Improving adherence to safe prescription guidelines for Dapsone: harnessing an enhanced electronic medical records system and a team approach

International Journal of Dermatology
Ching Yin NeohRoy K W Chan

Abstract

Dapsone is a commonly prescribed medication in dermatological practice. Its use is associated with a broad spectrum of adverse effects. Careful selection and monitoring of patients on dapsone are paramount in the prevention and early recognition of adverse effects. We designed a risk-management program for dapsone at National Skin Centre, Singapore, enhancing an existing electronic medical records system and harnessing a team approach involving the nurses. This includes the performance of key laboratory tests before and after starting dapsone, ensuring adequate counseling before starting dapsone and screening for adverse effects using a questionnaire every visit. This system of dapsone prescription efficiently improved the adherence to safe prescription and monitoring guidelines. Average adherence rates for key safety parameters improved from 61.4% pre-implementation to 95.3% at six months and were sustained at 12 months at 91.3%. Percentage of follow-up cases in which all three key monitoring parameters were fulfilled increased from 9.5% to 79.6% (p=0.0001) after 12months. The percentage of new patients in which all four key monitoring parameters were met increased from 50% to 80%. It was not statistically significant possibly...Continue Reading

References

Jul 1, 1986·Clinical Pharmacokinetics·J ZuidemaF W Merkus
May 1, 1994·Clinical and Experimental Dermatology·P ToddA Pembroke
May 20, 2008·Seminars in Cutaneous Medicine and Surgery·Stanford I Lamberg
Mar 18, 2009·Archives of Dermatology·Carrie B LyndeRoy S Rogers
Sep 22, 2010·Archives of Dermatology·Joshua A GrosshandlerRobert T Brodell

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Citations

Apr 17, 2015·Journal of Huazhong University of Science and Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban·Shang-Feng TangRui Huang
Oct 28, 2017·British Dental Journal·M K ShephardT Hodgson

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