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de-prescribing pharmacy

Marc Righini, Jean-Philippe Galanaud, Hervé Guenneguez, Dominique Brisot, Antoine Diard, Pascale Faisse, Marie-Thérèse Barrellier, Claudine Hamel-Desnos, Christine Jurus, Olivier Pichot, Myriam Martin, Lucia Mazzolai, Clarisse Choquenet, Sandrine Accassat, Helia Robert-Ebadi, Marc Carrier, Grégoire Le Gal, Bernadette Mermilllod, Jean-Pierre Laroche, Henri Bounameaux, Arnaud Perrier, Susan R Kahn, Isabelle Quere
BACKGROUND: The efficacy and safety of anticoagulant treatment is not established for patients with acute symptomatic deep vein thrombosis (DVT) of the calf. We aimed to assess whether therapeutic anticoagulation is superior to placebo in patients with symptomatic calf DVT. METHODS: In this randomised, double-blind, placebo-controlled trial, we enrolled low-risk outpatients (without active cancer or previous venous thromboembolic disease) with a first acute symptomatic DVT in the calf from 23 university medical centres or community medical clinics in Canada, France, and Switzerland...
November 7, 2016: Lancet Haematology
Lívia Falcão Lima, Bruna Cristina Cardoso Martins, Francisco Roberto Pereira de Oliveira, Rafaela Michele de Andrade Cavalcante, Vanessa Pinto Magalhães, Paulo Yuri Milen Firmino, Liana Silveira Adriano, Adriano Monteiro da Silva, Maria Jose Nascimento Flor, Eugenie Desirée Rabelo Néri
Objective: To describe and analyze the pharmaceutical orientation given at hospital discharge of transplant patients. Methods: This was a cross-sectional, descriptive and retrospective study that used records of orientation given by the clinical pharmacist in the inpatients unit of the Kidney and Liver Transplant Department, at Hospital Universitário Walter Cantídio, in the city of Fortaleza (CE), Brazil, from January to July, 2014. The following variables recorded at the Clinical Pharmacy Database were analyzed according to their significance and clinical outcomes: pharmaceutical orientation at hospital discharge, drug-related problems and negative outcomes associated with medication, and pharmaceutical interventions performed...
July 2016: Einstein
Brandon Battis, Linda Clifford, Mostaqul Huq, Edrick Pejoro, Scott Mambourg
OBJECTIVES: Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve...
October 12, 2016: Journal of Oncology Pharmacy Practice
Lonneke Timmers, Christel C L M Boons, Dirk Mangnus, Peter M Van de Ven, Pieter H Van den Berg, Aart Beeker, Eleonora L Swart, Richard J Honeywell, Godefridus J Peters, Epie Boven, Jacqueline G Hugtenburg
Introduction: Capecitabine is a widely prescribed oral anticancer agent. We studied medication adherence and explored its use in daily practice from a patients' perspective. Patients and Methods: Patients (n = 92) starting capecitabine were followed up to five 3-week cycles. Adherence was assessed using a pill count, pharmacy data and dosing information from the patients' medical file. Self-reported adherence was measured using the Medication Adherence Report Scale (MARS). At baseline and during week 2 of cycles 1, 3, and 5, patients filled out questionnaires about quality of life, symptoms, attitude toward medicines and disease and use in daily practice...
2016: Frontiers in Pharmacology
Trusha C Dhanani, Emily H Mantovani, J Rick Turner
All biologically active agents carry the potential to lead to adverse reactions in certain individuals, including serious cardiac adverse reactions. Since 2005, there has been an international regulatory landscape governing the investigation of a new drug's propensity to lead to the polymorphic ventricular tachycardia Torsades de Pointes (Torsades), a rare but potentially fatal occurrence. When a regulatory agency considers it appropriate, warning information is placed in a medicine's patient information leaflet (label) concerning drug-induced QT interval prolongation, a phenomenon associated with Torsades...
September 28, 2016: International Journal of Pharmacy Practice
Aubrey Chichonyi Kalungia, Johanita Burger, Brian Godman, Juliana de Oliveira Costa, Chimwemwe Simuwelu
INTRODUCTION: In Zambia, antibiotics are categorized as prescription-only medicines. Antibiotics dispensed without a prescription pose a public health threat, which is a concern. AIM: Ascertain the extent of non-prescription sales and dispensing of antibiotics in community pharmacies in Zambia. METHODS: The practice of non-prescription sale and dispensing were assessed in 73 randomly selected community retail pharmacies, using a structured interviewer-administered questionnaire with simulated case scenarios...
August 22, 2016: Expert Review of Anti-infective Therapy
Paolo Ortolani, Stefano Di Bartolomeo, Massimiliano Marino, Fabio Vagnarelli, Paolo Guastaroba, Claudio Rapezzi, Rossana De Palma
AIMS: In accordance with current guidelines, patients discharged after acute myocardial infarction (AMI) are usually prescribed agents acting on the renin-angiotensin system (ACE-I/ARB). However, adherence to prescribing medications is a recognized problem and most studies demonstrating the value of adherence were limited by their non-randomized design and by 'healthy-adherer' bias. Herein we sought to evaluate the relationship between adherence to ACE-I/ARB and risk of subsequent AMIs, by using the self-controlled case-series design which virtually eliminates interpersonal confounding, being based on intrapersonal comparisons...
October 2015: European Heart Journal. Cardiovascular Pharmacotherapy
Sarah Parent, Edith Pituskin, D Ian Paterson
Improved cancer survivorship has resulted in a growing number of Canadians affected by cancer and cardiovascular disease. As a consequence, cardio-oncology programs are rapidly emerging to treat cancer patients with de novo and preexisting cardiovascular disease. The primary goal of a cardio-oncology program is to preserve cardiovascular health to allow the timely delivery of cancer therapy and achieve disease-free remission. Multidisciplinary programs in oncology and cardiology have been associated with enhanced patient well-being and improved clinical outcomes...
July 2016: Canadian Journal of Cardiology
Rita Palmeira-de-Oliveira, Marina Macedo, Rita M Machado, Ana Filipa Pacheco, Ana Palmeira-de-Oliveira, José Martinez-de-Oliveira, Paulo Duarte
A study of compounding practices among Portuguese community pharmacies from 2008 to 2011 and pharmacists' perspectives concerning compounding was conducted. The retrospective study was based on an online questionnaire developed to gather information on pharmacies characteristics frequency, and type of compounded preparations. Additionally, difficulties, motivations, and pharmacist's perspectives regarding compounding were assessed. Up to 1,450 Portuguese pharmacies were contacted, and 250 completed questionnaires obtained...
March 2016: International Journal of Pharmaceutical Compounding
Ian Fredericks, Samantha Hollingworth, Alex Pudmenzky, Laurence Rossato, Therése Kairuz
OBJECTIVE: Australians are among the highest users of antibiotics in the developed world. The primary aim was to determine the 'age' of antibiotic prescriptions at the time of dispensing as a possible contributor to antibiotic misuse and ultimately, resistance. The secondary aim was to test customised software to permit extraction and de-identification of dispensing records for analysis. METHODS: Data were extracted and de-identified from computerised dispensing systems in three community pharmacies in Brisbane, Australia, according to a strict ethical protocol...
June 13, 2016: International Journal of Pharmacy Practice
Elizabeth MacLean, Laura Cisar, Kimberly Mehle, Daria Eremina, Jane M Quigley
BACKGROUND: Axitinib is approved by the FDA for the treatment of advanced renal cell carcinoma (RCC) after failure of 1 previous systemic therapy and is distributed primarily through specialty pharmacies. Although the efficacy and safety of axitinib have been established in clinical trials, information from real-world populations will help to elucidate patients' clinical profiles and utilization patterns. Prescription records alone provide limited information on patient characteristics and other treatment experiences...
June 2016: Journal of Managed Care & Specialty Pharmacy
Nancy A Dreyer, Stella Cf Blackburn, Shahrul Mt-Isa, Jonathan L Richardson, Simon Thomas, Maja Laursen, Priscilla Zetstra-van der Woude, Anna Jamry-Dziurla, Valerie Hliva, Alison Bourke, Lolkje de Jong-van den Berg
BACKGROUND: Little is known about the effects of human fetal exposure when a new drug is authorized unless it was specifically developed for use in pregnancy. Since many factors may contribute to adverse fetal effects, having comprehensive information about in utero exposures will enhance our ability to make correct determinations about causality. OBJECTIVE: The objective of the study was to assess the extent to which women, recruited without the intervention of health care professionals (HCPs), will provide information, suitable for research purposes, via the Internet or by phone on some potential risk factors in pregnancy...
July 2015: JMIR Public Health and Surveillance
Reethi N Iyengar, Abbey L LeFrancois, Rochelle R Henderson, Rebecca M Rabbitt
BACKGROUND: Taking medications as prescribed is imperative for their effectiveness. In populations such as Medicare, where two thirds of Medicare beneficiaries have at least 2 or more chronic conditions requiring treatment with medications and account for more than 90% of Medicare health care spend, examining ways to improve medication adherence in patients with comorbidities is warranted. OBJECTIVE: To examine the association of pharmacy dispensing channel (home delivery or retail pharmacy) with medication adherence for Medicare patients taking medications with comorbid conditions of diabetes, hypertension, and high blood cholesterol (3 of the top 5 most prevalent conditions), while controlling for various confounders...
May 2016: Journal of Managed Care & Specialty Pharmacy
Jason T Hurwitz, Amy J Grizzle, Jill Augustine, Rick Rehfeld, Ann Wild, Ivo Abraham
BACKGROUND: National guidelines and initiatives have promoted the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) for patients with diabetes. The University of Arizona Medication Management Center (UA-MMC) is contracted by Medicare health plans, pharmacy benefit managers (PBMs), and multiple commercial health insurance plans to provide medication therapy management (MTM) services for plan members. As part of the MTM program, recommendations have been made for those patients who may benefit from the addition of an ACEI/ARB...
January 2016: Journal of Managed Care & Specialty Pharmacy
James Harnett, Daniel Wiederkehr, Robert Gerber, David Gruben, Jeffrey Bourret, Andrew Koenig
BACKGROUND: Adherence to biologic disease-modifying antirheumatic drugs (bDMARDs) among patients with rheumatoid arthritis (RA) is often suboptimal in routine clinical practice. Low or nonadherence can reduce the effectiveness of bDMARD therapies. OBJECTIVE: To evaluate filling of newly prescribed initial bDMARDs for the treatment of RA and evaluate potential for characterizing treatment decisions and patient outcomes. METHODS: In this retrospective cohort analysis, patients aged ≥ 18 years with an RA diagnosis (ICD-9-CM code 714...
March 2016: Journal of Managed Care & Specialty Pharmacy
Ymkje Anna de Vries, Peter de Jonge, Luuk Kalverdijk, Jens H J Bos, Catharina C M Schuiling-Veninga, Eelko Hak
The Dutch guideline for the treatment of depression in young people recommends initiating antidepressant treatment with fluoxetine, as the evidence for its efficacy is strongest and the risk of suicidality may be lower than with other antidepressants. Furthermore, low starting doses are recommended. We aimed to determine whether antidepressant prescriptions are in accord with guidelines. A cohort of young people aged between 6 and 17 at the time of antidepressant initiation was selected from IABD, a Dutch pharmacy prescription database...
November 2016: European Child & Adolescent Psychiatry
Iara Alves de Camargo, Bruna Cipriano Almeida Barros, Miriam Sanches do Nascimento Silveira, Claudia Garcia Serpa Osorio-de-Castro, Gordon Guyatt, Luciane Cruz Lopes
PURPOSE: Biological agents used for the treatment of rheumatoid arthritis (RA) are associated with serious adverse events. Guidelines provide standards for the prescribing and monitoring of these drugs. In São Paulo, health litigation for access to medicines has fueled the demand for biological therapy. The extent to which biological agents are being appropriately prescribed and patients are being appropriately monitored is uncertain. Our goal was to determine whether RA clinical guidelines are being translated into clinical practice for patients receiving treatment as a result of lawsuits against the government...
May 2016: Clinical Therapeutics
Thomas Ciesielski, Reethi Iyengar, Amit Bothra, Dave Tomala, Geoffrey Cislo, Brian F Gage
BACKGROUND: Determining risk factors for opioid abuse or dependence will help clinicians practice informed prescribing and may help mitigate opioid abuse or dependence. The purpose of this study is to identify variables predicting opioid abuse or dependence. METHODS: A retrospective cohort study using de-identified integrated pharmacy and medical claims was performed between October 2009 and September 2013. Patients with at least 1 opioid prescription claim during the index period (index claim) were identified...
July 2016: American Journal of Medicine
Anna Giulia Pedrazzoli, Daniela Malnis, Sarah Cattaneo, Gianni Rovelli, Stefano De Servi, Silvio Klugman, Maurizio Marzegalli, Antonio Giampiero Russo
OBJECTIVES: to compare the benefit of a personalised outpatient therapy prescribed upon discharge by the cardiology unit to the patients undergoing a percutaneous coronary intervention with drug-eluting stent or bare-metal stent vs. the usual practice. DESIGN: controlled, multicentre, non-randomized study that enrolled patients who underwent coronary stent implantation and treated in the year after stent implantation with two protocols: the treatment group received Clopidogrel directly from the cardiology unit at each monitoring visit; the control group received a prescription for outpatient treatment through the standard retail pharmacy channel...
January 2016: Epidemiologia e Prevenzione
Wladimir Mendes Borges Filho, Silvana Maria de Almeida, Fabio Teixeira Ferracini, Constantino Jose Fernandes Júnior
OBJECTIVE: The purpose of this survey was to reduce the use of human albumin 20% in non-supported indications at Hospital Israelita Albert Einstein. METHODS: During a 30-day period, in December 2006, a preliminary prospective analysis of medical prescriptions of human albumin 20% and therapeutic indications according to ANVISA RDC 115 guidelines was performed. Based on this analysis, a project was developed. In January 2007, a daily routine to follow up albumin prescriptions by the Hospital pharmacists was established...
June 2010: Einstein
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