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https://www.readbyqxmd.com/read/28227779/revealing-oral-medication-patterns-from-reconstructed-long-term-medication-history-of-type-2-diabetes
#1
Purnomo Husnul Khotimah, Yuichi Sugiyama, Masatoshi Yoshikawa, Akihiro Hamasaki, Kazuya Okamoto, Tomohiro Kuroda, Purnomo Husnul Khotimah, Yuichi Sugiyama, Masatoshi Yoshikawa, Akihiro Hamasaki, Kazuya Okamoto, Tomohiro Kuroda, Kazuya Okamoto, Purnomo Husnul Khotimah, Yuichi Sugiyama, Akihiro Hamasaki, Masatoshi Yoshikawa, Tomohiro Kuroda
With the growing attention to evidence-based medical guideline development, longitudinal analysis of Electronic Medical Records (EMR) has become a good tool for providing insight into and new knowledge on the existing therapy. For chronic diseases, longitudinal analysis of medication history plays a key role in reaching this goal. However, raw medication data in EMR are not suitable for longitudinal analysis for several reasons. First, many prescriptions have a short duration. Second, the prescription duration may have a gap or overlap with other prescription durations...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28220735/sustained-reduction-in-antibiotic-consumption-in-a-south-african-public-sector-hospital-four-year-outcomes-from-the-groote-schuur-hospital-antibiotic-stewardship-program
#2
T H Boyles, V Naicker, N Rawoot, P J Raubenheimer, B Eick, M Mendelson
BACKGROUND: Overuse of antibiotics has driven global bacterial resistance to the extent that we have entered a post-antibiotic era, where infections that were once easily treatable are now becoming untreatable. Efforts to control consumption have focused on antibiotic stewardship programmes (ASPs), aimed at optimising use. OBJECTIVE: To report antibiotic consumption and cost over 4 years from a public hospital ASP in South Africa (SA). METHODS: A comprehensive ASP comprising online education, a dedicated antibiotic prescription chart and weekly dedicated ward rounds was introduced at Groote Schuur Hospital, Cape Town, in 2012...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219437/the-effect-of-a-test-ordering-software-intervention-on-the-prescription-of-unnecessary-laboratory-tests-a-randomized-controlled-trial
#3
Carlos Manuel Silva Martins, Andreia Sofia da Costa Teixeira, Luís Filipe Ribeiro de Azevedo, Luísa Maria Barbosa Sá, Paulo Alexandre Azevedo Pereira Santos, Maria Luciana Gomes Domingues do Couto, Altamiro Manuel Rodrigues da Costa Pereira, Alberto Augusto Oliveira Pinto Hespanhol, Cristina Maria Nogueira da Costa Santos
BACKGROUND: The way software for electronic health records and laboratory tests ordering systems are designed may influence physicians' prescription. A randomised controlled trial was performed to measure the impact of a diagnostic and laboratory tests ordering system software modification. METHODS: Participants were family physicians working and prescribing diagnostic and laboratory tests. The intervention group had a modified software with a basic shortcut menu changes, where some tests were withdrawn or added, and with the implementation of an evidence-based decision support based on United States Preventive Services Task Force (USPSTF) recommendations...
February 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28216955/patterns-of-prescription-drugs-use-among-pregnant-women-at-sultan-qaboos-university-hospital-and-sultan-qaboos-university-hospital-family-and-community-medicine-clinic-oman
#4
J Z Al-Hamimi, K A Al Balushi
OBJECTIVE: This study evaluates the patterns of prescription drugs use among women attending antenatal clinic at Sultan Qaboos University Hospital (SQUH) and SQUH Family and Community Medicine clinic (FAMCO), Oman. METHODS: The study was a descriptive retrospective cross-sectional study on pregnant women who attended the antenatal clinic at SQUH and FAMCO from February to April 2014 and received a prescription containing at least one drug. Patients' information was extracted from SQUH electronic records...
October 2016: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#5
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213381/outcomes-of-treatment-with-direct-acting-antivirals-for-infection-with-hepatitis-c-virus-genotypes-1-4-in-an-ambulatory-care-setting
#6
Timothy A Bach, Kathy Zaiken
PURPOSE: Outcomes with direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) genotypes 1-4 were determined. METHODS: A total of 360 patients at 36 clinical sites in Massachusetts with HCV genotypes 1-4 and a prescription for at least one DAA medication between May 2011 and October 2015 were included. The primary investigator completed a retrospective and concurrent chart review, and data were collected through April 2016. RESULTS: A total of 446 patients were assessed for eligibility into the study, with 86 patients excluded...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28208876/prescribing-pattern-of-antifungal-medications-at-a-tertiary-care-hospital-in-oman
#7
Khalid A Al Balushi, Mohammed A Alzaabi, Fatma Alghafri
INTRODUCTION: Inappropriate use of antifungal agents is implicated in the global burden of antifungal resistance, adverse outcomes like persistent infections, unnecessary exposure and increased cost. Data collection from time to time is to be done in order to have a check on the resistance/sensitivity pattern of the commonly prescribed antifungal drugs. AIM: To describe the pattern of antifungal drug prescription and administration to patients attending a university hospital in Oman...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28202428/patient-use-of-electronic-prescription-refill-and-secure-messaging-and-its-association-with-undetectable-hiv-viral-load-a-retrospective-cohort-study
#8
D Keith McInnes, Stephanie L Shimada, Amanda M Midboe, Kim M Nazi, Shibei Zhao, Justina Wu, Casey M Garvey, Thomas K Houston
BACKGROUND: Electronic personal health records (PHRs) can support patient self-management of chronic conditions. Managing human immunodeficiency virus (HIV) viral load, through taking antiretroviral therapy (ART) is crucial to long term survival of persons with HIV. Many persons with HIV have difficulty adhering to their ART over long periods of time. PHRs contribute to chronic disease self-care and may help persons with HIV remain adherent to ART. Proportionally veterans with HIV are among the most active users of the US Department of Veterans Affairs (VA) PHR, called My HealtheVet...
February 15, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28197420/the-challenges-of-electronic-health-records-and-diabetes-electronic-prescribing-implications-for-safety-net-care-for-diverse-populations
#9
REVIEW
Neda Ratanawongsa, Lenny L S Chan, Michelle M Fouts, Elizabeth J Murphy
Widespread electronic health record (EHR) implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1) the adoption of RxNorm; (2) standardized naming and picklist options for high alert medications such as insulin; (3) the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4) enhanced bidirectional communication with pharmacy partners; and (5) informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28196459/care-provision-and-prescribing-practices-of-physicians-treating-children-and-adolescents-with-adhd
#10
Ayush Patel, Rohan Medhekar, Melissa Ochoa-Perez, Rajender R Aparasu, Wenyaw Chan, Jeffrey T Sherer, Joy Alonzo, Hua Chen
OBJECTIVE: Care provision and prescribing practices of physicians treating children with attention-deficit hyperactivity disorder (ADHD) were compared. METHODS: A retrospective cohort study was conducted with the 1995-2010 General Electric Centricity Electronic Medical Record database. The sample included children (≤18 years) with newly diagnosed ADHD (ICD-9-CM code 314.XX) who received a prescription for a stimulant or atomoxetine. Identification of comorbid psychiatric disorders, duration from initial ADHD diagnosis to treatment, prescription of other psychotropic medications, and follow-up care during the ten months after the ADHD treatment initiation were compared across provider type (primary care physicians [PCPs], child psychiatrists, and physicians with an unknown specialty)...
February 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28193241/present-state-and-issues-in-iort-physics
#11
REVIEW
Frank W Hensley
Literature was reviewed to assess the physical aspects governing the present and emerging technologies used in intraoperative radiation therapy (IORT). Three major technologies were identified: treatment with electrons, treatment with external generators of kV X-rays and electronic brachytherapy. Although also used in IORT, literature on brachytherapy with radioactive sources is not systematically reviewed since an extensive own body of specialized literature and reviews exists in this field. A comparison with radioactive sources is made in the use of balloon catheters for partial breast irradiation where these are applied in almost an identical applicator technique as used with kV X-ray sources...
January 27, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28188601/sensitivity-of-the-uk-clinical-practice-research-datalink-to-detect-neurodevelopmental-effects-of-medicine-exposure-in-utero-comparative-analysis-of-an-antiepileptic-drug-exposed-cohort
#12
R A Charlton, A McGrogan, J Snowball, L M Yates, A Wood, J Clayton-Smith, W H Smithson, J L Richardson, N McHugh, S H L Thomas, G A Baker, R Bromley
INTRODUCTION: Electronic healthcare data have several advantages over prospective observational studies, but the sensitivity of data on neurodevelopmental outcomes and its comparability with data generated through other methodologies is unknown. OBJECTIVES: The objectives of this study were to determine whether data from the UK Clinical Practice Research Datalink (CPRD) produces similar risk estimates to a prospective cohort study in relation to the risk of neurodevelopmental disorders (NDDs) following prenatal antiepileptic drug (AED) exposure...
February 10, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28186442/clinical-determinants-and-treatment-gaps-in-familial-hypercholesterolemia-data-from-a-multi-ethnic-regional-health-service
#13
Barak Zafrir, Ayman Jubran, Gil Lavie, David A Halon, Moshe Y Flugelman, Chen Shapira
Background Familial hypercholesterolemia is characterized by markedly increased low-density lipoprotein cholesterol and risk for premature atherosclerotic cardiovascular disease. Models of care vary and reflect differing health policies and resources. The availability of electronic databases may enable better identification and assessment of familial hypercholesterolemia in the community. Methods A regional healthcare database was utilized to identify patients with a high probability of familial hypercholesterolemia, clinically defined by age-dependent-peak low-density lipoprotein cholesterol cutoffs and exclusion of secondary causes of severe hypercholesterolemia...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28181568/predictive-modeling-of-physician-patient-dynamics-that-influence-sleep-medication-prescriptions-and-clinical-decision-making
#14
Andrew L Beam, Uri Kartoun, Jennifer K Pai, Arnaub K Chatterjee, Timothy P Fitzgerald, Stanley Y Shaw, Isaac S Kohane
Insomnia remains under-diagnosed and poorly treated despite its high economic and social costs. Though previous work has examined how patient characteristics affect sleep medication prescriptions, the role of physician characteristics that influence this clinical decision remains unclear. We sought to understand patient and physician factors that influence sleep medication prescribing patterns by analyzing Electronic Medical Records (EMRs) including the narrative clinical notes as well as codified data. Zolpidem and trazodone were the most widely prescribed initial sleep medication in a cohort of 1,105 patients...
February 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28166777/associations-between-chronic-comorbidity-and-exacerbation-risk-in-primary-care-patients-with-copd
#15
Janine A M Westerik, Esther I Metting, Job F M van Boven, Waling Tiersma, Janwillem W H Kocks, Tjard R Schermer
BACKGROUND: COPD often coexists with chronic conditions that may influence disease prognosis. We investigated associations between chronic (co)morbidities and exacerbations in primary care COPD patients. METHOD: Retrospective cohort study based on 2012-2013 electronic health records from 179 Dutch general practices. Comorbidities from patients with physician-diagnosed COPD were categorized according to International Classification of Primary Care (ICPC) codes. Chi-squared tests, uni- and multivariable logistic, and Cox regression analyses were used to study associations with exacerbations, defined as oral corticosteroid prescriptions...
February 6, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28163115/jia-jian-di-huang-yin-zi-decoction-reduces-apoptosis-induced-by-both-mitochondrial-and-endoplasmic-reticulum-caspase12-pathways-in-the-mouse-model-of-parkinson-s-disease
#16
Jingsi Zhang, Zhennian Zhang, Jie Bao, Zhonghai Yu, Min Cai, Xiangting Li, Ting Wu, Jun Xiang, Dingfang Cai
ETHNOPHARMACOLOGICAL RELEVANCE: As a classical prescription of traditional Chinese medicine (TCM), Jia-Jian-Di-Huang-Yin-Zi decoction (JJDHYZ) has been used to treat the symptoms of neurological disorders with a long history. AIM OF THE STUDY: To evaluate the effects and possible mechanisms of JJDHYZ on a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced subacute mouse model of Parkinson's disease. MATERIALS AND METHODS: Adult male C57BL/6 mice were randomly divided into five groups: control, MPTP, JJDHYZ low dosage (JJDHYZ-L, 8...
February 2, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28161301/pharmacy-communications-with-physician-offices-to-clarify-prescriptions
#17
Marie Smith, Bradley Sprecher
OBJECTIVES: Our study was conducted to: (1) characterize the type and extent of prescription clarification communications between community pharmacies and physician offices, (2) describe the interventions made by community pharmacists, and (3) determine the time frame to clarify prescriptions prior to dispensing. DESIGN: A convenience sample and cross-sectional study. SETTING: Five independent community pharmacies. PARTICIPANTS: Pharmacists and pharmacy technician staff members...
February 1, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28158981/hypertension-management-in-rural-primary-care-facilities-in-zambia-a-mixed-methods-study
#18
Lily D Yan, Cindy Chirwa, Benjamin H Chi, Samuel Bosomprah, Ntazana Sindano, Moses Mwanza, Dennis Musatwe, Mary Mulenga, Roma Chilengi
BACKGROUND: Improved primary health care is needed in developing countries to effectively manage the growing burden of hypertension. Our objective was to evaluate hypertension management in Zambian rural primary care clinics using process and outcome indicators to assess the screening, monitoring, treatment and control of high blood pressure. METHODS: Better Health Outcomes through Mentoring and Assessment (BHOMA) is a 5-year, randomized stepped-wedge trial of improved clinical service delivery underway in 46 rural Zambian clinics...
February 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28156651/oams-at-the-end-the-end-of-the-beginning-or-the-beginning-of-the-end
#19
Barbara Marie Galligan, Chintan Shah, Iris Chen Zhao, Brian Paciotti, Nathan Fairman, Quy Tran
: 229 Background: In 2001, after three months of review, the FDA approved the oral anticancer agent imatinib, making it the fastest approval in FDA history. Since then, the FDA has approved over 40 oral anti-cancer medications (OAMs) and the number continues to rise, transforming cancer care, improving survival in specific cancers and providing new hope. However, the rapid development of OAMs has produced uncertainty over the best use of these new medications, particularly at the end of life...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156499/palliative-treatment-directives-for-bone-metastases-a-quality-directed-approach-to-guiding-institutional-practice
#20
Lucille Lee, Petrina Zuvic, Isabella Bingchan Zhang, Louis Potters, Beatrice Bloom
: 188 Background: The efficacy of single fraction (fx) radiation treatment (RT) has proven to have equipoise for palliation of bone metastases when compared to courses of 10 fx or more. Despite these data, there has been a slow adoption of this practice in the US and worldwide. Examination of our multicenter practice from 2004 - 2016 showed that single fx RT utilization has remained at 17% and hypofractionationed (HFX) courses (1 or 5 fx) have remained at 71% since 2009. We hypothesized that evidence-based, treatment-guiding directives could improve HFX utilization in this population...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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