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https://www.readbyqxmd.com/read/28527640/influences-on-patient-satisfaction-among-patients-who-use-emergency-departments-frequently-for-pain-related-complaints
#1
Patricia Newcomb, Marian Wilson, Ralph Baine, Terence McCarthy, Nicholas Penny, Caroline Nixon, Justin Orren
INTRODUCTION: The primary purpose of this study was to assess relationships between opioid prescribing practices, patient and ED attributes, and patient satisfaction ratings of nursing and physician care among patients with high utilization of the emergency department for pain relief. METHODS: A retrospective cohort study was conducted to examine 305 individual patient satisfaction surveys from users with high ED utilization for pain complaints. Responses were compared with an age-matched control group (n = 305) of nonfrequent ED users...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
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
#2
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/28526011/risk-of-acute-kidney-injury-and-survival-in-patients-treated-with-metformin-an-observational-cohort-study
#3
Samira Bell, Bassam Farran, Stuart McGurnaghan, Rory J McCrimmon, Graham P Leese, John R Petrie, Paul McKeigue, Naveed Sattar, Sarah Wild, John McKnight, Robert Lindsay, Helen M Colhoun, Helen Looker
BACKGROUND: Whether metformin precipitates lactic acidosis in patients with chronic kidney disease (CKD) remains under debate. We examined whether metformin use was associated with an increased risk of acute kidney injury (AKI) as a proxy for lactic acidosis and whether survival among those with AKI varied by metformin exposure. METHODS: All individuals with type 2 diabetes and available prescribing data between 2004 and 2013 in Tayside, Scotland were included. The electronic health record for diabetes which includes issued prescriptions was linked to laboratory biochemistry, hospital admission, death register and Scottish Renal Registry data...
May 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28520904/sources-of-unsafe-primary-care-for-older-adults-a-mixed-methods-analysis-of-patient-safety-incident-reports
#4
Alison Cooper, Adrian Edwards, Huw Williams, Huw P Evans, Anthony Avery, Peter Hibbert, Meredith Makeham, Aziz Sheikh, Liam J Donaldson, Andrew Carson-Stevens
Background: older adults are frequent users of primary healthcare services, but are at increased risk of healthcare-related harm in this setting. Objectives: to describe the factors associated with actual or potential harm to patients aged 65 years and older, treated in primary care, to identify action to produce safer care. Design and Setting: a cross-sectional mixed-methods analysis of a national (England and Wales) database of patient safety incident reports from 2005 to 2013...
May 16, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28515934/zolpidem-prescribing-practices-before-and-after-food-and-drug-administration-required-product-labeling-changes
#5
Jessica L Norman, Danielle R Fixen, Joseph J Saseen, Laura M Saba, Sunny A Linnebur
BACKGROUND: Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release) or 6.25 mg (controlled release) per night in women. OBJECTIVES: The primary objective of this study was to compare prescribing practices before and after the 2013 zolpidem labeling change...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28510645/nurse-interventions-to-improve-medication-adherence-among-discharged-older-adults-a-systematic-review
#6
Henk Verloo, Arnaud Chiolero, Blanche Kiszio, Thomas Kampel, Valérie Santschi
Background: discharged older adult inpatients are often prescribed numerous medications. However, they only take about half of their medications and many stop treatments entirely. Nurse interventions could improve medication adherence among this population. Objective: to conduct a systematic review of trials that assessed the effects of nursing interventions to improve medication adherence among discharged, home-dwelling and older adults. Method: we conducted a systematic review according to the methods in the Cochrane Collaboration Handbook and reported results according to the PRISMA statement...
May 16, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28508796/emedication-meets-ehealth-with-the-electronic-medication-management-assistant-emma
#7
Mauro Tschanz, Tim Lucas Dorner, Kerstin Denecke
BACKGROUND: A patient's healthcare team is often missing a complete overview on the prescribed and dispensed medication. This is due to an inconsistent information flow between the different actors of the healthcare system. Often, only the patient himself knows exactly which drugs he is actually taking. OBJECTIVES: Our objective is to exploit different eHealth technologies available or planned in Switzerland to improve the information flow of the medication data among the stakeholder and to support the patient in managing his medication...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28506977/development-of-a-medication-review-service-for-patients-with-enteral-tubes-in-a-community-teaching-hospital
#8
Tracey Li, Alison Eisenhart, Jennifer Costello
PURPOSE: The results of a study to develop a hospital-wide medication review service for patients with enteral tubes to improve patient safety are presented. SUMMARY: Inappropriate enteral administration of medications can result in occluded tubes, altered clinical response, and an increase in adverse effects. At Saint Barnabas Medical Center, a 600-bed community teaching hospital located in Livingston, New Jersey, a medication review service for patients with an enteral tube was developed...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28506380/use-of-communication-tool-within-electronic-medical-record-to-improve-primary-nonadherence
#9
Daniel E Kerner, Emily L Knezevich
OBJECTIVES: The primary objective of this study was to determine if an online reminder decreased the rate of primary nonadherence for antihypertensive medications in patients seen in 2 primary care clinics in Omaha, NE. The secondary objectives were to determine if patients receiving the intervention achieved lower blood pressure values at follow-up visits and to determine if the intervention decreased the number of days between prescribing and prescription pick-up. METHODS: A report was generated in an electronic health record to identify patients prescribed a new antihypertensive medication from a physician at one of the primary care clinics...
May 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28506378/pharmacist-to-prescriber-intervention-to-close-therapeutic-gaps-for-statin-use-in-patients-with-diabetes-a-randomized-controlled-trial
#10
Hannah M Renner, Amanda Hollar, Samuel F Stolpe, Macary Weck Marciniak
OBJECTIVE: To assess the effect of a community pharmacist-led intervention on the proportion of patients with diabetes placed on statin therapy. DESIGN: The Pharmacy Quality Alliance endorsed a performance measure, Statin Use in Persons with Diabetes, which evaluates the percentage of patients aged 40-75 years who were dispensed a medication for diabetes and also received a statin medication. SETTING: This new measure has been implemented within the Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) dashboard...
May 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28503676/learning-optimal-individualized-treatment-rules-from-electronic-health-record-data
#11
Yuanjia Wang, Peng Wu, Ying Liu, Chunhua Weng, Donglin Zeng
Medical research is experiencing a paradigm shift from "one-size-fits-all" strategy to a precision medicine approach where the right therapy, for the right patient, and at the right time, will be prescribed. We propose a statistical method to estimate the optimal individualized treatment rules (ITRs) that are tailored according to subject-specific features using electronic health records (EHR) data. Our approach merges statistical modeling and medical domain knowledge with machine learning algorithms to assist personalized medical decision making using EHR...
October 2016: IEEE International Conference on Healthcare Informatics IEEE International Conference on Healthcare Informatics
https://www.readbyqxmd.com/read/28502506/attitudes-and-actions-a-survey-to-assess-statin-use-among-finnish-patients-with-increased-risk-for-cardiovascular-events
#12
Reija Silvennoinen, Juha H Turunen, Petri T Kovanen, Mikko Syvänne, Matti J Tikkanen
BACKGROUND: Statins are the first-line treatment for lowering serum cholesterol and preventing coronary artery disease (CAD). Patients who fail to comply with the prescribed statin treatment face a markedly increased risk for cardiovascular events. OBJECTIVE: The aim of the article was to study the subjective factors, which modulate persistence with and adherence to statin therapy among Finnish patients at high risk for cardiovascular events. METHODS: A total of 1022 Finnish adults diagnosed with CAD, diabetes, hypertension, or severe hereditary dyslipidemia completed an electronic questionnaire survey during a visit in 1 of the 84 community pharmacies participating in the study...
March 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28500199/data-quality-in-electronic-medical-records-in-manitoba-do-problem-lists-reflect-chronic-disease-as-defined-by-prescriptions
#13
Alexander Singer, Andrea L Kroeker, Sari Yakubovich, Roberto Duarte, Brenden Dufault, Alan Katz
OBJECTIVE: To determine if the problem list (health conditions) in primary care electronic medical records (EMRs) accurately reflects the conditions for which chronic medications are prescribed in the EMR. DESIGN: A retrospective analysis of EMR data. SETTING: Eighteen primary care clinics across rural and urban Manitoba using the Accuro EMR. PARTICIPANTS: Data from the EMRs of active patients seen in an 18-month period (December 18, 2011, to June 18, 2013, or December 3, 2012, to June 3, 2014) were used...
May 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28495028/real-world-clinical-outcomes-among-patients-with-type-2-diabetes-receiving-canagliflozin-at-a-specialty-diabetes-clinic-subgroup-analysis-by-baseline-hba1c-and-age
#14
June Felice Johnson, Rahul Parsa, Robert A Bailey
PURPOSE: Canagliflozin, a sodium glucose co-transporter 2 inhibitor developed for the treatment of type 2 diabetes mellitus (T2DM), has demonstrated effectiveness in patients with T2DM receiving care at a specialty diabetes clinic. We report the outcomes in these patients in subgroups classified by baseline hemoglobin A1c (HbA1c) and age. METHODS: This subgroup analysis was based on a review of data from the electronic health records of adults with T2DM who were prescribed canagliflozin at a specialty diabetes clinic and who returned for ≥1 follow-up office visit...
May 8, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28490554/feasibility-cluster-randomised-controlled-trial-of-a-within-consultation-intervention-to-reduce-antibiotic-prescribing-for-children-presenting-to-primary-care-with-acute-respiratory-tract-infection-and-cough
#15
Peter S Blair, Sophie Turnbull, Jenny Ingram, Niamh Redmond, Patricia Jane Lucas, Christie Cabral, Sandra Hollinghurst, Padraig Dixon, Tim Peters, Jeremy Horwood, Paul Little, Nick A Francis, Anna Gilbertson, Catherine Jameson, Alastair D Hay
OBJECTIVE: To investigate recruitment and retention, data collection methods and the acceptability of a 'within-consultation' complex intervention designed to reduce antibiotic prescribing. DESIGN: Primary care feasibility cluster randomised controlled trial. SETTING: 32 general practices in South West England recruiting children from October 2014 to April 2015. PARTICIPANTS: Children (aged 3 months to <12 years) with acute cough and respiratory tract infection (RTI)...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28487930/the-effects-of-medication-alerts-on-prescriber-response-in-a-pediatric-hospital
#16
Judith W Dexheimer, Eric S Kirkendall, Michal Kouril, Philip A Hagedorn, Thomas Minich, Leo L Duan, Monifa Mahdi, Rhonda Szczesniak, S Andrew Spooner
OBJECTIVE: More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider's response to any EHR alert. The primary goal was to evaluate the effects of alert burden on user response to the alerts. METHODS: We performed a retrospective study of medication alerts over a 24-month period (1/2013-12/2014) in a large pediatric academic medical center...
May 10, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28485536/an-innovative-framework-to-improve-teratogenic-medication-risk-counseling
#17
Swati Shroff, Melissa McNeil, Sonya Borrero
Health care providers in the Veterans Affairs system are caring for a growing number of women of childbearing age. Prior research shows that a significant number of women veterans are prescribed category D or X teratogenic medications. However, the majority do not receive teratogenic risk or contraceptive counseling. In order to improve teratogenic medication prescribing practices at the Veterans Affairs Pittsburgh Healthcare System, we developed a framework called TARCC to guide primary care providers through appropriate teratogenic risk counseling...
May 9, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28482963/paradoxical-upgrading-reaction-in-extra-pulmonary-tuberculosis-association-with-vitamin-d-therapy
#18
D A Barr, A K Coussens, S Irvine, N D Ritchie, K Herbert, B Choo-Kang, D Raeside, D J Bell, R A Seaton
SETTING: Glasgow, Scotland, UK. BACKGROUND: Paradoxical reactions in tuberculosis (TB) are a notable example of our incomplete understanding of host-pathogen interactions during anti-tuberculosis treatment. OBJECTIVES: To determine risk factors for a TB paradoxical reaction, and specifically to assess for an independent association with vitamin D use. DESIGN: Consecutive human immunodeficiency virus (HIV) negative adult patients treated for extra-pulmonary TB were identified from an Extended Surveillance of Mycobacterial Infections database...
June 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28479220/electronic-medication-complete-communication-strategy-for-opioid-prescriptions-in-the-emergency-department-rationale-and-design-for-a-three-arm-provider-randomized-trial
#19
Danielle M McCarthy, D Mark Courtney, Patrick M Lank, Kenzie A Cameron, Andrea M Russell, Laura M Curtis, Kwang-Youn A Kim, Surrey M Walton, Enid Montague, Abbie L Lyden, Stephanie J Gravenor, Michael S Wolf
BACKGROUND: Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. OBJECTIVES: To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC(2)) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. METHODS: The ED EMC(2) Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions...
May 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28476877/incidence-of-clinically-relevant-medication-errors-in-the-era-of-electronically-prepopulated-medication-reconciliation-forms-a-retrospective-chart-review
#20
Kaitlin R Stockton, Maeve E Wickham, Simon Lai, Katherin Badke, Karen Dahri, Diane Villanyi, Vi Ho, Corinne M Hohl
BACKGROUND: To reduce medication discrepancies (unintended differences between a patient's outpatient and inpatient medication regimens), Canadian institutions have implemented medication reconciliation forms that are prepopulated with outpatient medication dispensing data. These may prompt prescribers to reorder discontinued medications or continue newly contraindicated medications. Our objective was to evaluate the incidence of medication discrepancies and errors of commission after the implementation of such forms...
May 5, 2017: CMAJ Open
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