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Inappropriate prescribing

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https://www.readbyqxmd.com/read/28648901/the-asia-pacific-clinical-practice-guidelines-for-the-management-of-frailty
#1
Elsa Dent, Christopher Lien, Wee Shiong Lim, Wei Chin Wong, Chek Hooi Wong, Tze Pin Ng, Jean Woo, Birong Dong, Shelley de la Vega, Philip Jun Hua Poi, Shahrul Bahyah Binti Kamaruzzaman, Chang Won, Liang-Kung Chen, Kenneth Rockwood, Hidenori Arai, Leocadio Rodriguez-Mañas, Li Cao, Matteo Cesari, Piu Chan, Edward Leung, Francesco Landi, Linda P Fried, John E Morley, Bruno Vellas, Leon Flicker
OBJECTIVE: To develop Clinical Practice Guidelines for the screening, assessment and management of the geriatric condition of frailty. METHODS: An adapted Grading of Recommendations, Assessment, Development, and Evaluation approach was used to develop the guidelines. This process involved detailed evaluation of the current scientific evidence paired with expert panel interpretation. Three categories of Clinical Practice Guidelines recommendations were developed: strong, conditional, and no recommendation...
July 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28640946/physicians-non-uniform-approach-to-prescribing-drugs-to-older-patients-a-qualitative-study
#2
Line Due Christensen, Janne Petersen, Ove Andersen, Susanne Kaae
Multi-morbidity and polypharmacy are common in older patients and increase their susceptibility to adverse drug events and hospitalizations. Rational drug prescription is critical, however, little is known about physicians' perspectives on how to prescribe drugs for older patients. The aim of this study was to explore physicians' approach to prescribe drugs to older patients, including identifying the drugs that physicians perceive to be risk drugs for older patients and comparing them with established lists of potentially inappropriate medications...
June 22, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28634909/categorical-risk-perception-drives-variability-in-antibiotic-prescribing-in-the-emergency-department-a-mixed-methods-observational-study
#3
Eili Y Klein, Elena M Martinez, Larissa May, Mustapha Saheed, Valerie Reyna, David A Broniatowski
BACKGROUND: Adherence to evidence-based antibiotic therapy guidelines for treatment of upper respiratory tract infections (URIs) varies widely among clinicians. Understanding this variability is key for reducing inappropriate prescribing. OBJECTIVE: To measure how emergency department (ED) clinicians' perceptions of antibiotic prescribing risks affect their decision-making. DESIGN: Clinician survey based on fuzzy-trace theory, a theory of medical decision-making, combined with retrospective data on prescribing outcomes for URI/pneumonia visits in two EDs...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28634655/effect-of-adherence-on-pharmacokinetic-pharmacodynamic-relationships-of-oral-targeted-anticancer-drugs
#4
Evelina Cardoso, Chantal Csajka, Marie P Schneider, Nicolas Widmer
The emergence of oral targeted anticancer agents transformed several cancers into chronic conditions with a need for long-term oral treatment. Although cancer is a life-threatening condition, oncology medication adherence-the extent to which a patient follows the drug regimen that is intended by the prescriber-can be suboptimal in the long term, as in any other chronic disease. Poor adherence can impact negatively on clinical outcomes, notably because most of these drugs are given as a standard non-individualized dosage despite marked inter-individual variabilities that can lead to toxic or inefficacious drug concentrations...
June 20, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28633631/knowledge-of-antibiotic-resistance-and-antibiotic-prescription-practices-among-prescribers-in-the-brong-ahafo-region-of-ghana-a-cross-sectional-study
#5
Kwaku Poku Asante, Ellen Abrafi Boamah, Martha Ali Abdulai, Kwame Ohene Buabeng, Emmanuel Mahama, Francis Dzabeng, Edith Gavor, Edith Andrews Annan, Seth Owusu-Agyei, Martha Gyansa-Lutterodt
BACKGROUND: Antibiotic resistance (ABR) has become a major public health challenge in most parts of the world including Ghana and is a major threat to gain in bacterial disease control. The role of prescribers in the control of antibiotics is identified as crucial in developing interventions to control ABR. To guide policy recommendations on ABR, a study was carried out among prescribers to identify gaps in their knowledge of ABR and to document their prescription practices. METHOD: A cross-sectional survey was conducted among prescribers from both public and private facilities in the Brong Ahafo Region of Ghana using both quantitative and qualitative methods in 2014...
June 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28633334/knowledge-attitude-and-practice-of-gambian-health-practitioners-towards-antibiotic-prescribing-and-microbiological-testing-a-cross-sectional-survey
#6
Pa Saidou Chaw, Kristin Maria Schlinkmann, Heike Raupach-Rosin, André Karch, Mathias W Pletz, Johannes Huebner, Rafael Mikolajczyk
Background: Inappropriate antibiotic use is the leading cause of antibiotic resistance worldwide. At the same time, the practice of antibiotic prescribing in Africa is less well documented when compared to developed countries. The objective of the study was to assess the knowledge, attitude, and practice (KAP) of health practitioners towards antibiotic prescribing and microbiological testing in The Gambia. Methods: A KAP survey was conducted in The Gambia from March to May 2016...
March 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28631001/the-effect-of-emphasizing-patient-societal-and-institutional-harms-of-inappropriate-antibiotic-prescribing-on-physician-support-of-financial-penalties-a-randomized-trial
#7
Joshua M Liao, Marilyn S Schapira, Amol S Navathe, Nandita Mitra, Arlene Weissman, David A Asch
No abstract text is available yet for this article.
June 20, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28625935/evaluation-of-prescription-along-three-health-care-periods-in-the-elderly
#8
Fannie Santoni, Valéry Antoine, Alberto di Castri, Maurice Viala, Laetitia Geronimi-Robelin, Cédric LeGuillou, Christine de Taddeo, Sophie Bastide, Claude Jeandel, Benoit de Wazieres
Polypharmacy, potentially inappropriate prescriptions and inadequate coordination between prescribers are among main factors explaining the occurrence of adverse drug events in elderly patients. Prospective and descriptive study of medication prescriptions for elderly patients during a continuous period of health-care: entry in an acute geriatric unit (T1), at discharge (T2) and two months after hospitalization (T3). A global iatrogenic risk was defined: presence of poly-pharmacy and/or PPI (Laroche criteria) and/or absence of quality indicators for prescription according to the French health authority...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28622741/characterization-of-guideline-evidence-for-off-label-medication-use-in-the-intensive-care-unit
#9
Bethany R Shoulders, Pamela L Smithburger, Stephanie Tchen, Mitchell Buckley, Ishaq Lat, Sandra L Kane-Gill
BACKGROUND: Non-Food and Drug Administration (FDA) or off-label medication prescribing occurs commonly in the intensive care unit (ICU). Off-label medication use creates a concern for untoward adverse effects; however, this worry may be alleviated by supportive literature. OBJECTIVE: To evaluate the evidence behind off-label medication use by determining the presence of guideline support and compare graded recommendations to an online tertiary resource, DRUGDEX...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28622739/impact-of-a-collaborative-strategy-to-reduce-the-inappropriate-use-of-acid-suppressive-therapy-in-non-intensive-care-unit-patients
#10
Kristen D Belfield, Arpi G Kuyumjian, Rafael Teran, Mariette Amadi, Melissa Blatt, Keri Bicking
BACKGROUND: Stress ulcer prophylaxis (SUP) is inappropriately prescribed in more than 30% of non-intensive care unit (ICU) patients, leading to unnecessary adverse events as well as increases in economic burden. OBJECTIVE: There was an increasing trend in the prophylactic use of acid suppressive therapy (AST) in non-critically ill patients at our institution, which prompted this initiative aimed at reducing the inappropriate use of AST in non-ICU patients. METHODS: This was a retrospective interventional study that consisted of formulation of a guideline, education to the hospitalist service, and intervention by clinical pharmacists...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28619704/applying-stopp-guidelines-in-primary-care-through-electronic-medical-record-decision-support-randomized-control-trial-highlighting-the-importance-of-data-quality
#11
Morgan Price, Iryna Davies, Raymond Rusk, Mary Lesperance, Jens Weber
BACKGROUND: Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly. OBJECTIVE: We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non-academic) primary care practices. METHODS: We conducted a mixed-method, pragmatic, cluster, randomized control trial in research naïve primary care practices...
June 15, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28618875/implementation-of-guideline-based-therapy-for-chronic-obstructive-pulmonary-disease-differences-between-men-and-women-veterans
#12
Seppo T Rinne, A Rani Elwy, Chuan-Fen Liu, Renda Soylemez Wiener, Lisa Thayer, Alexandra Gerity, Lori A Bastian
Chronic obstructive pulmonary disease (COPD) is common among both men and women, and guidelines recommend the same therapy for both sexes. While previous studies have identified gender differences in other chronic disease management, few studies have examined how implementation of COPD guidelines differs between men and women. We performed a cross-sectional study of veterans admitted to Veterans Affairs (VA) hospitals for COPD during October 1, 2008, to September 30, 2011. We collected information on baseline COPD medications during the 6 months prior to hospitalization and categorized therapies as "appropriate" or "inappropriate" based on current guidelines...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28618239/extent-and-risks-of-antipsychotic-off-label-use-in-children-and-adolescents-in-germany-between-2004-and-2011
#13
Carsten Schröder, Michael Dörks, Bianca Kollhorst, Tilo Blenk, Ralf W Dittmann, Edeltraut Garbe, Oliver Riedel
OBJECTIVE: Only little is known about antipsychotic (AP) off-label use (OLU) in pediatric populations. It was the aim of this study to examine the frequency as well as the risks of off-label AP use in underaged patients. METHODS: To calculate the frequency of off-label AP prescriptions for the years 2004-2011, we used claims data of more than two million minors aged 0-17 years. Off-label prescriptions were analyzed with regard to type of OLU, physician specialty, and underlying diagnoses...
June 15, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28618134/potentially-inappropriate-use-of-furosemide-in-a-very-elderly-population-an-observational-study
#14
Carla Rodriguez-Cillero, Didier Menu, Philippe d'Athis, Sophie Perrin, Mélanie Dipanda, Sanaa Asgassou, Hélène Guepet, Emmanuel Mazen, Patrick Manckoundia, Alain Putot
OBJECTIVE: Little is known about furosemide prescription modalities in elderly people. We describe furosemide prescription in ambulatory elderly patients. METHODS: All patients aged over 80 years, affiliated to Mutualité Sociale Agricole de Bourgogne, a French regional health insurance plan, with a medical prescription delivered in March 2015, were retrospectively included. RESULTS: Among 15 141 patients with a median age of 86 years, comprising 61...
June 15, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28611111/the-impact-of-interventions-to-improve-the-quality-of-prescribing-and-use-of-antibiotics-in-primary-care-patients-with-respiratory-tract-infections-a-systematic-review-protocol
#15
Nahara Anani Martínez-González, Samuel Coenen, Andreas Plate, Annelies Colliers, Thomas Rosemann, Oliver Senn, Stefan Neuner-Jehle
INTRODUCTION: Respiratory tract infections (RTIs) are the most common reason for primary care (PC) consultations and for antibiotic prescribing and use. The majority of RTIs have a viral aetiology however, and antibiotic consumption is ineffective and unnecessary. Inappropriate antibiotic use contributes greatly to antibiotic resistance (ABR) leading to complications, increased adverse events, reconsultations and costs. Improving antibiotic consumption is thus crucial to containing ABR, which has become an urgent priority worldwide...
June 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28608525/antimicrobials-used-for-surgical-prophylaxis-by-equine-veterinary-practitioners-in-australia
#16
L Y Hardefeldt, G F Browning, K Thursky, J R Gilkerson, H Billman-Jacobe, M A Stevenson, K E Bailey
BACKGROUND: Antimicrobials are widely used in Australian veterinary practices, but no investigation into the classes of antimicrobials used or the appropriateness of use in horses has been conducted. OBJECTIVES: The aim of the study was to describe antimicrobial use for surgical prophylaxis in equine practice in Australia. STUDY DESIGN: Cross-sectional questionnaire survey. METHODS: An online questionnaire was used to document antimicrobial usage patterns...
June 13, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28603710/use-of-non-prescription-remedies-by-ghanaian-human-immunodeficiency-virus-positive-persons-on-antiretroviral-therapy
#17
Amos K Laar, Awewura Kwara, Priscillia A Nortey, Augustine K Ankomah, Michael P K Okyerefo, Margaret Y Lartey
BACKGROUND: Inappropriate use of non-prescription remedies by persons living with human immunodeficiency virus (PLHIV) may result in adverse events or potentiate non-adherence to prescribed medications. This study investigated the use of non-prescription remedies among PLHIV receiving antiretroviral therapy (ART) from four treatment centers in southern Ghana. METHODS: A mixed method design using quantitative and qualitative methods was used. This article focuses on the quantitative survey of 540 respondents...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28601963/frailty-polypharmacy-and-potentially-inappropriate-medications-in-old-people-findings-in-a-representative-sample-of-the-french-population
#18
Marie Herr, Nicolas Sirven, Hélène Grondin, Sylvain Pichetti, Catherine Sermet
PURPOSE: This study analyses the relationship between medication use and frailty by considering the quantity of medications prescribed (polypharmacy) and the quality of medication prescribing (according to French criteria for Potentially Inappropriate Medications-PIMs) in people aged 65 and over. METHODS: This is a cross-sectional study based on the data from a nationally representative study about health and use of healthcare resources in France (ESPS 2012). The number of frailty criteria was assessed among exhaustion, unintentional weight loss, muscle weakness, impaired mobility, and low level of physical activity...
June 11, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28572098/prophylactic-acid-suppressive-therapy-in-hospitalized-adults-indications-benefits-and-infectious-complications
#19
Andrew C Faust, Kelly L Echevarria, Rebecca L Attridge, Lyndsay Sheperd, Marcos I Restrepo
Acid-suppressive therapy for prophylaxis of stress ulcer bleeding is commonly prescribed for hospitalized patients. Although its use in select, at-risk patients may reduce clinically significant gastrointestinal bleeding, the alteration in gastric pH and composition may place these patients at a higher risk of infection. Although any pharmacologic alteration of the gastric pH and composition is associated with an increased risk of infection, the risk appears to be highest with proton pump inhibitors, perhaps owing to the potency of this class of drugs in increasing the gastric pH...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28571945/applying-the-lists-of-risk-drugs-for-thai-elderly-lrdte-as-a-mechanism-to-account-for-patient-age-and-medicine-severity-in-assessing-potentially-inappropriate-medication-use
#20
Vanida Prasert, Manabu Akazawa, Aiko Shono, Farsai Chanjaruporn, Chanuttha Ploylearmsang, Kamolnut Muangyim, Thanased Wattanapongsatit, Uthen Sutin
BACKGROUND: Potential inappropriate medication (PIM) prescribing is a medication that puts patients at risk rather than having benefits. PIM use has been associated with hospitalization, morbidity, and mortality resulting from ADRs in elderly patients. The Lists of Risk Drugs for Thai Elderly (LRDTE) was developed as the new screening tool to identify PIMs use. The prevalence of PIM use using the LRDTE has not been determined in Thailand. PURPOSE: The main purpose of this study was to examine the prevalence of PIM use based on the LRDTE...
May 23, 2017: Research in Social & Administrative Pharmacy: RSAP
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