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https://www.readbyqxmd.com/read/29159310/factors-associated-with-gender-affirming-surgery-and-age-of-hormone-therapy-initiation-among-transgender-adults
#1
Noor Beckwith, Sari L Reisner, Shayne Zaslow, Kenneth H Mayer, Alex S Keuroghlian
Purpose: Gender-affirming surgeries and hormone therapy are medically necessary treatments to alleviate gender dysphoria; however, significant gaps exist in the research and clinical literature on surgery utilization and age of hormone therapy initiation among transgender adults. Methods: We conducted a retrospective review of electronic health record data from a random sample of 201 transgender patients of ages 18-64 years who presented for primary care between July 1, 2010 and June 30, 2015 (inclusive) at an urban community health center in Boston, MA...
2017: Transgender Health
https://www.readbyqxmd.com/read/29157787/a-consultation-phone-service-for-patients-with-total-joint-arthroplasty-may-reduce-unnecessary-emergency-department-visits
#2
Eerik Hällfors, Sami A Saku, Tatu J Mäkinen, Rami Madanat
BACKGROUND: Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs. To our knowledge, a similar consultation service had not been described previously. We aimed at examining the rates and reasons for early postdischarge phone calls and evaluating the efficacy of this consultation service...
October 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29156868/a-nationwide-evaluation-of-off-label-drug-utilization-in-turkey
#3
Emine Nur Özdamar, Ahmet Akıcı, Ali Alkan, Banu Bayar, Hakkı Gürsöz
Background/aim: Off-label drug use (OLDU) is under the control of the Turkish Medicines and Medical Devices Agency (TMMDA) in Turkey. It was aimed to investigate demographic and medical features of patients with OLDU applications in Turkey. Materials and methods: A total of 4426 electronic OLDU application records of the TMMDA were evaluated retrospectively. Information regarding patients? demographic characteristics, diagnoses, requested drugs, institutions, and specialties of the physicians were evaluated...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29155848/an-electronic-health-record-based-model-predicts-statin-adherence-ldl-cholesterol-and-cardiovascular-disease-in-the-united-states-military-health-system
#4
Joseph E Lucas, Taylor C Bazemore, Celan Alo, Patrick B Monahan, Deepak Voora
HMG-CoA reductase inhibitors (or "statins") are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk...
2017: PloS One
https://www.readbyqxmd.com/read/29155555/medication-exposure-in-highly-adherent-psychiatry-patients
#5
Jeffrey J Sutherland, Thomas M Daly, Karen Jacobs, Elias A Khawam, Leo Pozuelo, Ryan D Morrison, Stephen B Milne, J Scott Daniels, Timothy Patrick Ryan
Medication exposure is dependent upon many factors, the single most important being if the patient took the prescribed medication as indicated. To assess medication exposure for psychotropic and other medication classes, we enrolled 115 highly adherent psychiatry patients prescribed five or more medications. In these patients, we measured 21 psychotropic and 38 non-psychotropic medications comprising a 59-medication multiplex assay panel. Strict enrollment criteria and reconciliation of the electronic health record medication list prior to study initiation produced a patient cohort that was compliant with 91% of their prescribed medications as determined by comparing medications detected empirically in blood to the electronic health record medication list...
November 20, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29151840/adherence-with-epinephrine-autoinjector-prescriptions-in-primary-care
#6
Elissa M Abrams, Alexander G Singer, Lisa Lix, Alan Katz, Marina Yogendran, F Estelle R Simons
Background: The aim of this study was to estimate primary adherence for epinephrine autoinjector (EA) prescriptions in primary care practices in Manitoba, Canada. Methods: A retrospective analysis of electronic medical record and administrative data was performed to determine primary adherence, defined as dispensation of a new EA prescription within 90 days of the date the prescription was written. Multivariable logistic regression models were used to test predictors of filling an EA prescription...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/29147805/can-clinical-practice-indicator-relating-to-long-acting-benzodiazepine-use-in-the-elderly-be-easily-generated-in-a-hospital-setting
#7
Badria Kadri, Antonio Teixeira, Christelle Duteil, Annabelle Tan, Hélène Barreteau, Christophe Segouin, Pénélope Troude
BACKGROUND: To improve the appropriate use of long-acting benzodiazepine (la.bzd) prescriptions in the elderly, the Haute Autorité de Santé (HAS) has developed clinical practice indicators (CPI). The alert indicator (AI) evaluates the prevalence of la.bzd prescription among older people. The mastering indicator (MI) corresponds to the prevalence of elderly with a justified, i.e., appropriate, la.bzd prescription among all the elderly with la.bzd prescriptions. OBJECTIVE: The objective of this study was to test the feasibility of routine generation of CPI regarding la...
November 16, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29144250/case-not-closed-prescription-errors-12-years-after-computerized-physician-order-entry-implementation
#8
Gili Kadmon, Michal Pinchover, Avichai Weissbach, Shirley Kogan Hazan, Elhanan Nahum
OBJECTIVE: To assess the prolonged impact of computerized physician order entry (CPOE) on medication prescription errors in pediatric intensive care patients. STUDY DESIGN: This observational study was conducted at a pediatric intensive care unit in which a CPOE (Metavision, iMDsoft, Israel) with a limited clinical decision support system was implemented between 2004 and 2007. Since then, no changes were made to the systems. We analyzed 2500 electronic prescriptions (1250 prescriptions from 2015 and 1250 prescriptions from 2016)...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29141618/what-do-australian-consumers-pharmacists-and-prescribers-think-about-documenting-indications-on-prescriptions-and-dispensed-medicines-labels-a-qualitative-study
#9
Mona Garada, Andrew J McLachlan, Gordon D Schiff, Elin C Lehnbom
BACKGROUND: Documenting the indication on prescriptions and dispensed medicines labels is not standard practice in Australia. However, previous studies that have focused on the content and design of dispensed medicines labels, have suggested including the indication as a safety measure. The aim of this study was to investigate the perspectives of Australian consumers, pharmacists and prescribers on documenting the indication on prescriptions and dispensed medicines labels. METHODS: Semi-structured interviews were conducted and mock-up of dispensed medicines labels were designed for participants...
November 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29139110/unconditional-cash-transfers-for-reducing-poverty-and-vulnerabilities-effect-on-use-of-health-services-and-health-outcomes-in-low-and-middle-income-countries
#10
REVIEW
Frank Pega, Sze Yan Liu, Stefan Walter, Roman Pabayo, Ruhi Saith, Stefan K Lhachimi
BACKGROUND: Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age or HIV infection) are a type of social protection intervention that addresses a key social determinant of health (income) in low- and middle-income countries (LMICs). The relative effectiveness of UCTs compared with conditional cash transfers (CCTs; provided so long as the recipient engages in prescribed behaviours such as using a health service or attending school) is unknown...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29138175/statin-prescribing-trends-for-primary-and-secondary-prevention-of-cardiovascular-disease
#11
Felicity Brown, Alexander Singer, Alan Katz, Gerald Konrad
OBJECTIVE: To determine the proportion of patients receiving statins for primary or secondary prevention of cardiovascular disease (CVD), as well as to describe lipid-screening trends. DESIGN: Retrospective chart review using the Manitoba Primary Care Research Network repository. SETTING: Manitoba. PARTICIPANTS: A total of 149 262 patients. MAIN OUTCOME MEASURES: Proportion of patients who were taking statins for primary or secondary prevention of cardiovascular disease (CVD), who did not have evidence of CVD recorded in their charts, and who underwent lipid screening; distribution of statins among age groups; and the proportion of patients eligible for lipid screening when the age cutoffs of the 2012 and 2016 Canadian Cardiovascular Society guidelines were applied...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29136566/treatment-for-opioid-use-and-outcomes-in-older-adults-a-systematic-literature-review
#12
REVIEW
Anne Marie Carew, Catherine Comiskey
BACKGROUND: Historically, issues relating to problem substance use among older people have received little attention, and have only recently been recognised. METHODS: A literature review of relevant material was conducted in November 2015 to assess current outcome research among older adults treated for opioid dependence. Multiple electronic databases were searched and results were supplemented by grey literature, library and online searches, and relevant references within selected articles...
November 7, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29135900/ondansetron-prescription-for-home-use-in-a-pediatric-emergency-department
#13
James M Gray, Jaya D Maewal, Scott A Lunos, Ronald A Furnival, Marissa A Hendrickson
OBJECTIVES: Ondansetron has been shown to decrease admission rates and the need for intravenous fluids among pediatric emergency department (ED) patients with acute gastroenteritis, but there is limited evidence regarding its use after ED discharge. This study describes prescribing patterns for ondansetron and assesses the effects of ondansetron home prescription on rate of return. METHODS: Data were gathered from the electronic health record on 2 separate but overlapping groups of patients seen in a pediatric ED from 2012 to 2014...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29135452/drug-drug-interactions-in-cancer-chemotherapy-an-observational-study-in-a-tertiary-health-care-centre
#14
Harminder Singh, Baltej Singh
BACKGROUND: The objective of this study was to evaluate the occurrence of drug-drug interactions (DDIs) in patients on cancer chemotherapy, with the identification of risk factors for these DDIs. METHODS: This was a cross-sectional, descriptive study carried out at the Department of Onco-Radiation at Guru Gobind Singh Medical College, Faridkot, Punjab. The DDIs were recorded with the help of a drug interaction/interplay information software. RESULTS: In total, 354 interactions were identified from 283 patient records...
November 14, 2017: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/29133496/factors-influencing-allopurinol-initiation-in-primary-care
#15
Lorna E Clarson, Samantha L Hider, John Belcher, Edward Roddy, Christian D Mallen
Despite guidance on appropriate initiation, urate-lowering therapy is prescribed for only a minority of patients with gout. Electronic health records for 8,142 patients with gout were used to investigate the effect of age, sex, comorbidities, number of consultations, and meeting internationally agreed eligibility criteria on time to allopurinol initiation. Time to first prescription was modeled using multilevel Cox proportional hazards regression. Allopurinol initiation was positively associated with meeting eligibility criteria at diagnosis of gout, but negatively associated with becoming eligible after diagnosis...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29131655/psychotropic-drug-prescription-in-adolescents-a-retrospective-study-in-a-swiss-psychiatric-university-hospital
#16
Nicolas Ansermot, Véronique Jordanov, Michal Smogur, Laurent Holzer, Chin B Eap
OBJECTIVES: This retrospective study aims to evaluate off-label prescriptions and administrations of psychotropic medications in adolescents in a university psychiatric hospital in Switzerland. METHODS: Data were collected during the entire stays from the electronic database for 76 inpatients in 2008 and 76 inpatients in 2014. Data collected included gender, age, psychiatric diagnosis, duration of hospitalization, and psychotropic drug prescriptions and administrations...
November 13, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/29129325/protracted-febrile-myalgia-syndrome-treated-with-pulse-of-corticosteroids
#17
Eran Rom, Gil Amarilyo, Yoel Levinski, Efraim Bilavsky, Ori Goldberg, Jacob Amir, Liora Harel
OBJECTIVE: This study describes our 5-year experience treating protracted febrile myalgia syndrome (PFMS) with pulsed doses of corticosteroids. METHODS: Eight patients with PFMS who received pulse corticosteroid therapy were identified from the electronic database of a tertiary pediatric medical center (2011-2016). Their clinical and laboratory data were collected. Differences in continuous variables between hospital admission and discharge were analyzed using Wilcoxon's matched pairs test...
October 12, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29126081/multiple-chronic-condition-profiles-and-survival-among-oldest-old-male-patients-with-hip-fracture
#18
Jinmyoung Cho, Eileen M Stock, I-Chia Liao, John E Zeber, Brian K Ahmedani, Rashmita Basu, Charlene C Quinn, Laurel A Copeland
To improve understanding of survival among very elderly male patients with surgically repaired hip fractures, this study applied classification techniques to multiple chronic conditions (MCC) then modeled survival by latent class. Veterans Health Administration (VHA)'s electronic medical records on male inpatients age 85-100 years (n=896) with hip fracture diagnosis and repair were used. MCC defined by Charlson and Elixhauser disorders, medications, demographic covariates, and 5 years follow-up survival were included...
October 28, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29119475/comparative-cost-effectiveness-analysis-of-three-different-automated-medication-systems-implemented-in-a-danish-hospital-setting
#19
Bettina Wulff Risør, Marianne Lisby, Jan Sørensen
INTRODUCTION: Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice. METHODS: The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS)...
November 8, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29119469/learning-to-prescribe-intravenous-fluids-a%C3%A2-scoping-review
#20
REVIEW
Richard F R McCrory, Gerard Joseph Gormley, Alexander Peter Maxwell, Tim Dornan
INTRODUCTION: Prescribing intravenous (IV) fluid therapy is a core skill expected of qualified doctors at the point of graduation, but medical graduates often feel ill-equipped to perform this task. This lack of preparedness contributes to treatment-related patient harm. This scoping review maps the current state of published evidence about how junior doctors prescribe IV fluid therapy and learn how to do it. METHODS: We searched five electronic databases and grey literature from 1994 until June 2016 for articles describing any aspect of IV fluid prescribing practice or its education...
November 8, 2017: Perspectives on Medical Education
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