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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
#1
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/28202428/patient-use-of-electronic-prescription-refill-and-secure-messaging-and-its-association-with-undetectable-hiv-viral-load-a-retrospective-cohort-study
#2
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/28197420/the-challenges-of-electronic-health-records-and-diabetes-electronic-prescribing-implications-for-safety-net-care-for-diverse-populations
#3
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/28193619/improving-specialist-drug-prescribing-in-primary-care-using-task-and-error-analysis-an-observational-study
#4
Narinder Chana, Talya Porat, Cate Whittlesea, Brendan Delaney
BACKGROUND: Electronic prescribing has benefited from computerised clinical decision support systems (CDSSs); however, no published studies have evaluated the potential for a CDSS to support GPs in prescribing specialist drugs. AIM: To identify potential weaknesses and errors in the existing process of prescribing specialist drugs that could be addressed in the development of a CDSS. DESIGN AND SETTING: Semi-structured interviews with key informants followed by an observational study involving GPs in the UK...
March 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28186051/evaluation-of-electronic-prescribing-decision-support-system-at-a-tertiary-care-pediatric-hospital-the-user-acceptance-perspective
#5
Abdurahman Omar, Johan Ellenius, Synnöve Lindemalm
This study aims to evaluate pediatrician's acceptance, perception and use of Electronic Prescribing Decision Support Systems (EPDSS) at a tertiary care using Extended Technology Acceptance Model (TAM2). Qualitative research methodology was applied. Semi-structured questions were developed according to TAM2 model. Pediatricians perceived that the EPDSS is useful and they showed a favorable attitude. However, perceived ease of use and output quality appeared to affect use of EPDSS. Concerns were expressed about complicated screens, difficulty to read and view medication overview of the patient, the navigation requires many clicks and medication system don't meet their need...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28174319/exploring-the-roots-of-unintended-safety-threats-associated-with-the-introduction-of-hospital-eprescribing-systems-and-candidate-avoidance-and-or-mitigation-strategies-a-qualitative-study
#6
Hajar Mozaffar, Kathrin M Cresswell, Robin Williams, David W Bates, Aziz Sheikh
OBJECTIVE: Hospital electronic prescribing (ePrescribing) systems offer a wide range of patient safety benefits. Like other hospital health information technology interventions, however, they may also introduce new areas of risk. Despite recent advances in identifying these risks, the development and use of ePrescribing systems is still leading to numerous unintended consequences, which may undermine improvement and threaten patient safety. These negative consequences need to be analysed in the design, implementation and use of these systems...
February 7, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28161301/pharmacy-communications-with-physician-offices-to-clarify-prescriptions
#7
Marie Smith, Bradley Sprecher
OBJECTIVES: Our study was conducted to: (1) characterize the type and extent of prescription clarification communications between community pharmacies and physician offices, (2) describe the interventions made by community pharmacists, and (3) determine the time frame to clarify prescriptions prior to dispensing. DESIGN: A convenience sample and cross-sectional study. SETTING: Five independent community pharmacies. PARTICIPANTS: Pharmacists and pharmacy technician staff members...
February 1, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28152747/connecting-specialty-practices-with-primary-care
#8
Suzanne Morton, Tyler Oberlander, Sarah Hudson Scholle, Michael Barr
: 47 Background: Public and private payers are beginning to adopt alternative payment structures that call for greater attention to patient-centered care and quality improvement activities (CMMI 2015; MACRA 2015). The National Committee for Quality Assurance (NCQA) developed standards for Patient-Centered Specialty Practice based on American College of Physicians principles. The report describes achievement on the standards among an initial cohort of recognized physicians. METHODS: We analyzed practice characteristics and determined how practices performed on each of the 21 elements in the PCSP program by showing the percent of practices scoring less than 50% of points, or 100% of points (i...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28126703/ecological-assessment-of-clinicians-antipsychotic-prescription-habits-in-psychiatric-inpatients-a-novel-web-and-mobile-phone-based-prototype-for-a-dynamic-clinical-decision-support-system
#9
Sofian Berrouiguet, Maria Luisa Barrigón, Sara A Brandt, George C Nitzburg, Santiago Ovejero, Raquel Alvarez-Garcia, Juan Carballo, Michel Walter, Romain Billot, Philippe Lenca, David Delgado-Gomez, Juliette Ropars, Ivan de la Calle Gonzalez, Philippe Courtet, Enrique Baca-García
BACKGROUND: Electronic prescribing devices with clinical decision support systems (CDSSs) hold the potential to significantly improve pharmacological treatment management. OBJECTIVE: The aim of our study was to develop a novel Web- and mobile phone-based application to provide a dynamic CDSS by monitoring and analyzing practitioners' antipsychotic prescription habits and simultaneously linking these data to inpatients' symptom changes. METHODS: We recruited 353 psychiatric inpatients whose symptom levels and prescribed medications were inputted into the MEmind application...
January 26, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28120338/the-effect-of-medications-which-cause-inflammation-of-the-gastro-oesophageal-tract-on-cancer-risk-a-nested-case-control-study-of-routine-scottish-data
#10
John Busby, Peter Murchie, Liam Murray, Lisa Iversen, Amanda J Lee, Andrew Spence, Margaret C Watson, Chris R Cardwell
Bisphosphonate, tetracycline and spironolactone use has been shown to increase gastro-oesophageal inflammation, an accepted risk factor for cancer. However, evidence of the effect of these medications on gastro-oesophageal cancer risk are mixed or missing entirely. Therefore, we conducted a nested case-control study using the Primary Care Clinical Information Unit Research (PCCIUR) database from Scotland. Cases with oesophageal or gastric cancer between 1999 and 2011 were matched to up to five controls based on age, gender, year of diagnosis and general practice...
January 24, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28079746/sentinel-surveillance-for-expedited-partner-therapy-prescriptions-using-pharmacy-data-in-2-new-york-city-neighborhoods-2015
#11
Ebiere Okah, Vibhuti Arya, Meighan Rogers, Michelle Kim, Julia Ann Schillinger
BACKGROUND: Expedited partner therapy (EPT) for Chlamydia trachomatis (Ct) is the practice of providing Ct-infected patients with medication, or prescription (prescription-EPT) to deliver to their sex partners without first examining those partners. New York City (NYC) providers commonly use prescription-EPT, yet NYC pharmacists report only occasional receipt of EPT prescriptions. This project assessed the frequency of EPT prescriptions filled in 2 NYC neighborhoods. METHODS: The 2 NYC facilities reporting the most frequent use of prescription-EPT were identified from Ct provider case reports and contacted to ascertain their EPT practices...
February 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28067675/it-s-time-to-adopt-electronic-prescriptions-for-opioids
#12
Atul A Gawande
No abstract text is available yet for this article.
January 6, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28063462/going-digital-a-narrative-overview-of-the-clinical-and-organisational-impacts-of-ehealth-technologies-in-hospital-practice
#13
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes.Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
January 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28060051/e-prescribing-and-adverse-drug-events-an-observational-study-of-the-medicare-part-d-population-with-diabetes
#14
Meghan Hufstader Gabriel, Christopher Powers, William Encinosa, Julie P W Bynum
BACKGROUND: Although the adoption of e-prescriptions among physicians has increased substantially under the Medicare Improvements for Patients and Providers Act and Meaningful Use programs, little is known of its impact on patient outcomes. OBJECTIVE: To examine the impact of e-prescribing on emergency visits or hospitalizations for diabetes-related adverse drug events (ADEs) including hypoglycemia. DESIGN: This is a prospective, observational cohort study with patient fixed effects...
January 3, 2017: Medical Care
https://www.readbyqxmd.com/read/28059691/establishing-data-intensive-healthcare-the-case-of-hospital-electronic-prescribing-and-medicines-administration-systems-in-scotland
#15
Kathrin Cresswell, Pam Smith, Charles Swainson, Angela Timoney, Aziz Sheikh
BACKGROUND: Creating learning health systems, characterised by the use and repeated reuse of demographic, process and clinical data to improve the safety, quality and efficiency of care, is a key aim in realising the potential benefits and efficiency savings associated with the implementation of health information technology. OBJECTIVES: We sought to investigate stakeholder perspectives on and experiences of the implementation of hospital electronic prescribing and medicines administration (HEPMA) systems in Scotland and use these to inform political decisions on approaches to promoting the use and reuse of digitised prescribing and medication administration data in order to improve care processes and outcomes...
October 4, 2016: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/28045650/reduction-in-alert-fatigue-in-an-assisted-electronic-prescribing-system-through-the-lean-six-sigma-methodology
#16
Mª Jesús Cuéllar Monreal, Jorge Reig Aguado, Isabel Font Noguera, José Luis Poveda Andrés
OBJECTIVE: To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. METHOD: An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed...
January 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27999065/electronic-prescribing-system-design-priorities-for-antimicrobial-stewardship-a-cross-sectional-survey-of-142-uk-infection-specialists
#17
Kieran S Hand, Debbie Cumming, Susan Hopkins, Sean Ewings, Andy Fox, Sandya Theminimulle, Robert J Porter, Natalie Parker, Joanne Munns, Adel Sheikh, Taryn Keyser, Richard Puleston
BACKGROUND: The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). OBJECTIVES: To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. METHODS: A questionnaire was developed using nominal group technique and transmitted via email links through professional networks...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27966005/eprescribing-reducing-costs-through-in-class-therapeutic-interchange
#18
Shane P Stenner, Rohini Chakravarthy, Kevin B Johnson, William L Miller, Julie Olson, Marleen Wickizer, Nate N Johnson, Rick Ohmer, David R Uskavitch, Gordon R Bernard, Erin B Neal, Christoph U Lehmann
INTRODUCTION: Spending on pharmaceuticals in the US reached $373.9 billion in 2014. Therapeutic interchange offers potential medication cost savings by replacing a prescribed drug for an equally efficacious therapeutic alternative. METHODS: Hard-stop therapeutic interchange recommendation alerts were developed for four medication classes (HMG-CoA reductase inhibitors, serotonin receptor agonists, intranasal steroid sprays, and proton-pump inhibitors) in an electronic prescription-writing tool for outpatient prescriptions...
December 14, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27940770/a-quality-improvement-initiative-improving-the-frequency-of-inpatient-electronic-prescribing
#19
Jennifer Fuchs, Huay-Ying Lo, Andrew Peterman, Elizabeth Camp, Lindsay Chase
OBJECTIVE: To improve the frequency of electronic prescribing (e-prescribing) of discharge prescriptions at a children's hospital via a bundle of quality improvement interventions. METHODS: Surveys and focus groups were conducted with patient families and pediatric residents to identify barriers and propose solutions to e-prescribing. These data were used to generate a series of interventions, including the following: (1) provider education; (2) changes in patient registration workflow; and (3) electronic health record changes to improve the frequency of e-prescribing on the pediatric hospital medicine (PHM) service...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27933156/improving-the-accuracy-of-electronic-prescribing-in-west-bay-health-center-in-qatar
#20
Wafaa Yousuf, Sheren Elkomy, Mona Soliman, Noof Al-Mansouri, Mohamed Salem, Amal Al-Ali, Mohamed H Mahmoud, Hisham Elmahdi
Primary healthcare in Qatar uses electronic prescribing to reduce the risk of medication errors. Electronic prescribing is supported by computerized Physician Order Entry systems through Cerner (electronic medical record system). There are still prescription errors, despite electronic prescribing being in place for one year at West Bay Health Center. West Bay Health Center is a famous primary healthcare center in Qatar. It is a training center for the family medicine residency program, which is accredited by the accreditation council of general medical education international (ACGME-I)...
2016: BMJ Quality Improvement Reports
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