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https://www.readbyqxmd.com/read/28182982/rapid-widespread-distribution-of-intranasal-naloxone-for-overdose-prevention
#1
Desiree Madah-Amiri, Thomas Clausen, Philipp Lobmaier
BACKGROUND: Take home naloxone programs have been successful internationally in training bystanders to reverse an opioid overdose with naloxone, an opioid antagonist. A multi-site naloxone distribution program began in Norway in 2014 as part of a national overdose prevention strategy. The aim of this study was to a) describe the program, and b) present findings from the government-supported intervention. METHODS: From July 2014 to December 2015, staff from multiple low-threshold facilities trained clients on how to use intranasal naloxone...
January 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28156658/changes-in-opioid-type-and-dose-among-cancer-patients-referred-to-outpatient-palliative-care
#2
Joseph Baidoo, Yee Choon Meng, Donna S Zhukovsky, Kimberson Cochien Tanco, Holly A Stewart, Tonya Edwards, Manju P Joy, Leela Kuriakose, Zhanni Lu, Diane D Liu, Janet L Williams, Eduardo Bruera
: 106 Background: Opioid prescriptions are regulated at both federal and state levels. Examples of such regulations include use of risk evaluation and mitigation strategies (REMS), mandatory sharing of prescription data with state prescription drug monitoring programs and the reclassification of hydrocodone as schedule II opioid in October 2014. One possible consequence of such changes would be earlier referral to palliative care (PC) for opioid management. Alternatively, primary oncologist may treat patients with weak opioids or use strong opioids with lower daily dose...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152973/multidisciplinary-process-improvement-to-optimize-oral-chemotherapy-safety
#3
Kerin B Adelson, Monica Fradkin, Renee Havriliak, Michelle Renee Harrison, Osama Abdelghany, Stephanie Kregling, Jessica Wright, Bret Morrow, Roberta Sterling, Mandeep Smith, Frank Esposito, Martha Stutsky, LeeAnn Miller, Rogerio Lilenbaum, Catherine A Lyons, Anne C Chiang, Howard Cohen
: 134 Background: The rapid development of oral chemotherapy agents brings unique challenges. These drugs must be treated with the same vigilance as parenteral chemotherapy. The oral chemotherapy system is not optimized or integrated across our hospital. A quality assessment survey identified the need for a better means to monitor and improve oral chemotherapy patient outcomes. METHODS: Patient and staff satisfaction with the current process was measured. A chartered multidisciplinary task force reviewed existing practice and developed a program to identify patients, ensure drug access, standardize prescription and consent, ensure on-going clinical support including patient education, regimen specific adherence monitoring, toxicity assessment and address patient concerns...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152391/prescription-drug-monitoring-programs-nonmedical-use-of-prescription-drugs-and-heroin-use-evidence-from-the-national-survey-of-drug-use-and-health
#4
Mir M Ali, William N Dowd, Timothy Classen, Ryan Mutter, Scott P Novak
In the United States, nonmedical prescription opioid use is a major public health concern. Various policy initiatives have been undertaken to tackle this crisis, including state prescription drug monitoring programs (PDMPs). This study uses the 2004-2014 National Survey of Drug Use and Health (NSDUH) and exploits state-level variation in the timing of PDMP implementation and PDMP characteristics to investigate whether PDMPs are associated with a reduction in prescription opioid misuse or whether they have the unintended consequence of increasing heroin use...
January 6, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28152337/how-states-are-tackling-the-opioid-crisis
#5
Shalini Wickramatilake, Julia Zur, Norah Mulvaney-Day, Melinda Campopiano von Klimo, Elizabeth Selmi, Henrick Harwood
OBJECTIVES: We used data from the 2015 National Association of State Alcohol and Drug Abuse Directors Web-based questionnaire and other sources to demonstrate the range and scope of state initiatives being used to deal with the opioid crisis in the United States. METHODS: State alcohol and drug agency directors and designated senior agency managers responded to the questionnaire, which asked respondents about recent opioid-related state-level public health initiatives at their agencies...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28127666/examining-fatal-opioid-overdoses-in-marion-county-indiana
#6
Bradley Ray, Kenna Quinet, Timothy Dickinson, Dennis P Watson, Alfarena Ballew
Drug-related overdoses are now the leading injury-related death in the USA, and many of these deaths are associated with illicit opioids and prescription opiate pain medication. This study uses multiple sources of data to examine accidental opioid overdoses across 6 years, 2010 through 2015, in Marion County, IN, an urban jurisdiction in the USA. The primary sources of data are toxicology reports from the county coroner, which reveal that during this period, the most commonly detected opioid substance was heroin...
January 26, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/28127641/assessment-of-linezolid-prescriptions-in-three-french-hospitals
#7
C Dentan, E Forestier, M Roustit, S Boisset, S Chanoine, O Epaulard, P Pavese
The use of linezolid to treat gram-positive cocci infections is increasing in France. Linezolid is approved in pneumonia and complicated skin and soft tissue infections. Overuse and misuse of linezolid can favor the emergence and spreading of linezolid-resistant strains. We aimed to assess the appropriateness of linezolid use in French hospitals. This is a multicenter, retrospective study conducted in three tertiary care hospitals. Appropriateness of linezolid indications and adequacy (composite score concerning dosage, route of administration and blood monitoring) were assessed...
January 26, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28101955/prescription-drug-monitoring-programs-produce-a-limited-impact-on-painkiller-prescribing-in-medicare-part-d
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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-nonmalignant-pain
#16
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic nonmalignant 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...
January 2017: 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
#17
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
#18
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
#19
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
#20
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
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