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Inappropriate prescribing

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https://www.readbyqxmd.com/read/29332434/relationship-between-antimicrobial-resistance-programs-and-antibiotic-dispensing-for-upper-respiratory-tract-infection-an-analysis-of-australian-data-between-2004-and-2015
#1
Jianyun Wu, Daniel Taylor, Ludmila Ovchinikova, Aine Heaney, Tessa Morgan, Jonathan Dartnell, Rachel Holbrook, Lauren Humphreys, Lynn Weekes, Suzanne Blogg
Objective NPS MedicineWise aims to ensure that medicines are prescribed and used in a manner consistent with current evidence-based best practice. A series of nationwide educational and advertising interventions for general practitioners and consumers were implemented in Australia between 2009 and 2015 with the aim of reducing antibiotic prescriptions for upper respiratory tract infections (URTIs). The work described in this paper quantifies the change in antibiotic dispensing following these interventions...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29332346/vaginal-packing-volume-impact-on-dose-parameters-during-radiography-and-computed-tomography-based-postoperative-brachytherapy-of-cervical-carcinoma
#2
Aleksandar Tomasevic, Vesna Plesinac-Karapandzic, Suzana Stojanovic-Rundic, Sandra Vuckovic, Jasmina Stevanovic, Dusica Gavrilovic, Mirjan Nadrljanski
PURPOSE: To investigate the influence of the vaginal packing volume on the registered dose parameters evaluated by radiography (2D) and computed tomography (CT) (3D) based brachytherapy planning in cervical cancer patients treated with postoperative radiotherapy. METHODS: The postoperative radiotherapy was performed in 40 cervical cancer patients with increased risk for disease relapse. Both, radiography and CT based brachytherapy planning were done in all patients...
November 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29330585/potentially-inappropriate-medications-in-community-dwelling-older-adults-undertaken-as-a-comprehensive-geriatric-risk-assessment
#3
Sharmin S Bala, Sujita W Narayan, Prasad S Nishtala
PURPOSE: The prescription of potentially inappropriate medications (PIMs) is associated with an increase in adverse events, prescribing cascades, high health-care costs, morbidity, and mortality in the elderly. The overarching objective of this study is to examine the prevalence of PIMs in the elderly, applying the 2012 American Geriatrics Society Beers criteria for the study period 2012-2014, and the updated 2015 Beers criteria for 2015. METHODS: The study population (N = 70,479) included a continuously recruited national cohort of community-dwelling older (aged ≥ 65 years) New Zealanders who had undertaken the International Resident Assessment Instrument-Home Care (interRAI-HC) assessments between September 2012 and October 2015...
January 12, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29326146/prior-authorization-requirements-for-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-across-us-private-and-public-payers
#4
Jalpa A Doshi, Justin T Puckett, Michael S Parmacek, Daniel J Rader
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are an innovative treatment option for patients with familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require further lowering of low-density lipoprotein cholesterol. However, the high costs of these agents have spurred payers to implement utilization management policies to ensure appropriate use. We examined prior authorization (PA) requirements for PCSK9is across private and public US payers...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29325708/promising-roles-for-pharmacists-in-addressing-the-u-s-opioid-crisis
#5
Wilson M Compton, Christopher M Jones, Jack B Stein, Eric M Wargo
Overdoses of prescription or illicit opioids claimed the lives of 116 Americans each day in 2016, and the crisis continues to escalate. As healthcare systems evolve to address the crisis, the potential of pharmacists to make a positive difference is significant. In addition to utilizing available prescription drug monitoring programs to help prevent diversion of opioids, practicing pharmacists can be alert for signs of opioid misuse by patients (e.g., multiple prescriptions from different physicians) as well as inappropriate prescribing or hazardous drug combinations that physicians may not be aware of (e...
December 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#6
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29318696/an-underutilised-resource-for-antimicrobial-stewardship-a-snapshot-of-the-community-pharmacists-role-in-delayed-or-wait-and-see-antibiotic-prescribing
#7
Minyon L Avent, Jasmina Fejzic, Mieke L van Driel
OBJECTIVES: Various strategies have been implemented in primary care to address the inappropriate use of antibiotics, with varying degrees of success. One such intervention is delayed or 'wait and see' prescribing, where the prescriber indicates to wait a few days before dispensing the antibiotic. The aim of this study was to explore community pharmacists' perceptions and practice experiences with delayed antibiotic prescribing. METHODS: An online survey was advertised in two professional pharmacy organisations' e-newsletters for community and internship pharmacists in Queensland, Australia, from January to April 2016...
January 10, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29301404/impact-of-medication-reviews-on-inappropriate-prescribing-in-aged-care
#8
Linda Ghali Koria, Tabish Syed Zaidi, Gregory Peterson, Prasad Nishtala, Paul J Hannah, Ronald Castelino
BACKGROUND: Inappropriate prescribing (IP) is prevalent among elderly people in aged care facilities. Little has been published on the effect of pharmacists performing residential medication management reviews (RMMRs) in aged care, on the appropriateness of prescribing. RMMRs represents a key strategy for achieving quality use of medicines, by assisting residents in aged care facilities and their carers to better manage their medicines. However, the structure of RMMR has moved from annual to every two years for each resident...
January 4, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29281041/patterns-of-multi-morbidity-and-prediction-of-hospitalisation-and-all-cause-mortality-in-advanced-age
#9
Ruth O Teh, Oliver H Menzies, Martin J Connolly, Rob N Doughty, Tim J Wilkinson, Avinesh Pillai, Thomas Lumley, Cristin Ryan, Anna Rolleston, Joanna B Broad, Ngaire Kerse
Background: multi-morbidity is associated with poor outcomes and increased healthcare utilisation. We aim to identify multi-morbidity patterns and associations with potentially inappropriate prescribing (PIP), subsequent hospitalisation and mortality in octogenarians. Methods: life and Living in Advanced Age; a Cohort Study in New Zealand (LiLACS NZ) examined health outcomes of 421 Māori (indigenous to New Zealand), aged 80-90 and 516 non-Māori, aged 85 years in 2010...
December 21, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29278992/comorbidity-polytherapy-and-drug-interactions-in-a-neurological-context-an-example-of-a-multidisciplinary-approach-to-promote-the-rational-use-of-drugs
#10
Giulia Busa, Alessandro Burlina, Vera Damuzzo, Marco Chiumente, Angelo C Palozzo
PURPOSE: A high number of adverse drug reactions (ADRs), mainly caused by drug-drug interactions (DDIs), occur in neurological wards and few data are available about incidence and prevalence of DDIs in this context. This study investigated-(1) the prevalence of drug-drug and drug-disease interactions in patients admitted to a neurological unit in Italy, (2) the risk factors for DDIs, and (3) the diseases and the drug classes mostly involved in drug-drug and drug-disease interactions. METHODS: For 2 months, we performed a retrospective, observational study in the neurological unit of St Bassiano Hospital, enrolling 79 patients who received a drug prescription at discharge...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29277528/determinants-of-inappropriate-empirical-antibiotic-treatment-systematic-review-and-meta-analysis
#11
REVIEW
Elena Carrara, Iris Pfeffer, Oren Zusman, Leonard Leibovici, Mical Paul
OBJECTIVES: To assess study-level determinants of non-covering (inappropriate) empirical antibiotic treatment (IEAT), focusing on the influence of study years and the prevalence of multidrug-resistant organisms (MDROs) in the study. METHODS: Systematic review of prospective or retrospective observational studies reporting on the association between IEAT and mortality in adult patients with microbiologically documented infections published between 2008-2016. Meta-analysis of IEAT rates was conducted using a random-effects model...
December 22, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29277130/an-interdisciplinary-academic-detailing-approach-to-decrease-inappropriate-medication-prescribing-by-physician-residents-for-older-veterans-treated-in-the-emergency-department
#12
Jason M Moss, William E Bryan, Loren M Wilkerson, Heather A King, George L Jackson, Ryan K Owenby, Courtney H Van Houtven, Melissa B Stevens, James Powers, Camille P Vaughan, William W Hung, Ula Hwang, Alayne D Markland, Richard Sloane, William Knaack, Susan Nicole Hastings
OBJECTIVE: To evaluate the impact of an academic detailing intervention delivered as part of a quality improvement project by a physician-pharmacist pair on (1) self-reported confidence in prescribing for older adults and (2) rates of potentially inappropriate medications (PIMs) prescribed to older adults by physician residents in a Veteran Affairs emergency department (ED). METHODS: This quality improvement project at a single site utilized a questionnaire that assessed knowledge of Beers Criteria, self-perceived barriers to appropriate prescribing in older adults, and self-rated confidence in ability to prescribe in older adults which was administered to physician residents before and after academic detailing delivered during their emergency medicine rotation...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29273072/monitoring-adherence-to-guidelines-of-antibiotic-use-in-pediatric-pneumonia-the-marea-study
#13
Pasquale Di Pietro, Ornella Della Casa Alberighi, Michela Silvestri, Maria Angela Tosca, Anna Ruocco, Giorgio Conforti, Giovanni A Rossi, Elio Castagnola, Maria Caterina Merlano, Simona Zappettini, Salvatore Renna
BACKGROUND: Children are the most vulnerable population exposed to the use of antibiotics often incorrectly prescribed for the treatment of infections really due to viruses rather than to bacteria. We designed the MAREA study which consisted of two different studies: i) a surveillance study to monitor the safety/efficacy of the antibiotics for the treatment of pneumonia (CAP), pharyngotonsillitis and acute otitis media in children younger than 14 yrs old, living in Liguria, North-West Italy and ii) a pre-/post-interventional study to evaluate the appropriateness of antibiotic prescription for the treatment these infections...
December 22, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29246708/prescription-of-dpp-4-inhibitors-to-type-2-diabetes-mellitus-patients-with-renal-impairment-a-uk-primary-care-experience
#14
Dionysis Spanopoulos, Brendan Barrett, Michael Busse, Toni Roman, Chris Poole
Members of the dipeptidyl peptidase-4 inhibitor drug class are indicated for glycemic control in patients with type 2 diabetes mellitus and all, except linagliptin, require dose adjustment in renal impairment. A cross-sectional analysis of a cohort of type 2 diabetes mellitus patients treated with dipeptidyl peptidase-4 inhibitors identified in the Clinical Practice Research Datalink was conducted to explore compliance with the renal adjustment requirements of the Summaries of Product Characteristics. Approximately one third of type 2 diabetes mellitus patients with creatinine clearance <50 mL/min who were at risk of inappropriate prescribing, were initiated on a DPP-4 inhibitor at a higher dose than the specified in their respective Summary of Product Characteristics...
December 12, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29246247/intervention-to-improve-the-appropriate-use-of-polypharmacy-for-older-patients-with-hip-fractures-an-observational-study
#15
Junpei Komagamine, Kazuhiko Hagane
BACKGROUND: Polypharmacy is frequently observed in hip fracture patients. Although it is associated with an increased risk of hip fracture, polypharmacy often continues after hip fracture recovery. This study aimed to evaluate the effectiveness of an intervention to improve appropriate polypharmacy for elderly patients admitted to the hospital for hip fractures. METHODS: We conducted a retrospective observational study to compare the outcomes of patients receiving the intervention (n = 32) with those of patients who received usual care (n = 132)...
December 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29245333/a-rare-case-of-methimazole-induced-cholestatic-jaundice-in-an-elderly-man-of-asian-ethnicity-with-hyperthyroidism-a-case-report
#16
Hongjian Ji, Feng Yue, Jianxiang Song, Xiaohua Zhou
BACKGROUND: Methimazole is an antithyroid drug that is widely used for the treatment of hyperthyroidism. As an inhibitor of the enzyme thyroperoxidase, methimazole is generally well-tolerated. However, there have been increasing reports of methimazole-induced liver damage, although this effect of methimazole has been limited by the absence of objective diagnosis of the liver condition or the inappropriate use of the Naranjo scale. We present the case of an elderly man with hyperthyroidism, gastritis, and epilepsy who developed liver damage after administration of multiple drugs...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29240687/decreasing-inappropriate-use-of-antibiotics-in-primary-care-in-four-countries-in-south-america-cluster-randomized-controlled-trial
#17
Inés Urbiztondo, Lars Bjerrum, Lidia Caballero, Miguel Angel Suarez, Monica Olinisky, Gloria Córdoba
High antibiotic prescribing and antimicrobial resistance in patients attending primary care have been reported in South America. Very few interventions targeting general practitioners (GPs) to decrease inappropriate antibiotic prescribing have been investigated in this region. This study assessed the effectiveness of online feedback on reducing antibiotic prescribing in patients with suspected respiratory tract infections (RTIs) attending primary care. The aim was to reduce antibiotic prescribing in patients with acute bronchitis and acute otitis media...
December 14, 2017: Antibiotics
https://www.readbyqxmd.com/read/29239764/treatment-choices-for-the-glycaemic-management-of-patients-with-type-2-diabetes-and-chronic-kidney-disease-analysis-of-the-sail-patient-linked-dataset
#18
Thinzar Min, Gareth I Davies, Sam Rice, James Chess, Jeffrey W Stephens
AIMS: Chronic kidney disease (CKD) is common in type 2 diabetes and limits the treatment choices for glycaemic control. Our aim was to examine real-world prescribing for managing hyperglycaemia in the presence of CKD. METHODS: The SAIL (Secure Anonymised Information Linkage) databank was used to examine prescribing during the period from the 1st of January to 30th December 2014. CKD was defined as:- none or mild CKD, eGFR ≥60mL/min/1.73m2; moderate CKD eGFR <60mL/min/1...
November 23, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29239248/use-of-and-microbial-resistance-to-antibiotics-in-china-a-path-to-reducing-antimicrobial-resistance
#19
Dan Cui, Xinliang Liu, Peter Hawkey, Hao Li, Quan Wang, Zongfu Mao, Jing Sun
We analyzed China's current use of and microbial resistance to antibiotics, and possible means of reducing antimicrobial resistance. Interventions like executive orders within clinical settings and educational approach with vertical approaches rather than an integrated strategy to curb the use of antimicrobials remain limited. An underlying problem is the system of incentives that has resulted in the intensification of inappropriate use by health professionals and patients. There is an urgent need to explore the relationship between financial and non-financial incentives for providers and patients, to eliminate inappropriate incentives...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29237045/informing-antimicrobial-stewardship-factors-associated-with-inappropriate-antimicrobial-prescribing-in-primary-care
#20
Alexander Singer, Sergio Fanella, Leanne Kosowan, Jamie Falk, Brenden Dufault, Kevin Hamilton, Ashley Walus
Background: Antimicrobial stewardship (AS) programs promote the optimal use of antimicrobials and safe patient care. With most antimicrobials prescribed in the ambulatory setting, establishing benchmark data is imperative to gauge the impact of future AS initiatives. Objectives: To determine the frequency of potentially inappropriate antimicrobial prescribing in primary care practices in Manitoba, Canada and to assess the association between potentially inappropriate antimicrobial prescribing and patient, prescriber and practice-related factors...
December 10, 2017: Family Practice
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