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https://www.readbyqxmd.com/read/28535241/management-of-depression-in-older-adults-a-review
#1
Rob M Kok, Charles F Reynolds
Importance: Depression in older adults is a common psychiatric disorder affecting their health-related quality of life. Major depression occurs in 2% of adults aged 55 years or older, and its prevalence rises with increasing age. In addition, 10% to 15% of older adults have clinically significant depressive symptoms, even in the absence of major depression. Observations: Depression presents with the same symptoms in older adults as it does in younger populations...
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#2
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28526836/characterisation-of-antibiotic-prescriptions-for-acute-respiratory-tract-infections-in-danish-general-practice-a-retrospective-registry-based-cohort-study
#3
Rune Aabenhus, Malene Plejdrup Hansen, Laura Trolle Saust, Lars Bjerrum
Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice...
May 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28523461/prevalence-and-correlates-of-inappropriate-use-of-benzodiazepines-in-kosovo
#4
Zejdush Tahiri, Suela Kellici, Iris Mone, Driton Shabani, Musa Qazimi, Genc Burazeri
BACKGROUND: In post-war Kosovo, the magnitude of inappropriate use of benzodiazepines is unknown to date. OBJECTIVE: The aim of this study was to assess the prevalence and correlates of continuation of intake of benzodiazepines beyond prescription (referred to as "inappropriate use") in the adult population of Gjilan region in Kosovo. METHOD: A cross-sectional study was conducted in Gjilan region in 2015 including a representative sample of 780 individuals attending different pharmacies and reporting use of benzodiazepines (385 men and 395 women; age range 18-87 years; response rate: 90%)...
May 18, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28522282/quality-indicators-for-the-use-of-systemic-antibiotics-in-dentistry
#5
Rugzan Jameel Hussein, Robert Krohn, Petra Kaufmann-Kolle, Gerald Willms
BACKGROUND: Risks resulted from using systemic antibiotics such as increasing rates of bacterial resistance, allergy and side effects should be always weighed individually for each patient against any potential benefits. Routine antibiotic prescribing must be therefore discouraged. The Federal Joint Committee ("Gemeinsamer Bundesauschuss", G-BA) commissioned the AQUA-Institute with the development of an external quality assurance procedure, examining systemic antibiotic use in periodontal, conservative and surgical treatments in ambulatory dental health care...
May 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28520738/pediatric-fluoroquinolone-prescription-in-south-korea-before-and-after-a-regulatory-intervention-a-nationwide-study-2007-2015
#6
Seung Yeon Song, Joo Hee Shin, Su Yeong Hyeon, Donguk Kim, Won Ku Kang, Soo-Han Choi, Yae-Jean Kim, Eun Young Kim
OBJECTIVE: To investigate the impact of national implementation of age restriction on fluoroquinolone prescription in children and adolescents. METHODS: Data collected from the database of Health Insurance Review and Assessment Service in South Korea, a national health insurance system to analyze fluoroquinolone prescribing practice in children and adolescents younger than 18 years, between 2007 and 2015. The age restriction was implemented in December 2009. The annual prescription rate of FQ per 100,000 person-years was calculated and an autoregressive model was used to predict the prescription pattern if an intervention had not occurred...
2017: PloS One
https://www.readbyqxmd.com/read/28515903/the-threat-of-antimicrobial-resistance-in-developing-countries-causes-and-control-strategies
#7
REVIEW
James A Ayukekbong, Michel Ntemgwa, Andrew N Atabe
The causes of antimicrobial resistance (AMR) in developing countries are complex and may be rooted in practices of health care professionals and patients' behavior towards the use of antimicrobials as well as supply chains of antimicrobials in the population. Some of these factors may include inappropriate prescription practices, inadequate patient education, limited diagnostic facilities, unauthorized sale of antimicrobials, lack of appropriate functioning drug regulatory mechanisms, and non-human use of antimicrobials such as in animal production...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28506569/-identifying-potentially-inappropriate-prescriptions-in-patients-over-65-years-old-using-original-beers-criteria-and-their-spanish-adaptation
#8
Josep Pastor Cano, Ana Aranda García, Juan José Gascón Cánovas, José Francisco Sánchez Ruiz, Víctor José Rausell Rausell, Mariana Tobaruela Soto
OBJECTIVE: To compare the detection of potentially inappropriate medication (PIM) using the original Beers criteria, a global reference for evaluating prescriptions in the elderly, and their Spanish version. DESIGN: Retrospective observational study LOCATION: A Primary Care area in the province of Murcia, Spain. PARTICIPANTS: A total of 7,856 subjects aged 65 and over, with at least one drug prescribed in a Primary Care Area of Spain during study period...
May 13, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28492914/antibiotic-prescribing-for-nonbacterial-acute-upper-respiratory-infections-in-elderly-persons
#9
Michael Silverman, Marcus Povitz, Jessica M Sontrop, Lihua Li, Lucie Richard, Sonny Cejic, Salimah Z Shariff
Background: Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice. Objective: To determine the prevalence of antibiotic prescribing for nonbacterial AURIs and whether prescribing rates varied by physician characteristics. Design: Retrospective analysis of linked administrative health care data. Setting: Primary care physician practices in Ontario, Canada (January-December 2012)...
May 9, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28487009/real-world-prescribing-patterns-of-long-acting-benzodiazepine-for-elderly-koreans-in-2013%C3%A2
#10
So Yun Park, SeungJin Bae, Ju-Young Shin
OBJECTIVE: We aimed to estimate the prevalence of prescriptions to long-acting benzodiazepines (BZDs) among elderly outpatients in Korea in 2013 and analyze the factors that led to inappropriate prescription practices. METHODS: Using the Korea Health Insurance Review and Assessment Service-National Patients Sample database in 2013, we estimated the pattern of BZD prescription among elderly outpatients. BZDs were categorized as long-acting (half-life (T1/2) ≥ 20 hours) or short-acting (T1/2...
May 10, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28483289/an-observational-study-to-determine-whether-routinely-sending-patients-home-with-a-24-hour-supply-of-topical-tetracaine-from-the-emergency-department-for-simple-corneal-abrasion-pain-is-potentially-safe
#11
Neil Waldman, Ben Winrow, Ian Densie, Andrew Gray, Scott McMaster, George Giddings, John Meanley
STUDY OBJECTIVE: To determine if the number of emergency department (ED) rechecks, persistent fluorescein uptake, ophthalmology referrals, or complications would be affected by the prescription of topical tetracaine for pain relief from simple corneal abrasions (SCAs). METHODS: This retrospective cohort study was conducted in an ED where policy change allowed physicians to use topical tetracaine hydrochloride 1% eye drops for 24 hours for pain treatment for patients with corneal abrasions...
May 2, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28482834/the-redistributive-effects-of-copayment-in-outpatient-prescriptions-evidence-from-lombardy
#12
Paolo Berta, Rosella Levaggi, Gianmaria Martini, Stefano Verzillo
BACKGROUND: In Italy, copayment has changed its nature and it can no longer be simply considered a system to curb inappropriate expenditure. It has become an important form of revenue for public health care provision, but it might also become a source of distortions in income and health benefits redistribution. METHODS: We use a rich administrative dataset gathering information on patients demand (whose records have been matched to income declared for tax purposes) to study the effects of an additional copayment (the so called "superticket" introduced by the Italian government in 2012) in Lombardy, the biggest Italian Region whose socio-economic dimension is comparable to that of many European countries (e...
May 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28479207/measures-that-identify-prescription-medication-misuse-abuse-and-related-events-in-clinical-trials-acttion-critique-and-recommended-considerations
#13
Shannon M Smith, Judith K Jones, Nathaniel P Katz, Carl L Roland, Beatrice Setnik, Jeremiah J Trudeau, Stephen Wright, Laurie B Burke, Sandra D Comer, Richard C Dart, Raymond Dionne, J David Haddox, Jerome H Jaffe, Ernest A Kopecky, Bridget A Martell, Ivan D Montoya, Marsha Stanton, Ajay D Wasan, Dennis C Turk, Robert H Dworkin
Accurate assessment of inappropriate medication use events (i.e., misuse, abuse, and related events [MAREs]) occurring in clinical trials is an important component in evaluating a medication's abuse potential. A meeting was convened to review all instruments measuring such events in clinical trials according to previously published standardized terminology and definitions [27]. Only 2 approaches have been reported that are specifically designed to identify and classify MAREs occurring in clinical trials, rather than to measure an individual's risk of using a medication inappropriately: the Self-Reported Misuse, Abuse, and Diversion [SR-MAD] instrument and the Misuse, Abuse, and Diversion Drug Event Reporting System [MADDERS]...
May 4, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28468911/impact-of-two-step-urine-culture-ordering-in-the-emergency-department-a-time-series-analysis
#14
Amanda Stagg, Haydon Lutz, Sakshi Kirpalaney, John Justin Matelski, Adam Kaufman, Jerome Leis, Janine McCready, Jeff Powis
BACKGROUND: Despite evidence against the use of antimicrobials for asymptomatic bacteriuria (ASB), they are frequently prescribed leading to unnecessary adverse events. Prior studies have shown that reducing unnecessary urine cultures (UCs) results in decreased antimicrobial utilisation for ASB. Emergency departments (EDs) submit the largest volume of UCs, yet efforts to limit overordering in this patient setting have had limited success. METHODS: A new two-step model of care for urine collection, using a novel UC collection container, was implemented in the ED of a large community hospital...
May 3, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28467437/differences-in-antimicrobial-consumption-prescribing-and-isolation-rate-of-multidrug-resistant-klebsiella-pneumoniae-pseudomonas-aeruginosa-and-acinetobacter-baumannii-on-surgical-and-medical-wards
#15
Vladimir Zivanovic, Ljiljana Gojkovic-Bukarica, Radisav Scepanovic, Teodora Vitorovic, Radmila Novakovic, Nenad Milanov, Zoran Bukumiric, Biljana Carevic, Jasmina Trajkovic, Jovana Rajkovic, Vladimir Djokic
In order to provide guidance data for clinically rational use of an antibiotics consuption, prescribing and prevalence of multidrug resistant (MDR) Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii were monitored on the surgical (S) and medical (M) wards of the University Hospital Center "Dr. Dragisa Misovic-Dedinje" (Belgrade, Serbia), in the study period from 2012 to 2015. Appropriateness of antimicrobial use was evaluated using the Global-Prevalence Survey method designed by the University of Antwerp...
2017: PloS One
https://www.readbyqxmd.com/read/28466396/utilization-of-simulated-patients-to-assess-diabetes-and-asthma-counseling-practices-among-community-pharmacists-in-qatar
#16
Bridget Paravattil, Nadir Kheir, Adil Yousif
Background Patient counseling is one of the most important services a pharmacist can provide to patients. Studies have shown that counseling provided by pharmacists may prevent medication related problems and improve adherence to medication therapy. Objective To explore counseling practices among community pharmacists using simulated patients and to determine if patient, pharmacist, and pharmacy characteristics influence the counseling provided by community pharmacists. Setting Private community pharmacies within Qatar...
May 2, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28465825/investigation-of-antimicrobial-use-at-a-tertiary-care-hospital-in-southern-punjab-pakistan-using-who-methodology
#17
Muhammad Atif, Muhammad Azeem, Anum Saqib, Shane Scahill
BACKGROUND: Globally, between 20 to 50% of antimicrobial consumption is inappropriate, causing significant impact on the quality of care, cost of therapy and incidence of adverse drug reactions. The purpose of this study was to investigate the prescribing patterns and utilization of antimicrobials in ten selected wards at Bahawal Victoria Hospital (BVH), Bahawalpur, Punjab, Pakistan. METHODS: A descriptive cross-sectional study was designed using the World Health Organization (WHO) indicators for antimicrobial use...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28462635/antibiotic-prescribing-for-upper-respiratory-infections-among-children-in-rural-china-a-cross-sectional-study-of-outpatient-prescriptions
#18
Zhitong Zhang, Yanhong Hu, Guanyang Zou, Mei Lin, Jun Zeng, Simin Deng, Rony Zachariah, John Walley, Joseph D Tucker, Xiaolin Wei
BACKGROUND: Overuse of antibiotics contributes to the development of antimicrobial resistance. OBJECTIVE: This study aims to assess the condition of antibiotic use at health facilities at county, township and village levels in rural Guangxi, China. METHODS: We conducted a cross-sectional study of outpatient antibiotic prescriptions in 2014 for children aged 2-14 years with upper respiratory infections (URI). Twenty health facilities were randomly selected, including four county hospitals, eight township hospitals and eight village clinics...
2017: Global Health Action
https://www.readbyqxmd.com/read/28459929/behavioral-approach-to-appropriate-antimicrobial-prescribing-in-hospitals-the-dutch-unique-method-for-antimicrobial-stewardship-dumas-participatory-intervention-study
#19
Jonne J Sikkens, Michiel A van Agtmael, Edgar J G Peters, Kamilla D Lettinga, Martijn van der Kuip, Christina M J E Vandenbroucke-Grauls, Cordula Wagner, Mark H H Kramer
Importance: Inappropriate antimicrobial prescribing leads to antimicrobial resistance and suboptimal clinical outcomes. Changing antimicrobial prescribing is a complex behavioral process that is not often taken into account in antimicrobial stewardship programs. Objective: To examine whether an antimicrobial stewardship approach grounded in behavioral theory and focusing on preserving prescriber autonomy and participation is effective in improving appropriateness of antimicrobial prescribing in hospitals...
May 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28459898/high-prevalence-of-inappropriate-benzodiazepine-and-sedative-hypnotic-prescriptions-among-hospitalized-older-adults
#20
Elisabeth Anna Pek, Andrew Remfry, Ciara Pendrith, Chris Fan-Lun, R Sacha Bhatia, Christine Soong
BACKGROUND: Benzodiazepines and sedative hypnotics are commonly used to treat insomnia and agitation in older adults despite significant risk. A clear understanding of the extent of the problem and its contributors is required to implement effective interventions. OBJECTIVE: To determine the proportion of hospitalized older adults who are inappropriately prescribed benzodiazepines or sedative hypnotics, and to identify patient and prescriber factors associated with increased prescriptions...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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