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Inappropriate prescribing

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https://www.readbyqxmd.com/read/29133312/exploring-perceptions-and-experiences-of-patients-who-have-chronic-pain-as-state-prescription-opioid-policies-change-a-qualitative-study-in-indiana
#1
Morhaf Al Achkar, Debra Revere, Barbara Dennis, Palmer MacKie, Sumedha Gupta, Shaun Grannis
OBJECTIVES: The misuse and abuse of prescription opioids (POs) is an epidemic in the USA today. Many states have implemented legislation to curb the use of POs resulting from inappropriate prescribing. Indiana legislated opioid prescribing rules that went into effect in December 2013. The rules changed how chronic pain is managed by healthcare providers. This qualitative study aims to evaluate the impact of Indiana's opioid prescription legislation on the patient experiences around pain management...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29123600/activities-performed-by-pharmacists-integrated-in-family-health-teams-results-from-a-web-based-survey
#2
Ulrika Gillespie, Lisa Dolovich, Simone Dahrouge
Objectives: Family health teams (FHTs), an interprofessional primary care practice model, were established in Ontario in 2005. As of October 2014, 191 FHT organizations were in operation, and 111 (58%) included one or several pharmacists. The objective of this study was to document the focus of pharmacist activities in FHTs. Approach: We invited all 155 known FHT pharmacists to a web-based survey. The survey was constructed using information obtained from previously done semi-structured telephone interviews with pharmacists working in FHTs...
November 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29123310/worldwide-pattern-of-antibiotic-prescription-in-endodontic-infections
#3
(no author information available yet)
Antibiotic prescribing practices are frequently inappropriate in endodontic therapy.
November 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/29120540/-detecting-and-assessing-the-impactof-anticholinergic-medications
#4
Chantal Csajka, Catherine Brémond, Pierre Olivier Lang
Limitation of inappropriate prescribing must be a medical concern in daily practice especially in older patients. In particular, anti-cholinergic drugs (anti-ACh), which are not all explicitly classified as anti-ACh, are commonly prescribed for a wide range of indications (pulmonary obstructive diseases, anxiety, insomnia, urinary incontinence, Parkinson's disease, congestive heart failure). Their prescription is however associated with a reduced quality of life and increased morbidity and mortality. Tools detecting inappropriate prescriptions and clinical scales that quantify the anti-ACh burden contribute, despite some limitations, to secure and optimize these drugs' prescription in this vulnerable population...
November 8, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29107890/potentially-inappropriate-prescribing-according-to-stopp-2-criteria-among-patients-discharged-from-internal-medicine-prevalence-involved-drugs-and-economic-cost
#5
Alfredo José Pardo-Cabello, Victoria Manzano-Gamero, Mónica Zamora-Pasadas, Francisco Gutiérrez-Cabello, David Esteva-Fernández, Juan de Dios Luna-Del Castillo, Juan Jiménez-Alonso
AIM: This study aims to determine the prevalence of potentially inappropriate prescribing (PIP) among patients discharged from Internal Medicine, the drugs and factors associated and economic cost of PIP. METHODS: This retrospective cross-sectional, single-center study included participants aged ≥65 years consecutively discharged from the Internal Medicine Unit in a tertiary hospital of Southern Spain. PIP was defined by the Screening Tool for Older Persons Prescriptions (STOPP-2) criteria version 2 (2015 update)...
November 2, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29105270/inappropriate-inhaled-corticosteroid-prescribing-in-chronic-obstructive-pulmonary-disease-patients
#6
Amelia Harrison, Brigitte Borg, Bruce Thompson, Mark Hew, Eli Dabscheck
The Australian National Chronic Obstructive Pulmonary Disease (COPD) guidelines recommend that inhaled corticosteroids (ICS) be reserved for patients with a post-bronchodilator forced expiratory volume in 1 s (FEV1 ) less than 50% predicted and those who experience ≥2 exacerbations in 12 months. In total, 707 COPD patients were identified from the lung function test database at our tertiary hospital; 52.4% of patients with a post-bronchodilator FEV1 ≥50% were prescribed an ICS. Significant discordance exists between guideline recommendations and inhaler prescription...
November 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29102353/effect-of-a-training-and-educational-intervention-for-physicians-and-caregivers-on-antibiotic-prescribing-for-upper-respiratory-tract-infections-in-children-at-primary-care-facilities-in-rural-china-a-cluster-randomised-controlled-trial
#7
Xiaolin Wei, Zhitong Zhang, John D Walley, Joseph P Hicks, Jun Zeng, Simin Deng, Yu Zhou, Jia Yin, James N Newell, Qiang Sun, Guanyang Zou, Yan Guo, Ross E G Upshur, Mei Lin
BACKGROUND: Inappropriate antibiotic prescribing contributes to the generation of drug resistance worldwide, and is particularly common in China. We assessed the effectiveness of an antimicrobial stewardship programme aiming to reduce inappropriate antibiotic prescribing in paediatric outpatients by targeting providers and caregivers in primary care hospitals in rural China. METHODS: We did a pragmatic, cluster-randomised controlled trial with a 6-month intervention period...
October 25, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/29092735/potentially-inappropriate-prescribing-of-drugs-in-elderly-patients-on-chronic-hemodialysis-treatment%C3%A2
#8
Gorana Nedin Ranković, Slobodan M Janković, Radmila Veličković Radovanović, Zorica Jović, Gordana Pešić, Svetlana Pavlović, Branislava Ranković, Jasmina Ranković, Dragana Stokanović, Dane Krtinić
PURPOSE: The aim of this study was to determine the prevalence of potentially inappropriate drug prescription (PIP) in older patients who were on chronic hemodialysis treatment and to explore the factors that lead to PIP. MATERIALS AND METHODS: The study was performed at the Department of Nephrology, Clinical Center Niš, Serbia. It included patients who were 65 years old and older who suffered from the end-stage of kidney failure and were treated by hemodialysis...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29091149/interventions-of-the-clinical-pharmacist-in-an-intermediate-care-unit-for-elderly-patients
#9
Stéphanie de Souza Costa Viana, Tiago Arantes, Sabrina Corrêa da Costa Ribeiro
OBJECTIVE: To discuss the role of the clinical pharmacist in hospital care of critical elderly patients. METHODS: Critical patients aged 60 years and over admitted by the clinical staff to an Intermediate Care Unit were followed-up for 4 months regarding their drug therapies. Medical prescriptions were reviewed daily on the basis of patients' clinical conditions, with the view to identify opportunities for optimization of drug therapies, contributing to safer prescribing, reduced discomfort and correct and rational use of drugs...
July 2017: Einstein
https://www.readbyqxmd.com/read/29089750/inappropriate-pharmacological-treatment-in-older-adults-affected-by-cardiovascular-disease-and-other-chronic-comorbidities-a-systematic-literature-review-to-identify-potentially-inappropriate-prescription-indicators
#10
Ersilia Lucenteforte, Niccolò Lombardi, Davide Liborio Vetrano, Domenico La Carpia, Zuzana Mitrova, Ursula Kirchmayer, Giovanni Corrao, Francesco Lapi, Alessandro Mugelli, Alfredo Vannacci
Avoiding medications in which the risks outweigh the benefits in the elderly patient is a challenge for physicians, and different criteria to identify inappropriate prescription (IP) exist to aid prescribers. Definition of IP indicators in the Italian geriatric population affected by cardiovascular disease and chronic comorbidities could be extremely useful for prescribers and could offer advantages from a public health perspective. The purpose of the present study was to identify IP indicators by means of a systematic literature review coupled with consensus criteria...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29081401/inadequate-drug-prescribing-comparison-of-inappropriate-drug-rates-at-the-end-of-a-geriatric-short-stay-service-with-three-prescribing-tools
#11
Jean-Luc Fanon, Sandra Dechavigny, Moustapha Dramé, Lidvine Godaert
To compare the proportion of prescriptions containing at least one inappropriate drug, as identified using three tools for optimizing drug prescriptions in the elderly. Cross-sectional, observational study based on the analysis of prescriptions of patients discharged between 1 September and 31 October 2014 in a short-stay geriatrics unit at the Louis Domergue de Trinité Hospital in Martinique (France). Each prescription was analysed using 3 tools, namely one for general medicine (Vidal © drug dictionary) and two tools specifically designed for geriatrics (the Laroche list of potentially inappropriate medications, and the STOPP-START toolkit)...
October 27, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29080051/reducing-unnecessary-chest-x-rays-antibiotics-and-bronchodilators-through-implementation-of-the-nice-bronchiolitis-guideline
#12
Richard Breakell, Benjamin Thorndyke, Julie Clennett, Christian Harkensee
Chest X-rays (CXR), antibiotics and inhaled/nebulized therapy are overused in bronchiolitis, despite evidence-based guidelines suggesting supportive management only. This study investigates the effect of the implementation of the NICE bronchiolitis guideline in a secondary paediatric unit in England. We present a quality improvement project with a completed audit cycle (winter 2014-2015 and 2015-2016) pre- and post-implementation of the NICE bronchiolitis guideline. The educational intervention included sessions for raising awareness of appropriate and inappropriate management of bronchiolitis for both clinicians and nursing staff...
October 28, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29079010/-impact-of-medium-term-outcomes-of-inappropriate-prescribing-in-older-patients-discharged-from-a-short-stay-unit
#13
Elena Rodríguez Del Río, Javier Perdigones, Manuel Fuentes Ferrer, Juan González Del Castillo, Juan González Armengol, M Isabel Borrego Hernando, M Lourdes Arias Fernández, Francisco Javier Martín-Sánchez
OBJECTIVE: To study the association between the potential inappropriate prescriptions (PIP) and the 30 and 180-day adverse event rate after discharge from a Short Stay Unit (SSU). METHODOLOGY: A retrospective cohort observational study was conducted on patients aged ≥75years discharged from an SSU from February to April, 2014. STOPP-START criteria version2 was used. The main outcome was 30 and 180-day adverse event rate after being discharged. RESULTS: A total of 179 patients, with a mean age of 84 (SD5) years were included...
October 24, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29077003/antibiotic-prescribing-for-uncomplicated-acute-bronchitis-is-highest-in-younger-adults
#14
Larissa Grigoryan, Roger Zoorob, Jesal Shah, Haijun Wang, Monisha Arya, Barbara W Trautner
Reducing inappropriate antibiotic prescribing is currently a global health priority. Current guidelines recommend against antibiotic treatment for acute uncomplicated bronchitis. We studied antibiotic prescribing patterns for uncomplicated acute bronchitis and identified predictors of inappropriate antibiotic prescribing. We used the Epic Clarity database (electronic medical record system) to identify all adult patients with acute bronchitis in family medicine clinics from 2011 to 2016. We excluded factors that could justify antibiotic use, such as suspected pneumonia, COPD or immunocompromising conditions...
October 27, 2017: Antibiotics
https://www.readbyqxmd.com/read/29072998/real-world-utilization-and-impact-of-the-wearable-cardioverter-defibrillator-in-a-community-setting
#15
Aditi Naniwadekar, Talal Alnabelsi, Kamal Joshi, Edinrin Obasare, Allan Greenspan, Sumeet Mainigi
INTRODUCTION: The wearable cardioverter-defibrillator (WCD) is used in patients at risk for sudden cardiac death (SCD) but not immediate candidates for intracardiac defibrillator (ICD) implantation. METHODS: We performed a single center retrospective study of patients prescribed WCD upon hospital discharge from January 2002 to October 2015. Clinical characteristics were obtained from the hospital electronic database and device data from Zoll LifeVest database. RESULTS: Of 140 patients, 62% were men, 85...
May 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29072544/a-narrative-review-of-the-safety-concerns-of-deprescribing-in-older-adults-and-strategies-to-mitigate-potential-harms
#16
Emily Reeve, Frank Moriarty, Rayan Nahas, Justin P Turner, Lisa Kouladjian O'Donnell, Sarah N Hilmer
As with prescribing or continuing medications, deprescribing brings with it the potential for harm as well as benefit. Uncertainty and avoidance of harm has been reported as a barrier to deprescribing in practice and may contribute to continuation of inappropriate medications. Areas covered: This narrative review covers four main safety concerns/potential harms of deprescribing in older adults: adverse drug withdrawal events, return of medical condition(s), reversal of drug-drug interactions and damage to the doctor-patient relationship...
October 26, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29071221/evaluating-adherence-of-health-care-team-to-standard-guideline-of-colistin-use-at-intensive-care-units-of-a-referral-hospital-in-shiraz-southwest-of-iran
#17
Afsaneh Vazin, Iman Karimzadeh, Atiyeh Zand, Nazafarin Hatami-Mazinani, Dena Firouzabadi
Purpose: To evaluate colistin use according to global standard drug consumption in intensive care units of a referral hospital in Shiraz, Iran Methods: A prospective, interventional study was performed during an 11 month period on 100 patients admitted to ICUs of a teaching hospital being treated with colistin for at least 3 subsequent doses. Required demographic, clinical, and paraclinical data were gathered by a pharmacist. Fifteen indexes were considered to evaluate colistin use. A clinical pharmacist reviewed indication and dose of colistin at the time of prescribing this agent...
September 2017: Advanced Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/29070067/prescription-of-potentially-inappropriate-medications-among-older-people-with-intellectual-disability-a-register-study
#18
Anna Axmon, Magnus Sandberg, Gerd Ahlström, Patrik Midlöv
BACKGROUND: Older people have a greater disease burden and are more likely than younger to be prescribed medications. They are also more sensitive to adverse effects. With this in mind, a range of medications have been suggested inappropriate in this population. People with intellectual disability (ID) have a higher disease burden than the general population, putting them at even greater risk of prescription of such medications. The aim of this study was to describe prescription of potentially inappropriate medications among older people with ID in relation to prescriptions among their age peers in the general population...
October 25, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29066875/potentially-inappropriate-medications-in-hospitalized-older-patients-a-cross-sectional-study-using-the-beers-2015-criteria-versus-the-2012-criteria
#19
Xiaolin Zhang, Shuang Zhou, Kunming Pan, Xinran Li, Xia Zhao, Ying Zhou, Yimin Cui, Xinmin Liu
AIM: Polypharmacy and potentially inappropriate medications (PIMs) are prominent prescribing issues in elderly patients. The purpose of the study was to investigate the prevalence of PIMs identified by the Beers 2015 and 2012 criteria in older patients in China and identify the correlates of PIMs. METHODS: This retrospective, cross-sectional study was conducted at Peking University First Hospital. The Beers 2015 and 2012 criteria were applied to evaluate PIMs among hospitalized patients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29066874/optimization-of-drug-therapy-in-elderly-individuals-admitted-to-a-geriatric-unit
#20
Antoine Piau, Yoann Huet, Adeline Gallini, Laurine Andre, Bruno Vellas, Fati Nourhashemi
BACKGROUND: A substantial share of adverse drug events involves inappropriate prescribing (IP). Specialized geriatric units are supposed to pay particular attention to prescribing appropriateness and to promoting a higher prescribing quality. OBJECTIVE: The objective of this study was to evaluate the reality of such assessment and optimization in real life (usual care) in a population of elderly individuals admitted to a geriatric unit. METHOD: This is an observational study including all older patients admitted to an acute geriatric unit over a 6-month period...
2017: Clinical Interventions in Aging
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