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https://www.readbyqxmd.com/read/28715535/improving-adherence-to-long-term-opioid-therapy-guidelines-to-reduce-opioid-misuse-in-primary-care-a-cluster-randomized-clinical-trial
#1
Jane M Liebschutz, Ziming Xuan, Christopher W Shanahan, Marc LaRochelle, Julia Keosaian, Donna Beers, George Guara, Kristen O'Connor, Daniel P Alford, Victoria Parker, Roger D Weiss, Jeffrey H Samet, Julie Crosson, Phoebe A Cushman, Karen E Lasser
Importance: Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. Objective: To determine whether a multicomponent intervention, Transforming Opioid Prescribing in Primary Care (TOPCARE; http://mytopcare.org/), improves guideline adherence while decreasing opioid misuse risk. Design, Setting, and Participants: Cluster-randomized clinical trial among 53 primary care clinicians (PCCs) and their 985 patients receiving long-term opioid therapy for pain...
July 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28712738/a-technology-supported-collaboration-between-a-health-plan-and-a-community-pharmacy-to-improve-blood-pressure-control
#2
Caitlin K Frail, Susan Cooper, Tim Gallagher, Josh Sarkis, Laura Topor, Richard J Bruzek
OBJECTIVES: To assess the impact of a health plan and community pharmacy partnership to improve blood pressure control. SETTING: A midwestern health plan and a regional community pharmacy chain. PRACTICE INNOVATION: Health plan members with a hypertension diagnosis and attributed to the pharmacy chain based on prescription claims were invited to participate. Interested patients enrolled in the program at their pharmacies and were assigned a "smart card" for use with a blood pressure kiosk in the pharmacy...
July 14, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28708603/monte-carlo-skin-dose-simulation-in-intraoperative-radiotherapy-of-breast-cancer-using-spherical-applicators
#3
Farhad Moradi, Ngie Min Ung, M U Khandaker, Ghafour Amouzad Mahdiraji, Marniza Saad, Rozita Abdul Malik, Anita Zarina Bustam, Zainor Zaili, David A Bradley
The relatively new treatment modality electronic intraoperative radiotherapy (IORT) is gaining popularity, irradiation being obtained within a surgically produced cavity being delivered via a low-energy X-ray source and spherical applicators, primarily for early stage breast cancer. Due to the spatially dramatic dose-rate fall off with radial distance from the source and effects related to changes in the beam quality of the low keV photon spectra, dosimetric account of the Intrabeam system is rather complex...
July 14, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#4
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28704624/a-systematic-review-of-emg-studies-in-normal-shoulders-to-inform-postoperative-rehabilitation-following-rotator-cuff-repair
#5
Peter K Edwards, Jay R Ebert, Chris Littlewood, Tim Ackland, Allan Wang
Study Design Systematic review. Background Electromyography (EMG) has previously been used to guide postoperative rehabilitation progression following rotator cuff repair, to prevent deleterious loading of early surgical repair. Objective To review the current literature investigating EMG during rehabilitation exercises in normal shoulders, to identify exercises that meet a cut point of ≤15% maximal voluntary isometric contraction (MVIC) and unlikely to result in excessive loading in the early postoperative stages...
July 13, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28697871/patterns-of-antimicrobial-agent-prescription-in-a-sentinel-population-of-canine-and-feline-veterinary-practices-in-the-united-kingdom
#6
D A Singleton, F Sánchez-Vizcaíno, S Dawson, P H Jones, P J M Noble, G L Pinchbeck, N J Williams, A D Radford
Antimicrobial resistance is an increasingly important global health threat and the use of antimicrobial agents is a key risk factor in its development. This study describes antimicrobial agent prescription (AAP) patterns over a 2year period using electronic health records (EHRs) from booked consultations in a network of 457 sentinel veterinary premises in the United Kingdom. A semi-automated classification methodology was used to map practitioner defined product codes in 918,333 EHRs from 413,870 dogs and 352,730 EHRs from 200,541 cats, including 289,789 AAPs...
June 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28697492/incidence-and-causes-for-early-ticagrelor-discontinuation-a-real-world-dutch-registry-experience
#7
Thomas O Bergmeijer, Paul W A Janssen, Mathijs van Oevelen, Dymphie van Rooijen, Thea C Godschalk, Johannes C Kelder, Vera H M Deneer, Victor L Serebruany, Jurriën M Ten Berg
OBJECTIVES: The PLATO trial revealed superiority of ticagrelor over clopidogrel for the prevention of atherothrombotic events in patients with acute coronary syndrome. However, adverse events such as bleeding, dyspnea, and bradycardia were frequently reported, potentially leading to excess early ticagrelor discontinuation (ETD), later confirmed in the PEGASUS trial. We here evaluated the incidence and causes for ETD in a real-world patient cohort in a high-volume nonacademic percutaneous coronary intervention center in the Netherlands...
July 12, 2017: Cardiology
https://www.readbyqxmd.com/read/28697295/using-electronic-medical-records-to-assess-the-rate-of-treatment-for-osteoporosis-in-australia
#8
Megan Elliott-Rudder, Catherine Harding, Joseph McGirr, Alexa Seal, Louis Pilotto
BACKGROUND: Despite available Medicare Benefits Schedule subsidies, it has been suggested that screening and treatment for osteoporosis are under-accessed in Australia, particularly in patients ≥70 years. This study describes the rate of osteoporosis treatment in those aged ≥70 years in regional New South Wales as identified in the electronic medical records (EMR) of 11 general practices. METHODS: EMR data were extracted using a Canning Tool adaptation. The prevalence of osteoporosis, fracture and bone-active medication prescriptions were described, and associations examined...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28695313/elderly-patients-with-chronic-kidney-disease-have-higher-risk-of-hyperparathyroidism
#9
Rosilene M Elias, Rosa M A Moysés
PURPOSE: As the world's population ages, the incidence of chronic kidney disease (CKD) is growing. There is ongoing debate regarding whether high levels of parathyroid hormone (PTH) would be more common in elderly than young patients, and which factors are driven the risk of secondary hyperparathyroidism (SHPT), independent of renal function. METHODS: Elderly patients (age ≥ 65 years, N = 518) were compared to a 1:1 sex- and estimated glomerular filtration rate (eGFR)-matched sample of young patients (age < 65 years), in a cross-sectional analysis...
July 10, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28693334/impact-of-hospital-wide-comprehensive-pain-management-initiatives
#10
Paula E Lester, Janet Shehata, Melissa Fazzari, Shahidul Islam
This project aimed to improve pain management through clinician education, updated assessment tools, computer resources, and improved ordering and delivery systems. Clinicians were surveyed and results analyzed using Wilcoxon-Mann-Whitney testing and χ(2) testing. Prescribing patterns were evaluated by comparing proportions of prescription orders and dose intervals. Cochran-Armitage Trend Test was used for linear trends in proportion of prescription orders over time. Knowledge scores improved significantly for nurses ( P = ...
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28692402/enhanced-influenza-surveillance-using-telephone-triage-and-electronic-syndromic-surveillance-in-the-department-of-veterans-affairs-2011-2015
#11
Cynthia Lucero-Obusan, Carla A Winston, Patricia L Schirmer, Gina Oda, Mark Holodniy
Telephone triage (TT) is a method whereby medical professionals speak by telephone to patients to assess their symptoms or health concerns and offer advice. These services are often administered through an electronic TT system, which guides TT professionals during the encounter through the use of structured protocols and algorithms to help determine the severity of the patients' health issue and refer them to appropriate care. TT is also an emerging data source for public health surveillance of infectious and noninfectious diseases, including influenza...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28686333/ehealth-provides-a-novel-opportunity-to-exploit-the-advantages-of-the-nordic-countries-in-psychiatric-genetic-research-building-on-the-public-health-care-system-biobanks-and-registries
#12
REVIEW
Ole A Andreassen
Nordic countries have played an important role in the recent progress in psychiatric genetics, both with large well-characterized samples and expertise. The Nordic countries have research advantages due to the organization of their societies, including system of personal identifiers, national health registries with information about diseases, treatment and prescriptions, and a public health system with geographical catchment areas. For psychiatric genetic research, the large biobanks and population surveys are a unique added value...
July 7, 2017: American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics
https://www.readbyqxmd.com/read/28683700/degree-of-technological-implementation-in-intravenous-chemotherapy-management-in-hospitals-of-the-autonomous-community-of-madrid
#13
Belén Ortiz-Martín, Silvia Peña-Cabia
OBJECTIVE: To understand the degree of technological implementation in the processes of preparation and administration of cytostatics drugs that is available in those hospitals of the Autonomous Community of Madrid where intravenous chemotherapy is prepared. METHOD: A descriptive observational study through the completion of a survey targeted to the staff responsible for the preparation of this type of treatments. RESULTS: The degree of implementation of assisted electronic prescription is high, there is a medium degree in the case of bar code reading technology, and low in terms of vial re-labelling and gravimetric and voice control for preparation...
July 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28668688/massive-misuse-of-antibiotics-by-university-students-in-all-regions-of-china-implications-for-national-policy
#14
Xiaomin Wang, Dandan Peng, Weiyi Wang, Yannan Xu, Xudong Zhou, Therese Hesketh
Antimicrobial resistance (AMR) is one of the greatest threats to population health this century. The primary cause of AMR is antibiotic misuse, especially the routine use of antibiotics for self-limiting illnesses. The major aim of this study was to explore behaviours in relation to antibiotic use in university students across China. An electronic questionnaire was distributed at a major university in each of the six regions. A cluster random sampling method was adopted. Chi-square and logistic regression were used to assess the relationship between knowledge and behaviour...
June 28, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28663027/evaluation-of-adherence-patterns-in-schizophrenia-using-electronic-monitoring-mems%C3%A2-a-six-month-post-discharge-prospective-study
#15
David Misdrahi, Arnaud Tessier, Mathilde Husky, Anne-Catherine Lange, Bernard Vrijens, Pierre-Michel Llorca, Franck Jean Baylé
BACKGROUND: Medication Event Monitoring System (MEMS®) is considered the gold standard for the evaluation of medication adherence, yet few studies have applied this method, especially over long periods of time. OBJECTIVE: To investigate medication adherence patterns in a sample of post-discharge patients with schizophrenia monitored with MEMS caps during a six-month period. METHOD: Adherence to antipsychotics was prospectively investigated using MEMS among 68 patients with schizophrenia...
June 26, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28662000/using-prospective-risk-analysis-tools-to-improve-safety-in-pharmacy-settings-a-systematic-review-and-critical-appraisal
#16
Tatjana Stojkovic, Valentina Marinkovic, Tanja Manser
OBJECTIVES: This study aimed to review and critically appraise the published literature on 2 selected prospective risk analysis tools, Failure Mode and Effects Analysis and Socio-Technical Probabilistic Risk Assessment, as applied to the dispensing of medicines in both inpatient and outpatient pharmacy settings. METHODS: A comprehensive search of electronic databases (PubMed and Scopus) was conducted (January 1990-March 2016), supplemented by hand search of reference lists...
June 29, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28660121/point-of-care-testing-to-promote-cardiovascular-disease-risk-assessment-a-proof-of-concept-study
#17
Kunal N Karmali, Tiffany Brown, Thomas Sanchez, Timothy Long, Stephen D Persell
Updated cholesterol guidelines emphasize multivariable cardiovascular disease (CVD) risk estimation to guide treatment decision-making in primary prevention. This study tested the preliminary feasibility, acceptability and efficacy of point-of-care testing (POCT) and quantitative CVD risk assessment in high-risk adults to increase guideline-recommended statin use in primary prevention. Participants were aged 40-75 years, without CVD or diabetes mellitus, and potentially-eligible for consideration of statins based on estimated 10-year CVD risk from last-measured risk factor levels in the electronic health record...
September 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28656746/therapeutic-inertia-in-patients-treated-with-two-or-more-antidiabetics-in-primary-care-factors-predicting-intensification-of-treatment
#18
Manel Mata-Cases, Josep Franch-Nadal, Jordi Real, Mònica Gratacòs, Flora López-Simarro, Kamlesh Khunti, Dídac Mauricio
AIMS: To determine the patterns and predictors of treatment intensification in patients with type 2 diabetes on ≥2 non-insulin antidiabetic drugs (NIADs) and inadequate glycemic control in primary care in Catalonia, Spain. MATERIAL AND METHODS: Retrospective analysis using electronic medical records from patients with HbA1c ≥7% and a first prescription for a new NIAD or insulin recorded from January 2010 to December 2014. Therapeutic inertia was defined as no intensification if HbA1c ≥8% at baseline or during follow-up...
June 28, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28656132/cost-effectiveness-of-antibiotics-for-copd-management-observational-analysis-using-cprd-data
#19
Sarah J Ronaldson, Anan Raghunath, David J Torgerson, Tjeerd Van Staa
It is often difficult to determine the cause of chronic obstructive pulmonary disease (COPD) exacerbations, and antibiotics are frequently prescribed. This study conducted an observational cost-effectiveness analysis of prescribing antibiotics for exacerbations of COPD based on routinely collected data from patient electronic health records. A cohort of 45 375 patients aged 40 years or more who attended their general practice for a COPD exacerbation during 2000-2013 was identified from the Clinical Practice Research Datalink...
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28653333/investigating-real-world-clopidogrel-pharmacogenetics-in-stroke-using-a-bioresource-linked-to-electronic-medical-records
#20
Aleksi Tornio, Rob Flynn, Steve Morant, Elena Velten, Colin N A Palmer, Thomas M MacDonald, Alex S F Doney
Clopidogrel efficacy is influenced by genetic variation of CYP2C19, however few studies have considered stroke patients. We used electronic medical records (EMR) linked to a bioresource to examine real-world implications of clopidogrel pharmacogenetics in stroke. Patients hospitalized for any arterial thrombo-occlusive event (ATO) who subsequently redeemed clopidogrel prescriptions in the community were entered into the study (n=651). During 24 months follow-up the primary endpoint of recurrent ATO or death occurred in 299 (46%) patients...
June 27, 2017: Clinical Pharmacology and Therapeutics
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