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https://www.readbyqxmd.com/read/28101955/prescription-drug-monitoring-programs-produce-a-limited-impact-on-painkiller-prescribing-in-medicare-part-d
#1
Courtney R Yarbrough
OBJECTIVE: To measure the impact of prescription drug monitoring programs (PDMPs) on prescribing of opioid and nonopioid painkillers. DATA SOURCE: 2010-2013 physician-level Medicare Part D prescribing data released by the Centers for Medicare and Medicaid Services and Propublica. STUDY DESIGN: Using difference-in-differences models with physician-level fixed effects, the study compares prescribing in states with and without PDMPs for opioid and nonopioid analgesics, oxycodone, hydrocodone, and opioids by controlled substances Schedules II-IV...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28033313/increases-in-drug-and-opioid-involved-overdose-deaths-united-states-2010-2015
#2
Rose A Rudd, Puja Seth, Felicita David, Lawrence Scholl
The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999-2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid (1). Illicit opioids are contributing to the increase in opioid overdose deaths (2,3). In an effort to target prevention strategies to address the rapidly changing epidemic, CDC examined overall drug overdose death rates during 2010-2015 and opioid overdose death rates during 2014-2015 by subcategories (natural/semisynthetic opioids, methadone, heroin, and synthetic opioids other than methadone)...
December 30, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28033245/vkorc1-and-cyp2c9-polymorphisms-related-to-adverse-events-in-case-control-cohort-of-anticoagulated-patients
#3
Silvia Misasi, Giuliana Martini, Oriana Paoletti, Stefano Calza, Giovanni Scovoli, Alessandra Marengoni, Sophie Testa, Luigi Caimi, Eleonora Marchina
Vitamin K antagonists (VKAs) are highly effective but have a narrow therapeutic index and require routine monitoring of the INR. The primary aim of pharmacogenetics (PGx) is to optimize patient care, achieving drug treatments that are personalized according to the genetic profile of each patient. The best-characterized genes involved in VKA PGx involve pharmacokinetics (VKORC1) and pharmacodynamics (CYP2C9) of VKA metabolism. The role of these genes in clinical outcomes (bleeding and thrombosis) during oral anticoagulant (OAC) therapy is controversial...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28009931/do-more-robust-prescription-drug-monitoring-programs-reduce-prescription-opioid-overdose
#4
Bryce Pardo
BACKGROUND AND AIMS: In the United States, overdose deaths attributed to opioid pain relievers (OPR) have quadrupled since 1999, prompting many states to adopt Prescription Drug Monitoring Programs (PMP). This study aimed to 1) estimate the relationship of PMP strength with OPR overdose deaths across states and over time; 2) measure what threshold in PMP strength is associated with the greatest reduction in OPR overdose; and 3) assess the relationship of medical marijuana dispensaries with OPR overdose deaths...
December 23, 2016: Addiction
https://www.readbyqxmd.com/read/28007411/a-qualitative-analysis-of-prescribers-and-dispensers-views-on-improving-prescription-drug-monitoring-programs
#5
Neal A Carnes, Eric R Wright, Connor W Norwood
BACKGROUND: Prescription drug abuse is epidemic in the United States (US). To help address the problem, most states operate prescription drug monitoring programs (PDMPs). PDMPs are designed to monitor and help control the distribution of controlled therapeutic medications and to assist prescribers and dispensers in making informed clinical decisions. To this end, PDMPs rely on timely and accurate data submission, as well as review of the data. Consequently, provider acceptance of these systems is essential to maximize their effectiveness...
December 12, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27989494/self-monitoring-of-blood-glucose-impact-of-quantity-limits-in-public-drug-formularies-on-provincial-costs-across-canada
#6
Sandra R Knowles, Kathy Lee, J Michael Paterson, Baiju R Shah, Muhammad M Mamdani, David N Juurlink, Tara Gomes
OBJECTIVES: For most patients with diabetes, routine use of blood glucose test strips (BGTS) has not been shown to be beneficial, yet the economic implications of broad publicly funded reimbursement for BGTS are substantial. We assessed the potential impact of BGTS quantity limits on utilization and costs for 6 publicly funded drug plans across Canada. METHODS: A cross-sectional analysis was conducted in 6 provinces (Alberta, Saskatchewan, Manitoba, Nova Scotia, Newfoundland and Labrador and Prince Edward Island) for patients who received at least 1 prescription for BGTS in 2014 through the public drug program...
December 15, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27971914/impact-of-state-mandated-queries-of-the-prescription-drug-monitoring-programs-on-opioid-and-non-opioid-drug-related-adverse-effects-a-difference-in-difference-approach
#7
C J Hayes, D Chopra, A B Shah, B C Martin
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27951589/primary-care-physician-volume-and-quality-of-diabetes-care-a-population-based-cohort-study
#8
Andrew Cheung, Thérèse A Stukel, David A Alter, Richard H Glazier, Vicki Ling, Xuesong Wang, Baiju R Shah
Background: A relationship between higher patient volume and both better quality of care and better outcomes has been shown for many acute care conditions. Whether a volume-quality relationship exists for the outpatient management of chronic diseases is uncertain. Objective: To explore the association between primary care physician volume and quality of diabetes care. Design: Cohort study. Setting: The study was conducted using linked population-based health care administrative data in Ontario, Canada...
December 13, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27897471/use-of-risk-mitigation-practices-by-family-nurse-practitioners-prescribing-opioids-for-the-management-of-chronic-non-malignant-pain
#9
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27893567/determining-whether-a-dosage-specific-and-individualized-home-exercise-program-with-consults-reduces-fall-risk-and-falls-in-community-dwelling-older-adults-with-difficulty-walking-a-randomized-control-trial
#10
Estelle Gallo, Maria Stelmach, Fernanda Frigeri, Dong-Hyun Ahn
BACKGROUND AND PURPOSE: The development and implementation of effective interventions to prevent falls in older adults is a public health priority. The purpose of this study was to compare the efficacy of a new practice model, incorporating Shubert's evidence-based fall prevention recommendations, with the usual ambulatory physical therapy (PT) at Rusk Rehabilitation, to decrease fall risk among older adults living in the community. The hypotheses were (1) the proposed program would decrease participants' fall risk, (2) it would be more effective than our usual PT, and (3) the addition of 4 consults after discharge would improve compliance with a home exercise program...
November 23, 2016: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/27887597/technology-enhanced-multi-domain-at-home-continuum-of-care-program-with-respect-to-usual-care-for-people-with-cognitive-impairment-the-ability-telerehabilitation-study-protocol-for-a-randomized-controlled-trial
#11
O Realdon, F Rossetto, M Nalin, I Baroni, M Cabinio, R Fioravanti, F L Saibene, M Alberoni, F Mantovani, M Romano, R Nemni, F Baglio
BACKGROUND: According to the World Alzheimer Report (Prince, The Global Impact of Dementia: an Analysis of Prevalence, Incidence, Cost and Trends, 2015), 46.8 million people worldwide are nowadays living with dementia. And this number is estimated to approximate 131.5 million by 2050, with an increasing burden on society and families. The lack of medical treatments able to stop or slow down the course of the disease has moved the focus of interest toward the nonpharmacological approach and psychosocial therapies for people with/at risk of dementia, as in the Mild Cognitive Impairment (MCI) condition...
November 25, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27878317/-what-is-currently-available-for-sport-medicine-therapy
#12
U Tegtbur
After 30 years of age physical capacity decreases with increasing age by 5-20% per decade. High physical activity in daily life as well as exercise training of endurance, strength, coordination and mobility can delay the functional and anatomical loss of muscle, bone, cartilage and connective tissue by more than 10 years. In recent years, numerous concepts have scientifically been proven in the exercise therapy of internal diseases; therefore, similar to drug treatment, cellular mechanisms of exercise training adaptation are known in detail...
December 2016: Der Internist
https://www.readbyqxmd.com/read/27874151/a-stepwise-introduction-of-a-successful-antimicrobial-stewardship-program-experience-from-a-tertiary-care-university-hospital-in-western-saudi-arabia
#13
Maha M Alawi, Bayan M Darwesh
OBJECTIVES: To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center. METHODS: Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs)...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#14
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27852516/changes-in-the-management-of-type-2-diabetic-patients-in-family-medicine-practices-in-the-bursa-region
#15
Olgun Göktaş, Özen Öz Gül, Erdinç Ertürk
AIM: The aim of the study was to investigate the treatment and monitoring patterns of type 2 diabetes patients in the Bursa region over the last 5 years since the implementation of family practice in Turkey in 2010. METHODS: A total of 216 volunteer family doctors working in family health centers took part in this study. The records of 44,819 diabetic patients who visited these doctors between January 1, 2010 and December 31, 2014 were inspected retrospectively...
November 13, 2016: Primary Care Diabetes
https://www.readbyqxmd.com/read/27797283/from-dispensed-to-disposed-evaluating-the-effectiveness-of-disposal-programs-through-a-comparison-with-prescription-drug-monitoring-program-data
#16
Kathleen L Egan, Eric Gregory, Michael Sparks, Mark Wolfson
BACKGROUND: Organized disposal of controlled medications, such as take-back events and permanent drug donation boxes, is a prevention strategy that has been widely used to reduce the availability of controlled medications for diversion or abuse. However, little is known as to whether this strategy actually reduces the overall availability of these medications for the purposes of diversion or abuse. OBJECTIVES: The objective of this study was to compare the number and types of controlled medications that were disposed through organized efforts to the number dispensed in local communities...
October 31, 2016: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/27794549/clinicians-use-of-prescription-drug-monitoring-programs-in-clinical-practice-and-decision-making
#17
Gillian J Leichtling, Jessica M Irvine, Christi Hildebran, Deborah J Cohen, Sara E Hallvik, Richard A Deyo
OBJECTIVES:  Little is known about clinicians' use of prescription drug monitoring program (PDMP) profiles in decision-making. The objective of this qualitative study was to understand how clinicians use, interpret, and integrate PDMP profiles with other information in making clinical decisions. DESIGN : Qualitative interviews of clinician PDMP users. SETTING:  Oregon registrants in the state's PDMP. SUBJECTS:  Thirty-three clinicians practicing in primary care, emergency medicine, pain management, psychiatry, dentistry, and surgery...
October 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27794547/national-and-northern-new-england-opioid-prescribing-patterns-2013-2014
#18
Adam R Toth, Carl J Possidente, Linda M Sawyer, Mark A DiParlo, Gilbert J Fanciullo
: OBJECTIVE : To evaluate current opioid prescribing patterns nationally and regionally across several northern New England states and compare with prescription data on an institutional level over a two-year period, between 2013 and 2014. DESIGN, SETTING, AND SUBJECTS:  The IMS Health National Prescription Audit (NPA) database was used to obtain prescription data from US retail pharmacies between 2013 and 2014. METHODS:  Our study compared noninjectable opioid dispensing between two time periods: January-June 2013 and July-December 2014...
October 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27759833/the-good-pharmacy-practice-on-einstein-program-at-parais%C3%A3-polis-community
#19
Lara Tânia de Assumpção Domingues Gonçalves de Oliveira, Camila Pontes da Silva, Maria das Vitorias Guedes, Ana Célia de Oliveira Sousa, Flávio Sarno
Objectives: To describe indicators and processes developed and implemented for pharmaceutical assistance at the Einstein Program at Paraisópolis Community pharmacy. Methods: This was a descriptive study of retrospective data from January 2012 to December 2015. Data were obtained from spreadsheets developed for monitoring the productivity and care quality provided at the pharmacy. The evaluated variables were pharmaceutical assistance to prescription, pharmaceutical intervention, orientation (standard and pharmaceutical) and pharmaceutical orientation rate...
July 2016: Einstein
https://www.readbyqxmd.com/read/27754719/provider-experiences-with-the-identification-management-and-treatment-of-co-occurring-chronic-noncancer-pain-and-substance-use-in-the-safety-net
#20
Jamie Suki Chang, Margot Kushel, Christine Miaskowski, Rachel Ceasar, Kara Zamora, Emily Hurstak, Kelly R Knight
BACKGROUND: In the United States and internationally, providers have adopted guidelines on the management of prescription opioids for chronic noncancer pain (CNCP). For "high-risk" patients with co-occurring CNCP and a history of substance use, guidelines advise that providers monitor patients using urine toxicology screening tests, develop opioid management plans, and refer patients to substance use treatment. OBJECTIVE: We report primary care provider experiences in the safety net interpreting and implementing prescription opioid guideline recommendations for patients with CNCP and substance use...
January 28, 2017: Substance Use & Misuse
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