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Article ; Online: Bridging the gap between clinical pharmacology and rational drug prescribing 2.0: An up-date after 30 years.

Donker, Erik M / Bakkum, Michiel J / Richir, Milan C / Tichelaar, Jelle

British journal of clinical pharmacology

2024

Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Journal Article
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.16051
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Feasibility and evaluation of high-fidelity simulation education for acute clinical toxicology.

Brinkman, David J / Wackwitz, Nella S / Donker, Erik / Tichelaar, Jelle

British journal of clinical pharmacology

2024 Volume 90, Issue 5, Page(s) 1357–1364

Abstract: To prepare medical students appropriately for the management of toxicological emergencies, we have developed a simulation-based medical education (SBME) training in acute clinical toxicology. Our aim is to report on the feasibility, evaluation and ... ...

Abstract	To prepare medical students appropriately for the management of toxicological emergencies, we have developed a simulation-based medical education (SBME) training in acute clinical toxicology. Our aim is to report on the feasibility, evaluation and lessons learned of this training. Since 2019, each year approximately 180 fifth-year medical students are invited to participate in the SBME training. The training consists of an interactive lecture and two SBME stations. For each station, a team of students had to perform the primary assessment and management of an intoxicated patient. After the training, the students completed a questionnaire about their experiences and confidence in clinical toxicology. Overall, the vast majority of students agreed that the training provided a fun, interactive and stimulating way to teach about clinical toxicology. Additionally, they felt more confident regarding their skills in this area. Our pilot study shows that SBME training was well-evaluated and feasible over a longer period.
MeSH term(s)	Humans ; Feasibility Studies ; Students, Medical/psychology ; Pilot Projects ; Toxicology/education ; Clinical Competence ; High Fidelity Simulation Training/methods ; Surveys and Questionnaires ; Education, Medical, Undergraduate/methods ; Simulation Training/methods
Language	English
Publishing date	2024-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.16023
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Quality indicators for appropriate in-hospital pharmacotherapeutic stewardship: An international modified Delphi study.

Mahomedradja, Rashudy F / Tichelaar, Jelle / Mokkink, Lidwine B / Sigaloff, Kim C E / van Agtmael, Michiel A

British journal of clinical pharmacology

2024 Volume 90, Issue 5, Page(s) 1280–1300

Abstract: Aims: In-hospital prescribing errors may result in patient harm, such as prolonged hospitalisation and hospital (re)admission, and may be an emotional burden for the prescribers and healthcare professionals involved. Despite efforts, in-hospital ... ...

Abstract	Aims: In-hospital prescribing errors may result in patient harm, such as prolonged hospitalisation and hospital (re)admission, and may be an emotional burden for the prescribers and healthcare professionals involved. Despite efforts, in-hospital prescribing errors and related harm still occur, necessitating an innovative approach. We therefore propose a novel approach, in-hospital pharmacotherapeutic stewardship (IPS). The aim of this study was to reach consensus on a set of quality indicators (QIs) as a basis for IPS. Methods: A three-round modified Delphi procedure was performed. Potential QIs were retrieved from two systematic searches of the literature, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. In two written questionnaires and a focus meeting (held between the written questionnaire rounds), potential QIs were appraised by an international, multidisciplinary expert panel composed of members of the European Association for Clinical Pharmacology and Therapeutics (EACPT). Results: The expert panel rated 59 QIs and four general statements, of which 35 QIs were accepted with consensus rates ranging between 79% and 97%. These QIs describe the activities of an IPS programme, the team delivering IPS, the patients eligible for the programme and the outcome measures that should be used to evaluate the care delivered. Conclusions: A framework of 35 QIs for an IPS programme was systematically developed. These QIs can guide hospitals in setting up a pharmacotherapeutic stewardship programme to reduce in-hospital prescribing errors and improve in-hospital medication safety.
MeSH term(s)	Humans ; Delphi Technique ; Quality Indicators, Health Care/standards ; Medication Errors/prevention & control ; Consensus ; Surveys and Questionnaires ; Hospitalization ; Hospitals/standards
Language	English
Publishing date	2024-02-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.16015
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Article ; Online: Sustainable medicines use in clinical practice-It is time to help the teacher.

Bakkum, Michiel J / Richir, Milan C / van Agtmael, Michiel A / Tichelaar, Jelle

British journal of clinical pharmacology

2022 Volume 88, Issue 7, Page(s) 3030–3031

Language	English
Publishing date	2022-04-05
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.15340
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Factors influencing in-hospital prescribing errors: A systematic review.

Mahomedradja, Rashudy F / Schinkel, Michiel / Sigaloff, Kim C E / Reumerman, Michael O / Otten, René H J / Tichelaar, Jelle / van Agtmael, Michiel A

British journal of clinical pharmacology

2023 Volume 89, Issue 6, Page(s) 1724–1735

Abstract: Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted ... ...

Abstract	Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted interventions to prevent or reduce in-hospital PEs, identification and understanding of facilitating and protective factors influencing in-hospital PEs in current daily practice is necessary, adopting a Safety-II perspective. The aim of this systematic review was to create an overview of all factors reported in the literature, both protective and facilitating, as influencing in-hospital PEs. Methods: PubMed, EMBASE.com and the Cochrane Library (via Wiley) were searched, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, for studies that identified factors influencing in-hospital PEs. Both qualitative and quantitative study designs were included. Results: Overall, 19 articles (6 qualitative and 13 quantitative studies) were included and 40 unique factors influencing in-hospital PEs were identified. These factors were categorized into five domains according to the Eindhoven classification ('organization-related', 'prescriber-related', 'prescription-related', 'technology-related' and 'unclassified') and visualized in an Ishikawa (Fishbone) diagram. Most of the identified factors (87.5%; n = 40) facilitated in-hospital PEs. The most frequently identified facilitating factor (39.6%; n = 19) was 'insufficient (drug) knowledge, prescribing skills and/or experience of prescribers'. Conclusion: The findings of this review could be used to identify points of engagement for future intervention studies and help hospitals determine how to optimize prescribing. A multifaceted intervention, targeting multiple factors might help to circumvent the complex challenge of in-hospital PEs.
MeSH term(s)	Humans ; Health Care Costs ; Hospitals ; Knowledge ; Patient Harm ; Protective Factors
Language	English
Publishing date	2023-03-17
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.15694
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Article ; Online: Using artificial intelligence to create diverse and inclusive medical case vignettes for education.

Bakkum, Michiel J / Hartjes, Mariëlle G / Piët, Joost D / Donker, Erik M / Likic, Robert / Sanz, Emilio / de Ponti, Fabrizio / Verdonk, Petra / Richir, Milan C / van Agtmael, Michiel A / Tichelaar, Jelle

British journal of clinical pharmacology

2024 Volume 90, Issue 3, Page(s) 640–648

Abstract: Aims: Medical case vignettes play a crucial role in medical education, yet they often fail to authentically represent diverse patients. Moreover, these vignettes tend to oversimplify the complex relationship between patient characteristics and medical ... ...

Abstract	Aims: Medical case vignettes play a crucial role in medical education, yet they often fail to authentically represent diverse patients. Moreover, these vignettes tend to oversimplify the complex relationship between patient characteristics and medical conditions, leading to biased and potentially harmful perspectives among students. Displaying aspects of patient diversity, such as ethnicity, in written cases proves challenging. Additionally, creating these cases places a significant burden on teachers in terms of labour and time. Our objective is to explore the potential of artificial intelligence (AI)-assisted computer-generated clinical cases to expedite case creation and enhance diversity, along with AI-generated patient photographs for more lifelike portrayal. Methods: In this study, we employed ChatGPT (OpenAI, GPT 3.5) to develop diverse and inclusive medical case vignettes. We evaluated various approaches and identified a set of eight consecutive prompts that can be readily customized to accommodate local contexts and specific assignments. To enhance visual representation, we utilized Adobe Firefly beta for image generation. Results: Using the described prompts, we consistently generated cases for various assignments, producing sets of 30 cases at a time. We ensured the inclusion of mandatory checks and formatting, completing the process within approximately 60 min per set. Conclusions: Our approach significantly accelerated case creation and improved diversity, although prioritizing maximum diversity compromised representativeness to some extent. While the optimized prompts are easily reusable, the process itself demands computer skills not all educators possess. To address this, we aim to share all created patients as open educational resources, empowering educators to create cases independently.
MeSH term(s)	Humans ; Artificial Intelligence ; Education, Medical ; Ethnicity
Language	English
Publishing date	2024-01-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.15977
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Medical students as junior adverse drug event managers facilitating reporting of ADRs.

Reumerman, Michael O / Tichelaar, Jelle / Richir, Milan C / van Agtmael, Michiel A

British journal of clinical pharmacology

2021 Volume 87, Issue 12, Page(s) 4853–4860

Abstract: The Junior Adverse Drug Event Manager (J-ADEM) team is a multifaceted intervention focusing on real-life education for medical students that has been shown to assist healthcare professionals in managing and reporting suspected adverse drug reactions ( ... ...

Abstract	The Junior Adverse Drug Event Manager (J-ADEM) team is a multifaceted intervention focusing on real-life education for medical students that has been shown to assist healthcare professionals in managing and reporting suspected adverse drug reactions (ADRs) to the Netherlands Pharmacovigilance Centre Lareb. The aim of this study was to quantify and describe the ADRs reported by the J-ADEM team and to determine the clinical potential of this approach. The J-ADEM team consisted of medical students tasked with managing and reporting ADRs in hospitalized patients. All ADRs screened and reported by J-ADEM team were recorded anonymously, and categorized and analysed descriptively. From August 2018 through January 2020, 209 patients on two wards in an academic hospital were screened for ADR events. The J-ADEM team reported 101 ADRs. Although most ADRs (67%) were first identified by healthcare professionals and then reported by the J-ADEM team, the team also reported an additional 33 not previously identified serious ADRs. In 10% of all reported ADRs, the J-ADEM team helped optimize ADR treatment. The ADR reports were largely well-documented (78%), and ADRs were classified as type A (66%), had a moderate or severe severity (85%) and were predominantly avoidable reactions (69%). This study shows that medical students are able to screen patients for ADRs, can identify previously undetected ADRs and can help optimize ADR management. They significantly increased (by 300%) the number of ADR reports submitted, showing that the J-ADEM team can make a valuable clinical contribution to hospital care.
MeSH term(s)	Adverse Drug Reaction Reporting Systems ; Drug-Related Side Effects and Adverse Reactions/diagnosis ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Humans ; Patients ; Pharmacovigilance ; Students, Medical
Language	English
Publishing date	2021-05-26
Publishing country	England
Document type	Journal Article
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.14885
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Article ; Online: A comparison of the clinical pharmacotherapy knowledge of medical and surgical residents and consultants.

van den Hanenberg, Floor / Ozturk, Ekin / van Haastrecht, Mariska / Tichelaar, Jelle / van Goor, Harry / van Agtmael, Michiel A / Keijsers, Carolina J P W

European journal of clinical pharmacology

2023 Volume 79, Issue 5, Page(s) 671–677

Abstract: Purpose: Knowledge of clinical pharmacotherapy is essential for all who prescribe medication. The aims of this study were to investigate differences in the pharmacotherapy and polypharmacy knowledge of medical and surgical residents and consultants and ... ...

Abstract	Purpose: Knowledge of clinical pharmacotherapy is essential for all who prescribe medication. The aims of this study were to investigate differences in the pharmacotherapy and polypharmacy knowledge of medical and surgical residents and consultants and whether this knowledge can be improved by following an online course. Methods: Design: A before-and-after-measurement. Setting: An online course available for Dutch residents and consultants working in hospitals. Study population: Dutch residents and consultants from different disciplines who voluntarily followed an online course on geriatric care. Intervention: An online 6-week course on geriatric care, with 1 week dedicated to clinical pharmacotherapy and polypharmacy. Variables, such as medical vs surgical specialty, consultant vs resident, age, and sex, that could predict the level of knowledge. The effects of the online course were studied using repeated measures ANOVA. The study was approved by the National Ethics Review Board of Medical Education (NERB dossier number 996). Results: A total of 394 residents and 270 consultants, 220 from surgical and 444 from medical specialties, completed the online course in 2016 and 2017. Residents had higher test scores than consultants for pharmacotherapy (73% vs 70%, p < 0.02) and polypharmacy (75% vs 72%, p < 0.02). The learning effect did not differ. Medical residents/consultants had a better knowledge of pharmacotherapy (74% vs 68%, p < 0.001) and polypharmacy (77% vs 66%, p < 0.001) than surgical residents/consultants, but the learning effect was the same. Conclusions: Residents and consultants had a similar learning curve for acquiring knowledge, but residents outperformed consultants on all measures. In addition, surgical and medical residents/consultants had similar learning curves, but medical residents/consultants had higher test scores on all measures.
MeSH term(s)	Humans ; Aged ; Internship and Residency ; Consultants ; Polypharmacy ; Clinical Competence
Language	English
Publishing date	2023-04-01
Publishing country	Germany
Document type	Journal Article
ZDB-ID	121960-1
ISSN	1432-1041 ; 0031-6970
ISSN (online)	1432-1041
ISSN	0031-6970
DOI	10.1007/s00228-023-03481-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Contextualizing patient care: opportunities for pharmacotherapy education.

Brinkman, David J / Tichelaar, Jelle / van Agtmael, Michiel A

European journal of clinical pharmacology

2017 Volume 73, Issue 5, Page(s) 643–644

MeSH term(s)	Curriculum ; Drug Therapy ; Education, Medical/methods ; Humans ; Patient Care/standards ; Students, Medical
Language	English
Publishing date	2017-01-20
Publishing country	Germany
Document type	Letter
ZDB-ID	121960-1
ISSN	1432-1041 ; 0031-6970
ISSN (online)	1432-1041
ISSN	0031-6970
DOI	10.1007/s00228-017-2203-9
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Article ; Online: Educational value of international and intercultural differences in prescribing: the international and interprofessional student-run clinic project.

Bakkum, Michiel J / Donker, Erik M / Spitaleri Timpone, Pietro / Hagen, Charlotte A M / Richir, Milan C / van Agtmael, Michiel A / De Ponti, Fabrizio / Tichelaar, Jelle

European journal of clinical pharmacology

2023 Volume 79, Issue 4, Page(s) 571–574

MeSH term(s)	Humans ; Interprofessional Relations ; Students, Health Occupations ; Student Run Clinic ; Cooperative Behavior
Language	English
Publishing date	2023-02-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	121960-1
ISSN	1432-1041 ; 0031-6970
ISSN (online)	1432-1041
ISSN	0031-6970
DOI	10.1007/s00228-023-03465-9
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