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Inappropriate prescribing

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https://www.readbyqxmd.com/read/28933275/a-case-of-inappropriate-self-medication-compounded-with-prescribing-vis-%C3%A3-vis-dispensing-errors-and-the-hazardous-consequence
#1
Sukalyan Saha Roy, Anupam Roy, Ranjita Santra Dhali, Chiranjib Bagchi, Gautam Banerjee, Santanu K Tripathi
INTRODUCTION Dispensing error, a type of medication error, is not infrequent but seldom reported. Self-medication behavior appears to be a commonplace. And when it is ignorant it may prove dangerous. We report here a case of acute vesico-bullous eruptions from methotrexate in a patient of psoriasis who indulged in self-medication and was wrongfully dispensed higher doses of methotrexate. CASE DESCRIPTION A 50-year-old gentleman presented to the dermatology OPD with erythematous, vesico-bullar lesions spread all over the body including both limbs and scalp, with oral mucosal involvement without any history of fever...
September 19, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28931456/perceptions-of-barriers-to-the-management-of-respiratory-tract-infections-in-general-practice-settings-in-australia
#2
Stephanie Fletcher-Lartey, Rabia Khan
Inappropriate prescribing of antibiotics for the management of respiratory tract infections (RTIs) has contributed to increased prevalence of antibiotic resistance, and this remains a challenge. The aim of this study was to evaluate the effect of general practitioners' (GPs) participation in the Antibiotics: Clinical e-Audit, a quality-improvement activity, on GP self-reported knowledge and practice change, and explored barriers encountered in the management of respiratory tract infections (RTIs). Participants completed a survey at the end of the activity to assess the usefulness of the audit, any reported changes made and barriers encountered to their clinical practice...
September 21, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28929815/the-challenge-of-curbing-aminoglycoside-resistance-can-antimicrobial-stewardship-programs-play-a-critical-role
#3
Vassiliki Pitiriga, Evangelia Dimitroulia, George Saroglou, Athanassios Tsakris
Aminoglycosides are useful antimicrobials, primarily for serious infections involving aerobic gram-negative pathogens. The inevitable increase in aminoglycoside resistance has led to calls for reducing levels of inappropriate aminoglycoside prescribing through the implementation of various antibiotic stewardship programs (ASPs). These programs mainly include restriction policies and aminoglycoside cycling. Although aminoglycoside resistance rates appear essential for measuring effectiveness of these interventions, most studies have focused on economic outcomes or clinical efficacy and toxicities...
September 20, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28927372/potentially-inappropriate-medication-use-in-nursing-homes-an-observational-study-using-the-norgep-nh-criteria
#4
Gunhild Nyborg, Mette Brekke, Jørund Straand, Svein Gjelstad, Maria Romøren
BACKGROUND: Frail residents in the nursing home sector call for extra care in prescribing. The Norwegian General Practice Nursing Home (NORGEP-NH) list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed explicitly for this population. The aim of this study was to employ the NORGEP-NH Criteria to study the extent of potentially inappropriate medication use among nursing home residents and explore possible associated factors. METHODS: Cross-sectional observational pharmacoepidemiological study from residents in nursing homes in the county of Vestfold, Norway...
September 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28917110/prevalence-and-predictors-of-potentially-inappropriate-prescribing-of-central-nervous-system-and-psychotropic-drugs-among-elderly-patients-a-national-population-study-in-korea
#5
Hyeonseok Cho, Junjeong Choi, Young-Sang Kim, Sang Joon Son, Kang Soo Lee, Hee-Jin Hwang, Hye-Young Kang
OBJECTIVES: To investigate the prevalence of potentially inappropriate prescribing (PIP) of central nervous system and psychotropic (CNS-PS) drugs to the Korean elderly population, and to identify PIP-associated factors. METHODS: Ambulatory care visits were identified from the 2013 National Aged Patient Sample (HIRA-APS-2013) data, composed of 20% random samples of all enrollees in the universal health security program aged ≥65 years. The CNS-PS section of Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria version 2 was used to identify PIP at these visits...
September 6, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28906047/a-systematic-review-to-explore-influences-on-parental-attitudes-towards-antibiotic-prescribing-in-children
#6
REVIEW
Helen Bosley, Catherine Henshall, Jane V Appleton, Debra Jackson
AIM: To understand the factors influencing parental attitudes towards antibiotic prescribing. BACKGROUND: Overuse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance (AMR), and is significant global threat to patient safety. In Primary Care settings, substantial numbers of antibiotics are prescribed for young children, despite viral nature of illness for which antibiotics are ineffective. Parents, play a vital role in decision making regarding accessing healthcare services and requesting treatment for their children...
September 14, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28905171/pharmacist-intervention-acceptance-for-the-reduction-of-potentially-inappropriate-drug-prescribing-in-acute-psychiatry
#7
Sophia Hannou, Pierre Voirol, André Pannatier, Marie-Laure Weibel, Farshid Sadeghipour, Armin von Gunten, Jean-Frédéric Mall, Isabella De Giorgi Salamun
Background Prescribing for the elderly is challenging. A previous observational study conducted in our geriatric psychiatry admission unit (GPAU) using STOPP/START criteria showed a high number of potentially inappropriate drug prescriptions (PIDPs). A clinical pharmacist was added to our GPAU as a strategy to reduce PIDPs. Objective The objective of the present study was to assess the impact of a clinical pharmacist on PIDPs by measuring acceptance rates of pharmacist interventions (PhIs). Setting This study was conducted at the GPAU of Lausanne University Hospital...
September 13, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28905162/quality-of-prescribing-in-community-dwelling-elderly-patients-in-france-an-observational-study-in-community-pharmacies
#8
E Bourcier, F Mille, V Brunie, V Korb-Savoldelli, C Lafortune, M Buyse, C Fernandez, P Hindlet
Background In order to ensure safer prescriptions in the elderly, lists of potentially inappropriate medications (PIMs) and guidelines have been introduced. Whereas the effectiveness of these measures has been well studied in hospitals, data are sparse for the community-dwelling patients. Objective To assess the quality of prescriptions among community-dwelling elderly patients, and potential associations between prescription patterns, patient characteristics and medication adherence. Setting Community pharmacies in France...
September 14, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28902135/point-prevalence-surveys-of-antimicrobial-use-among-hospitalized-children-in-six-hospitals-in-india-in-2016
#9
Sumanth Gandra, Sanjeev K Singh, Dasaratha R Jinka, Ravishankar Kanithi, Ashok K Chikkappa, Anita Sharma, Dhanya Dharmapalan, Anil Kumar Vasudevan, Onkaraiah Tunga, Akhila Akula, Garima Garg, Yingfen Hsia, Srinivas Murki, Gerardo Alvarez-Uria, Mike Sharland, Ramanan Laxminarayan
The prevalence of antimicrobial resistance in India is among the highest in the world. Antimicrobial use in inpatient settings is an important driver of resistance, but is poorly characterized, particularly in hospitalized children. In this study, conducted as part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) project, we examined the prevalence of and indications of antimicrobial use, as well as antimicrobial agents used among hospitalized children by conducting four point prevalence surveys in six hospitals between February 2016 and February 2017...
September 13, 2017: Antibiotics
https://www.readbyqxmd.com/read/28895169/we-have-had-a-gutful-the-need-for-deprescribing-proton-pump-inhibitors
#10
M Naunton, G M Peterson, L S Deeks, H Young, S Kosari
WHAT IS KNOWN AND OBJECTIVE: Proton pump inhibitor (PPI) prescribing may often be inappropriate and expose patients to a risk of adverse effects, while incurring unnecessary healthcare expenditure. Our objective was to determine PPI usage in Australia since 2002 and review international studies investigating inappropriate PPI prescribing, including those that discussed interventions to address this issue. METHODS: Australian Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) data were analysed...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28891406/clinical-practice-guideline-evaluation-of-the-neck-mass-in-adults
#11
Melissa A Pynnonen, M Boyd Gillespie, Benjamin Roman, Richard M Rosenfeld, David E Tunkel, Laura Bontempo, Itzhak Brook, Davoren Ann Chick, Maria Colandrea, Sandra A Finestone, Jason C Fowler, Christopher C Griffith, Zeb Henson, Corinna Levine, Vikas Mehta, Andrew Salama, Joseph Scharpf, Deborah R Shatzkes, Wendy B Stern, Jay S Youngerman, Maureen D Corrigan
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28889650/correlation-of-recommendations-of-treatment-guidelines-and-frequently-prescribed-antibiotics-evaluation-of-their-pharmaceutical-pack-size
#12
Shoma Mukherjee, Nilanjan Saha
There are various factors that contribute to development of antimicrobial resistance. Overuse, inappropriate prescribing and extensive agricultural use of antibiotics are some of the factors which have been identified. Antibiotics are almost always universally packaged by manufacturers in packs that are heavily driven by cost of economies and convenience rather than by any scientific basis or duration of therapy. So, in the present study, the correlation of the treatment guidelines with the choice of antibiotics and whether packing size contributes to left-over dosing units when used according to guideline recommendations were assessed...
September 10, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28887290/individual-feedback-to-reduce-inappropriate-antimicrobial-prescriptions-for-treating-acute-upper-respiratory-tract-infections-in-an-outpatient-setting-of-a-thai-university-hospital
#13
Pinyo Rattanaumpawan, Nuttagarn Chuenchom, Visanu Thamlikitkul
BACKGROUND: Excessive antimicrobial use for acute Upper Respiratory InfectionBackground Excessive antimicrobial use for acute Upper Respiratory Infections (URIs) is one of the most common problems in clinical practice. Interventions are needed to reduce antimicrobial overuse in these common infections.s (URIs) is one of the most common problems in clinical practice. Interventions are needed to reduce antimicrobial overuse in these common infections. METHODS: During a 9-month study period (June 2014-February 2015), we conducted a quasi-experimental (pre/post) study among internal medicine residents and fellows in an outpatient setting of Siriraj Hospital, Thailand...
September 5, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28887019/are-we-still-prescribing-opioids-for-osteoarthritis
#14
David E DeMik, Nicholas A Bedard, S Blake Dowdle, Robert A Burnett, Michael A McHugh, John J Callaghan
BACKGROUND: The United States is in the midst of an opioid epidemic. These medications continue to be used to manage pain associated with osteoarthritis, despite mounting evidence questioning the benefits. The rate at which opioids are prescribed for osteoarthritis is largely unknown. We sought to identify rates of opioid prescriptions for osteoarthritis and identify factors associated with higher rates of prescribing. METHODS: We queried the Humana, Inc. administrative claims database from 2007 to 2014...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28879246/opioid-analgesic-prescribing-practices-of-dental-professionals-in-the-united-states
#15
C N Steinmetz, C Zheng, E Okunseri, A Szabo, C Okunseri
The prescription of opioid analgesics by dental professionals is widespread in the United States. Policy makers, government agencies, and professional organizations consider this phenomenon a growing public health concern. This study examined trends in the prescription of opioid analgesics for adults by dental professionals and associated factors in the United States. Data from the Medical Expenditure Panel Survey (1996-2013) were analyzed. Descriptive statistics were calculated separately for each year. Logistic regression analyses were conducted to estimate the overall trend during the period with and without adjusting for dental procedures and personal characteristics...
July 2017: JDR Clinical and Translational Research
https://www.readbyqxmd.com/read/28871317/-drug-therapy-safety-at-the-transition-from-hospital-to-community-medicine
#16
M Hahn, S C Roll, J Klein
OBJECTIVE: We evaluated the qualitative and quantitative changes of medications during the stay on a geriatric-psychiatric ward where the medication was optimized by a clinical pharmacist, and after discharge. The goal of the study was to analyze the continuity of the medication at the transfer from hospital to ambulatory care. METHODS: We interviewed 41 patients on the phone about their drug regimen 4 and 12 weeks after discharge. Medications were compared to their discharge medication...
September 4, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28870508/inappropriate-dexamethasone-use-by-a-trekker-in-nepal-a-case-report
#17
Nicholas R Haslam, Rachel Garth, Nicola Kelly
We present a case of inappropriate dexamethasone use in a trekker in the Everest region of Nepal. We aim to increase awareness among health professionals of the possible use of this medication by trekkers and promote knowledge of potential complications. In this case, a previously altitude-naive trekker was prescribed prophylactic dexamethasone by physicians in a Western travel clinic before high-altitude trekking in Nepal. There were no indications for prophylactic medication nor for the use of dexamethasone...
September 1, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28869712/acute-oxygen-therapy-an-audit-of-prescribing-and-delivery-practices-in-a-tertiary-hospital-in-perth-western-australia
#18
Anam Kamran, Elisa Chia, Claire Tobin
BACKGROUND: Oxygen is a widely used drug in the hospital setting. However, international audits suggest that oxygen administration practices are often not compliant with prescribed standards. This can place patients at risk and cause serious adverse events. AIM: To analyse data related to recent practices of oxygen prescription and administration at Royal Perth Hospital (RPH), Western Australia. The results of this audit aim to guide further research on possible interventional studies implementing key solutions...
September 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28861211/adverse-effects-of-proton-pump-inhibitor-use-in-older-adults-a-review-of-the-evidence
#19
REVIEW
Marina L Maes, Danielle R Fixen, Sunny Anne Linnebur
Proton-pump inhibitors (PPIs) are a widely prescribed class of medications used to treat acid-related disorders and use has significantly increased over the last few decades. PPIs are often inappropriately prescribed and since they have been on the market, a number of post-marketing studies have been published demonstrating associations between longer duration of PPI therapy and a number of adverse effects that are a concern in older adults. The objective of this review is to discuss the existing literature of potential adverse effects with long-term PPI use in older adults and to summarize the implications in clinical practice...
September 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28858118/an-evaluation-of-medication-appropriateness-and-frailty-among-residents-of-aged-care-homes-in-malaysia-a-cross-sectional-study
#20
Syed Shahzad Hasan, Chia Siang Kow, Rohit Kumar Verma, Syed Imran Ahmed, Piyush Mittal, David W K Chong
Aging is significantly associated with the development of comorbid chronic conditions. These conditions indicate the use of multiple medications, and are often warranted by clinical guidelines. The aim of the present study was to evaluate medication appropriateness and frailty among Malaysian aged care home residents with chronic disease. The participants were 202 elderly (≥65 years) individuals, a cross-sectional sample from 17 aged care homes. After ethics approval, each participant was interviewed to collect data on sociodemographics, frailty status (Groningen Frailty Indicator [GFI]), medication appropriateness (Medication Appropriateness Index (MAI), the 2015 Beers' criteria (Potentially Inappropriate Medication [PIM]), and 2014 STOPP criteria (Potentially Inappropriate Prescribing [PIP])...
September 2017: Medicine (Baltimore)
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