Stephen Byrne

Stephen Byrne
University College Cork | UCC · School of Pharmacy

BSc (Hon) Pharmacy, PhD, Dip Stat, Cert Health Econ, Cert Clin Pharm,

About

247
Publications
84,329
Reads
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8,408
Citations
Citations since 2016
144 Research Items
6614 Citations
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201620172018201920202021202202004006008001,000
201620172018201920202021202202004006008001,000
Additional affiliations
January 2012 - present
Queen's University Belfast
January 2012 - present
Université Catholique de Louvain - UCLouvain
Position
  • Université catholique de Louvain
January 2006 - December 2010
University College Cork
Education
October 1997 - December 2001
Trinity College Dublin
Field of study
  • Pharmacy Practice
September 1993 - July 1996
University of Sunderland
Field of study
  • Pharmacy

Publications

Publications (247)
Conference Paper
Background and Objective: Frail older people residing in nursing homes are often prescribed inappropriate and unnecessary medications. Whilst the STOPPFrail criteria can aid deprescribing in such residents with limited life expectancy, there is insufficient research showing pharmacists’ application of this tool (1,2). Therefore, the objective of th...
Article
Full-text available
Background: Pharmacists are being increasingly employed as part of general practice teams globally, and their input has been associated with several clinical and economic benefits. However, there is a paucity of research focussing on general practitioners' (GPs') perceptions of pharmacist integration into practices in countries where this novel ro...
Article
Full-text available
Background To help address the issue of inappropriate antipsychotic prescribing to nursing home residents with dementia, the ‘Rationalising Antipsychotic Prescribing in Dementia’ (RAPID) complex intervention was developed, comprising staff education and training, academic detailing and a novel resident assessment tool. Objectives The primary objec...
Article
Background and objective: Prescribing cascades occur when a drug is prescribed to manage side effects of another drug, typically when a side effect is misinterpreted as a new condition. A consensus list of clinically important prescribing cascades that adversely affect older persons' health (i.e., where risks of the prescribing cascade usually exc...
Article
Full-text available
Background Heart failure (HF) guideline-led prescribing improves patient outcomes; however, little is known about the factors influencing guideline-led prescribing in critical care settings. This study used a cross-sectional survey to assess the factors that influence physicians when prescribing to heart failure patients in a critical care setting...
Article
Full-text available
Background Inappropriate polypharmacy has been linked with adverse outcomes in older, multimorbid adults. OPERAM is a European cluster-randomized trial aimed at testing the effect of a structured pharmacotherapy optimization intervention on preventable drug-related hospital admissions in multimorbid adults with polypharmacy aged 70 years or older....
Article
Full-text available
Context Subclinical thyroid dysfunction and anemia are common disorders, and both have increasing prevalence numbers with advancing age. Objective The aim of this study was to assess whether levothyroxine treatment leads to a rise in hemoglobin levels in older persons with subclinical hypothyroidism. Design A pre-planned combined analysis of two...
Article
Communication plays a key role in the provision of safe patient care, and miscommunication in healthcare can lead to avoidable patient harm or mortality. Interprofessional communication (IPCom) can be challenging due to differences in training, education and roles between healthcare professions. The aim of this systematic review was to synthesize t...
Conference Paper
Background and Objective: Pharmacist services in general practice are expanding worldwide, with evidence to show that pharmacists in this setting reduce the number of patients’ appointments with their general practitioner (GP), improve medication management, and reduce medication costs. Yet, little is known globally about GPs’ views of the role of...
Article
Background Irish and European antimicrobial resistance (AMR) surveillance data have highlighted increasing AMR in Enterobacterales and vancomycin resistance in Enterococcus faecium (VRE). Antimicrobial consumption (AC) in Irish hospital settings is also increasing. Methods A retrospective time series analysis (TSA) was conducted to evaluate the tr...
Article
Full-text available
Purpose Oral anti-cancer therapies offer advantages over parenteral therapies in terms of their non–invasive nature and reduced intrusiveness. However, the shift from directly observed administration of these therapies to home administration means that continuous monitoring is needed. The oral anti-cancer therapy market is rapidly growing, with an...
Poster
Full-text available
Background and Objective: Pharmacist services in general practice are expanding worldwide, with evidence to show that pharmacists in this setting reduce the number of patients’ appointments with their general practitioner (GP), improve medication management, and reduce medication costs. Yet, little is known globally about GPs’ views of the role of...
Article
Full-text available
Background Pharmacist services in general practice are expanding worldwide, with evidence to show pharmacists’ presence in general practice has financial, workload, and clinical benefits. Yet, little is known globally about general practitioners’ (GPs’) views on their presence in general practice. Objective To synthesize the qualitative research e...
Conference Paper
Introduction: The SENATOR trial intervention aimed to optimise pharmacological therapy for multi-morbid older adults in hospital with the provision of recommendations based on STOPP/START criteria and drug interactions. Even though inappropriate prescribing in renal impairment can cause adverse drug reactions (ADRs), the SENATOR software did not ai...
Article
Full-text available
Objective To examine the effect of optimising drug treatment on drug related hospital admissions in older adults with multimorbidity and polypharmacy admitted to hospital. Design Cluster randomised controlled trial. Setting 110 clusters of inpatient wards within university based hospitals in four European countries (Switzerland, Netherlands, Belg...
Article
Full-text available
Aim: Non-implementation of pharmacist recommendations by physician prescribers may prolong potentially inappropriate prescribing in hospitalised older adults, increasing the risk of adverse clinical outcomes. The aim of this study was to ascertain the key factors affecting physician prescriber implementation of pharmacists' medication appropriaten...
Article
Full-text available
When this paper was first published, there were errors in Figure 1 and Table 3. These errors have now been corrected online. In Figure 1, the text that read “No data available/lost to follow-up n = 56” should have read “No data available/lost to follow-up n = 40”. In Table 3, the text reading “Mortality (all-cause) within 30 days of randomization”...
Article
Background The Irish healthcare system is currently recognised as being understaffed and under-resourced due to historic underfunding and the aftermath of the 2008 global financial crisis. This descriptive study investigated healthcare providers’ perceptions of the safety culture in a large Irish teaching hospital.AimThe aim of this study was to in...
Article
Full-text available
Background Measuring the quality and effectiveness of antimicrobial stewardship (AMS) programmes with quality indicators (QIs) is an area of increasing interest. We conducted a systematic review to identify QIs of AMS programmes in the hospital setting and critically appraise their methodological quality. Methods We searched the Cochrane Library,...
Article
Full-text available
Introduction Communication is widely recognised to play a key role in patient care. The US Institute of Medicine’s 2002 report, ‘Crossing the Quality Chasm’, stated that ‘effective methods of communication, both among caregivers and between caregivers and patients, are critical to providing high-quality care’.(1) Interdisciplinary communication (ID...
Article
Full-text available
Background : Antipsychotics are commonly prescribed to people living with dementia in nursing home settings, despite strong guideline recommendations against their use except in limited circumstances. We aimed to transparently describe the development process for a complex intervention targeting appropriate requesting and prescribing of antipsychot...
Article
Purpose Cancer patients are a particularly vulnerable population group, facing an increase in physical, mental, logistical and financial difficulties. This as well as Ireland’s increased focus on primary care with the Sláintecare health plan led to the development of the Community Oncology Nursing Programme, where community nurses are trained to pr...
Article
Background Guidelines recommend heart failure (HF) patients be treated with multiple medications at doses proven to improve clinical outcomes. Objective To study guideline-led prescribing in an Irish outpatient HF population. Setting Cardiology Outpatient Clinic, Mercy University Hospital, Cork, Ireland. Methods Guideline-led prescribing was assess...
Article
Full-text available
Background: Developed in the late 20th century, the health policy triangle (HPT) is a policy analysis framework used and applied ubiquitously in the literature to analyse a large number of health-related issues. Objective: To explore and summarise the application of the HPT framework to health-related (public) policy decisions in the recent litera...
Article
Background Successful antimicrobial stewardship interventions are imperative in today’s environment of antimicrobial resistance. New antimicrobial stewardship interventions should include qualitative analysis such as a process evaluation to determine which elements within an intervention are effective and provide insight into the context in which t...
Article
Full-text available
Background: The EQ-5D-3L and EQ-5D-5L are two generic health-related quality of life measures, which may be used in clinical and health economic research. They measure impairment in 5 aspects of health: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The aim of this study was to assess the performance of the EQ-5D-3L...
Article
Full-text available
Purpose Ireland's Sláintecare health plan is placing an increased focus on primary care. A community oncology nursing programme was developed to train community nurses to deliver care in the community. While the initial pilot was proven to be clinically safe, no cost evaluation was carried out. This study aims to compare the costs of providing canc...
Article
Full-text available
Discharge prescriptions for heart failure (HF) patients may not adhere to the clinical practice guidelines. This study aimed to assess the impact of the clinical pharmacist as a member of a multidisciplinary team on the quality of prescribing to HF patients at discharge from a Critical Care Unit (CCU) in Egypt. This was a retrospective cohort study...
Article
Background: The SENATOR trial intervention included the provision of computer-generated medication recommendations to physician prescribers caring for hospitalised older adults (≥ 65 years), with the aim of reducing in-hospital adverse drug reactions. Interim data analysis during the trial revealed that the prescriber implementation rates of the co...
Article
Nursing home residents with dementia are commonly prescribed antipsychotics despite the associated increased risk of harms. Interventions to optimize prescribing practice have been found to be effective in the short term, but there is a lack of evidence to support sustainability of effects, along with a lack of theory, public involvement, and trans...
Article
Background: findings from a recent qualitative study indicate that the perceived clinical relevance of computer-generated STOPP/START recommendations was a key factor affecting their implementation by physician prescribers caring for hospitalised older adults in the SENATOR trial. Aim: to systematically evaluate the clinical relevance of these reco...
Article
Background: Multi-morbidity and polypharmacy increase the risk of non-trivial adverse drug reactions (ADRs) in older people during hospitalization. Despite this, there are no established interventions for hospital-acquired ADR prevention. Methods: We undertook a pragmatic, multi-national, parallel arm prospective randomized open-label, blinded e...
Article
Full-text available
Public discourse on medicine provision predominantly focuses on overall expenditure. However, current literature suggests measurement of alternative indicators can provide a method to benchmark or ameliorate medicine provision. Previous research has investigated the viability of using health-related outcome metrics, such as the number of patients t...
Conference Paper
Full-text available
Introduction: Pharmacists’ recommendations to physicians concerning medication appropriateness significantly reduce potentially inappropriate prescribing, adverse drug reactions, and medication‐related readmissions in hospitalised older adults. Intervention studies with a high proportion of prescribing recommendations implemented are more likely to...
Article
Background The measurement of safety culture, the way in which members of an organisation think about and prioritise safety, in a hospital can provide valuable insight and inform quality improvement strategies.AimsThe aim of this study is to describe the safety culture of a university teaching hospital in the Republic of Ireland.Methods This is a m...
Article
Full-text available
Background: Several approaches to medication optimisation by identifying drug-related problems in older people have been described. Although some interventions have shown reductions in drug-related problems (DRPs), evidence supporting the effectiveness of medication reviews on clinical and economic outcomes is lacking. Application of the STOPP/STA...
Article
Background Mandatory co-payments attached to prescription medicines on the Irish public health insurance [General Medical Services (GMS)] scheme have undergone multiple iterations since their introduction in October 2010. To date, whilst patients’ opinions on said co-payments have been evaluated, the perspectives of community pharmacists and genera...
Technical Report
Full-text available
This National Clinical Guideline provides evidence-based recommendations on the indications and risks of psychotropic medications for a person with dementia who has non-cognitive symptoms, such as anxiety or agitation.
Technical Report
Full-text available
This National Clinical Guideline provides evidence-based recommendations on the indications and risks of psychotropic medications for a person with dementia who has non-cognitive symptoms, such as anxiety or agitation. This is the full report.
Article
Background: In 2017, the World Health Organisation pledged to halve medication errors by 2022. In order to learn from medication errors and prevent their recurrence, it is essential that medication errors are reported when they occur. Objectives: The aim of this systematic review was to identify studies in which interventions were carried out in...
Conference Paper
Full-text available
Objective/purpose: Two large acute Irish University teaching hospitals changed the manner in which they treated human epidermal growth factor receptor (HER)2-positive breast cancer patients by implementing the administration of trastuzumab via the subcutaneous (SC) route into their clinical practice. The study objective is to compare the trastuzuma...
Article
Introduction: Stress negatively impacts upon physical and mental health, and pharmacy students demonstrate higher levels of stress than the general population. Mindfulness may be a suitable way to improve pharmacy students' stress and distress levels in order to cope with academic pressures and professional responsibilities. The objective of this...
Article
Background Medicine reconciliation is defined as ‘The process of creating and maintaining the most accurate list possible of all medications a person is taking’. Medicine reconciliation (MR) is supported by various Irish governmental agencies such as the HSE, HIQA, PSI and the State Claims Agency. In addition, Irish GPs and community pharmacists ar...
Article
Background Advances in medicines reconciliation, drug monitoring and patient counselling requirements as well as added non-clinical responsibilities at ward level have led to an increased workload on a ward-based pharmacist. There is a need to optimise the service to meet these demands. The aim of this study was to audit the current clinical pharma...
Article
Background With increasing numbers of older multi-morbid people being exposed to polypharmacy, research needs to focus on medication-related outcomes affecting quality-of-life (QoL). This study examines older-patients’ medication-related QoL (MRQoL), its relationship to medication burden/complexity, frailty, health-related QoL (HRQoL) and potential...
Article
Full-text available
Background: Diagnostic uncertainty and a high prevalence of viral infections present unique challenges for antimicrobial prescribing for respiratory tract infections (RTIs). Procalcitonin (PCT) has been shown to support prescribing decisions and reduce antimicrobial use safely in patients with RTIs, but recent study results have been variable. Me...
Article
Full-text available
Introduction: Multimorbidity and polypharmacy are important risk factors for drug-related hospital admissions (DRAs). DRAs are often linked to prescribing problems (overprescribing and underprescribing), as well as non-adherence with drug regimens for different reasons. In this trial, we aim to assess whether a structured medication review compare...
Article
Introduction: Stress negatively impacts pharmacy students' physical and mental health. Mindfulness has been shown to improve student wellbeing. The purpose of this study was to assess the feasibility and acceptability of an online mindfulness-based intervention and determine its effect on student wellbeing. Methods: A quasi-randomised controlled...
Article
Introduction: Stress negatively impacts upon physical and mental health. Pharmacy students demonstrate higher stress than the general population. Mindfulness may improve pharmacy students' stress and distress levels. The purpose of this study was to assess the quantitative effects of a mindfulness-based intervention on pharmacy student stress, dis...
Conference Paper
Full-text available
Introduction: The intervention in the SENATOR multicentre randomised-controlled trial included the provision of computer-generated medication recommendations to physician prescribers caring for hospitalised older adults (≥65 years), with the aim of reducing adverse drug reactions in this patient cohort. Interim data analysis during the trial reveal...
Conference Paper
Full-text available
Introduction: Findings from a recent qualitative study have suggested that the clinical relevance of computer-generated STOPP/START recommendations was a key factor affecting their implementation by prescribers in the SENATOR randomised-controlled trial (RCT).[1] Aims: The aims of this study were, firstly, to systematically evaluate the clinical re...
Conference Paper
Full-text available
Introduction: Safety culture – the way in which an organisation contemplates and prioritises safety – is measured using surveys such as the Safety Attitudes Questionnaire (SAQ) (1). These surveys calculate healthcare providers’ ‘scores’ in several dimensions of safety culture. However, few qualitative studies have been carried out to investigate th...
Article
Full-text available
Background The aim of this trial is to evaluate the effect of SENATOR software on incident, adverse drug reactions (ADRs) in older, multimorbid, hospitalized patients. The SENATOR software produces a report designed to optimize older patients’ current prescriptions by applying the published STOPP and START criteria, highlighting drug-drug and drug-...
Article
Full-text available
Purpose Older people are at risk of potentially inappropriate prescribing (PIP) due to polypharmacy arising from multi-morbidity. Despite available explicit criteria to reduce PIP, it is highly prevalent. Whilst community pharmacists have the required knowledge to help reduce PIP, they are not currently engaged with the problem. This study explores...
Article
Background: Two large acute Irish University teaching hospitals changed the manner in which they treated human epidermal growth factor receptor (HER)2-positive breast cancer patients by implementing the administration of trastuzumab via the subcutaneous (SC) route into their clinical practice. The study objective is to compare the trastuzumab SC a...
Article
Full-text available
Background Academic detailing is a form of continuing medical education in which a trained health professional such as a physician or pharmacist visits prescribers in their practice to provide evidence-based information. While academic detailing has been adopted in other countries, this strategy is not routinely used in Ireland. Objective The aim o...
Article
Full-text available
Background Two randomised controlled trials (RCTs) conducted simultaneously in the same Irish university teaching hospital have shown that provision of Screening Tool of Older Persons’ Prescriptions (STOPP)/Screening Tool to Alert doctors to Right Treatment (START) recommendations to attending prescribers by a physician or a pharmacist can reduce i...
Data
Table S1 Search strategy Table S2 Risk of bias assessment Table S3 Data extraction form Table S4 Behaviour change techniques taxonomy version 1 (BCTTv1) applied to the included studies and the prevalence of each BCT and BCT cluster
Data
Figure S1 Mean number of drugs per patient post‐intervention comparing experimental (intervention) group and control group Figure S2 Subgroup analysis on target person (patient or healthcare professional) for mean difference in the change in number of drugs per patient Figure S3 Subgroup analysis on risk of bias assessment (random sequence genera...
Poster
Full-text available
Potential cost savings from switching these 20 patients can range from €76,638 to €180,099. • Assuming no discount rate is applied to the publicly available ex-factory price, switching this cohort of patients to biosimilar infliximab CT-P13 can result in an immediate cost saving of 25% for the Irish healthcare sector • The availability of this bios...