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https://www.readbyqxmd.com/read/28640946/physicians-non-uniform-approach-to-prescribing-drugs-to-older-patients-a-qualitative-study
#1
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
#2
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/28633631/knowledge-of-antibiotic-resistance-and-antibiotic-prescription-practices-among-prescribers-in-the-brong-ahafo-region-of-ghana-a-cross-sectional-study
#3
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
#4
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/28630771/polypharmacy-among-underserved-older-african-american-adults
#5
Mohsen Bazargan, James Smith, Masoud Movassaghi, David Martins, Hamed Yazdanshenas, Seyede Salehe Mortazavi, Gail Orum
The purpose of the present study was to examine correlates of polypharmacy among underserved community-dwelling older African American adults. Methods. This study recruited 400 underserved older African Americans adults living in South Los Angeles. The structured face-to-face interviews collected data on participants' characteristics and elicited data pertaining to the type, frequency, dosage, and indications of all medications used by participants. Results. Seventy-five and thirty percent of participants take at least five and ten medications per day, respectively...
2017: Journal of Aging Research
https://www.readbyqxmd.com/read/28625935/evaluation-of-prescription-along-three-health-care-periods-in-the-elderly
#6
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/28619704/applying-stopp-guidelines-in-primary-care-through-electronic-medical-record-decision-support-randomized-control-trial-highlighting-the-importance-of-data-quality
#7
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/28619266/patterns-of-use-and-factors-associated-with-early-discontinuation-of-opioids-following-major-trauma
#8
Muhammad Ali Chaudhary, Rebecca Scully, Wei Jiang, Ritam Chowdhury, Cheryl K Zogg, Meesha Sharma, Anju Ranjit, Tracey Koehlmoos, Adil H Haider, Andrew J Schoenfeld
BACKGROUND: Inappropriate use of prescription opioids is a growing public-health issue. We sought to estimate the proportion of traumatic injury patients using legal prescription opioids up to 1-year after hospitalization. METHODS: We used 2006-2014 claims data from TRICARE insurance to identify adults hospitalized secondary to trauma between 2007 and 2013. Prescription opioid use was evaluated for one-year post-discharge. Risk-adjusted Cox Proportional-hazards models were used to evaluate predictors of opioid discontinuation...
June 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28618239/extent-and-risks-of-antipsychotic-off-label-use-in-children-and-adolescents-in-germany-between-2004-and-2011
#9
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
#10
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/28603710/use-of-non-prescription-remedies-by-ghanaian-human-immunodeficiency-virus-positive-persons-on-antiretroviral-therapy
#11
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
#12
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/28560761/physicians-reasons-not-to-discontinue-long-term-used-off-label-antipsychotic-drugs-in-people-with-intellectual-disability
#13
G M de Kuijper, P J Hoekstra
BACKGROUND: People with intellectual disability (ID) frequently use antipsychotic drugs on an off-label base, often for many years. Physicians' decisions to discontinue these drugs not only depend on patient characteristics, like the presence of mental or behavioural disorders, but also on environmental factors, such as inappropriate living circumstances, and on attitudes, knowledge and beliefs of staff, clients and their representatives towards the effects of antipsychotic drug use. In this study, we therefore investigated the influence of participant and setting-related factors on decisions of physicians not to discontinue off-label prescribed antipsychotics...
May 30, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28557587/the-prevalence-of-and-factors-associated-with-receiving-concurrent-controlled-substance-prescriptions
#14
Erin A Ferries, Aaron M Gilson, Rajendar R Aparasu, Hua Chen, Michael L Johnson, Marc L Fleming
BACKGROUND: Controlled substance prescription (CSP) use and abuse in the United States has become a public health epidemic. One common and dangerous indicator of abuse involves obtaining CSPs concurrently. OBJECTIVE: The objective of this study was to identify the prevalence and factors associated with individuals receiving potentially inappropriate concurrent CSPs. METHODS: This was a retrospective, cohort analysis using data from the 2013-2014 Texas prescription drug monitoring program (PDMP)...
May 30, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28550997/prescription-errors-related-to-the-use-of-computerized-provider-order-entry-system-for-pediatric-patients
#15
Kamel Alhanout, Sok-Siya Bun, Karine Retornaz, Laurent Chiche, Nathalie Colombini
OBJECTIVES: To evaluate the nature and frequency of medication errors resulting from the use of a computerized provider order-entry (CPOE) system in a pediatric department. METHODS: We conducted a retrospective study to examine errors related to computerized orders using the software Pharma(®) (Computer Engineering, France) in pediatric department between 31/05/2015 to 01/12/2015. These errors were signaled by pharmacists who examine CPOEs daily. RESULTS: A total of 302 pharmacist interventions (PharmInt) were carried out by clinical pharmacists during the study period...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28549620/the-effect-of-opioid-prescribing-guidelines-on-prescriptions-by-emergency-physicians-in-ohio
#16
Scott G Weiner, Olesya Baker, Sabrina J Poon, Ann F Rodgers, Chad Garner, Lewis S Nelson, Jeremiah D Schuur
STUDY OBJECTIVE: The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. METHODS: We used Ohio's prescription drug monitoring program data from January 1, 2010, to December 31, 2014, and included the 5 most commonly prescribed opioids (hydrocodone, oxycodone, tramadol, codeine, and hydromorphone)...
May 20, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28535241/management-of-depression-in-older-adults-a-review
#17
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
#18
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
#19
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
#20
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
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