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Inappropriate prescribing

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https://www.readbyqxmd.com/read/29774712/-diagnostic-imaging-procedures-and-prescribing-appropriateness-are-administrative-data-a-proper-instrument-an-experience-from-piedmont-region-northern-italy
#1
Eva Pagano, Laura Crosetto, Andrea Evangelista, Chiara Monagheddu, Ottavio Davini, Giulio Fornero, Ida Raciti, Guido Giustetto, Giovannino Ciccone
OBJECTIVES: to assess at population level if healthcare administrative data can be suitable to identify variability and determinants of the prescribing rates for some diagnostic imaging procedures at high-risk of inappropriateness. DESIGN: population-based observational study. SETTING AND PARTICIPANTS: Piedmont Region (Northern Italy) adult population (>20 years) in year 2013. The subjects included were 3,566,147, referring to 3,016 general practitioners (GPs), in 12 Local Health Authorities (LHAs)...
March 2018: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29774194/improper-use-of-thrombolytic-agents-in-acute-hemiparesis-following-misdiagnosis-of-acute-ischemic-stroke
#2
Min Chan Kim, Seok Won Kim
Objective: Acute hemiparesis is often an early presentation of acute ischemic stroke, though it can occur in various disorders. This study aimed to investigate the improper use of thrombolytic agents for patients with acute hemiparesis, following the misdiagnosis of acute ischemic stroke. Methods: We analyzed the clinical and radiological data of nine patients initially misdiagnosed with cerebral stroke in the emergency room from May 2013 to January 2017. All the patients were treated with tissue plasminogen activator (TPA) owing to the presence of acute hemiparesis...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29771900/inappropriate-prescribing-of-antibiotics-following-discharge-after-major-surgery-an-area-for-improvement
#3
Mary De Almeida, Catherine Gerrard, Joshua T Freeman, Eamon Duffy, Sally A Roberts
AIM: This study aims to determine the indications for antibiotic use in patients discharged following major surgery at Auckland City Hospital (ACH); to determine if the indications were appropriate and to identify opportunities where antimicrobial stewardship interventions would be beneficial. METHODS: This was a retrospective study of adult patients who were dispensed an antibiotic within the first two days of discharge after major surgery at ACH between 1 January 2013 and 31 December 2013...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29771104/-appropriateness-of-antimicrobial-prescriptions-in-the-emergency-department-of-a-tertiary-hospital
#4
L Yunquera-Romero, I Márquez-Gómez, A Henares-López, M J Morales-Lara, C Gallego Fernández, R Asensi-Díez
OBJECTIVE: Antibiotics are widely prescribed in the Emergency Department (ED), representing 26-62% of outpatient antibiotic prescriptions. Around 40% of antibiotic prescriptions in hospitalized patients are inappropriate or unnecessary. The aim of the study was to assess the appropriateness of antibiotic prescriptions according to local empirical antibiotic treatment guidelines, in the ED of a tertiary hospital. METHODS: Observational, retrospective study including patients attending the ED in November 2016, with an antibiotic prescription, excluding those from residents...
May 16, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29769025/use-of-diagnostic-tests-and-the-appropriateness-of-the-treatment-decision-in-patients-with-suspected-urinary-tract-infection-in-primary-care-in-denmark-observational-study
#5
Gloria Córdoba, Anne Holm, Tina Møller Sørensen, Volkert Siersma, Håkon Sandholdt, Marjukka Makela, Niels Frimodt-Møller, Lars Bjerrum
BACKGROUND: Inappropriate prescription of antibiotics is the leading driver of antimicrobial resistance (AMR). The majority of antibiotics are prescribed in primary care. Understanding how general practitioners (GPs) use diagnostic tests and the effect on treatment decision under daily practice conditions is important to reduce inappropriate prescription of antibiotics. The aim of the study was to investigate the use of diagnostic tests in primary care patients with suspected urinary tract infection (UTI) and to assess the appropriateness of the treatment decision (TD) under daily practice conditions in Denmark...
May 16, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29764887/how-effective-and-cost-effective-are-behaviour-change-interventions-in-improving-the-prescription-and-use-of-antibiotics-in-low-income-and-middle-income-countries-a-protocol-for-a-systematic-review
#6
Neha Batura, Carla Cuevas, Mishal Khan, Virginia Wiseman
INTRODUCTION: Antibiotic resistance endangers effective prevention and treatment of infections, and places significant burden on patients, families, communities and healthcare systems. Low-income and middle-income countries (LMICs) are especially vulnerable to antibiotic resistance, owing to high infectious disease burden, and limited resources for treatment. High prevalence of antibiotic prescription and use due to lack of provider's knowledge, prescriber's habits and perceived patient needs further exacerbate the situation...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29764430/drug-prescribing-during-pregnancy-in-a-central-region-of-italy-2008-2012
#7
Martina Ventura, Alice Maraschini, Paola D'Aloja, Ursula Kirchmayer, Ilaria Lega, Marina Davoli, Serena Donati
BACKGROUND: Drug consumption during pregnancy is a matter of concern, especially regarding drugs known or suspected to be teratogens. Little is known about drug use in pregnant women in Italy. The present study is aimed at examining the prevalence, and to detect potential inappropriateness of drug prescribing among pregnant women in Latium, a region of central Italy. METHODS: This retrospective study was conducted on a cohort of women aged 18-45 years who delivered between 2008 and 2012 in public hospitals...
May 15, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29762260/clinical-indications-associated-with-opioid-initiation-for-pain-management-in-ontario-canada-a-population-based-cohort-study
#8
Sachin V Pasricha, Mina Tadrous, Wayne Khuu, David N Juurlink, Muhammad M Mamdani, J Michael Paterson, Tara Gomes
Concerns over prescription opioids contributing to high levels of opioid use disorder and overdose have led policymakers and clinicians to seek means to reduce inappropriate and high-dose initial prescriptions. To inform such efforts, we sought to describe the clinical indications associated with opioid initiation and the characteristics of the initial prescriptions and patients through a retrospective population-based cohort study. Our cohort included Ontarians initiating prescription opioids for pain management between April 1, 2015, and March 31, 2016...
May 14, 2018: Pain
https://www.readbyqxmd.com/read/29761047/a-survey-of-the-views-and-capabilities-of-community-pharmacists-in-western-australia-regarding-the-rescheduling-of-selected-oral-antibiotics-in-a-framework-of-pharmacist-prescribing
#9
Fatima Sinkala, Richard Parsons, Bruce Sunderland, Kreshnik Hoti, Petra Czarniak
Background: Antibiotic misuse in the community contributes to antimicrobial resistance. One way to address this may be by better utilizing community pharmacists' skills in antibiotic prescribing. The aims of this study were to examine the level of support for "down-scheduling" selected antibiotics and to evaluate factors determining the appropriateness of community pharmacist prescribing for a limited range of infections, including their decision to refer to a doctor. Methods: Self-administered questionnaires, including graded case vignette scenarios simulating real practice, were sent to Western Australian community pharmacists...
2018: PeerJ
https://www.readbyqxmd.com/read/29754452/part-1-current-prescribing-trends-of-antibiotics-by-dentists-in-australia-from-2013-to-2016
#10
L Teoh, K Stewart, R J Marino, M J McCullough
BACKGROUND: Literature has shown dentists tend to overprescribe antibiotics and do not always prescribe in accordance with recommended guidelines. Unnecessary prescribing is one major factor that contributes to the development of antibiotic resistance. The aim of the present study was to assess the antibacterial prescribing patterns of dentists in Australia from 2013 to 2016. METHODS: Data on dental antibacterial prescriptions dispensed under the Pharmaceutical Benefits Scheme (PBS) from 2013 to 2016 was accessed and prescribing trends analysed...
May 13, 2018: Australian Dental Journal
https://www.readbyqxmd.com/read/29753315/potentially-inappropriate-prescribing-to-older-patients-criteria-prevalence-and-an-intervention-to-reduce-it-the-prescription-peer-academic-detailing-rx-pad-study-a-cluster-randomized-educational-intervention-in-norwegian-general-practice
#11
Sture Rognstad, Mette Brekke, Svein Gjelstad, Jørund Straand, Arne Fetveit
Potentially Inappropriate Prescriptions (PIP) is drug treatment, which in general, at the group level for a median/mean patient, can be considered unfavorable meaning that the risks commonly may outweigh the benefits. This MiniReview reports and discusses the main findings in a large cluster-randomized educational intervention in Norwegian general practice, aimed at reducing the prevalence of PIPs to patients ≥ 70 years (The Rx-PAD study). Targets for the intervention were general practitioners (GPs) in continuing medical education (CME) groups receiving educational outreach visits (i...
May 12, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29751840/prevalence-of-the-potentially-inappropriate-kampo-medications-to-be-used-with-caution-among-elderly-patients-taking-any-prescribed-kampo-medications-at-a-single-centre-in-japan-a-retrospective-cross-sectional-study
#12
Junpei Komagamine, Kazuhiko Hagane
BACKGROUND: Few studies have investigated the prevalence and characteristics of potentially inappropriate Kampo medication use among elderly ambulatory patients taking any prescribed Kampo medications. METHODS: A retrospective cross-sectional study was conducted using electronic medical records. All patients aged 65 years or older who continued visiting internal medicine physicians and were prescribed any Kampo medications from January 2015 to March 2015 were included...
May 11, 2018: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29750637/comment-to-rankovi%C3%A4-et-al-potentially-inappropriate-prescribing-of-drugs-in-elderly-patients-on-chronic-hemodialysis-treatment-clin-nephrol-2017-epub-ahead-of-print
#13
Anunciación González-López, Angel Chocarro-Martinez, Alvaro Nava-Rebollo
No abstract text is available yet for this article.
May 11, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29749943/experience-with-wearable-cardioverter-defibrillators-at-2-academic-medical-centers
#14
Jordan S Leyton-Mange, William J Hucker, Nino Mihatov, Matthew Reynolds, Christine Albert, Steven A Lubitz, David J Milan
OBJECTIVES: This study sought to characterize the experience in a cohort of patients prescribed a wearable cardioverter-defibrillator (WCD) over a 2-year interval at 2 academic medical centers. BACKGROUND: The WCD is available for patients felt to be at high risk of sudden cardiac death. However, there is a lack of randomized data to guide its use and prescribing patterns vary. METHODS: We retrospectively reviewed indications and therapies of all WCD prescriptions over a 2-year period from 2 large academic medical centers...
February 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29746637/potential-impact-of-influenza-vaccine-roll-out-on-antibiotic-use-in-africa
#15
Gwenan M Knight, Madeleine Clarkson, Thushan I de Silva
Background: Influenza infections result in both inappropriate and appropriate antibiotic prescribing. There is a huge burden of both influenza and infections caused by antimicrobial-resistant pathogens in Africa. Influenza vaccines have the potential to reduce appropriate antibiotic use, through reduction of secondary bacterial infections, as well as to reduce levels of influenza misdiagnosed and treated as a bacterial infection (inappropriate). Objectives: To estimate potential reductions in antibiotic use that are achievable by introducing an influenza vaccine into various African settings...
May 9, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29745441/appropriateness-of-oral-anticoagulant-therapy-prescription-and-its-associated-factors-in-hospitalized-older-people-with-atrial-fibrillation
#16
Carlotta Franchi, Stefania Antoniazzi, Marco Proietti, Alessandro Nobili, Pier Mannuccio Mannucci
BACKGROUND: Oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF). Despite this, they are often underused in this at particularly high risk population. OBJECTIVES: To assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. METHODS: Data were obtained from the retrospective phase of SIM-AF study, held in 32 Italian internal medicine and geriatric wards...
May 10, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29745338/hyponatraemia-associated-with-tramadol-use-a-case-report
#17
Tuck Y Yong, Kareeann S.F. Khow
Hyponatraemia is frequently encountered in clinical practice and common among hospitalized patients. Tramadol is a commonly prescribed analgesia with few adverse effects. However, on rare occasions, tramadol has been found to be associated with hyponatraemia. In two patients described in this report, tramadol use was associated with symptomatic hyponatraemia which required hospitalization. Hyponatraemia were corrected after discontinuation of tramadol. A small number of patients with tramadol-associated hyponatraemia have been reported in the English-language medical literature...
May 8, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29744901/hospital-readmissions-mortality-and-potentially-inappropriate-prescribing-a-retrospective-study-of-older-adults-discharged-from-hospital
#18
David Counter, James W T Millar, James S McLay
AIMS: Applying version 2 of the STOPP/START criteria to discharge prescriptions of older adults discharged from a general medical unit, assess potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs)and their association with hospital readmission and mortality. METHODS: Discharge medications, co-morbidities and patient demographics were recorded over an 8 month period for consecutive emergency admissions aged ≥ 65 years. PIMs and PPOs were identified using version 2 of the STOPP/START criteria...
May 9, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29744044/enhancing-pharmacists-role-in-developing-countries-to-overcome-the-challenge-of-antimicrobial-resistance-a-narrative-review
#19
REVIEW
M H F Sakeena, Alexandra A Bennett, Andrew J McLachlan
Background: Antimicrobial resistance (AMR) is a global health challenge and developing countries are more vulnerable to the adverse health impacts of AMR. Health care workers including pharmacists can play a key role to support the appropriate use of antimicrobials in developing countries and reduce AMR. Objective: The aim of this review is to investigate the role of pharmacists in the appropriate use of antibiotics and to identify how the pharmacists' role can be enhanced to combat AMR in developing countries...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29743330/protocol-for-a-randomised-trial-of-higher-versus-lower-intensity-patient-provider-communication-interventions-to-reduce-antibiotic-misuse-in-two-paediatric-ambulatory-clinics-in-the-usa
#20
Kathy Goggin, Andrea Bradley-Ewing, Angela L Myers, Brian R Lee, Emily A Hurley, Kirsten B Delay, Sarah Schlachter, Areli Ramphal, Kimberly Pina, David Yu, Kirsten Weltmer, Sebastian Linnemayr, Christopher C Butler, Jason G Newland
INTRODUCTION: Children with acute respiratory tract infections (ARTIs) are prescribed up to 11.4 million unnecessary antibiotic prescriptions annually. Inadequate parent-provider communication is a chief contributor, yet efforts to reduce overprescribing have only indirectly targeted communication or been impractical. This paper describes our multisite, parallel group, cluster randomised trial comparing two feasible interventions for enhancing parent-provider communication on the rate of inappropriate antibiotic prescribing (primary outcome) and revisits, adverse drug reactions and parent-rated quality of shared decision-making, parent-provider communication and visit satisfaction (secondary outcomes)...
May 9, 2018: BMJ Open
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