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https://www.readbyqxmd.com/read/28101955/prescription-drug-monitoring-programs-produce-a-limited-impact-on-painkiller-prescribing-in-medicare-part-d
#1
Courtney R Yarbrough
OBJECTIVE: To measure the impact of prescription drug monitoring programs (PDMPs) on prescribing of opioid and nonopioid painkillers. DATA SOURCE: 2010-2013 physician-level Medicare Part D prescribing data released by the Centers for Medicare and Medicaid Services and Propublica. STUDY DESIGN: Using difference-in-differences models with physician-level fixed effects, the study compares prescribing in states with and without PDMPs for opioid and nonopioid analgesics, oxycodone, hydrocodone, and opioids by controlled substances Schedules II-IV...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28099791/mitigating-the-prescription-drug-abuse-epidemic
#2
Mike Midgley
Focused attention on the prescription drug abuse epidemic needs to include evidence-based training for clinicians who manage patients with pain to facilitate accurate screening with consideration of comorbid conditions, diagnosis, selection of the appropriate treatment regimen, and focused monitoring of adherence to the established course of therapy. DEA licensure requirements need to be amended to mandate targeted training focused on pain medication upon initial application and renewal of license. A nationwide mandated real-time dispenser database that requires verification every time a clinician prescribes opioids and other key controlled substances should be a top priority...
January 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28099349/development-of-diabetes-mellitus-associated-with-quetiapine-a-case-series
#3
Hideki Nanasawa, Akahito Sako, Tomohiko Mitsutsuka, Kaori Nonogaki, Tadayuki Kondo, Shuichi Mishima, Yoriyasu Uju, Toshihiko Ito, Tetsuro Enomoto, Tatsuro Hayakawa, Hidekatsu Yanai
We aimed to describe the characteristics and clinical course of patients who developed diabetes associated with the use of quetiapine.This study included patients who received quetiapine for over a month between April 2008 and November 2013, and were diagnosed as having new-onset diabetes after initiation of quetiapine. We excluded patients who developed diabetes more than 1 year after discontinuation of quetiapine. We identified new-onset diabetes by hemoglobin A1c or prescriptions of antidiabetic drugs.Among 1688 patients who received quetiapine, hemoglobin A1c had been measured in 595 (35...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28096442/kinetic-modeling-of-incremental-ambulatory-peritoneal-dialysis-exchanges
#4
Steven Guest, John K Leypoldt, Michelle E Cassin, Martin J Schreiber
♦ Background: Incremental peritoneal dialysis (PD), the gradual introduction of dialysate exchanges at less than full-dose therapy, has been infrequently described in clinical reports. One concern with less than full-dose dialysis is whether urea clearance targets are achievable with an incremental regimen. In this report, we used a large database of PD patients, across all membrane transport types, and performed urea kinetic modeling determinations of possible incremental regimens for an individual membrane type...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28089608/piloting-the-united-kingdom-prescribing-safety-assessment-with-pharmacist-prescribers-in-scotland
#5
Fiona Reid, Ailsa Power, Derek Stewart, Anne Watson, Leon Zlotos, Derna Campbell, Trudi McIntosh, Simon Maxwell
BACKGROUND: Prescribing is a complex task requiring considerable knowledge and skills. The Prescribing Safety Assessment (PSA) was developed by the British Pharmacological Society and the United Kingdom (UK) Medical Schools Council. Between February and June 2014, over 7000 final year medical students undertook the PSA, with an overall pass rate of 94%. Independent prescribing for suitably trained pharmacists was introduced in the UK in 2006. To date there has been little focus on any objective measures of prescribing safety...
January 6, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28089479/estimation-of-radiation-induced-secondary-cancer-risks-for-early-stage-non-small-cell-lung-cancer-patients-after-stereotactic-body-radiation-therapy
#6
Chunhui Han, Timothy E Schultheiss, Jeffrey Y C Wong
PURPOSE: In this study, we evaluated radiation-induced secondary lung cancer risks for the lung and the breast from stereotactic body radiation therapy treatment of early-stage non-small cell lung cancer with different radiation therapy treatment modalities. METHODS AND MATERIALS: Ten patients (5 men and 5 women) with early-stage non-small cell lung cancer who received definitive stereotactic body radiation therapy treatments were retrospectively selected. For each patient, two 3-dimensional conformal radiation therapy (3D-CRT) plans using 6- and 10-MV photons, respectively; a helical tomotherapy (HT) plan; and 2 volumetric modulated arc therapy (VMAT) plans using 1 and 2 arcs, respectively, were generated...
October 19, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28087207/continuous-medication-monitoring-comm-a-foundational-model-to-support-the-clinical-work-of-community-pharmacists
#7
Amber M Goedken, Christine M Butler, Randal P McDonough, Michael J Deninger, William R Doucette
BACKGROUND: Under the Continuous Medication Monitoring (CoMM) approach, community pharmacists prevent, identify, resolve, and document drug therapy problems during the dispensing process. OBJECTIVE: To describe the patients receiving CoMM interventions and the pattern of delivery of CoMM interventions. METHODS: Pharmacy dispensing and clinical records were reviewed for patients filling at least one prescription and receiving at least one continuous medication monitoring intervention at a community pharmacy from April 2014 through March 2015...
January 2, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28086866/perceptions-and-utilization-of-generic-medicines-in-guatemala-a-mixed-methods-study-with-physicians-and-pharmacy-staff
#8
David Flood, Irène Mathieu, Anita Chary, Pablo García, Peter Rohloff
BACKGROUND: Access to low-cost essential generic medicines is a critical health policy goal in low-and-middle income countries (LMICs). Guatemala is an LMIC where there is both limited availability and affordability of these medications. However, attitudes of physicians and pharmacy staff regarding low-cost generics, especially generics for non-communicable diseases (NCDs), have not been fully explored in Guatemala. METHODS: Semi-structured interviews with 30 pharmacy staff and 12 physicians in several highland towns in Guatemala were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28078665/computerized-pharmacy-surveillance-and-alert-system-for-drug-related-problems
#9
O Ferrández, O Urbina, S Grau, J Mateu-de-Antonio, M Marin-Casino, J Portabella, S Mojal, M Riu, E Salas
WHAT IS KNOWN AND OBJECTIVE: Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment...
January 12, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28075067/national-implementation-of-a-mental-health-service-model-a-survey-of-crisis-resolution-teams-in-england
#10
Brynmor Lloyd-Evans, Bethan Paterson, Steve Onyett, Ellie Brown, Hannah Istead, Richard Gray, Claire Henderson, Sonia Johnson
In response to pressures on mental health inpatient beds and a perceived 'crisis in acute care', Crisis Resolution Teams (CRTs), acute home treatment services, were implemented nationally in England following the NHS Plan in the year 2000: an unprecedentedly prescriptive policy mandate for three new types of functional community mental health team. We examined the effects of this mandate on implementation of the CRT service model. Two hundred and eighteen CRTs were mapped in England, including services in all 65 mental health administrative regions...
January 11, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28074635/physician-step-prescription-and-monitoring-to-improve-arterial-health-smarter-a-randomized-controlled-trial-in-type-2-diabetes-and-hypertension
#11
Kaberi Dasgupta, Ellen Rosenberg, Lawrence Joseph, Alexandra B Cooke, Luc Trudeau, Simon L Bacon, Deborah Chan, Mark Sherman, Rémi Rabasa-Lhoret, Stella S Daskalopoulou
AIMS: There are few strategies proven to enhance physical activity and cardiometabolic profiles in type 2 diabetes and hypertension. We examined the effects of physician-delivered step count prescriptions and monitoring. METHODS: Participants randomized to the active arm were provided with pedometers and recorded step counts. Over a 1-year period, their physicians reviewed their records and provided a written step count prescription at each clinic visit. The overall goal was a 3,000 step/day increase over 1-year (individualized rate of increase)...
January 11, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28074412/a-scientific-rationale-to-improve-resistance-training-prescription-in-exercise-oncology
#12
Ciaran M Fairman, Michael C Zourdos, Eric R Helms, Brian C Focht
To date, the prevailing evidence in the field of exercise oncology supports the safety and efficacy of resistance training to attenuate many oncology treatment-related adverse effects, such as risk for cardiovascular disease, increased fatigue, and diminished physical functioning and quality of life. Moreover, findings in the extant literature supporting the benefits of exercise for survivors of and patients with cancer have resulted in the release of exercise guidelines from several international agencies...
January 10, 2017: Sports Medicine
https://www.readbyqxmd.com/read/28072812/is-kratom-the-new-legal-high-on-the-block-the-case-of-an-emerging-opioid-receptor-agonist-with-substance-abuse-potential
#13
George C Chang-Chien, Charles A Odonkor, Prin Amorapanth
Kratom is an unscheduled opioid receptor agonist that comes in the form of dietary supplements currently being abused by chronic pain patients on prescription opioids. Active alkaloids isolated from kratom such as mitragynine and 7-hydroxymitragynine are thought to act on mu- and delta-opioid receptors as well as alpha-2 adrenergic and 5-HT2A receptors. Animal studies suggest that kratom may be more potent than morphine. Consequently, kratom consumption produces analgesic and euphoric feelings among users. In particular, some chronic pain patients on opioids take kratom to counteract the effects of opioid withdrawal...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28053201/evidence-that-supports-the-prescription-of-low-carbohydrate-high-fat-diets-a-narrative-review
#14
Timothy David Noakes, Johann Windt
Low-carbohydrate high-fat (LCHF) diets are a highly contentious current topic in nutrition. This narrative review aims to provide clinicians with a broad overview of the effects of LCHF diets on body weight, glycaemic control and cardiovascular risk factors while addressing some common concerns and misconceptions. Blood total cholesterol and LDL-cholesterol concentrations show a variable, highly individual response to LCHF diets, and should be monitored in patients adhering to this diet. In contrast, available evidence from clinical and preclinical studies indicates that LCHF diets consistently improve all other markers of cardiovascular risk-lowering elevated blood glucose, insulin, triglyceride, ApoB and saturated fat (especially palmitoleic acid) concentrations, reducing small dense LDL particle numbers, glycated haemoglobin (HbA1c) levels, blood pressure and body weight while increasing low HDL-cholesterol concentrations and reversing non-alcoholic fatty liver disease (NAFLD)...
January 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28049547/palliative-care-during-the-final-week-of-life-of-older-people-in-nursing-homes-a-register-based-study
#15
Jonas Smedbäck, Joakim Öhlén, Kristofer Årestedt, Anette Alvariza, Carl-Johan Fürst, Cecilia Håkanson
OBJECTIVE: Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes. METHOD: Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics...
January 4, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28048850/su-g-brc-14-multi-lesion-multi-rx-brain-radiosurgery-with-novel-single-isocenter-technique
#16
N Honig, S Alani, A Schlocker, N Shtraus, A Kanner
PURPOSE: There is a strong trend to treat multiple brain metastases with radiosurgery rather than whole brain irradiation. This feasibility study investigates a novel planning technique for radio-surgical treatment of multiple brain lesions with differing dose prescriptions, a single isocenter, and dynamic conformal arcs. The novel technique will be compared to the well-established single-isocenter volumetric modulated arc therapy (VMAT) technique commonly used for treating brain lesions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048682/su-f-t-188-a-robust-treatment-planning-technique-for-proton-pencil-beam-scanning-cranial-spinal-irradiation
#17
M Zhu, M Yam, M Mehta, S Badiyan, K Young, R Malyapa, W Regine, K Langen
PURPOSE: To propose a proton pencil beam scanning (PBS) cranial spinal irradiation (CSI) treatment planning technique robust against patient roll, isocenter offset and proton range uncertainty. METHOD: Proton PBS plans were created (Eclipse V11) for three previously treated CSI patients to 36 Gy (1.8 Gy/fractions). The target volume was separated into three regions: brain, upper spine and lower spine. One posterior-anterior (PA) beam was used for each spine region, and two posterior-oblique beams (15° apart from PA direction, denoted as 2PO_15) for the brain region...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048558/su-f-t-338-flattening-filter-free-photon-beams-can-achieve-the-same-plan-quality-as-conventional-flattened-beams-for-prostate-radiotherapy
#18
M Kolar, R Szwedowski, J Greskovich, P Xia
PURPOSE: Some modern linear accelerators are equipped with one low energy flat beam and two flattening filter free (FFF) beams at high and low energies. The purpose of this study is to investigate whether the high energy FFF beam can produce the same plan quality as the conventional low energy flat beam, using a volumetric modulated arc (VMAT) technique for prostate patients. METHODS: Ten prostate cancer patients were selected with a prescription of 78Gy. For each patient, three plans were created: (a) double arc flat 6MV plan used clinically; (b) double arc 10MV FFF plan; (c) single arc 10MV FFF plan...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048476/su-f-t-448-use-of-mixed-photon-energy-beam-in-volumetric-modulated-arc-therapy-vmat-treatment-plan-for-prostate-cancer
#19
D Manigandan, M Kumar, P Mohandas, A Puri, N Bhalla
PURPOSE: To study the impact of different photon beam combination during VMAT planning and treatment delivery. METHODS: Five prostate patients with no nodal involvement were chosen for the study and only prostate was considered as target (7920cGy/44fractions). In each case, three different VMAT plans were generated with two arcs (200°-160°&160°-200°). First plan used only 6MV in both arcs (6X-6X) and second utilized 6MV&15MV (6X-15X), whereas third one used 15MV&15MV (15X-15X)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048083/su-f-t-08-brachytherapy-film-dosimetry-in-a-water-phantom-for-a-ring-and-tandem-hdr-applicator
#20
B Lee, Z Grelewicz, Z Kang, D Cutright, M Gopalakrishnan, V Sathiaseelan, H Zhang
PURPOSE: The feasibility of dose measurement using new generation EBT3 film was explored in a water phantom for a ring and tandem HDR applicator for measurements tracking mucosal dose during cervical brachytherapy. METHODS: An experimental fixture was assembled to position the applicator in a water phantom. Prior to measurement, calibration curves for EBT3 film in water and in solidwater were verified. EBT3 film was placed at different known locations around the applicator in the water tank...
June 2016: Medical Physics
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