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https://www.readbyqxmd.com/read/28722184/appropriateness-of-antiplatelet-therapy-for-primary-and-secondary-cardio-and-cerebrovascular-prevention-in-acutely-hospitalized-older-people
#1
I Ardoino, R Rossio, D Di Blanca, A Nobili, L Pasina, P M Mannucci, F Peyvandi, C Franchi
BACKGROUND: Antiplatelet therapy is recommended for the secondary prevention of cardio- and cerebrovascular disease, but for primary prevention it is advised only in patients at very high risk. With this background, this study aims to assess the appropriateness of antiplatelet therapy in acutely hospitalized older people according to their risk profile. METHODS: Data were obtained from the REPOSI register held in Italian and Spanish internal medicine and geriatric wards in 2012 and 2014...
July 19, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28720634/physician-factors-associated-with-polypharmacy-and-potentially-inappropriate-medication-use
#2
Kenya Ie, Maria Felton, Sydney Springer, Stephen A Wilson, Steven M Albert
BACKGROUND: Despite accumulating evidence about the harm of polypharmacy in family medicine, few studies have investigated factors related to polypharmacy. The objective of this study was to explore factors related to physicians' prescribing behavior. METHODS: We conducted a survey of physicians at 5 family medicine residency practices and a linked health record review of their patients ≥65 years old. The determinants of physicians' mean number of prescriptions and potentially inappropriate medications (PIMs) were examined using a generalized linear model...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28717037/impact-of-a-carbapenem-antimicrobial-stewardship-program-on-patient-outcomes
#3
Valerie Xue Fen Seah, Rina Yue Ling Ong, Ashley Shi Yuan Lim, Chia Yin Chong, Natalie Woon Hui Tan, Koh Cheng Thoon
Antimicrobial stewardship programs (ASPs) aim to improve appropriate antimicrobials use. However, concerns of the negative consequences from accepting ASP interventions exist, particularly when de-escalation or discontinuation of broad-spectrum antibiotics are recommended. Hence, we sought to evaluate the impact on clinical outcomes when ASP interventions for inappropriate carbapenem use were accepted or rejected by primary providers.We retrospectively reviewed all carbapenem prescriptions deemed inappropriate according to institutional guidelines with ASP interventions between July 2011 and December 2014...
July 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28711429/-appropriateness-of-antibiotic-prescribing-in-paediatric-patients-in-a-hospital-emergency-department
#4
Borja Croche Santander, Elena Campos Alonso, Adela Sánchez Carrión, Laura Marcos Fuentes, Isabel Diaz Flores, Juan Carlos Vargas, Bárbara Fernández Domínguez, Cristóbal Toro Ibañez
INTRODUCTION: Antibiotics represent one of the most widely prescribed therapeutic agents in children. It has been estimated that 30-50% of antibiotic prescriptions for this population are inappropriate. In this scenario, analysis of prescription data provides an invaluable source of information as a basis for implementing strategies for improvement in this field. OBJECTIVE: To assess the appropriateness of antibiotic prescriptions in a paediatric population at an emergency department...
July 12, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28708203/medical-treatment-of-erectile-dysfunction-too-many-medical-prescriptions
#5
Paolo Capogrosso, Eugenio Ventimiglia, Davide Oreggia, Andrea Salonia, Francesco Montorsi
Erectile dysfunction (ED) is a worldwide commonly reported condition; epidemiological data showed a prevalence ranging from 2.3 to 53.4% within different population subsets. In this context, the advent of phosphodiesterase type 5 inhibitors (PDE5is) in the second mid of 1990s has deeply changed the treatment scenario of this bothersome condition. Being user-friendly compounds with an excellent overall safety profile, PDE5is emerged as the first-line treatment for ED, thus overcoming topical alprostadil and intracavernous injections (ICIs)...
July 5, 2017: Urologia
https://www.readbyqxmd.com/read/28704009/-benzodiazepines-in-elderly-patients-the-dark-side-of-a-magic-pill
#6
Rosaria Del Giorno, Alessandro Ceschi, Luca Gabutti
Clinical studies show that prescription of benzodiazepines increases with age, and well outside of recognized indications. It often is inappropriate and abusive. Its consequences can be very serious and considerably increase patients' morbidity and mortality. Strategies exist to stop these medications through a multidisciplinary approach. Widespread campaigns are necessary to correct what has become a significant public health problem.
January 25, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28702928/underuse-of-oral-anticoagulants-and-inappropriate-prescription-of-antiplatelet-therapy-in-older-inpatients-with-atrial-fibrillation
#7
Lorette Averlant, Grégoire Ficheur, Laurie Ferret, Stéphane Boulé, François Puisieux, Michel Luyckx, Julien Soula, Alexandre Georges, Régis Beuscart, Emmanuel Chazard, Jean-Baptiste Beuscart
BACKGROUND: Several studies have shown that the prescription of antiplatelet therapy (APT) is associated with an increased risk of oral anticoagulant (OAC) underuse in patients aged 75 years and over with atrial fibrillation (AF). An associated atheromatous disease may be the underlying reason for APT prescription. The objective of the study was to determine whether the association between underuse of OAC and APT prescription was explained by the presence of an atheromatous disease. METHODS AND RESULTS: We performed a retrospective, observational, single-centre study between 2009 and 2013 based on administrative data...
July 12, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28698021/impact-of-an-antimicrobial-stewardship-program-to-optimize-antimicrobial-use-for-outpatients-at-emergency-department
#8
Aurélien Dinh, Clara Duran, Benjamin Davido, Frédérique Bouchand, Laurène Deconinck, Morgan Matt, Olivia Sénard, Caroline Guyot, Anne-Sophie Levasseur, Julie Attal, David Razazi, Thomas Tritz, Alain Beauchet, Jérôme Salomon, Sébastien Beaune, Julie Grenet
BACKGROUND: Antimicrobial stewardship programs (ASPs) have proven to be effective in optimizing antibiotic use for inpatients. However, Emergency Department (ED)'s fast-paced clinical setting can be challenging for a successful ASP. AIM: In April 2015, an ASP was implemented in our ED and we aimed to determine its impact on antimicrobial use for outpatients. METHODS: Monocentric study comparing the quality of antibiotic prescriptions between a one-year period before ASP implementation (November 2012 to October 2013) and a one-year period after its implementation (June 2015 to May 2016)...
July 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28693407/patterns-of-drugs-prescribed-for-dental-outpatients-in-nigeria-findings-and-implications
#9
Joseph O Fadare, Kazeem A Oshikoya, Obitade S Obimakinde, Abayomi O Sijuade, Jide M Afolayan, Adeyinka A Adeleke, Brian Godman, Damilola O Ojumu
OBJECTIVES: There are concerns with inappropriate prescribing of medicines among dentists especially antimicrobials. It is more concerning if this increases resistance rates. This study aimed to address this by assessing patterns of drugs prescribed for outpatients attending a hospital dental clinic in Nigeria. The findings will be used to plan future interventions, particularly around antimicrobial prescribing, where there are concerns. METHODS AND MATERIALS: Medical records of patients attending the dental clinic of a leading teaching hospital in Nigeria were evaluated...
July 11, 2017: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/28685902/can-pay-for-performance-to-primary-care-providers-stimulate-appropriate-use-of-antibiotics
#10
Lina Maria Ellegård, Jens Dietrichson, Anders Anell
Antibiotic resistance is a major threat to public health worldwide. As the healthcare sector's use of antibiotics is an important contributor to the development of resistance, it is crucial that physicians only prescribe antibiotics when needed and that they choose narrow-spectrum antibiotics, which act on fewer bacteria types, when possible. Inappropriate use of antibiotics is nonetheless widespread, not least for respiratory tract infections (RTI), a common reason for antibiotics prescriptions. We examine if pay-for-performance (P4P) presents a way to influence primary care physicians' choice of antibiotics...
July 7, 2017: Health Economics
https://www.readbyqxmd.com/read/28683782/a-descriptive-study-of-self-medication-practices-among-sri-lankan-national-level-athletes
#11
A D A Fernando, L M H Bandara, H M S T Bandara, S Pilapitiya, A de Silva
BACKGROUND: Intake of medicines and supplements is widespread among the professional athletes in developed countries and there are reports to suggest inappropriate self-administration of medicine. Data from South Asia on this area is lacking. This study examined self-medication practices with regard to use of allopathic and herbal/traditional medicines among national -level Sri Lankan athletes. RESULTS: 209 athletes from 15 national sport teams were assessed using an anonymous, interviewer administered questionnaire...
July 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28674308/improved-clinical-outcomes-in-patients-with-positive-blood-culture-by-proactive-intervention-of-antimicrobial-use-impact-of-antimicrobial-stewardship-program-implementation-on-clinical-practice
#12
Takehiro Yamada, Keisuke Kagami, Shungo Imai, Koji Akizawa, Sumio Iwasaki, Tatsuya Fukumoto, Nobuhisa Ishiguro, Ken Iseki
 Bacteremia is one of the most serious infectious illness resulting from nosocomial infection. Therefore, appropriate antimicrobial chemotherapy should be provided as soon as possible to patients exhibiting symptoms of infectious disease and having positive blood culture results. Antimicrobial stewardship (AS) guidelines were recently released by the Infectious Diseases Society of America. The guidelines recommend "proactive intervention and feedback" as one of the core strategies for implementing optimal antimicrobial drug use to improve patient outcomes in clinical settings...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28665490/impact-of-china-s-essential-medicines-scheme-and-zero-mark-up-policy-on-antibiotic-prescriptions-in-county-hospitals-a-mixed-methods-study
#13
Xiaolin Wei, Jia Yin, John D Walley, Zhitong Zhang, Joseph P Hicks, Yu Zhou, Qiang Sun, Jun Zeng, Mei Lin
OBJECTIVE: To evaluate the impact of the national essential medicines scheme and zero-mark-up policy on antibiotic prescribing behaviour. METHODS: In rural Guangxi, a natural experiment compared one county hospital which implemented the policy with a comparison hospital which did not. All outpatient and inpatient records in 2011 and 2014 were extracted from the two hospitals. Primary outcome indicator was antibiotic prescribing rate (APR) among children aged 2-14 presenting in outpatients with a primary diagnosis of upper respiratory tract infection (URTI)...
June 30, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28663045/appropriateness-assessment-in-antiplatelet-therapy-apathy-registry-insight-from-current-clinical-practice
#14
Nazario Carrabba, Benedetta Bellandi, Guido Parodi, Emanuele Cecchi, Giorgio Baldereschi, Cristina Giglioli, Angela Migliorini, Renato Valenti, Serafina Valente, Rossella Marcucci, Niccolò Marchionni, David Antoniucci
BACKGROUND: In clinical practice there is a gap between guidelines recommendation and antiplatelet strategies used for acute coronary syndrome (ACS). We sought to evaluate appropriateness of antiplatelet strategies employed in a tertiary center. METHODS AND RESULTS: From January to June 2014, 430 ACS were treated with percutaneous coronary intervention by 3 groups of interventional cardiologists. Aspirin and clopidogrel (52%) were the most commonly used antiplatelet therapies, being prasugrel associated with aspirin in 110 (25...
June 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28660675/objectively-improving-appropriateness-of-absorbent-products-provision-to-patients-with-urinary-incontinence-the-diapper-study
#15
Emilio Sacco, Riccardo Bientinesi, Carlo Gandi, Giuseppe Palermo, Francesco Pierconti, Pierfrancesco Bassi
AIMS: To objectively assess and enhance the appropriateness of continence products provision to sufferers from urinary incontinence (UI) managed with containment strategies. METHODS: Incontinent patients of five Italian continence care services were included in this industry-supported study from 01/2012 to 03/2016. All patients/carers have been invited to perform a 48-h home-based pad test and to fill in a diary. The primary outcome was the product appropriateness defined as the use of a pad with maximum absorbent capacity (MAC) from 30% to 50% higher than the individually measured urine load...
June 29, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28657382/a-pilot-study-evaluating-the-prescribing-of-ceftriaxone-in-hospitals-in-ghana-findings-and-implications
#16
Daniel Kwame Afriyie, Seth Kwabena Amponsah, Justice Dogbey, Kwabena Agyekum, Samuel Kesse, Isle Truter, Joanna C Meyer, Brian Godman
BACKGROUND AND OBJECTIVES: Widespread empiric use of antibiotics exists especially in developing countries. This is a concern since inappropriate use of antibiotics, including their extended inappropriate use, will increase resistance rates. Consequently, there is a need to evaluate antibiotic utilisation across healthcare sectors to improve future use. This includes ceftriaxone, widely used among hospitals including those in Ghana. METHODS: A cross-sectional study to evaluate the appropriateness of ceftriaxone prescription in a leading hospital in Ghana...
June 28, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28640946/physicians-non-uniform-approach-to-prescribing-drugs-to-older-patients-a-qualitative-study
#17
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
#18
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
#19
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
#20
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
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