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https://www.readbyqxmd.com/read/29345553/quality-and-variability-of-patient-directions-in-electronic-prescriptions-in-the-ambulatory-care-setting
#1
Yuze Yang, Stacy Ward-Charlerie, Ajit A Dhavle, Michael T Rupp, James Green
BACKGROUND: The prescriber's directions to the patient (Sig) are one of the most quality-sensitive components of a prescription order. Owing to their free-text format, the Sig data that are transmitted in electronic prescriptions (e-prescriptions) have the potential to produce interpretation challenges at receiving pharmacies that may threaten patient safety and also negatively affect medication labeling and patient counseling. Ensuring that all data transmitted in the e-prescription are complete and unambiguous is essential for minimizing disruptions in workflow at prescribers' offices and receiving pharmacies and optimizing the safety and effectiveness of patient care...
January 18, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29251399/computerized-pediatric-oncology-prescriptions-review-by-pharmacist-a-descriptive-analysis-and-associated-risk-factors
#2
Claire Hamel, Lionel Tortolano, Elisabeth Bermudez, Romain Desmaris, Sébastien Klein, Florian Slimano, François Lemare
BACKGROUND: Systematic prescription analyses by clinical pharmacists result in pharmacist interventions (PIs) to reduce prescription errors and improve medication safety. PIs are particularly critical in oncology, because antineoplastic drugs are highly toxic with low therapeutic indexes especially in a pediatric population. The aim of this study is to describe PIs in a pediatric oncology department and to identify potential risk factors associated with prescription errors. PROCEDURE: We conducted a 20-month observational study in a pediatric oncology department concerning electronic prescription of injectable chemotherapies was conducted...
December 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29241438/realizing-e-prescribing-s-potential-to-reduce-outpatient-psychiatric-medication-errors
#3
Matthew E Hirschtritt, Steven Chan, Wilson O Ly
Preliminary evidence from observational and cohort studies suggests that replacement of paper- and phone-based medication prescriptions with electronic prescribing systems in ambulatory settings is associated with decreased medication errors. However, problems from traditional prescribing also occur with e-prescribing (such as incorrect medication dose and instructions or wrong patient), as do some new problems (a confusing user interface leading to prescribing the wrong medication). The authors present four steps for reducing medication errors in outpatient psychiatric settings: continuing to implement e-prescribing, streamlining user interfaces, improving interoperability among various e-prescribing and retail pharmacy systems, and using education and advocacy to achieve these goals...
December 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29222667/drug-burden-and-its-association-with-falls-among-older-adults-in-new-zealand-a-national-population-cross-sectional-study
#4
Hamish A Jamieson, Prasad S Nishtala, Richard Scrase, Joanne M Deely, Rebecca Abey-Nesbit, Martin J Connolly, Sarah N Hilmer, Darrell R Abernethy, Philip J Schluter
BACKGROUND: Adverse outcomes associated with advanced diseases are often exacerbated by polypharmacy. OBJECTIVES: The current study investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confounders. METHODS: We conducted a retrospective cross-sectional study of a continuously recruited national cohort of community-dwelling New Zealanders aged 65 years and over...
December 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29218815/prospective-systemic-risk-analysis-of-the-dispensing-process-in-german-community-pharmacies
#5
Tatjana Stojković, Olaf Rose, Ronja Woltersdorf, Valentina Marinković, Tanja Manser, Ulrich Jaehde
BACKGROUND: Medicine dispensing represents an error-prone activity, carrying a considerable risk for patients. OBJECTIVE: To prospectively identify and prioritize potential failure modes in the medicine dispensing process as well as to develop corrective actions for patient safety improvement in German community pharmacies. METHOD: Failure mode and effects analysis was performed in 2 community pharmacies in North Rhine-Westphalia, Germany, in October 2016...
December 7, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29205633/a-combined-connectivity-mapping-and-pharmacoepidemiology-approach-to-identify-existing-medications-with-breast-cancer-causing-or-preventing-properties
#6
John Busby, Liam Murray, Ken Mills, Shu-Dong Zhang, Fabio Liberante, Chris R Cardwell
PURPOSE: We applied a novel combined connectivity mapping and pharmacoepidemiological approach to identify medications that alter breast cancer risk. METHODS: The connectivity mapping process identified 6 potentially cancer-causing (meloxicam, azithromycin, rizatriptan, citalopram, rosiglitazone, and verapamil) and 4 potentially cancer-preventing (bendroflumethiazide, sertraline, fluvastatin, and budesonide) medications that were suitable for pharmacoepidemiological investigation...
December 4, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29196350/frequency-of-stepping-down-antibiotics-and-nebuliser-treatment-is-lower-at-weekends-compared-to-weekdays-an-observational-study
#7
Sarah Lewis, Tessa Langley, Julia Lacey, Rob Skelly, Mark Norwood, Nigel Sturrock, Andrew Fogarty
We hypothesised that delays in providing non-urgent medication step-downs at weekends to medical management may be associated with increased length of stay.In a novel use of electronic prescribing data, we analysed emergency admissions from a busy acute medical hospital over 52 weeks from November 2014 to October 2015. The main outcomes of interest were switching from intravenous antibiotics to oral antibiotics and stopping nebulised bronchodilators. The rate of switching from intravenous to oral antibiotics was lower on Saturdays and Sundays compared with weekdays, and the rate of stopping nebulised bronchodilators was similarly lower at weekends (p<0...
December 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
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/29119475/comparative-cost-effectiveness-analysis-of-three-different-automated-medication-systems-implemented-in-a-danish-hospital-setting
#9
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/29092694/reducing-antibiotic-prescribing-in-australian-general-practice-time-for-a-national-strategy
#10
REVIEW
Christopher B Del Mar, Anna Mae Scott, Paul P Glasziou, Tammy Hoffmann, Mieke L van Driel, Elaine Beller, Susan M Phillips, Jonathan Dartnell
In Australia, the antibiotic resistance crisis may be partly alleviated by reducing antibiotic use in general practice, which has relatively high prescribing rates - antibiotics are mostly prescribed for acute respiratory infections, for which they provide only minor benefits. Current surveillance is inadequate for monitoring community antibiotic resistance rates, prescribing rates by indication, and serious complications of acute respiratory infections (which antibiotic use earlier in the infection may have averted), making target setting difficult...
November 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29076013/hospital-staff-views-of-prescribing-and-discharge-communication-before-and-after-electronic-prescribing-system-implementation
#11
Pamela Ruth Mills, Anita Elaine Weidmann, Derek Stewart
Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#12
REVIEW
Cobin D Soelberg, Raeford E Brown, Derick Du Vivier, John E Meyer, Banu K Ramachandran
The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29029694/prescriber-response-to-computerized-drug-alerts-for-electronic-prescriptions-among-hospitalized-patients
#13
Yael Zenziper Straichman, Daniel Kurnik, Ilan Matok, Hillel Halkin, Noa Markovits, Amitai Ziv, Ari Shamiss, Ronen Loebstein
BACKGROUND: Clinical decision support systems (CDSS) reduce prescription errors, but their effectiveness is reduced by high alert rates, "alert fatigue", and indiscriminate rejection. OBJECTIVES: To compare acceptance rates of alerts generated by the SafeRx(®) prescription CDSS among different alert types and departments in a tertiary care hospital, identify factors associated with alert acceptance, and determine whether alert overrides were justified. METHODS: In a retrospective study, we compared acceptance rates of all prescription alerts generated in 2013 in 18 departments of Israel's largest tertiary care center...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29018058/impact-of-an-inpatient-electronic-prescribing-system-on-prescribing-error-causation-a-qualitative-evaluation-in-an-english-hospital
#14
Seetal Jheeta Puaar, Bryony Dean Franklin
BACKGROUND: Few studies have applied a systems approach to understanding the causes of specific prescribing errors in the context of hospital electronic prescribing (EP). A comprehensive understanding of underlying causes is essential for developing effective interventions to improve prescribing safety. Our objectives were to explore prescribers' perspectives of the causes of errors occurring with EP and to make recommendations to maximise benefits and minimise risks. METHODS: We studied a large hospital using inpatient EP...
October 10, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28972499/impact-of-pharmacy-reform-on-the-dynamics-of-the-use-of-drugs-and-psychoactive-substances-according-to-the-2013-2016-clinical-data-from-the-center-for-mental-health-and-prevention-of-addiction
#15
L Kiladze, Kh Todadze, T Balkhamishvili, E Gadelia, G Lezhava
Use of medications without doctor's prescription widely established in Georgia had negative impact on the health of the population and on the whole social situation. The use of home-made drugs "Krokodil", "Jeff" and "Vint" produced from the preparations bought without prescriptions (Codeine, Ephedrine), became a special matter of concern. Psychoactive substances became available for teenagers causing damage to their central nervous system and formation of drug-addiction in them. Due to the situation Georgian Government took a number of legislative measures, particularly, it set Criminal Liability for illegal circulation of pharmaceutical products containing Codeine and Ephedrine and Administrative Measures for issuing the psychoactive substances without prescription...
September 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28932389/challenges-facing-the-veterinary-profession-in-ireland-2-on-farm-use-of-veterinary-antimicrobials
#16
Manuel Magalhães-Sant'Ana, Simon J More, David B Morton, Alison J Hanlon
BACKGROUND: Antimicrobial resistance has emerged in recent years as a significant public health threat, which requires both an ethical and a scientific approach. In a recent Policy Delphi study, on-farm use of antimicrobials was a key concern identified by veterinary professionals in Ireland. In this case study (the second in a series of three resulting from a research workshop exploring the challenges facing the veterinary profession in Ireland; the other two case studies investigate clinical veterinary services and emergency/casualty slaughter certification) we aim to provide a value-based reflection on the constraints and possible opportunities for responsible use of veterinary antimicrobials in Ireland...
2017: Irish Veterinary Journal
https://www.readbyqxmd.com/read/28874948/impact-of-internally-developed-electronic-prescription-on-prescribing-errors-at-discharge-from-the-emergency-department
#17
Eveline Hitti, Hani Tamim, Rinad Bakhti, Dina Zebian, Afif Mufarrij
INTRODUCTION: Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%-38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28837665/the-effectiveness-of-computerised-decision-support-on-antibiotic-use-in-hospitals-a-systematic-review
#18
REVIEW
Christopher E Curtis, Fares Al Bahar, John F Marriott
BACKGROUND: Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR). Health information technology (HIT) in the form of Computerised Decision Support (CDS) represents an option for improving antimicrobial prescribing and containing AMR. OBJECTIVES: To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings. METHODS: A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo...
2017: PloS One
https://www.readbyqxmd.com/read/28826908/-comparison-of-predictive-models-for-the-selection-of-high-complexity-patients
#19
Marcos Estupiñán-Ramírez, Rita Tristancho-Ajamil, María Consuelo Company-Sancho, Hilda Sánchez-Janáriz
OBJECTIVE: To compare the concordance of complexity weights between Clinical Risk Groups (CRG) and Adjusted Morbidity Groups (AMG). To determine which one is the best predictor of patient admission. To optimise the method used to select the 0.5% of patients of higher complexity that will be included in an intervention protocol. METHOD: Cross-sectional analytical study in 18 Canary Island health areas, 385,049 citizens were enrolled, using sociodemographic variables from health cards; diagnoses and use of healthcare resources obtained from primary health care electronic records (PCHR) and the basic minimum set of hospital data; the functional status recorded in the PCHR, and the drugs prescribed through the electronic prescription system...
August 18, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28793906/the-impact-of-a-hospital-electronic-prescribing-and-medication-administration-system-on-medication-administration-safety-an-observational-study
#20
Seetal Jheeta, Bryony Dean Franklin
BACKGROUND: The aim of the study was to explore the impact of the implementation of an electronic prescribing and medication administration system (ePA) on the safety of medication administration in an inpatient hospital setting. Objectives were to compare the prevalence and types of: 1) medication administration errors, and 2) documentation discrepancies, between a paper and an ePA system. Additionally, we wanted to describe any observed changes to medication administration practices...
August 9, 2017: BMC Health Services Research
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