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Introduction
Sue Jordan currently works at the Department of Nursing , Swansea University. Sue does research in medicines management and adverse drug reactions. Their current project is the Adverse Drug Reaction (ADRe) Profile. In clinical trials, this has reduced patients' signs and symptoms of medicine-related harm, such as pain, sedation, nausea and falls. it also reduces prescribing of antipsychotics and sedatives. see http://www.swansea.ac.uk/adre/
Skills and Expertise
Current institution
Publications
Publications (350)
Background
Identification of real-time adverse drug reactions [ADRs] (as opposed to the risk of ADRs) in older poly-medicated people in primary care is a challenging task, often undertaken without an explicit strategy. This systematic review aims to evaluate replicable instruments and methods for identifying and addressing ADRs.
Methods
A systemat...
Aim: To estimate the prevalence of medication use in non-hospitalized pregnant women with COVID-19
Methods: A prospective two-stage individual patient meta-analysis across 10 data sources in Europe and North America studied medication use among non-hospitalized pregnant women with COVID-19 between January 2020 to December 2022. Comparisons were mad...
Background
In Europe, the prevalence of congenital ocular anomaly (COA) is estimated at 3.7 per 10,000 births. While certain COAs have a genetic origin, the cause for most patients remains unknown. The role of medications administered during pregnancy in COA genesis in humans is unclear.
Objective
To investigate any association between fetal expos...
Background
Congenital ocular anomalies (COA) are among the most common causes of visual impairment in children in high‐income countries. The aim of the study is to describe the prevalence of the various COA recorded in European population‐based registries of CA (EUROCAT) participating in the EUROmediCAT consortium.
Methods
Data from 19 EUROmediCAT...
Objectives
To compare 5-year survival rate and morbidity in children with spina bifida, transposition of great arteries (TGA), congenital diaphragmatic hernia (CDH) or gastroschisis diagnosed prenatally with those diagnosed postnatally.
Methods
Population-based registers’ data were linked to hospital and mortality databases.
Results
Children whos...
Purpose
The COVID-19 pandemic has impacted medication needs and prescribing practices, including those affecting pregnant women. Our goal was to investigate patterns of medication use among pregnant women with COVID-19, focusing on variations by trimester of infection and location.
Methods
We conducted an observational study using six electronic h...
Aim
The aim is to examine the risk of cerebral palsy, seizures/epilepsy, visual‐ and hearing impairments, cancer, injury/poisoning and child abuse in children with and without a congenital anomaly up to age 5 and 10 years.
Methods
This is a population‐based data linkage cohort study linking information from the European Surveillance of Congenital...
Nurses play an important role in interprofessional pharmaceutical care. Curricula related to pharmaceutical care, however, vary a lot. Mapping the presence of pharmaceutical care related domains and competences in nurse educational programs can lead to a better understanding of the extent to which curricula fit expectations of the labour market. Th...
Purpose
Studies focusing on safety outcomes typically require large populations to comprehensively characterise the patient groups exposed to the medicines under investigation. However, there is often less information for subpopulations, such as pregnant or breastfeeding women, particularly when new medicines are considered. It is important to unde...
Background
The purpose of this study was to evaluate the timing of the first cardiac surgery, the number of cardiac surgeries performed, and 30‐day postoperative mortality rate for children with severe congenital heart defects (sCHDs) in their first 5 years of life.
Methods and Results
This was a population‐based data linkage cohort study linking...
Objectives
To explore the risk of being prescribed/dispensed medications for respiratory symptoms and breathing difficulties in children with and without congenital anomalies.
Design
A EUROlinkCAT population-based data linkage cohort study. Data on children with and without congenital anomalies were linked to prescription databases to identify chi...
Background:
Preterm birth and young maternal age are known risk factors for infant and childhood mortality. There is limited knowledge of the impact of these risk factors in children born with major congenital anomalies (CAs), who have inherently higher risks of death compared with other children.
Objectives:
To investigate the risk factors for...
Linking routinely collected healthcare administrative data is a valuable method for conducting research on morbidity outcomes, but linkage quality and accuracy needs to be assessed for bias as the data were not collected for research. The aim of this study was to describe the rates of linking data on children with and without congenital anomalies t...
Introduction
Linking healthcare data sets can create valuable resources for research, particularly when investigating rare exposures or outcomes. However, across Europe, the permissions processes required to access data can be complex. This paper documents the processes required by the EUROlinkCAT study investigators to research the health and surv...
Background
Congenital anomalies (CAs) increase the risk of death during infancy and childhood. This study aimed to evaluate the accuracy of using death certificates to estimate the burden of CAs on mortality for children under 10 years old.
Methods
Children born alive with a major CA between 1 January 1995 and 31 December 2014, from 13 population-...
Objective:
To evaluate survival, hospitalisations and surgical procedures for children born with Pierre Robin sequence (PRS) across Europe.
Design:
Multicentre population-based cohort study.
Setting:
Data on 463 live births with PRS from a population of 4 984 793 from 12 EUROCAT congenital anomaly registries.
Methods:
Data on children with P...
Introduction
Information on the impact of medicines on breastfeeding and the breastfed infant remains scarce. The aims of this review were to identify databases and cohorts holding this information, and pinpoint current information and research deficits.
Method
We searched 12 electronic databases, including PubMed/ Medline and Scopus, using a comb...
Unlabelled:
Are children with major congenital anomalies more likely to develop diabetes requiring insulin therapy, as indicated by prescriptions for insulin, than children without congenital anomalies? The aim of this study is to evaluate prescription rates of insulin/insulin analogues in children aged 0-9 years with and without major congenital...
Little is known about morbidity for children with rare structural congenital anomalies. This European, population-based data-linkage cohort study analysed data on hospitalisations and surgical procedures for 5948 children born 1995–2014 with 18 rare structural congenital anomalies from nine EUROCAT registries in five countries. In the first year of...
Electronic health care databases are increasingly being used to investigate the epidemiology of congenital anomalies (CAs) although there are concerns about their accuracy. The EUROlinkCAT project linked data from eleven EUROCAT registries to electronic hospital databases. The coding of CAs in electronic hospital databases was compared to the (gold...
Aim:
Children with congenital anomalies often require surgery but data on the burden of surgery for these children are limited.
Methods:
A population-based record-linkage study in Finland, Wales and regions of Denmark, England, Italy and Spain. A total of 91,504 children with congenital anomalies born in 1995-2014 were followed to their tenth bi...
An intervention, SelfMED, was introduced to facilitate patient self-management of medication during hospitalization. This study aimed to evaluate the feasibility and safety of the SelfMED intervention. All patients in a cardiology ward in a Belgian regional hospital were assessed for suitability for inclusion, applying an evidence-based stepped ass...
Background
Congenital anomalies are the leading cause of perinatal, neonatal and infant mortality in developed countries. Large long-term follow-up studies investigating survival beyond the first year of life in children with rare congenital anomalies are costly and sufficiently large standardized cohorts are difficult to obtain due to the rarity o...
The aim of this systematic review was to describe and assess nurse-led interventions to enhance medication adherence and clinical outcomes among adults in community care. PubMed, Medline, Embase, CINAHL, and CENTRAL were searched for relevant studies. Randomized controlled trials (RCTs) published 2011–2021 that tested nurse-led interventions with c...
Background
Safe pharmaceutical care requires competent nurses with specific knowledge, skills and attitudes. It is unclear whether nursing students are adequately prepared to perform pharmaceutical care in practice. Mapping their pharmaceutical care competences can lead to a better understanding of the extent to which curricula fit expectations of...
Objectives:
Preterm children are exposed to many medications in neonatal intensive care units, but little is known about the effect of prematurity on medication use throughout infancy and childhood. We examined prescriptions of cardiovascular medication (CVM), antiseizure medication (ASM), antiasthmatic medication and antibiotics issued/dispensed...
Objectives
Education outcomes predict life chances; however disabilities and concurrent learning difficulties are often barriers to school performance. Low educational achievement is also linked with socio-economic deprivation. We aimed to quantify the association of these factors with education outcomes by ages 12 and 17 for children in Wales (UK)...
Background
The pharmacoepidemiology of the long-term benefits and harms of medicines in pregnancy and breastfeeding has received little attention. The impact of maternal medicines on children is increasingly recognised as a source of avoidable harm. The focus of attention has expanded from congenital anomalies to include less visible, but equally i...
Background
Congenital anomalies are a leading cause of childhood morbidity, but little is known about the long-term outcomes.
Objective
To quantify the burden of disease in childhood for children with congenital anomalies by assessing the risk of hospitalisation, the number of days spent in hospital and proportion of children with extended stays (...
Electronic health care databases are increasingly being used to investigate the epidemiology of congenital anomalies (CAs) although there are concerns about their accuracy. The EUROlinkCAT project linked data from eleven EUROCAT registries to electronic hospital databases. The coding of CAs in electronic hospital databases was compared to the (gold...
Purpose: Are children with major congenital anomalies more likely to develop type 1 diabetes, as indicated by prescriptions for insulin, than children without congenital anomalies? The aim of this study is to evaluate prescription rates of insulin/insulin analogues in children aged 0-9 years with and without major congenital anomalies.
Methods: A E...
Objective
To report and compare the proportion of children with and without congenital anomalies undergoing gastrostomy for tube feeding in their first 5 years.
Methods
A European, population-based data-linkage cohort study (EUROlinkCAT). Children up to 5 years of age registered in nine EUROCAT registries (national and regional) in six countries a...
Background:
Congenital anomalies are a major cause of perinatal, neonatal and infant mortality.
Objectives:
The aim was to investigate temporal changes and geographical variation in survival of children with major congenital anomalies (CA) in different European areas.
Methods:
In this population-based linkage cohort study, 17 CA registries mem...
Abstract: (1) Aims: Adverse drug reactions (ADRs) particularly affect older people prescribed multi�ple medicines. The professional bodies of nursing, medicine and pharmacy have issued guidelines on
identification and management of ADRs; however, ADRs continue to account for ~10% unplanned
hospital admissions in the UK. Current methods of ADR ident...
Objectives:
Advances in surgical management strategies have substantially reduced fatality from congenital heart defects (CHD). Decreased infant mortality might be expected, consequentially to result in greater morbidity in older children due to complications later in childhood and adolescence. This study aims to evaluate the use of cardiovascular...
In 2019, the Innovative Medicines Initiative (IMI) funded the ConcePTION project—Building an ecosystem for better monitoring and communicating safety of medicines use in pregnancy and breastfeeding: validated and regulatory endorsed workflows for fast, optimised evidence generation—with the vision that there is a societal obligation to rapidly redu...
Background
Administering medicines is one of the most high-risk tasks in health care. However, nurses are frequently interrupted during medicine administration, which jeopardises patient safety. Few studies have examined nurses’ experiences and the strategies they adopt to cope with interruptions during medicine rounds. This paper identifies nurses...
Pesticides use in Southeast Asia has increased steadily, driven by the growth of large-scale commercial farming, as well as a desire to maximise food production in rural subsistence economies. Given that use of chemical pesticides, such as organophosphates and carbamates, has known potential health impacts, there are concerns about the safety of ag...
EUROCAT is a European network of population-based congenital anomaly (CA) registries. Twenty-one registries agreed to participate in the EUROlinkCAT study to determine if reliable information on the survival of children born with a major CA between 1995 and 2014 can be obtained through linkage to national vital statistics or mortality records. Live...
Effective medicines optimisation involves the use of medicines to control disease while ensuring that adverse effects are kept to a minimum. However, medicines-related harm and symptom mismanagement represent significant risks to patients, particularly those with long-term conditions. These risks are accentuated by inadequate patient monitoring, wi...
Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before...
Objectives
To understand healthcare professionals’ experiences and perceptions of nurses’ potential or ideal roles in pharmaceutical care (PC).
Design
Qualitative study conducted through semi-structured in-depth interviews.
Setting
Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European count...
Background
Nurses play an important role in pharmaceutical care. They are involved in: detecting clinical change; communicating/discussing pharmacotherapy with patients, their advocates, and other healthcare professionals; proposing and implementing medication-related interventions; and ensuring follow-up of patients and medication regimens. To dat...
This study explores the legal considerations surrounding medicines management, providing a synthesis of existing knowledge. An integrative systematic review of the current international knowledge was performed. The search encompassed the online databases of PubMed (including Medline), Scopus, CINAHL, and Web of Science using MeSH terms and relevant...
Background
Nurse-led monitoring of patients for signs and symptoms associated with documented ‘undesirable effects’ of medicines has potential to prevent avoidable harm, and optimise prescribing.
Intervention
The Adverse Drug Reaction Profile for polypharmacy (ADRe-p) identifies and documents putative adverse effects of medicines commonly prescrib...
Aim
To compare doctors’ and nurses’ perceptions of factors influencing medical error reporting.
Background
In Nigeria, there is limited information on determinants of error reporting and systems.
Methods
From the total workforce (N=600), 140 nurses and 90 doctors were selected by random sampling and completed the questionnaire February to March 2...
Aim: To compare doctors’ and nurses’ perceptions of factors influencing medical error reporting.
Background: In Nigeria, there is limited information on determinants of error reporting and systems.
Methods: From the total workforce (N=600), 140 nurses and 90 doctors were selected by random sampling and completed the questionnaire February to March...
Aims
The aim of this systematic review was to explore and evaluate the efficacy of interventions to reduce the prevalence of look‐alike, sound‐alike (LASA) medication name errors.
Methods
We conducted a systematic review of the literature, searching PubMed, EMBASE, Scopus and Web of Science up to December 2016, and re‐ran the search in February 20...
Objectives
To explore associations between exposures to medicines prescribed for asthma and their discontinuation in pregnancy and preterm birth [<37 or <32 weeks], SGA [<10th and <3rd centiles], and breastfeeding at 6–8 weeks.
Methods
Design. A population-based cohort study.
Setting. The Secure Anonymised Information Linkage [SAIL] databank in Wa...
Medicines management is a high-risk and error prone process in healthcare settings, where nurses play an important role to preserve patient safety. In order to create a safe healthcare environment, nurses should recognize challenges that they face in this process, understand factors leading to medication errors, identify errors and systematically a...
Aim
To explore UK professionals’ interpretations of medicines optimization and expansion of nurses’ roles.
Design
This mixed‐methods study sought professionals’ views on nurses’ involvement, competency and engagement in monitoring patients for adverse effects of medicines, monitoring adherence, prescribing and patient education.
Method
An online...
Advances in medicines have increased the effectiveness of treatments and the social and cultural authority of doctors. However, as prescribing has become the dominant modality of treatment, the "pharmaceuticalization" of medical practice has often resulted in treatment "at a distance", with doctors having limited contact with patients. Older and po...
Objectives Safe pharmaceutical care (PC) requires an
interprofessional team approach, involving physicians,
nurses and pharmacists. Nurses’ roles however, are not
always explicit and clear, complicating interprofessional
collaboration. The aim of this study is to describe nurses’
practice and interprofessional collaboration in PC, from the
viewpoin...
Look‐alike or sound‐alike (LASA) medication names may be mistaken for each other, e.g. mercaptamine and mercaptopurine. If an error of this sort is not intercepted, it can reach the patient and may result in harm. LASA errors occur because of shared linguistic properties between names (phonetic or orthographic), and potential for error is compounde...
Patient safety is crucial for the sustainability of the healthcare system. However, this may be jeopardized by the high prevalence of practice errors, particularly in residential long-term care. Development of improvement initiatives depends on full reporting and disclosure of practice errors. This systematic review aimed to understand factors that...
Background:
Nurses' recognition of clinical deterioration is crucial for patient survival. Evidence for the effectiveness of modified early warning scores (MEWS) is derived from large observation studies in developed countries.
Methods:
We tested the effectiveness of the paper-based Cape Town (CT) MEWS vital signs observation chart and situation...
Many medications are prescribed and administered PRN (pro re nata, as needed). However, there are few integrative reviews to inform PRN psychotropic medication use in long-term care facilities and nursing or care homes. Accordingly, this integrative systematic review aimed to improve our understanding of PRN medicines management with a focus on psy...
Objectives
To explore associations between exposure to antidepressants, their discontinuation, depression [medicated or unmediated] and preterm birth [<37 and <32 weeks], small for gestational age (SGA) [<10th and <3rd centiles], breastfeeding [any] at 6–8 weeks.
Methods
Design: A population-based cohort study.
Setting: The Secure Anonymised Infor...
Introduction
Preventable adverse effects of medicines often pass unnoticed, but lead to real harm.
Intervention
Nurse-led monitoring using the structured Adverse Drug Reaction (ADRe) Profile identifies and addresses adverse effects of mental health medicines.
Objectives
This study investigated the implementation and clinical impact of ADRe, and b...
Background
The excellent paper by Panagioti et al. [1] reminds us of the significance impact of preventable iatrogenic harm, affecting around 6% of patients. More than half the harm is due to mismanagement of prescribed medicines and other therapeutic management incidents. Further research is unlikely to substantially alter this estimate [2], and these findin...
Prescription medicines aim to relieve patients' suffering but they can be associated with adverse side effects or adverse drug reactions (ADRs). ADRs are an important cause of hospital admissions and a financial burden on healthcare systems across the globe. There is little integrative and collective knowledge on ADR reporting and monitoring in the...
Objective
This study aimed to examine the rates of initiation and continuation of breastfeeding (BF) and their relationship with mothers’ sociodemographic, obstetric, neonatal, and medical interventions.
Methods
Data were collected from 199 first-time Jordanian mothers using medical records, face-to-face interviews within 24 hours of birth, and tw...
Introduction:
Improved medicines' management could lead to real and sustainable improvements to the care of older adults. The overuse of mental health medicines has featured in many reports, and insufficient patient monitoring has been identified as an important cause of medicine-related harms. Nurse-led monitoring using the structured adverse dru...
The power and influence of healthcare systems comes largely from the ability to prescribe efficacious medicine. However, medicine can sometimes cause harm rather than bring benefits. Systematically checking patients for the adverse effects of medicines, as listed in manufacturers’ literature, would protect patients from iatrogenic harm, but this is...
The power and influence of healthcare systems comes largely from the ability to prescribe efficacious medicine. However, medicine can sometimes cause harm rather than bring benefits. Systematically checking patients for the adverse effects of medicines, as listed in manufacturers' literature, would protect patients from iatrogenic harm, but this is...
PRN is the acronym for 'pro re nata,' written against prescriptions whose administration should be based on patients' needs, rather than at set times. The aim of this systematic review was to explore safety issues and adverse events arising from PRN prescription and administration. Electronic databases including Scopus, PubMed [including Medline],...
PRN is the acronym for 'pro re nata,' written against prescriptions whose administration should be based on patients' needs, rather than at set times. The aim of this systematic review was to explore safety issues and adverse events arising from PRN prescription and administration. Electronic databases including Scopus, PubMed [including Medline],...
Most randomised controlled trials (RCTs) are relatively short term and, due to costs and available resources, have limited opportunity to be re-visited or extended. There is no guarantee that effects of treatments remain unchanged beyond the study. Here, we illustrate the feasibility, benefits and cost-effectiveness of enriching standard trial desi...
Aims and objectives
To identify sources of interruptions and distractions to medicine administration rounds in hospitals.
Background
Nurses are frequently interrupted during medicine administration. There is no systematic description of nurses’ behaviours and interruptions during administration of medicines to patients.
Design
Exploratory non‐par...
PurposePregnancy prevention programmes (PPPs) exist for some medicines known to be highly teratogenic. It is increasingly recognised that the impact of these risk minimisation measures requires periodic evaluation. This study aimed to assess the extent to which some of the data needed to monitor the effectiveness of PPPs may be present in European...
Objectives
To evaluate the risk of major congenital anomaly associated with first-trimester exposure to insulin analogues compared with human insulin in offspring of women with pregestational diabetes.
Design and setting
A population-based cohort of women with pregestational diabetes (n=1661) who delivered between 1996 and 2012 was established ret...
Introduction
There are concerns that the high incidence of medicine-related adverse events is compromising patient safety. System errors and human factors, particularly inadequate knowledge of pharmacotherapy, are significant causes of medication errors. Little has been published on the continuing professional education of radiographers. We report...
Introduction
Health care providers can make errors when administering medicines, and when medicines are given intravenously (IV) or are high-alert medicines (e.g., contrast agents, analgesics, adrenergic agonists). Errors can result in significant patient harm. Radiology departments' professionals' medication competence should be developed and regu...
Objectives
9.4% of pregnant women in Wales are prescribed medicines for asthma. Prescription of asthma medicines in early pregnancy is associated with increased prevalence of congenital anomalies (aOR 1.20, 1.08 - 1.34). The literature offers less consensus on more common adverse outcomes: premature delivery (
Aims and objectives:
To develop and validate a modified Situation-Background-Assessment-Recommendation communication tool incorporating components of the Cape Town modified early warning score vital signs chart for reporting early signs of clinical deterioration.
Background:
Reporting early signs of physiological and clinical deterioration could...
Background
Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were int...
Primary care assessment survey questionnaire.
(DOC)
Annex on sampling: Information regarding selection of THPHs.
(DOC)
Background
Hypothesised associations between in utero exposure to selective serotonin reuptake inhibitors (SSRIs) and congenital anomalies, particularly congenital heart defects (CHD), remain controversial. We investigated the putative teratogenicity of SSRI prescription in the 91 days either side of first day of last menstrual period (LMP).
Metho...
Supplementary tables.
Tables Aa-c. The populations. Tables Ba and Bb. Anomalies and exposures for each SSRI and all antidepressants. Table C. Anomalies and SSRI exposure for each agent with data from 3 countries. Table D. Anomalies and SSRI exposure with and without antidepressants. Table E. Deprivation and selected exposures in Wales. Table F. Exp...
Aim The physical health of people with mental health conditions is often suboptimal, and in many cases this may be related to their prescription medicines. One issue is that patients are monitored inconsistently for adverse drug reactions (ADRs). The aim of this study was to explore whether the nurse-led West Wales Adverse Drug Reaction (WWADR) Pro...
Medication errors that occur when medications have similar-looking or similar-sounding names or similar product packaging and labelling are called look-alike, sound-alike (LASA) errors. The objective of this review is to systematically identify and evaluate the evidence on interventions delivered in any healthcare setting that aim to reduce the rat...
A symposium of five papers.
The aim of this symposium is to describe how the Community Nursing Research Strategy for Wales has been used to coordinate, support and develop knowledge for change and improvement.