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https://www.readbyqxmd.com/read/29052691/discontinuing-inappropriate-medication-use-in-nursing-home-residents-a-cluster-randomized-controlled-trial
#1
Hans Wouters, Jessica Scheper, Hedi Koning, Chris Brouwer, Jos W Twisk, Helene van der Meer, Froukje Boersma, Sytse U Zuidema, Katja Taxis
Background: Inappropriate prescribing is a well-known clinical problem in nursing home residents, but few interventions have focused on reducing inappropriate medication use. Objective: To examine successful discontinuation of inappropriate medication use and to improve prescribing in nursing home residents. Design: Pragmatic cluster randomized controlled trial, with clustering by elder care physicians and their wards. (ClinicalTrials.gov: NCT01876095)...
October 10, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29052231/audit-of-appropriate-use-of-platelet-transfusions-validation-of-adjudication-criteria
#2
M Etchells, J Spradbrow, R Cohen, Y Lin, C Armali, L Lieberman, C Cserti-Gazdewich, J Pendergrast, J Callum
BACKGROUND AND OBJECTIVES: Platelet (PLT) transfusions must be used appropriately, as they are in chronic short supply, costly and risky to patients. The goals of this audit were to: (1) validate preset adjudication criteria through an audit of appropriateness at four large academic hospitals; (2) identify variability in appropriateness across medical services, physician specialties or hospital locations; and (3) inform logistical or educational interventions that may reduce inappropriate use...
October 19, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29052224/opiate-prescribing-in-hospitalized-older-adults-patterns-and-outcomes
#3
Sutapa Maiti, Liron Sinvani, Michele Pisano, Andrzej Kozikowski, Vidhi Patel, Meredith Akerman, Karishma Patel, Christopher Smilios, Christian Nouryan, Guang Qiu, Renee Pekmezaris, Gisele Wolf-Klein
BACKGROUND/OBJECTIVES: Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults. DESIGN: Retrospective cohort study. SETTING: Tertiary care facility. PARTICIPANTS: Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80...
October 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29052109/assessments-of-opportunities-to-improve-antibiotic-prescribing-in-an-emergency-department-a-period-prevalence-survey
#4
Tristan T Timbrook, Aisling R Caffrey, Anais Ovalle, Maya Beganovic, William Curioso, Melissa Gaitanis, Kerry L LaPlante
INTRODUCTION: Approximately 30% of all outpatient antimicrobials are inappropriately prescribed. Currently, antimicrobial prescribing patterns in emergency departments (ED) are not well described. Determining inappropriate antimicrobial prescribing patterns and opportunities for interventions by antimicrobial stewardship programs (ASP) are needed. METHODS: A retrospective chart review was performed among a random sample of non-admitted, adult patients who received an antimicrobial prescription in the ED from January 1 to December 31, 2015...
October 19, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29047332/a-set-of-systematic-reviews-to-help-reduce-inappropriate-prescribing-to-older-people-study-protocol
#5
Yolanda V Martinez, Anna Renom-Guiteras, David Reeves, R Erandie Ediriweera de Silva, Aneez Esmail, Ilkka Kunnamo, Anja Rieckert, Christina Sommerauer, Andreas Sönnichsen
BACKGROUND: Multimorbidity and polypharmacy are common in older people. Assessment tools or lists of criteria aimed at supporting prescription decisions for older people exist, but have often been based on expert opinion with insufficient consideration of the evidence available. The present paper describes the methods we are using to systematically review the existing evidence on the efficacy and safety of the most commonly prescribed drugs for older people in the management of their chronic medical conditions and to develop recommendations to reduce inappropriate prescriptions for incorporation into the Comprehensive Medication Review (CMR) tool developed by the PRIMA-eDS European project...
October 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29045435/impact-of-clinical-pharmacist-interventions-on-inappropriate-prophylactic-acid-suppressant-use-in-hepatobiliary-surgical-patients-undergoing-elective-operations
#6
Hongli Luo, Qingze Fan, Shunlin Xiao, Kun Chen
OBJECTIVE: To evaluate the impact and cost-benefit of clinical pharmacist interventions on inappropriate use of prophylactic acid suppressant in hepatobiliary surgical patients in a Chinese tertiary hospital. METHODS: A retro-prospective intervention study of patients undergoing elective operations was performed in the Department of Hepatobiliary Surgery of the Affiliated Hospital of Southwest Medical University. Patients admitted from October to December 2015 and from October to December 2016, served as the pre-intervention and the post-intervention group, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/29045429/preclinical-antivenom-efficacy-testing-reveals-potentially-disturbing-deficiencies-of-snakebite-treatment-capability-in-east-africa
#7
Robert A Harrison, George O Oluoch, Stuart Ainsworth, Jaffer Alsolaiss, Fiona Bolton, Ana-Silvia Arias, José-María Gutiérrez, Paul Rowley, Stephen Kalya, Hastings Ozwara, Nicholas R Casewell
BACKGROUND: Antivenom is the treatment of choice for snakebite, which annually kills an estimated 32,000 people in sub-Saharan Africa and leaves approximately 100,000 survivors with permanent physical disabilities that exert a considerable socioeconomic burden. Over the past two decades, the high costs of the most polyspecifically-effective antivenoms have sequentially reduced demand, commercial manufacturing incentives and production volumes that have combined to create a continent-wide vacuum of effective snakebite therapy...
October 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29042380/potentially-inappropriate-prescribing-and-its-association-with-health-outcomes-in-middle-aged-people-a-prospective-cohort-study-in-ireland
#8
Frank Moriarty, Caitriona Cahir, Kathleen Bennett, Carmel M Hughes, Rose Anne Kenny, Tom Fahey
OBJECTIVES: To determine the prevalence of potentially inappropriate prescribing (PIP) in a cohort of community-dwelling middle-aged people and assess the relationship between PIP and emergency department (ED) visits, general practitioner (GP) visits and quality of life (QoL). DESIGN: Prospective cohort study. SETTING: The Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort study of ageing. PARTICIPANTS: Individuals aged 45-64 years recruited to TILDA who were eligible for the means-tested General Medical Services scheme and followed up after 2 years...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29040505/late-booking-amongst-african-women-in-a-london-borough-england-implications-for-health-promotion
#9
Martha J Chinouya, Cathrine Madziva
The National Institute for Health and Clinical Excellence guidance is that a pregnant woman should see a midwife within the first 13 weeks into her pregnancy, in what is known as the 'booking appointment' or the 'full assessment' where she discusses with the midwife her care plan, medical and family histories and social circumstances. Significant numbers of black African women present after 13 weeks into the pregnancy. This study explores why black African women access the booking appointment after 13 weeks of pregnancy in a London borough...
October 10, 2017: Health Promotion International
https://www.readbyqxmd.com/read/29040241/barriers-to-implementation-of-recommendations-for-transport-of-children-in-ground-ambulances
#10
Rashida H Woods, Manish Shah, Cara Doughty, Anthony Gilchrest
OBJECTIVES: The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. METHODS: We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29033556/swallowing-difficulties-with-medication-intake-assessed-with-a-novel-self-report-questionnaire-in-patients-with-systemic-sclerosis-a-cross-sectional-population-study
#11
Markus Messerli, Rebecca Aschwanden, Michael Buslau, Kurt E Hersberger, Isabelle Arnet
OBJECTIVES: To assess subjective swallowing difficulties (SD) with medication intake and their practical consequences in patients suffering from systemic sclerosis (SSc) with a novel self-report questionnaire. DESIGN AND SETTING: Based on a systematic literature review, we developed a self-report questionnaire and got it approved by an expert panel. Subsequently, we sent the questionnaire by post mail to SSc patients of the European Center for the Rehabilitation of Scleroderma Rheinfelden, Switzerland...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29029668/the-de-pharm-project-a-pharmacist-driven-deprescribing-initiative-in-a-nursing-facility
#12
Jennifer Pruskowski, Steven M Handler
OBJECTIVE: Many residents with life-limiting illnesses are being prescribed and taking potentially inappropriate medications (PIMs) and questionably beneficial medications either near or at the end of life. These medications can contribute to adverse drug reactions, increase morbidity, and increase unnecessary burden and cost. It is crucial that the process of deprescribing be incorporated into the care of these residents. After developing a clinical pharmacist-driven deprescribing initiative in the nursing facility, the objective of this project was to reduce the number of PIMs via accepted recommendations from the clinical pharmacist to the primary team...
August 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29028759/which-domains-of-the-odi-best-predict-change-in-physical-function-in-patients-after-surgery-for-degenerative-lumbar-spondylolisthesis
#13
Hamadi A Murphy, Eugene Warnick, Richard McGintee, Kristen Nicholson, Douglas A Hollern, Christie Stawicki, Daniel Tarazona, Gregory D Schroeder, Barrett I Woods, Mark F Kurd, Jeffrey A Rihn, Greg D Anderson, Christopher K Kepler, Alan S Hilibrand, Alexander R Vaccaro, Kris E Radcliff
STUDY DESIGN: Retrospective Review OBJECTIVE.: The purpose of this study is to determine the differential improvement of the various individual items of the ODI and to determine their relationship to other measures of HRQOL. SUMMARY OF BACKGROUND DATA: The oswestry disability index (ODI) is an easily scored, common, ten-item questionnaire about symptoms relevant to lumbar spine pathology. It is not clear if all of the items can be reliably applied to spine surgery...
October 12, 2017: Spine
https://www.readbyqxmd.com/read/29027030/diagnostic-accuracy-of-fungal-identification-in-histopathology-and-cytopathology-specimens
#14
V L Kung, R D Chernock, C-A D Burnham
Tools to diagnose fungal infection are microscopic examination, antigen or antibody-based detection tests, molecular diagnostics, and culture, with culture being the "gold standard" for species-level identification. Although these methods are commonly used in concert and yield concordant results, in some cases tissue is not available for culture, and/or different methodologies yield discrepant results. These discrepancies may be clinically significant, causing confusion and inappropriate or delayed initiation of antifungals...
October 13, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29026468/awareness-and-knowledge-of-ionizing-radiation-risks-between-prescribed-and-self-presenting-patients-for-common-diagnostic-radiological-procedures-in-bahrain
#15
Adel Al-Mallah, Asokan G Vaithinathan, Mahdi Al-Sehlawi, Mariam Al-Mannai
OBJECTIVES: Between 20 to 50% of medical imaging examinations are considered inappropriate, and unnecessary ionizing radiation exposures may lead to cancer. We hypothesized that Bahraini patients who self-present for ionizing radiation procedures are not aware of, and lack the requisite knowledge of, the inherent risks associated with their use than patients prescribed for diagnostic purposes. We attempted to examine and compare the awareness and knowledge of the associated risks of ionizing radiation in common diagnostic radiological procedures between prescribed and self-presenting patients in Bahrain...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29023938/a-pharmacist-led-program-to-evaluate-and-reduce-polypharmacy-and-potentially-inappropriate-prescribing-in-older-hiv-positive-patients
#16
I R McNicholl, M Gandhi, C Bradley Hare, M Greene, E Pierluissi
OBJECTIVE: The goal of this pharmacist-led study was to utilize 2 validated instruments, Beers and Screening Tool of Older Persons' Potentially inappropriate Prescriptions (STOPP), to assess potentially inappropriate prescribing (PIP) in older patients infected with the human immunodeficiency virus (HIV) and evaluate pharmacist interventions. DESIGN: Prospective, randomized, interventional trial. SETTING: Large urban clinic providing interdisciplinary primary and HIV care for approximately 2700 HIV-positive, publically insured patients...
October 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29021995/tumor-induced-osteomalacia
#17
Pablo Florenzano, Rachel I Gafni, Michael T Collins
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome clinically characterized by bone pain, fractures and muscle weakness. It is caused by tumoral overproduction of fibroblast growth factor 23 (FGF23) that acts primarily at the proximal renal tubule, decreasing phosphate reabsorption and 1α-hydroxylation of 25 hydroxyvitamin D, thus producing hypophosphatemia and osteomalacia. Lesions are typically small, benign mesenchymal tumors that may be found in bone or soft tissue, anywhere in the body...
December 2017: Bone Reports
https://www.readbyqxmd.com/read/29020352/the-mida-mortality-risk-score-development-and-external-validation-of-a-prognostic-model-for-early-and-late-death-in-degenerative-mitral-regurgitation
#18
Francesco Grigioni, Marie-Annick Clavel, Jean-Louis Vanoverschelde, Christophe Tribouilloy, Rodolfo Pizarro, Marianne Huebner, Jean-Francois Avierinos, Andrea Barbieri, Rakesh Suri, Agnés Pasquet, Dan Rusinaru, Gaetano D Gargiulo, Pablo Oberti, Alexis Théron, Francesca Bursi, Hector Michelena, Siham Lazam, Catherine Szymanski, Vuyisile T Nkomo, Martin Schumacher, Letizia Bacchi-Reggiani, Maurice Enriquez-Sarano
Aims: In degenerative mitral regurgitation (DMR), lack of mortality scores predicting death favours misperception of individual patients' risk and inappropriate decision-making. Methods and results: The Mitral Regurgitation International Database (MIDA) registries include 3666 patients (age 66 ± 14 years; 70% males; follow-up 7.8 ± 5.0 years) with pure, isolated, DMR consecutively diagnosed by echocardiography at tertiary (European/North/South-American) centres...
August 13, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29019014/incontinence-in-autism-spectrum-disorder-a-systematic-review
#19
REVIEW
Justine Niemczyk, C Wagner, A von Gontard
Autism spectrum disorders (ASD) are defined by persistent deficits in reciprocal social interaction, communication, and language, as well as stereotyped and repetitive behavior. Functional incontinence, as well as ASD are common disorders in childhood. The aim of this systematic review was to give an overview of the co-occurrence of nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) in ASD, and vice versa, of ASD in children with incontinence. A systematic literature search of the terms "incontinence", "enuresis", and "encopresis" in combination with "autism" or "Asperger" in four databases (Scopus, PubMed, PsycInfo and Web of science) was conducted...
October 10, 2017: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/29017505/study-protocol-patient-reported-outcomes-for-bladder-management-strategies-in-spinal-cord-injury
#20
Darshan P Patel, Sara M Lenherr, John T Stoffel, Sean P Elliott, Blayne Welk, Angela P Presson, Amitabh Jha, Jeffrey Rosenbluth, Jeremy B Myers
BACKGROUND: The majority of spinal cord injury (SCI) patients have urinary issues, such as incontinence, retention, and frequency. These problems place a significant burden on patients' physical health and quality of life (QoL). There are a wide variety of bladder management strategies available to patients with no clear guidelines on appropriate selection. Inappropriate bladder management can cause hospitalizations and serious complications, such as urosepsis and renal failure. Patients believe that both independence and ability to carry out daily activities are just as important as physical health in selecting the right bladder-management strategy but little is known about patient's QoL with different bladder managements...
October 10, 2017: BMC Urology
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