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Inappropriate prescribing

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https://www.readbyqxmd.com/read/28226416/the-contribution-of-the-emergency-department-to-opioid-pain-reliever-misuse-and-diversion-a-critical-review
#1
REVIEW
Tatyana Lyapustina, Renan Castillo, Elise Omaki, Wendy Shields, Eileen McDonald, Richard Rothman, Andrea Gielen
Prescription opioid pain reliever (OPR) misuse and diversion is an important and growing public health problem in the United States that is responsible for significant morbidity and mortality. Emergency physicians are among the top prescribers of OPRs, yet the relative contribution of emergency department (ED) OPR prescriptions to the overall opioid abuse epidemic remains unclear. This study critically reviews seven peer-reviewed studies that specifically identified the ED as a source of OPRs. Of the OPRs prescribed in the ED, approximately 10% are associated with indicators of inappropriate prescribing, and approximately 42% may ultimately be misused; of the OPRs that are diverted, approximately 10% originate from an ED prescription...
February 22, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#2
Margot Trotter Davis, Brian Bateman, Jerry Avorn
Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28224703/potentially-inappropriate-medications-in-chinese-older-adults-the-beers-criteria-compared-with-the-screening-tool-of-older-persons-prescriptions-criteria
#3
Hong Li, Shiyun Pu, Qinhui Liu, Xin Huang, Jiangying Kuang, Lei Chen, Jing Shen, Shihai Cheng, Tong Wu, Rui Li, Yanping Li, Li Mo, Wei Jiang, Yi Song, Jinhan He
AIM: The present study aimed to assess the prevalence of potentially inappropriate medications (PIM) use in West China Hospital residents aged ≥65 years, using two sets of criteria - the Beers and Screening Tool of Older Persons' Prescriptions (STOPP) criteria - and to compare the Beers and STOPP criteria, and to determine the better criteria for assessing PIM of older adults in China. METHODS: This was a retrospective cross-sectional study, and all patients were aged ≥65 years and admitted through the Information Center of West China Hospital from October 2010 to April 2013...
February 22, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28223868/assessment-of-novel-oral-anticoagulant-use-within-a-community-teaching-hospital
#4
Sultan Alghadeer, Lori Hornsby
: Background: Novel oral anticoagulants (NOACs) are considered to be at least as effective and safe as warfarin with several advantages such as predictable pharmacokinetics, allowing for standardized dosing without monitoring, a lack of food interactions and fewer drug interactions; however, their misuse could potentially result in patient harm. Objective: To evaluate the appropriate use of the NOACs within a community teaching hospital. SETTING: A community teaching hospital in the United States...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28216959/prescription-patterns-and-appropriateness-of-antibiotics-in-the-management-of-cough-cold-and-diarrhea-in-a-rural-tertiary-care-teaching-hospital
#5
Akram Ahmad, Muhammad Umair Khan, Sadiqa Malik, Guru Prasad Mohanta, S Parimalakrishnan, Isha Patel, Sameer Dhingra
BACKGROUND: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients. METHODS: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study...
October 2016: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28216952/risk-factors-for-developing-drug-related-problems-in-patients-with-cardiovascular-diseases-attending-gondar-university-hospital-ethiopia
#6
Ousman Abubeker Abdela, Akshaya Srikanth Bhagavathula, Henok Getachew, Yohannes Kelifa
BACKGROUND: Cardiovascular diseases (CVDs) are often accompanied with comoribidities and complications leading to taking multiple drugs and thus are more liable to be exposed to drug-related problems (DRPs). DRPs can occur at any stages of medication process from prescription to follow-up treatment. However, a few studies have assessed the specific risk factors for occurrence of at least one potential DRP per patient with CVDs in sub-Saharan African region. AIM: We aim to assess the risk factors for developing potential DRPs in patients with CVDs attending Gondar University Referral Hospital (GUH)...
October 2016: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28215652/polypathology-polypharmacy-medication-regimen-complexity-and-drug-therapy-appropriateness
#7
N Gómez Aguirre, A Caudevilla Martínez, L Bellostas Muñoz, M Crespo Avellana, J Velilla Marco, J Díez-Manglano
Polypathological patients are usually elderly and take numerous drugs. Polypharmacy affects 85% of these individuals and is not associated with greater survival. On the contrary, polypharmacy exposes these individuals to more adverse effects, such as weight loss, falls, functional and cognitive impairment and hospitalisations. The complexity of a drug regimen covers more aspects than the simple number of drugs consumed. The galenic form, the dosage and the method for preparing the drug can impede the understanding of and compliance with prescriptions...
February 16, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28213817/breakthrough-cancer-pain-and-rational-drug-use
#8
Juan Manuel Núñez Olarte
Recent data indicate that there are large disparities in the use of opioid analgesics to control breakthrough cancer pain (BTcP) in Europe and worldwide. While it is clear that affordability is a key factor, it is certainly not the only one, and other factors, such as cultural differences and overall awareness, are undoubtedly responsible. More work remains to be done to overcome barriers in the use of these medications when warranted. When prescribing a medication for BTcP, it must be considered that its time profile is different from chronic persistent pain...
February 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28212496/antipsychotic-use-in-dementia
#9
Julia Kirkham, Chelsea Sherman, Clive Velkers, Colleen Maxwell, Sudeep Gill, Paula Rochon, Dallas Seitz
Antipsychotics are necessary for many older adults to treat major mental illnesses or reduce distressing psychiatric symptoms. Current controversy exists over the role of antipsychotics in the management of neuropsychiatric symptoms (NPS) in persons with dementia. Although some NPS may be appropriately and safely treated with antipsychotics, a fine balance must be achieved between the benefits of these medications, which are often modest, and adverse events, which may have significant consequences. Approximately one-third of all persons with dementia are currently prescribed antipsychotic medications, and there is significant variation in the use of antipsychotics across care settings and providers...
March 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28212400/surveys-of-public-knowledge-and-attitudes-with-regard-to-antibiotics-in-poland-did-the-european-antibiotic-awareness-day-campaigns-change-attitudes
#10
Beata Mazińska, Izabela Strużycka, Waleria Hryniewicz
BACKGROUND: Antimicrobial resistance is a global public health problem. Monitoring the level of knowledge regarding antibiotics is a part of the European Union Community strategy against antimicrobial resistance. OBJECTIVE: To assess knowledge by the general public in Poland regarding antibiotics, AMR, and the impact of the European Antibiotic Awareness Day campaigns. METHODS: The repeated cross-sectional study was developed and carried out among the general public in Poland (in 5 waves between 2009 and 2011, embracing a total of 5004 respondents)...
2017: PloS One
https://www.readbyqxmd.com/read/28209203/crizotinib-associated-renal-cysts-carcs-incidence-and-patterns-of-evolution
#11
Laird B Cameron, Damian H S Jiang, Kate Moodie, Catherine Mitchell, Benjamin Solomon, Bimal Kumar Parameswaran
BACKGROUND: Novel therapeutic agents recently introduced for the treatment of cancer have several unusual side effects. An increased incidence of renal cystic lesions, often with features concerning for malignancy or infection, has been reported in patients with anaplastic lymphoma kinase (ALK) - rearranged advanced non-small cell lung cancer (NSCLC) treated with Crizotinib. Many of these lesions undergo spontaneous resolution despite developing complex features on imaging. We assess the incidence and patterns of evolution of Crizotinib Associated Renal Cysts [CARCs] at our institute and provide histopathology correlation of their benign nature...
February 16, 2017: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
https://www.readbyqxmd.com/read/28208876/prescribing-pattern-of-antifungal-medications-at-a-tertiary-care-hospital-in-oman
#12
Khalid A Al Balushi, Mohammed A Alzaabi, Fatma Alghafri
INTRODUCTION: Inappropriate use of antifungal agents is implicated in the global burden of antifungal resistance, adverse outcomes like persistent infections, unnecessary exposure and increased cost. Data collection from time to time is to be done in order to have a check on the resistance/sensitivity pattern of the commonly prescribed antifungal drugs. AIM: To describe the pattern of antifungal drug prescription and administration to patients attending a university hospital in Oman...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28205064/appropriateness-of-surgical-antibiotic-prophylaxis-for-breast-surgery-procedures
#13
Smeem Jaber, Crystal Rogers, Bruce Sunderland, Richard Parsons, Sarah MacKenzie, Jason Seet, Petra Czarniak
Background Guidelines for the appropriate use of antibiotic prophylaxis are provided in the Therapeutic Guidelines: Antibiotics (eTG) in Australia. Inappropriate use of antibiotics is problematic. Objective To examine adherence with therapeutic guidelines (eTG) in breast surgery and trends in non-adherence dependent on the type of breast surgery performed. Setting Major Western Australian teaching hospital. Method A retrospective cross-sectional study reviewed a random sample of 150 from 1049 eligible medical records of patients who underwent a breast surgical procedure in 2013 or 2014...
February 15, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28203365/polypharmacy-and-inappropriate-medication-use-in-patients-with-dementia-an-underresearched-problem
#14
REVIEW
Carole Parsons
Multimorbidity and polypharmacy are increasingly prevalent across healthcare systems and settings as global demographic trends shift towards increased proportions of older people in populations. Numerous studies have demonstrated an association between polypharmacy and potentially inappropriate prescribing (PIP), and have reported high prevalence of PIP across settings of care in Europe and North America and, as a consequence, increased risk of adverse drug reactions, healthcare utilization, morbidity and mortality...
January 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28194534/the-impact-of-physician-level-drug-budgets-on-prescribing-behavior
#15
Katharina Elisabeth Fischer, Taika Koch, Karel Kostev, Tom Stargardt
To contain pharmaceutical spending, drug budgets have been introduced across health systems. Apart from analyzing whether drug budgets fulfill their overall goal of reducing spending, changes in the cost and quality of prescribing and the enforcement mechanisms put in place need evaluation to assess the effectiveness of drug budgets at the physician level. In this study, we aim to analyze the cost and quality of prescribing conditional on the level of utilization of the drug budget and in view of varying levels of enforcement in cases of overspending...
February 13, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28193663/results-from-a-patient-based-health-education-intervention-in-reducing-antibiotic-use-for-acute-upper-respiratory-tract-infections-in-the-private-sector-primary-care-setting-in-singapore
#16
Magdalene Hui Min Lee, Darius Shaw Teng Pan, Joyce Huixin Huang, Mark I-Cheng Chen, Joash Wen Chen Chong, Ee Hui Goh, Lili Jiang, Yee Sin Leo, Tau Hong Lee, Chia Siong Wong, Victor Weng Keong Loh, Fong Seng Lim, Adrian Zhongxian Poh, Tat Yean Tham, Wei Mon Wong, Yue Yu
We investigated the efficacy of patient-targeted education in reducing antibiotic prescriptions for upper respiratory tract infections (URTIs) amongst adults in the private primary care setting in Singapore. Our randomized controlled trial enrolled patients aged 21 years and above presenting at GP (general practitioner) clinics with URTI symptoms for 7 days or less. Intervention arm patients were verbally educated via pamphlets about the aetiology of URTIs, role of antibiotics in treating URTIs, and consequences of inappropriate antibiotic use...
February 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28188510/medication-use-and-risk-of-falls-among-nursing-home-residents-a-retrospective-cohort-study
#17
Andrea Bor, Mária Matuz, Márta Csatordai, Gábor Szalai, András Bálint, Ria Benkő, Gyöngyvér Soós, Péter Doró
Background Geriatric falls are leading causes of hospital trauma admissions and injury-related deaths. Medication use is a crucial element among extrinsic risk factors for falls. To reduce fall risk and the prevalence of adverse drug reactions, potentially inappropriate medication (PIM) lists are widely used. Objective Our aim was to investigate the possible predictors of geriatric falls annualized over a 5-year-long period, as well as to evaluate the medication use of nursing home residents. Setting Nursing home residents were recruited from the same institution between 2010 and 2015 in Szeged, Hungary...
February 10, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28188508/potentially-inappropriate-prescribing-and-associated-factors-in-elderly-patients-at-hospital-discharge-in-brazil-a-cross-sectional-study
#18
Ana Luiza Pereira Moreira Mori, Renata Cunha Carvalho, Patricia Melo Aguiar, Maria Goretti Farias de Lima, Magali da Silva Pacheco Nobre Rossi, José Fernando Salvador Carrillo, Egídio Lima Dórea, Sílvia Storpirtis
Background The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria is used to identify instances of potentially inappropriate prescribing in a patient's medication regimen. Objective To determine the prevalence and predictors of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among elderly patients at hospital discharge. Setting A university hospital medical clinic in Brazil. Method Discharge prescriptions were examined using the STOPP/START criteria...
February 10, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28187084/uptake-of-hiv-pre-exposure-prophylaxis-prep-in-a-national-cohort-of-gay-and-bisexual-men-in-the-united-states
#19
Jeffrey T Parsons, H Jonathon Rendina, Jonathan M Lassiter, Thomas H F Whitfield, Tyrel J Starks, Christian Grov
OBJECTIVES: The HIV care cascade provides milestones to track the progress of HIV-positive people from seroconversion through viral suppression. We propose a Motivational pre-exposure prophylaxis (PrEP) Cascade involving 5 stages based on the Transtheoretical Model of Change. METHODS: We analyzed data from 995 men in One Thousand Strong, a longitudinal study of a national panel of HIV-negative gay and bisexual men in the United States. RESULTS: Nearly all (89%) participants were sexually active in the past 3 months and 65% met Centers for Disease Control criteria for PrEP candidacy...
1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28184303/deprescribing-medicines-in-the-acute-setting-to-reduce-the-risk-of-falls
#20
Vanessa Marvin, Emily Ward, Alan J Poots, Katie Heard, Arvind Rajagopalan, Barry Jubraj
BACKGROUND: Falls are a common cause of morbidity and hospitalisation in older people. Inappropriate prescribing and polypharmacy contribute to falls risk in elderly patients. This study's aim was to quantify the problem and find out if medication review in the hospital setting led to deprescribing of medicines associated with falls risk. METHODS: Admissions records for elderly patients were examined to identify those whose presenting complaint included a fall. Inpatient medication charts, pharmaceutical care notes, medical notes and discharge summaries were examined to identify any falls-risk medicines from admission histories and to determine if any medication review took place, and whether or not changes were made as a result...
January 2017: European Journal of Hospital Pharmacy. Science and Practice
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