled corticosteroid regimens in terms of dose equivalence. The historical approach to dose equivalence in asthma treatment guidelines is not appropriate for the wider range of molecules, potencies and device/formulations now available. A more robust method is needed that incorporates pharmacological principles. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 03/2015; DOI:10.1111/bcp.12637
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    ABSTRACT: Low-dose aspirin (LDA) and non-steroidal-anti-inflammatory drugs (NSAIDs) both increase the risk of upper gastrointestinal events (UGIEs). In the Netherlands recommendations regarding the prescription of gastroprotective agents (GPA) in LDA users were first issued in 2009 in the HARM-Wrestling consensus. National guidelines on gastroprotective strategies in NSAID users were already issued in the first part of the decade. To examine time-trends in gastroprotective strategies in patients initiating LDA and patients initiating NSAIDs between 2000 and 2012. Within a large electronic primary health care database, two cohorts were selected: (i) patients newly prescribed LDA and (ii) patients newly prescribed NSAIDs between 2000 and 2012. Excluded were patients who had been prescribed a GPA in the six months prior. For both cohorts, patients' risk of a UGIE was classified as low, moderate or high, based on the HARM-Wrestling consensus, and the presence of an adequate gastroprotective strategy was determined. 37 578 patients were included in the LDA cohort, 352 025 patients in the NSAID cohort. In both cohorts, an increase of gastroprotective strategies was observed over time, but prescription of GPA was lower in the LDA cohort. By 2012, an adequate gastroprotective strategy was present in 31.8% of high-risk LDA initiators, versus 48.0% of high-risk NSAID initiators. Despite a comparable risk of UGIEs, gastroprotective strategies are prescribed less in high-risk LDA initiators than in high-risk NSAID initiators. For both groups of patients, there is still room for improvement in guideline adherence. This article is protected by copyright. All rights reserved.
    British Journal of Clinical Pharmacology 03/2015; DOI:10.1111/bcp.12626
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    ABSTRACT: AimEducating physicians in the procedural as well as cognitive skills of IT-mediated medication management could be one of the missing links for improvement of patient safety. We aimed to compose a framework of tasks that need to be addressed to optimize medication management in outpatient care.Methods Formal task analysis: decomposition of a complex task into a set of subtasks. First, we obtained a general description of the medication management process from exploratory interviews. Secondly, we interviewed experts in-depth to further define tasks and subtasks. Setting: Outpatient care in different fields of medicine in six teaching and academic medical centers in the Netherlands and the United States. Participants: 20 experts. Tasks were decomposed into procedural, cognitive and macrocognitive tasks and categorized into the three components of dynamic decision-making.ResultsThe medication management process consists of three components: (1) reviewing the medication situation, (2) composing a treatment plan, and (3) accomplishing and communicate a treatment and surveillance plan. Subtasks include multiple cognitive tasks such as composing a list of current medication and evaluating the reliability of sources, and procedural tasks such as documenting current medication. The identified macrocognitive tasks were: planning, integration of information technology (IT) in workflow, managing uncertainties and responsibilities, and problem detection.Conclusion All identified procedural, cognitive and macrocognitive skills should be included when designing education for IT-mediated medication management. The resulting framework supports the design of educational interventions to improve IT-mediated medication management in outpatient care.
    British Journal of Clinical Pharmacology 03/2015; DOI:10.1111/bcp.12625