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https://www.readbyqxmd.com/read/28230449/real-world-glycemic-control-from-glp-1ra-therapy-with-and-without-concurrent-insulin-in-patients-with-type-2-diabetes
#1
Mukul Singhal, Sudhir Unni, Marisa Schauerhamer, Hiep Nguyen, Jeff Hurd, Carrie McAdam-Marx
BACKGROUND: Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are recommended as add-on therapy in patients with uncontrolled type 2 diabetes (T2D), with no specific guidance as to timing versus insulin. Furthermore, real-world data assessing GLP-1RA outcomes with or without concurrent insulin therapy are lacking. OBJECTIVE: To identify glycemic response with GLP-1RAs by insulin use in patients with T2D at 1-year follow-up to inform decisions regarding GLP-1RA use with or without insulin...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230448/opioid-use-for-pain-management-after-implementation-of-a-medicaid-short-acting-opioid-quantity-limit
#2
Catherine S Riggs, Sarah J Billups, Samantha Flores, Rachana J Patel, Rachel M F Heilmann, Jessica L Milchak
BACKGROUND: The United States is currently experiencing an opioid abuse epidemic. Many policies and programs have been implemented at local, state, and national levels in an attempt to decrease prescription opioid addiction and overdose. On August 1, 2014, Colorado Medicaid implemented a policy change that limited the quantity of short-acting opioids (SAOs) that could be filled through the Medicaid benefit to no more than 4 tablets per day, or 120 tablets in 30 days. OBJECTIVE: To compare mean total daily dose (TDD) of opioids purchased by Kaiser Permanente Colorado (KPCO) Medicaid patients before and after implementation of the Medicaid SAO quantity limit...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28228662/risk-of-gynecomastia-and-breast-cancer-associated-with-the-use-of-5-alpha-reductase-inhibitors-for-benign-prostatic-hyperplasia
#3
Katrina Wilcox Hagberg, Hozefa A Divan, Shona C Fang, J Curtis Nickel, Susan S Jick
BACKGROUND: Clinical trial results suggest that 5-alpha reductase inhibitors (5ARIs) for the treatment of benign prostatic hyperplasia (BPH) may increase the risk of gynecomastia and male breast cancer, but epidemiological studies have been limited. PATIENTS AND METHODS: We conducted a cohort study with nested case-control analyses using the UK Clinical Practice Research Datalink. We identified men diagnosed with BPH who were free from Klinefelter syndrome, prostate, genital or urinary cancer, prostatectomy or orchiectomy, or evidence of gynecomastia or breast cancer...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28228380/off-label-indications-for-antidepressants-in-primary-care-descriptive-study-of-prescriptions-from-an-indication-based-electronic-prescribing-system
#4
Jenna Wong, Aude Motulsky, Michal Abrahamowicz, Tewodros Eguale, David L Buckeridge, Robyn Tamblyn
Objective To examine off-label indications for antidepressants in primary care and determine the level of scientific support for off-label prescribing.Design Descriptive study of antidepressant prescriptions written by primary care physicians using an indication based electronic prescribing system.Setting Primary care practices in and around two major urban centres in Quebec, Canada.Participants Patients aged 18 years or older who visited a study physician between 1 January 2003 and 30 September 2015 and were prescribed an antidepressant through the electronic prescribing system...
February 21, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28227779/revealing-oral-medication-patterns-from-reconstructed-long-term-medication-history-of-type-2-diabetes
#5
Purnomo Husnul Khotimah, Yuichi Sugiyama, Masatoshi Yoshikawa, Akihiro Hamasaki, Kazuya Okamoto, Tomohiro Kuroda, Purnomo Husnul Khotimah, Yuichi Sugiyama, Masatoshi Yoshikawa, Akihiro Hamasaki, Kazuya Okamoto, Tomohiro Kuroda, Kazuya Okamoto, Purnomo Husnul Khotimah, Yuichi Sugiyama, Akihiro Hamasaki, Masatoshi Yoshikawa, Tomohiro Kuroda
With the growing attention to evidence-based medical guideline development, longitudinal analysis of Electronic Medical Records (EMR) has become a good tool for providing insight into and new knowledge on the existing therapy. For chronic diseases, longitudinal analysis of medication history plays a key role in reaching this goal. However, raw medication data in EMR are not suitable for longitudinal analysis for several reasons. First, many prescriptions have a short duration. Second, the prescription duration may have a gap or overlap with other prescription durations...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224108/implementation-of-enteral-feeding-protocol-in-an-intensive-care-unit-before-and-after-study
#6
Martin Padar, Gerli Uusvel, Liis Starkopf, Joel Starkopf, Annika Reintam Blaser
AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection Control Service...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28220735/sustained-reduction-in-antibiotic-consumption-in-a-south-african-public-sector-hospital-four-year-outcomes-from-the-groote-schuur-hospital-antibiotic-stewardship-program
#7
T H Boyles, V Naicker, N Rawoot, P J Raubenheimer, B Eick, M Mendelson
BACKGROUND: Overuse of antibiotics has driven global bacterial resistance to the extent that we have entered a post-antibiotic era, where infections that were once easily treatable are now becoming untreatable. Efforts to control consumption have focused on antibiotic stewardship programmes (ASPs), aimed at optimising use. OBJECTIVE: To report antibiotic consumption and cost over 4 years from a public hospital ASP in South Africa (SA). METHODS: A comprehensive ASP comprising online education, a dedicated antibiotic prescription chart and weekly dedicated ward rounds was introduced at Groote Schuur Hospital, Cape Town, in 2012...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28220511/review-article-pharmacotherapy-for-alcohol-dependence-the-why-the-what-and-the-wherefore
#8
REVIEW
E T Goh, M Y Morgan
BACKGROUND: The development of alcohol dependence is associated with significant morbidity and mortality. For the majority of affected people the most appropriate goal, in terms of drinking behaviour, is abstinence from alcohol. Psychosocial intervention is the mainstay of the treatment but adjuvant pharmacotherapy is also available and its use recommended. AIM: To provide an updated analysis of current and potential pharmacotherapeutic options for the management of alcohol dependence...
February 20, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28219437/the-effect-of-a-test-ordering-software-intervention-on-the-prescription-of-unnecessary-laboratory-tests-a-randomized-controlled-trial
#9
Carlos Manuel Silva Martins, Andreia Sofia da Costa Teixeira, Luís Filipe Ribeiro de Azevedo, Luísa Maria Barbosa Sá, Paulo Alexandre Azevedo Pereira Santos, Maria Luciana Gomes Domingues do Couto, Altamiro Manuel Rodrigues da Costa Pereira, Alberto Augusto Oliveira Pinto Hespanhol, Cristina Maria Nogueira da Costa Santos
BACKGROUND: The way software for electronic health records and laboratory tests ordering systems are designed may influence physicians' prescription. A randomised controlled trial was performed to measure the impact of a diagnostic and laboratory tests ordering system software modification. METHODS: Participants were family physicians working and prescribing diagnostic and laboratory tests. The intervention group had a modified software with a basic shortcut menu changes, where some tests were withdrawn or added, and with the implementation of an evidence-based decision support based on United States Preventive Services Task Force (USPSTF) recommendations...
February 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28216955/patterns-of-prescription-drugs-use-among-pregnant-women-at-sultan-qaboos-university-hospital-and-sultan-qaboos-university-hospital-family-and-community-medicine-clinic-oman
#10
J Z Al-Hamimi, K A Al Balushi
OBJECTIVE: This study evaluates the patterns of prescription drugs use among women attending antenatal clinic at Sultan Qaboos University Hospital (SQUH) and SQUH Family and Community Medicine clinic (FAMCO), Oman. METHODS: The study was a descriptive retrospective cross-sectional study on pregnant women who attended the antenatal clinic at SQUH and FAMCO from February to April 2014 and received a prescription containing at least one drug. Patients' information was extracted from SQUH electronic records...
October 2016: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#11
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213381/outcomes-of-treatment-with-direct-acting-antivirals-for-infection-with-hepatitis-c-virus-genotypes-1-4-in-an-ambulatory-care-setting
#12
Timothy A Bach, Kathy Zaiken
PURPOSE: Outcomes with direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) genotypes 1-4 were determined. METHODS: A total of 360 patients at 36 clinical sites in Massachusetts with HCV genotypes 1-4 and a prescription for at least one DAA medication between May 2011 and October 2015 were included. The primary investigator completed a retrospective and concurrent chart review, and data were collected through April 2016. RESULTS: A total of 446 patients were assessed for eligibility into the study, with 86 patients excluded...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28211183/a-comparison-of-the-self-reported-dry-eye-practices-of-new-zealand-optometrists-and-ophthalmologists
#13
Ally L Xue, Laura E Downie, Susan E Ormonde, Jennifer P Craig
PURPOSE: The aim of this cross-sectional survey was to evaluate the self-reported clinical practices of New Zealand optometrists and ophthalmologists with respect to the diagnosis and management of dry eye disease. It also sought to compare these behaviours with the current research evidence base. METHODS: An anonymous survey was distributed electronically to New Zealand eye care clinicians (optometrists n = 614, ophthalmologists n = 113) to determine practitioner interest in dry eye disease, practice experience, practice modality, preferred diagnostic and management strategies, and information used to guide patient care...
March 2017: Ophthalmic & Physiological Optics: the Journal of the British College of Ophthalmic Opticians (Optometrists)
https://www.readbyqxmd.com/read/28208876/prescribing-pattern-of-antifungal-medications-at-a-tertiary-care-hospital-in-oman
#14
Khalid A Al Balushi, Mohammed A Alzaabi, Fatma Alghafri
INTRODUCTION: Inappropriate use of antifungal agents is implicated in the global burden of antifungal resistance, adverse outcomes like persistent infections, unnecessary exposure and increased cost. Data collection from time to time is to be done in order to have a check on the resistance/sensitivity pattern of the commonly prescribed antifungal drugs. AIM: To describe the pattern of antifungal drug prescription and administration to patients attending a university hospital in Oman...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207996/the-use-of-a-contextual-modal-and-psychological-classification-of-medication-errors-in-the-emergency-department-a-retrospective-descriptive-study
#15
C J Cabilan, J A Hughes, C Shannon
BACKGROUND: The causes of medication errors are unique in every clinical setting; hence error minimisation strategies are not always effective. For this reason, it is fundamental to understand the causes specific to the emergency department so that targeted strategies can be implemented. OBJECTIVES: To describe the contextual, modal, and psychological classification of medication errors in the emergency department to know the factors associated with the reported medication errors...
February 16, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28202428/patient-use-of-electronic-prescription-refill-and-secure-messaging-and-its-association-with-undetectable-hiv-viral-load-a-retrospective-cohort-study
#16
D Keith McInnes, Stephanie L Shimada, Amanda M Midboe, Kim M Nazi, Shibei Zhao, Justina Wu, Casey M Garvey, Thomas K Houston
BACKGROUND: Electronic personal health records (PHRs) can support patient self-management of chronic conditions. Managing human immunodeficiency virus (HIV) viral load, through taking antiretroviral therapy (ART) is crucial to long term survival of persons with HIV. Many persons with HIV have difficulty adhering to their ART over long periods of time. PHRs contribute to chronic disease self-care and may help persons with HIV remain adherent to ART. Proportionally veterans with HIV are among the most active users of the US Department of Veterans Affairs (VA) PHR, called My HealtheVet...
February 15, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28202365/optimising-the-use-of-medicines-to-reduce-acute-kidney-injury-in-children-and-babies
#17
REVIEW
L Oni, D B Hawcutt, M A Turner, M W Beresford, S McWilliam, C Barton, B K Park, P Murray, B Wilm, I Copple, R Floyd, M Peak, A Sharma, D J Antoine
The majority of medications in children are administered in an unlicensed or off-label manner. Paediatricians are obliged to prescribe using the limited evidence available. The 2007 EU regulation on the use of paediatric drugs means pharmaceutical companies are now obliged to (and receive incentives for) contributing to paediatric drug data and carrying out paediatric clinical trials. This is important, as the efficacy and adverse effect profiles of medicines vary across childhood. Additionally, there are significant age-related changes in the pharmacodynamic and pharmacokinetic activity of many drugs...
February 12, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28202233/practice-makes-perfect-a-systematic-review-of-the-expertise-development-of-pharmacist-and-nurse-independent-prescribers-in-the-united-kingdom
#18
REVIEW
Aseel S Abuzour, Penny J Lewis, Mary P Tully
BACKGROUND: Prescribing is a complex and error-prone task that demands expertise. McLellan et al.'s theory of expertise development model ("the model"), developed to assess medical literature on prescribing by medical students, proposes that in order to develop, individuals should deliberately engage their knowledge, skills and attitudes within a social context. Its applicability to independent prescribers (IP) is unknown. AIM: A systematic review was conducted to explore whether the model is applicable to non-medical independent prescribing and to assess the factors underpinning expertise development reported in the literature...
February 7, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28197420/the-challenges-of-electronic-health-records-and-diabetes-electronic-prescribing-implications-for-safety-net-care-for-diverse-populations
#19
REVIEW
Neda Ratanawongsa, Lenny L S Chan, Michelle M Fouts, Elizabeth J Murphy
Widespread electronic health record (EHR) implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1) the adoption of RxNorm; (2) standardized naming and picklist options for high alert medications such as insulin; (3) the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4) enhanced bidirectional communication with pharmacy partners; and (5) informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28196459/care-provision-and-prescribing-practices-of-physicians-treating-children-and-adolescents-with-adhd
#20
Ayush Patel, Rohan Medhekar, Melissa Ochoa-Perez, Rajender R Aparasu, Wenyaw Chan, Jeffrey T Sherer, Joy Alonzo, Hua Chen
OBJECTIVE: Care provision and prescribing practices of physicians treating children with attention-deficit hyperactivity disorder (ADHD) were compared. METHODS: A retrospective cohort study was conducted with the 1995-2010 General Electric Centricity Electronic Medical Record database. The sample included children (≤18 years) with newly diagnosed ADHD (ICD-9-CM code 314.XX) who received a prescription for a stimulant or atomoxetine. Identification of comorbid psychiatric disorders, duration from initial ADHD diagnosis to treatment, prescription of other psychotropic medications, and follow-up care during the ten months after the ADHD treatment initiation were compared across provider type (primary care physicians [PCPs], child psychiatrists, and physicians with an unknown specialty)...
February 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
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