Successful Intervention (successful + intervention)

Distribution by Scientific Domains


Selected Abstracts


Systematic review of cholecystostomy as a treatment option in acute cholecystitis

HPB, Issue 3 2009
Anders Winbladh
Abstract Objectives:, Percutaneous cholecystostomy (PC) is an established low-mortality treatment option for elderly and critically ill patients with acute cholecystitis. The primary aim of this review is to find out if there is any evidence in the literature to recommend PC rather than cholecystectomy for acute cholecystitis in the elderly population. Methods:, In April 2007, a systematic electronic database search was performed on the subject of PC and cholecystectomy in the elderly population. After exclusions, 53 studies remained, comprising 1918 patients. Three papers described randomized controlled trials (RCTs), but none compared the outcomes of PC and cholecystectomy. A total of 19 papers on mortality after cholecystectomy in patients aged >65 years were identified. Results:, Successful intervention was seen in 85.6% of patients with acute cholecystitis. A total of 40% of patients treated with PC were later cholecystectomized, with a mortality rate of 1.96%. Procedure mortality was 0.36%, but 30-day mortality rates were 15.4 % in patients treated with PC and 4.5% in those treated with acute cholecystectomy (P < 0.001). Conclusions:, There are no controlled studies evaluating the outcome of PC vs. cholecystectomy and the papers reviewed are of evidence grade C. It is not possible to make definitive recommendations regarding treatment by PC or cholecystectomy in elderly or critically ill patients with acute cholecystitis. Low mortality rates after cholecystectomy in elderly patients with acute cholecystitis have been reported in recent years and therefore we believe it is time to launch an RCT to address this issue. [source]


Successful intervention in a disease outbreak in the endangered Iberian lynx: what can we learn?

ANIMAL CONSERVATION, Issue 3 2009
K. A. Alexander
No abstract is available for this article. [source]


Fetal Alcohol Spectrum Disorders: Understanding the Effects of Prenatal Alcohol Exposure and Supporting Students

JOURNAL OF SCHOOL HEALTH, Issue 3 2007
Jennifer H. Green PhD
ABSTRACT Background:, Fetal Alcohol Spectrum Disorders (FASD) affect a significant number of children in this country. This article addresses diagnostic issues related to fetal alcohol syndrome (FAS) and other alcohol-related disabilities, discusses associated features and behaviors of FASD, and introduces interventions to support children with FASD in school settings. Methods:, A comprehensive review of FAS and FASD literature as it relates to school functioning was conducted. Results:, Prenatal alcohol exposure can result in a broad range of negative developmental consequences, including deficits in cognitive and academic functioning, psychological disorders, behavioral problems, and difficulties with independent living. Children with prenatal alcohol exposure are at risk for a spectrum of difficulties at school. Conclusions:, This topic is of considerable relevance to all professionals in a school setting, including teachers, administrators, school psychologists, special education providers, special service providers, and school nurses who interact with children who may be prenatally exposed to alcohol. Successful interventions will need to balance the use of environmental modifications, immediate and meaningful positive and negative consequences for behaviors, and opportunities to teach children skills to monitor and modify their behavior. [source]


Integral conflict analysis: A comprehensive quadrant analysis of an organizational conflict

CONFLICT RESOLUTION QUARTERLY, Issue 3 2005
Richard McGuigan
Influenced by Ken Wilber's brilliant synthesis of some of the world's most influential thinkers, including Jürgen Habermas, the authors have developed an integral model of conflict analysis and action. The integral approach has been helpful in explaining conflict dynamics to clients and allows more comprehensive response, thus ensuring a greater chance of successful intervention. [source]


Pre-operative screening for excessive alcohol consumption among patients scheduled for elective surgery

DRUG AND ALCOHOL REVIEW, Issue 2 2007
SWATI SHOURIE
Abstract Pre-operative intervention for excessive alcohol consumption among patients scheduled for elective surgery has been shown to reduce complications of surgery. However, successful intervention depends upon an effective and practical screening procedure. This study examines current screening practices for excessive alcohol consumption amongst patients scheduled for elective surgery in general hospitals. It also examines the appropriateness of potential sites and staff for pre-operative screening. Forms used routinely to assess alcohol consumption in the pre-admission clinics (PAC) of eight Sydney hospitals were examined. In addition, the appropriateness of six staff categories (surgeons, surgeons' secretaries, junior medical officer, anaesthetists, nurses and a research assistant) and of two sites (surgeons' office and PAC) in conducting additional screening was assessed at two hospitals. Outcomes included observed advantages and disadvantages of sites and personnel, and number of cases with excessive drinking identified. There was duplication in information collected routinely on alcohol use in the PACs in eight Sydney Hospitals. Questions on alcohol consumption in patient self-completion forms were not validated. The PAC provided for efficient screening but time to surgery was typically too short for successful intervention in many cases. A validated tool and efficient screening procedure is required to detect excessive drinking before elective surgery. Patients often present to the PAC too close to the time of surgery for any change in drinking to reverse alcohol's effects. The role of the referring general practitioner and of printed advice from the surgeon in preparing patients for surgery needs further investigation. [source]


Immediate and Follow-Up Results of Repeat Percutaneous Mitral Balloon Commissurotomy for Restenosis After a Succesful First Procedure

ECHOCARDIOGRAPHY, Issue 7 2010
Nuran Yaz, lu M.D.
Background: The widespread use of percutaneous mitral commissurotomy (PMC) has led to an increase in restenosis cases. The data regarding follow-up results of repeat PMC are quite limited. The aim of this retrospective analysis is to evaluate the immediate and midterm results of the second PMC, in patients with symptomatic mitral restenosis after a succesful first procedure. Methods: Twenty patients (95% female, mean age 37 ± 4 years) who have undergone a second PMC, 6.3 ± 2.5 years after a first successful intervention built the study group. All were in sinus rhythm, with a mean Wilkins score of 8.5 ± 1.2. Results: The valve area increased from 1.2 ± 0.2 to 1.9 ± 0.2 cm2 and mean gradient decreased from 10.5 ± 3.4 to 6.1 ± 1.1 mmHg. There were no complications except for a transient embolic event without sequela (5%) and two cases (10%) of severe mitral regurgitation. The immediate success rate was 90%. The mean follow-up was 70 ± 29 months (36,156 months). The 5-year restenosis and intervention (repeat PMC or valve replacement) rates were 9.1 ± 5.2% and 3.6 ± 3.3%, respectively. The intervention free 5-year survival in good functional capacity (New York Heart Association [NYHA] I,II) was 95.1 ± 5.5% and restenosis and intervention free 5-year survival with good functional capacity was 89.7 ± 6.8%. Conclusions: Although from a limited number of selected patients, these findings indicate that repeat PMC is a safe and effective method, with follow-up results similar to a first intervention and should be considered as the first therapeutic option in suitable patients. (Echocardiography 2010;27:765-769) [source]


Early Results of Balloon Dilatation of the Stenotic Bovine Jugular Vein Graft in the Right Ventricular Outflow Tract in Children

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2008
J. STEINBERG M.D.
The aim of this study was to evaluate the early results of interventional balloon dilatation of stenotic bovine jugular vein (BJV) grafts implanted for reconstruction of the right ventricular outflow tract (RVOT) in children. Methods: From May 2001 to December 2005, 153 BJV grafts were implanted in children in our institution. An average of 16.9 (7.6,41.1) months after implantation, 17 balloon dilatations in a significant stenosis proximal (n = 1), distal anastomosis (n = 8), BJV valve (n = 3), or at multiple sites (n = 5) were performed in 15 children (male:female = 9:6) with a mean age of 3.9 (0.8,13.0) years. Balloon diameter was 75,133.3% (mean 100.3) of the original BJV size. Mean follow-up was 8.8 (2 days to 22.8 months) months. Results: In 10 interventions (58.8%) the instantaneous peak gradient was reduced below 50 mmHg. A balloon diameter ,100% of the original BJV size correlated significantly with a successful intervention. No major complications, two minor (nonobstructive floating membranes at the dilatation site and one septicemia) occurred afterward. Freedom from reintervention after 6 months was 58.2% for all, 77.8% for dilatations of the proximal anastomosis and mixed stenotic lesions, and 33.3% for the distal anastomosis. Conclusion: Balloon dilatation of stenotic BJV grafts is safe and can significantly reduce the pressure gradient in two-thirds of interventions. Balloon diameters above the original graft size should be aimed for. The most frequent stenosis of the distal anastomosis tends to renarrow early after dilatation. Nevertheless, balloon dilatation should be considered in nearly every stenotic graft to gain time until a surgical or interventional graft exchange. [source]


Promoting Physical Activity in Girls

JOURNAL OF SCHOOL HEALTH, Issue 2 2005
A Case Study of One School's Success
ABSTRACT: This case study profiles one of 24 high schools that participated in a school-based, NIH-funded study to increase physical activity among high school girls. The case study school was one of 12 randomly assigned to the intervention group. The study intervention was based on the premise that a successful intervention is developed and tailored by teachers and staff to fit the context of their school. Intervention guidelines (Essential Elements) and the Coordinated School Health Program (CSHP) model were used to direct intervention activities for physical education, health education, school environment, school health services, faculty/staff health promotion, and family/community involvement. All girls at the case study school received the intervention. A team of school employees provided leadership to develop and implement the intervention in collaboration with a university project staff. Data collected over a two-year period were used to describe changes that occurred in each CSHP area. Key changes were made in the school environment, curricula, policies, and practices. Qualitative measures showed girls more involved in physical activity. Quantitative measures taken in eighth grade, and repeated with the same set of girls in ninth grade, showed increases in both moderate-to-vigorous physical activity (p = < .01) and vigorous physical activity (p = .04). Other schools can use this case to modify components of the CSHP model to increase physical activity among high school girls. [source]


Statewide Assessment of Response to Domestic Violence in Louisiana

JUVENILE AND FAMILY COURT JOURNAL, Issue 1 2003
STACY C. MOAK J.D. PH.D.
ABSTRACT The Louisiana statewide assessment of domestic violence attitudes and services was a cooperative effort between the Louisiana Community Policing Institute and the Criminal Justice Program at the University of Louisiana, Monroe. The research project included both surveys and focus groups from Louisiana's eight law enforcement planning districts. Results indicate that the response to domestic violence in Louisiana is generally inadequate. Furthermore, problems exist with respect to the definition of domestic violence among agencies. Finally, four basic barriers to successful intervention were identified, including lack of resources, lack of education and training, victims' lack of confidence in the system, and lack of a coordinated response to the problem. Recommendations are presented for overcoming these obstacles. [source]


Early detection of acute kidney injury: Emerging new biomarkers (Review Article)

NEPHROLOGY, Issue 2 2008
ZOLTAN H ENDRE
SUMMARY: Acute kidney injury (AKI) has recently become the preferred term to describe the syndrome of acute renal failure (ARF) with ,failure' or ,ARF' restricted to patients who have AKI and need renal replacement therapy.1 This allows capture of the broader clinical spectrum of modest reductions in creatinine, which are themselves known to be associated with major increases in both short- and long-term mortality risk.2,5 It is hoped that this change in nomenclature will facilitate an expansion of our understanding of the underlying pathophysiology and also facilitate definitions of AKI, which allow comparisons among clinical trials of patients with similar duration and severity of illness. This review will cover the need for early detection of AKI and the role of urinary and plasma biomarkers, including enzymuria. The primary message is that use of existing criteria to diagnose AKI, namely elevation of the serum creatinine with or without oliguria, results in identification that is too late to allow successful intervention. New biomarkers are essential to change the dire prognosis of this common condition. [source]


Failure of Intimate Partner Violence Screening Among Patients With Substance Use Disorders

ACADEMIC EMERGENCY MEDICINE, Issue 8 2010
Esther K. Choo MD
ACADEMIC EMERGENCY MEDICINE 2010; 17:886,889 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, This study examined the relationship between substance use disorder (SUD) and intimate partner violence (IPV) screening and management practices in the emergency department (ED). Methods:, This was a retrospective cohort study of adult ED patients presenting to an urban, tertiary care teaching hospital over a 4-month period. An automated electronic data abstraction process identified consecutive patients and retrieved visit characteristics, including results of three violence screening questions, demographic data, triage acuity, time of visit, and International Classifications of Disease, 9th revision (ICD-9), diagnosis codes. Data on management were collected using a standardized abstraction tool by two reviewers masked to the study question. Multivariate logistic regression was used to determine predictors of screening and management. Results:, In 10,071 visits, 6,563 violence screens were completed. IPV screening was documented in 33.5% of patients with alcohol-related diagnoses (95% confidence interval [CI] = 27.7% to 39.3%, ,2 = 116.78, p < 0.001) and 53.3% of patients with drug-related diagnoses (95% CI = 44.3% to 62.3%, ,2 = 7.69, p = 0.006), compared to 66.1% of patients without these diagnoses (95% CI = 65.2% to 67.1%). In the multivariate analysis, alcohol (odds ratio [OR] = 0.30, 95% CI = 0.22 to 0.40) and drug use (OR = 0.56, 95% CI = 0.38 to 0.83) were associated with decreased odds of screening. Of completed screens, 429 (6.5%) were positive, but violence was addressed further in only 55.7% of patients. Substance abuse did not appear to affect the odds of having positive screens addressed further by providers (OR = 1.96, 95% CI = 0.39 to 10.14). Conclusions:, This study found an association between SUD and decreased odds of IPV screening. Failure to screen for IPV in the setting of substance use may represent a missed opportunity to address a critical health issue and be a barrier to successful intervention. [source]


Pathologic Correlates of Dementia in Individuals with Lewy Body Disease

BRAIN PATHOLOGY, Issue 3 2010
Joshua A. Sonnen
Abstract Cognitive impairment and dementia are more common in patients with Parkinson disease (PD) than age-matched controls and appear to become more frequent as PD progresses. However, estimates of dementia in patients with PD have varied widely, likely due in part to differences in case definition, case ascertainment and methodology. First, we review investigations of usual pathologic correlates of dementia in patients with brainstem (b) Lewy Body Disease (LBD) and report our findings from the initial 266 brain autopsies from a population-based study of brain aging and incident dementia. Our results showed that 2.6% of subjects were diagnosed with PD during life but that 20% had bLBD at autopsy. Seventy percent of individuals with bLBD had high level of one or more cerebral pathologic changes significantly associated with dementia: Alzheimer's disease (AD), cerebral (c) LBD or microvascular brain injury (µVBI); these were commonly co-morbid. Next we consider proposed contributors to cognitive impairment and dementia in the approximately 30% of patients with only bLBD, including regionally selective dendritic degeneration of neostriatal medium spiny neurons. Diseases contributing to cognitive impairment and dementia in patients with bLBD are heterogeneous, providing diagnostic challenges as well as multiple opportunities for successful intervention in patients with PD. [source]


Postnatal peer counselling on exclusive breastfeeding of low-birthweight infants: A randomized, controlled trial

ACTA PAEDIATRICA, Issue 8 2005
Grace V Agrasada
Abstract Aim: Exclusive breastfeeding increases survival and optimizes growth of low-birthweight (LBW) infants. If supported, mothers can overcome the unique difficulties associated with breastfeeding from birth to 6 mo. We tested the efficacy of postnatal peer counselling among first-time mothers that aimed to increase exclusive breastfeeding of term LBW infants. Methods: In a Manila hospital, 204 mothers were randomized into three groups. Two intervention groups receiving home-based counselling visits, one by counsellors trained in breastfeeding counselling (n=68), the other by counsellors trained in general childcare (n=67), were compared with a control group of mothers (n=69) who did not receive counselling. Results: Eighty-eight per cent of the participating pairs completed the trial. At 6 mo, 44% of the breastfeeding counselled mothers, 7% childcare-counselled mothers and none of the mothers in the control group were exclusively breastfeeding. More mothers in the breastfeeding counselled group than in the other groups were still breastfeeding at 6 mo. Twenty-four infants who were exclusively breastfed for 6 mo did not have any diarrhoea. All groups had improved mean weight-for-age Z-scores at 6 mo. Conclusion: This study has provided fundamental evidence of successful intervention to achieve 6 mo of exclusive breastfeeding among term LBW infants. By improving health outcomes, enhanced breastfeeding offers a distinct possibility of disrupting the intergenerational cycle of undernourished women giving birth to LBW infants. [source]


Theoretical influences on research on language development and intervention in individuals with mental retardation

DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 3 2004
Leonard Abbeduto
Abstract In this article, we consider the theoretical debates and frameworks that have shaped research on language development and intervention in persons with mental retardation over the past four decades. Our starting point is the nativist theory, which has been espoused most forcefully by Chomsky. We also consider more recent alternatives to the nativist approach, including the social-interactionist and emergentist approaches, which have been developed largely within the field of child language research. We also consider the implications for language development and intervention of the genetic syndrome-based approach to behavioral research advocated by Dykens and others. We briefly review the impact and status of the debates spurred by the nativist approach in research on the course of language development in individuals with mental retardation. In addition, we characterize some of the achievements in language intervention that have been made possible by the debates spurred by nativism and the various alternatives to it. The evidence we consider provides support for all three alternatives to the nativist approach. Moreover, successful interventions appear to embody elements of several of these approaches as well as other theoretical approaches (e.g., behaviorism). We conclude that language intervention must be theoretically eclectic in its approach, with different strategies appropriate for teaching different features of language, at different points in development, and for children displaying different characteristics or learning histories. © 2004 Wiley-Liss, Inc. MRDD Research Reviews 2004;10:184,192. [source]


Stubborn Reliance on Intuition and Subjectivity in Employee Selection

INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY, Issue 3 2008
SCOTT HIGHHOUSE
The focus of this article is on implicit beliefs that inhibit adoption of selection decision aids (e.g., paper-and-pencil tests, structured interviews, mechanical combination of predictors). Understanding these beliefs is just as important as understanding organizational constraints to the adoption of selection technologies and may be more useful for informing the design of successful interventions. One of these is the implicit belief that it is theoretically possible to achieve near-perfect precision in predicting performance on the job. That is, people have an inherent resistance to analytical approaches to selection because they fail to view selection as probabilistic and subject to error. Another is the implicit belief that prediction of human behavior is improved through experience. This myth of expertise results in an overreliance on intuition and a reluctance to undermine one's own credibility by using a selection decision aid. [source]


Healthcare professionals' perceptions of existential distress in patients with advanced cancer

JOURNAL OF ADVANCED NURSING, Issue 7 2010
Esther Mok
mok e., lau k-p., lam w-m., chan l-n., ng j.s.c. & chan k-s. (2010) Healthcare professionals' perceptions of existential distress in patients with advanced cancer. Journal of Advanced Nursing,66(7), 1510,1522. Abstract Title.,Healthcare professionals' perceptions of existential distress in patients with advanced cancer. Aim., This paper is a report of an exploration of the phenomenon of existential distress in patients with advanced cancer from the perspectives of healthcare professionals. Background., Existential distress is an important concern in patients with advanced cancer; it affects their well-being and needs to be addressed in the provision of holistic care. Method., Focus groups were conducted from November 2008 to February 2009 with physicians, nurses, social workers, occupational therapists, physiotherapists, and chaplains working in a palliative care unit that served patients with advanced cancer in Hong Kong. Data collection and analysis were guided by the grounded theory approach. All categories were saturated when five focus groups had been held with a total number of 23 participants. Findings., We found three causal conditions of existential distress: anticipation of a negative future, failure to engage in meaningful activities and relationships, and having regrets. Three basic (caring, relating and knowing) and six specific (positive feedback, religious support, new experiences, task setting, exploring alternatives and relationship reconciliation) intervening strategies were identified. Whether the intervening strategies would be effective would depend on patients' openness and readiness; healthcare professionals' self-awareness, hopefulness, and interest in knowing the patients; and a trusting relationship between patients and healthcare professionals. A sense of peace in patients was considered a consequence of successful interventions. Conclusion., This paper acknowledges the lack of an accepted conceptual framework of existential distress in patients with advanced cancer. It is based on healthcare professionals' views, and further studies from the perspectives of patients and their families are needed. [source]


Meta-Analysis of Psychosocial Interventions for Caregivers of People with Dementia

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2003
FRACP, FRANZCP, Henry Brodaty MD
OBJECTIVES: To review published reports of interventions for caregivers (CGs) of persons with dementia, excluding respite care, and provide recommendations to clinicians. DESIGN: Meta-analytical review. Electronic databases and key articles were searched for controlled trials, preferably randomized, published in English from 1985 to 2001 inclusive. Thirty studies were located and scored according to set criteria, and the interventions' research quality and clinical significance were judged. SETTING: Home or noninstitutional environment. PARTICIPANTS: Informal CGs,persons providing unpaid care at home or in a noninstitutional setting. MEASUREMENTS: The primary measures were psychological morbidity and burden. Other varied outcome measures such as CG coping skills and social support were combined with measures of psychological distress and burden to form a main outcome measure. RESULTS: The quality of research increased over the 17 years. Results from 30 studies (34 interventions) indicated, at most-current follow-up, significant benefits in caregiver psychological distress (random effect size (ES) = 0.31; 95% confidence interval (CI) = 0.13,0.50), caregiver knowledge (ES = 0.51; CI = 0.05,0.98), any main caregiver outcome measure (ES = 0.32; CI = 0.15,0.48), and patient mood (ES = 0.68; CI = 0.30,1.06), but not caregiver burden (ES = 0.09; CI = ,0.09,0.26). There was considerable variability in outcome, partly because of differences in methodology and intervention technique. Elements of successful interventions could be identified. Success was more likely if, in addition to CGs, patients were involved. Four of seven studies indicated delayed nursing home admission. CONCLUSION: Some CG interventions can reduce CG psychological morbidity and help people with dementia stay at home longer. Programs that involve the patients and their families and are more intensive and modified to CGs' needs may be more successful. Future research should try to improve clinicians' abilities to prescribe interventions. [source]


Fibromyalgia,Management of a misunderstood disorder

JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 7 2007
Education & Training Flight Commander), Erin L. Peterson RN, FNP (Major; Family Nurse Practitioner
Abstract Purpose: The purpose of this article is to review (a) what is currently known about the pathophysiology of fibromyalgia (FM), (b) how to identify patients who are susceptible to this disorder, and (c) the recommended pharmacological and nonpharmacological treatment options. Data sources: Data sources include reviews and original research from scholarly journals and Internet sites. Conclusions: There are approximately 6 million individuals in the United States diagnosed with FM, making it the third most prevalent rheumatologic disorder in this country. Failure to identify a specific causal mechanism for FM has resulted in a shift in the focus of research from etiology to treatment (Baumstark & Buckelew, 2002). Based on the literature, the most successful interventions for reduction of chronic symptoms in the FM patient is a combination of education, psychological assistance, and exercise, along with medications. It is essential that nurse practitioners (NPs) understand the issues and concerns of patients afflicted with this complex disorder. Although the organic etiology of FM syndrome remains unclear, the goals of treatment are to control pain and improve adjustment, well-being, and daily functioning of these patients to the maximum extent possible. Implications for practice: NPs are in a unique position to help identify patients who may be suffering from FM or those diagnosed with FM reporting inadequate relief of symptoms. The incomplete understanding of the biological underpinnings, as well as the multiple symptoms that characterize FM syndrome, make it a challenging disorder to diagnose and treat. It takes time and patience to care for FM patients, and there are no "quick fixes." Diagnosis is made by a combination of patient history, physical examination, laboratory evaluations, and exclusion of other causes of symptoms confused with FM. Understanding the symptomology and recommended treatments will allow NPs to give appropriate care that may include making referrals for multidisciplinary treatment of these complex patients. [source]


Using health information technology to improve drug monitoring: a systematic review

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 12 2009
Geoffrey L. Hayward MD
Abstract Purpose To conduct a systematic review of current evidence regarding the use of health information technology (HIT) interventions to improve drug monitoring in ambulatory care. Methods We searched PubMed, CINAHL, the Cochrane Library, and other computerized databases from 1 January 1998 to 30 June 2008 using the key words "drug monitoring," "medical records systems, computerized," "ambulatory care," and "outpatients." We manually reviewed reference lists of articles identified through computer searches and asked experts in the field to review our search strategy and results for completeness. Results Seven relevant studies were identified. Four of these studies assessed real-time interventions that used alerts to physicians at the time of medication ordering to ensure adequate monitoring, only one of which showed an improvement in monitoring. Of three studies using HIT outside the physician encounter, two suggested some improvement in monitoring rates. Methodological limitations were apparent in all studies identified. Conclusions Few studies have assessed the effectiveness of HIT interventions to improve drug monitoring, and among them, there is no clear consensus regarding the most consistently effective approaches to reducing drug monitoring errors. There is a clear need for well designed randomized trials to evaluate possible interventions to reduce drug monitoring errors. Such studies should incorporate health outcomes and detailed cost analyses to further characterize the feasibility of successful interventions. Copyright © 2009 John Wiley & Sons, Ltd. [source]